Osteoporosis in Indian women aged 40–60 years

Summary

The study investigates BMD pattern in Indian women aged 40–60 years through a retrospective assessment using DEXA scan of hip and spine of 1,282 asymptomatic Indian women. The Study group indicated high incidence of decreased bone mass and significantly lower BMD as compared to western and other Asian counterparts.

Introduction

An understanding of BMD pattern in women aged 40–60 years is crucial for prevention, diagnosis of osteoporosis and management of its complications in later life. Hence, the present study investigates BMD in Indian women aged 40–60 years for which no data exists in literature.

Method

A retrospective assessment of BMD by DEXA scan of hip and spine of 1,282 asymptomatic women in age group 40–60 was performed. Standardized BMD was calculated and compared with other population groups.

Results

Osteoporosis and osteopenia are widely prevalent among females of the 40–60 age group as a meager 35% of subjects had normal bone density. Average BMD of spine was 0.89 (SD 0.14) gm/cm² and average BMD of hip was 0.85(0.15) gm/cm². The correlation between BMD and age was negative. Spine DEXA was found to be more significant than hip DEXA (p value?<?0.0001) for osteoporosis assessment. Similarly, T scores of spine were more significantly correlated in this age group (p value?<?0.0001) for osteoporosis than hip T scores.

Conclusion

The study group indicated high incidence of decreased bone mass, and significantly lower BMD as compared to western and other Asian counterparts. This study emphasizes on early screening and treatment in study group to avoid long-term complications.     

Spine radiographs to improve the identification of women at high risk for fractures

Summary

In women older than 60 years with clinical risk factors for osteoporosis but without osteoporosis based on bone mineral density (T-score?≥??2.5), a systematic survey with X-rays of the spine identified previously unknown vertebral deformities in 21% of women.

Introduction

This study determines the prevalence of vertebral deformities in elderly women with clinical risk factors for osteoporosis but with BMD values above the threshold for osteoporosis (T-score?≥??2.5).

Methods

Bisphosphonate naïve women older than 60 years attending 35 general practices in the Netherlands with ≥2 clinical risk factors for osteoporosis were invited for BMD measurement (DXA). In women with T-score?≥??2.5 at both spine and the hips, lateral radiographs of the thoracic and lumbar spine were performed.

Results

Of 631 women with a DXA measurement, 187 (30%) had osteoporosis (T-score?T-score?≥??2.5 at both spine and hip, 387 had additional spine radiographs, of whom 80 (21%) had at least one vertebral deformity.

Conclusion

In elderly women with clinical risk factors for osteoporosis but BMD T-score?≥??2.5, addition of spine radiographs identified vertebral deformities in 21% (95% CI: 17–25). Since these women are at risk of future fractures, antiosteoporotic treatment should be considered.     

Association of P2X7 receptor polymorphisms with bone mineral density and osteoporosis risk in a cohort of Dutch fracture patients

Summary

The P2X₇ receptor is thought to be involved in bone physiology in a pro-osteogenic manner. Therefore, we examined associations between genetic variations in the P2X₇ receptor gene and bone mineral density (BMD). We found an association between four non-synonymous polymorphism of the human P2X₇ receptor and the risk of osteoporosis.

Introduction

The purpose of this study was to determine whether genetic variation in the P2X₇ receptor gene (P2RX7) is associated with decreased BMD and risk of osteoporosis in fracture patients.

Methods

Six hundred ninety women and 231 men aged ≥50 years were genotyped for 15 non-synonymous P2RX7 SNPs. BMD was measured at the total hip, lumbar spine and femoral neck.

Results

Four non-synonymous SNPs were associated with BMD. The Ala348Thr gain-of-function polymorphism was associated with increased BMD values at the lumbar spine (p?=?0.012). Decreased hip BMD values were associated with two loss-of-function SNPs in the P2RX7, i.e., in subjects homozygous for the Glu496Ala polymorphism as well as in subjects carrying at least one variant allele of the Gly150Arg polymorphism (p?=?0.018 and p?=?0.011; respectively). In men, we showed that subjects either heterozygous or homozygous for the Gln460Arg gain-of-function polymorphism in the P2RX7 had a significantly 40 % decrease in risk of a lower T-score value (OR?=?0.58 [95%CI, 0.33–1.00]).

Conclusion

Thus, genetic aberrations of P2X7R function are associated with lower BMD and increased osteoporosis risk. Therefore, detection of non-synonymous SNPs within the P2RX7 might be useful for osteoporosis risk estimation at an early stage, potentially enabling better osteoporosis prevention and treatment.     

Prevalence and awareness of osteoporosis among postmenopausal Palestinian women

Summary

The prevalence and awareness of postmenopausal osteoporosis was assessed among 569 postmenopausal women randomly selected from the population. Osteoporosis was assessed based on bone mineral density (BMD) values at three indicative sites. The results indicate a significant prevalence of the disease among this fraction of the population with a poor knowledge of its risk factors.

Introduction

Postmenopausal osteoporosis is a major health problem at the individual and population levels. Assessment of its prevalence and awareness of risk factors provide the basis for health plans to control the disease. No previous studies have been done in our population. A cross-sectional study including 569 postmenopausal women showed a significant prevalence of osteoporosis with a poor awareness of risk factors.

Methods

Included in the study were 569 randomly selected postmenopausal women (≥49 years of age). BMD was measured in 505 subjects at the lumbar spine, femoral neck and total hip using dual energy x-ray absorptiometry. Awareness was evaluated using a special questionnaire.

Results

Osteoporosis affected the lumbar spine, femoral neck and total hip in 24%, 14% and 29.7% of subjects, respectively. There was a significant negative correlation (p<0.001) between age and number of years since menopause and BMD at all the sites evaluated. Conversely, BMD increased at the three sites as weight, height and BMI increased. There was a significant positive correlation between BMD at the three sites and the physical characteristics of the subjects (weight, height and BMI) (p<0.001 at the hip and femoral neck, and p=0.05 at the lumbar spine). BMD was higher at the lumbar spine and femoral neck among subjects aware of the disease (0.893 and 0.746 g/cm², respectively) than among subjects unaware of the disease (0.835 and 0.712 g/cm², respectively). This investigation is the first among Palestinian women in this region. It indicates the urgent need for a comprehensive national programme to reduce the incidence of osteoporosis.

Conclusion

Postmenopausal osteoporosis is significant among the Palestinian population and there is a poor awareness of the risk factors.     

A follow-up association study of two genetic variants for bone mineral density variation in Caucasians

Summary

We tested whether two genetic variants were associated with BMD at multiple clinically relevant skeletal sites in Caucasians. We found that variant rs7776725 is consistently associated with hip, spine, wrist and whole-body BMD, which highlights the potential importance of this variant or linked variants for osteoporosis.

Introduction

A recent genome-wide association study identified two single nucleotide polymorphisms (SNPs), rs7776725 and rs1721400, that were associated with bone mineral density (BMD) variation at the radius, tibia and calcaneus in a Korean population. In this study, we aimed to test whether the association of these two genetic variants can be replicated in Caucasians and whether their association with BMD can be extended to other clinically relevant skeletal sites.

Methods

We performed this study in two large cohorts of unrelated US Caucasians. Area BMD at the hip, spine, wrist (ultra-distal radius) and whole body were measured with Hologic dual-energy X-ray absorptiometer. SNPs were genotyped with Affymetrix human genome-wide genotyping arrays. Association analyses were performed using PLINK.

Results

We detected highly significant association (combined p?=?1.42?×?10^?16) of rs7776725 with wrist BMD but only borderline association signal (combined p?=?0.017) for rs1721400 with wrist BMD. In addition, we found that rs7776725 was associated with BMD at the hip, spine and whole body. At the FAM3C gene locus where rs7776725 was located, we identified several other SNPs (rs4727922, rs1803389, rs718766 and rs7793554) that were also associated with BMD.

Conclusions

This is the first follow-up association study of rs7776725 and rs1721400 with BMD. The rs7776725 showed consistent association with BMD at multiple clinically important skeletal sites, which highlighted the potential importance of rs7776725 or linked SNPs for risk of osteoporosis. Further in-depth re-sequencing studies and functional assays are necessary to elucidate the underlying mechanisms.     

The influence of participation in Better Bones and Balance? on skeletal health: evaluation of a community-based exercise program to reduce fall and fracture risk

Summary

Older women participating in Better Bones and Balance? (BBB) had similar bone mass at the hip compared to a sample of low active/sedentary controls. However, both groups had higher than expected hip BMD, despite higher risk for osteoporosis among BBB participants.

Introduction

BBB is a community-based fall and fracture risk reduction program shown to reduce bone loss at the hip in older women under controlled laboratory conditions. Whether bone benefits are derived from BBB as delivered in the community setting is unknown. The purpose of this study is to evaluate the relationship between community-based BBB participation and parameters of skeletal health in postmenopausal women.

Methods

Women were recruited from BBB classes (n=69) and compared to low active/sedentary controls (n=46); total sample aged 69 + 7.7 years. Bone mineral density (BMD) of the hip and spine was measured using DXA; hip bone structure [cross-sectional area, cross-sectional moment of inertia] at the narrow neck and intertrochanter were derived using hip structural analysis software. Diet, physical activity, and health history were assessed by questionnaires. Group differences in bone outcomes were determined using ANCOVA controlling for age and body mass.

Results

While controls were heavier and exhibited greater total body BMD compared to BBB participants (p<0.05), there were no differences between groups in hip or spine BMD or bone structural outcomes (p>0.05) despite BBB participants reporting more frequent prior diagnoses of or risk factors for osteoporosis compared to controls. Both controls and BBB participants had higher than average T-scores at the hip (p<0.05) when compared to an age-matched cohort from NHANES.

Conclusions

These data suggest that participation in BBB may not result in direct benefits to bone. However long-term participation may be associated with other positive outcomes.     

Effect of the cathepsin K inhibitor odanacatib administered once weekly on bone mineral density in Japanese patients with osteoporosis—a double-blind, randomized, dose-finding study

Summary

The efficacy and safety of oral placebo or odanacatib 10, 25, or 50 mg once weekly for 52 weeks were evaluated in a double-blind, randomized, multi-center study in Japanese female and male patients with osteoporosis.

Introduction

Odanacatib is a selective and reversible cathepsin K inhibitor that decreases bone resorption and increases bone mineral density (BMD).

Methods

The primary efficacy endpoint was percent change from baseline to week 52 in lumbar spine BMD. Secondary endpoints included percent change in total hip, femoral neck, and trochanter BMD and in bone biomarkers after treatment for 52 weeks.

Results

In this study, 286 patients [94 % female, mean age (SD) 68.2 (7.1) years] were included in the analysis. The least-squares mean percent changes from baseline to week 52 in the groups receiving placebo, 10, 25 and 50 mg of odanacatib for lumbar spine (L1～L4) BMD were 0.5, 4.1, 5.7, and 5.9 % and for total hip BMD were ?0.4, 1.3, 1.8, and 2.7 %, respectively. The changes in femoral neck and trochanter BMD were similar to those at the total hip. Bone turnover markers were reduced in a dose-dependent manner. However, the effects of odanacatib on bone formation markers were less compared with the effects on bone resorption markers. Tolerability and safety profiles were similar among all treatment groups with no dose-related trends in any adverse events.

Conclusions

Weekly odanacatib treatment for 52 weeks increased BMD at the lumbar spine and at all hip sites in a dose-dependent manner and was well tolerated in Japanese patients with osteoporosis.     

Six-year follow-up study of bone mineral density in patients with systemic lupus erythematosus

Summary

Long-term bone mineral density (BMD) changes and the associated factors in systemic lupus erythematosus (SLE) patients were assessed. Despite the remarkably low overall bone loss, significant spine bone loss was associated with the use of glucocorticoids, use of antimalarials, and lower 25-hydroxyvitamin D levels, stressing the importance of prevention of osteoporosis and vitamin D deficiency in SLE patients.

Introduction

The aim of this study is to assess the BMD changes in patients with SLE and to identify the associated factors.

Methods

Demographic and clinical data of 126 SLE patients were collected, and BMD measurements of the lumbar spine and the total hip were performed by dual-energy X-ray absorptiometry at baseline and follow-up. Statistical analyses were performed using independent Mann–Whitney U tests and linear regression analyses.

Results

At baseline, 39.7 % of the patients (90 % female, mean age 39?±?12.2 years) had osteopenia, and 6.3 % had osteoporosis. The median follow-up duration was 6.7 years (range 1.9–9.3 years). Mean changes in BMD at the lumbar spine (?0.08 %/year) and the hip (?0.20 %/year) were not significant. During follow-up, 70 % of the patients used glucocorticoids. The mean ± SD daily glucocorticoid dose was 5.0?±?5.0 mg. In multiple regression analysis, BMD loss at the spine was significantly associated with higher daily glucocorticoid dose and lower baseline 25-hydroxyvitamin D levels. BMD loss at the hip was associated with lower 25-hydroxyvitamin D levels at baseline, reduction of body mass index, and baseline use of antimalarials.

Conclusions

In this 6-year follow-up study, bone loss was remarkably low. A dose-dependent relationship between glucocorticoid use and spinal bone loss was found. In addition, the use of antimalarials and lower 25-hydroxyvitamin D levels at baseline were associated with BMD loss. These findings underline the importance of prevention and treatment of vitamin D deficiency and osteoporosis in SLE, especially in patients using glucocorticoids or antimalarials.     

An investigation of the association between omega 3 FA and bone mineral density among older adults: results from the National Health and Nutrition Examination Survey years 2005–2008

Summary

The relation of omega 3 fatty acids (n-3 FA) with bone mineral density (BMD) was assessed among adults >60 years; NHANES data (2005–2008). The association of dietary n-3 FA with measures of hip BMD was equivocal, but n-3 FA supplement use was significantly associated with higher spine BMD—a finding that deserves further study.

Introduction

Associations between polyunsaturated fatty acids and bone mineral density are not well understood.

Purpose

To evaluate the cross-sectional relation between dietary omega 3 fatty acid intake (specifically docosahexaenoic acid, eicosapentaenoic acid, and octadecatetraenoic) and BMD at the hip and spine among older adults.

Methods

Omega 3 FA intake (g/day) was assessed from two 24-h recalls using the National Health and Nutrition Examination Survey (NHANES, in 2005–2008); and omega 3 FA supplement use (yes/no) via questionnaire. Multivariable regression models were developed to explain variance in femoral neck, total femur, and lumbar spine BMD among 2,125 men and women over 60 years.

Results

Mean age was 70 years. In adjusted models, dietary omega 3 FA were marginally associated with greater femoral neck BMD (p?=?0.0505), but not with total femur BMD (p?=?0.95) or lumbar spine BMD (p?=?0.74). Omega 3 supplement use was significantly positively associated with lumbar spine BMD (p?=?0.005) but not with femoral neck or total femur BMD.

Conclusions

Dietary intakes of omega 3 FA were marginally associated with femoral neck BMD; however, omega 3 supplement use was significantly associated with higher lumbar spine BMD in older adults. These results emphasize the need for assessment of total omega 3 intakes (diet and supplements) to provide a greater range of intake and a more accurate picture of the relation between omega 3 FA and BMD.     

33% radius evaluation to assess bone mineral density in prostate cancer patients

Purpose

Dual-energy X-ray absorptiometry (DXA) is the standard method to assess bone mineral density (BMD). The International Society for Clinical Densitometry recommends the measurement of BMD at lumbar spine, total hip and femoral neck, but in certain circumstances the 33% radius may be the recommended area to measure BMD. The aim of this study has been to analyze whether 33% radius should be considered the recommended area to assess BMD in prostate cancer patients.

Methods

This is a retrospective study where BMD was assessed by DXA at 33% radius, lumbar spine, total hip, and femoral neck (cDXA) in 141 prostate cancer patients. Twenty-eight patients were hormone na?ve while 113 were subjected to androgen suppression (AS) during the mean period of 29?months. Osteoporosis was diagnosed when T-score was lower than ?2.5 and osteopenia when it ranged between ?1 and ?2.5.

Results

The osteoporosis rate was 29.8% at 33% radius, 23.4% at femoral neck, 19.9% at lumbar spine, and 12.8% at total hip. The overall osteoporosis rate at cDXA was 29.1%. Osteoporosis was detected in 52.2% at 33% radius and 36.2% at cDXA. Normal BMD was found in 17.7% at 33% radius and 34.8% at cDXA. The 33% radius was the only site where a significant increase in the osteoporosis rate was detected in patients subjected to AS compared to those hormone na?ve (33 and 13.8%).

Conclusions

The 33% radius seems more sensible than the central skeleton areas to detect bone mass loss in patients with prostate cancer.     

Are changes in bone mineral density different between groups of early rheumatoid arthritis patients treated according to a tight control strategy with or without prednisone if osteoporosis prophylaxis is applied?

Summary

Addition of 10 mg prednisone daily to a methotrexate-based tight control strategy does not lead to bone loss in early rheumatoid arthritis (RA) patients receiving preventive treatment for osteoporosis. A small increase in lumbar bone mineral density (BMD) during the first year of treatment was recorded, regardless of use of glucocorticoids.

Introduction

This study aims to describe effects on BMD of treatment according to EULAR guidelines with a methotrexate-based tight control strategy including 10 mg prednisone daily versus the same strategy without prednisone in early RA patients who received preventive therapy for osteoporosis.

Methods

Early RA patients were included in the CAMERA-II trial: a randomized, placebo-controlled, double-blind 2-year trial, in which effects of addition of 10 mg prednisone daily to a methotrexate-based tight control strategy were studied. All patients received calcium, vitamin D and bisphosphonates. Disease activity was assessed every 4 weeks. Radiographs of hands and feet and dual-energy X-ray absorptiometry of lumbar spine and left hip were performed at baseline and after 1 and 2 years of treatment.

Results

BMD increased significantly over time in both treatment groups at the lumbar spine with a mean of 2.6 % during the first year (p?<?0.001), but not at the hip; at none of the time points did BMD differ significantly between the prednisone and placebo group. Higher age and lower weight at baseline and higher disease activity scores during the trial, but not glucocorticoid therapy, were associated with lower BMD at both the lumbar spine and the hip in mixed-model analyses.

Conclusion

Addition of 10 mg prednisone daily to a methotrexate-based tight control strategy does not lead to bone loss in early RA patients on bisphosphonates. A small increase in lumbar BMD during the first year of treatment was found, regardless of use of glucocorticoids.     

Skeletal health in adult patients with classic galactosemia

Summary

This study evaluated bone health in adults with galactosemia. Associations between bone mineral density (BMD) and nutritional and biochemical variables were explored. Calcium level predicted hip and spine BMD, and gonadotropin levels were inversely associated with spinal BMD in women. These results afford insights into management strategies for these patients.

Introduction

Bone loss is a complication of galactosemia. Dietary restriction, primary ovarian insufficiency in women, and disease-related alterations of bone metabolism may contribute. This study examined relationships between clinical factors and BMD in patients with galactosemia.

Methods

This cross-sectional sample included 33 adults (16 women) with classic galactosemia, mean age 32.0?±?11.8 years. BMD was measured by dual-energy X-ray absorptiometry, and was correlated with age, height, weight, fractures, nutritional factors, hormonal status, and bone biomarkers.

Results

There was a significant difference in hip BMD between women and men (0.799 vs. 0.896 g/cm², p?=?0.014). The percentage of subjects with BMD-Z <?2.0 was also greater for women than men [33 vs. 18 % (spine), 27 vs. 6 % (hip)], and more women reported sustaining fractures. Bivariate analyses yielded correlations between BMI and BMD-Z [at the hip in women (r?=?0.58, p?<?0.05) and spine in men (r?=?0.53, p?<?0.05)]. In women, weight was also correlated with BMD-Z (r?=?0.57, p?<?0.05 at hip), and C-telopeptides (r?=??0.59 at spine and ?0.63 hip, p?<?0.05) and osteocalcin (r?=??0.71 at spine and ?0.72 hip, p?<?0.05) were inversely correlated with BMD-Z. In final regression models, higher gonadotropin levels were associated with lower spinal BMD in women (p?=?0.017); serum calcium was a significant predictor of hip (p?=?0.014) and spine (p?=?0.013) BMD in both sexes.

Conclusions

Bone density in adults with galactosemia is low, indicating the potential for increased fracture risk, the etiology of which appears to be multifactorial.     

Changes in bone mineral density in men starting androgen deprivation therapy and the protective role of vitamin D

Summary

Androgen deprivation therapy in 80 men was associated with declines in bone mineral density (BMD), which were greatest in the first year, and in the lumbar spine compared to controls. Vitamin D use was associated with improved BMD in the lumbar spine and in the first year.

Introduction

Decreased BMD is a common side effect of androgen deprivation therapy (ADT), leading to increased risk of fractures. Although loss of BMD appears to be greatest within the first year of starting ADT, there are few long-term studies of change in BMD, and risk factors for bone loss are not well-characterized.

Methods

Men aged 50+ with nonmetastatic prostate cancer starting continuous ADT were enrolled in a prospective longitudinal study. BMD was determined by dual-energy x-ray absorptiometry at baseline and yearly for 3 years. Matched controls were men with prostate cancer not receiving ADT. Multivariable regression analysis examined predictors of BMD loss.

Results

Eighty ADT users and 80 controls were enrolled (mean age 69 years); 52.5 % had osteopenia and 8.1 % had osteoporosis at baseline. After 1 year, in adjusted models, ADT was associated with significant losses in lumbar spine BMD compared to controls (?2.57 %, p?=?0.006), with a trend towards greater declines at the total hip (p?=?0.09). BMD changes in years 2 and 3 were much smaller and not statistically different from controls. Use of vitamin D but not calcium was associated with improved BMD in the lumbar spine in year 1 (+6.19 %, p?<?0.001) with smaller nonsignificant increases at other sites (+0.86 % femoral neck, +0.86 % total hip, p?>?0.10) primarily in the first year.

Conclusions

Loss of BMD associated with ADT is greatest at the lumbar spine and in the first year. Vitamin D but not calcium may be protective particularly in the first year of ADT use.     

Bone mineral density in men and children with haemophilia A and B: a systematic review and meta-analysis

Summary

Although haemophilia is not considered among the classic causes of secondary osteoporosis, the present meta-analysis provides strong evidence that men with haemophilia have a significant reduction in both lumbar spine and femoral bone mineral density, which appears to begin in childhood.

Introduction

Haemophilia is not considered among the classic causes of secondary osteoporosis. The aim of this study was to systematically review the literature for case–control trials that have studied bone mass in males with haemophilia and to meta-analyze the best evidence available.

Methods

Electronic databases MEDLINE, EMBASE and CENTRAL were systematically searched for case–control trials that have studied bone mass in men or boys with haemophilia. Standardized mean difference (SMD) for bone mineral density (BMD) in the lumbar spine was the main study outcome and SMD in femoral neck and total hip BMD the secondary ones. Patient and control characteristics, such as age, body mass index (BMI), level of physical activity and blood-borne infections were recorded as possible predictors of the main outcome.

Results

Thirteen studies were included in the systematic review and ten in the main outcome meta-analysis. Men with haemophilia demonstrated reduced lumbar spine [random effects SMD [95 % confidence interval (CI)] = ?0.56 (?0.84, ?0.28), between-study heterogeneity (I ²)?=?51 %] and femoral neck BMD [random effects SMD (95 % CI) = ?0.82 (?1.21, ?0.44), I ²?=?63 %] compared with controls, which indicated a large and clinically significant association. Similar results were obtained for children [random effects SMD (95 % CI) = ?0.92 (?1.77, ?0.07), I ²?=?92 %]. No evidence of publication bias was detected. There was no evidence that age, BMI, level of physical activity or presence of blood-borne infections predicted lumbar spine BMD.

Conclusions

This meta-analysis shows that men with haemophilia present a significant reduction in both lumbar spine and hip BMD, which appears to begin in childhood.     

Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

Summary

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.

Introduction

To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.

Methods

In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.

Results

Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p?<?0.01) and QCT (5.7%, p?<?0.0001). Between-treatment differences were significant for trabecular spine (p?=?0.0017) [non-parametric test], trabecular trochanter (10.7%, p?<?0.0001), total hip (10.8%, p?<?0.0001), and compressive strength indices at femoral neck (8.6%, p?=?0.0001), and trochanter (14.1%, p?<?0.0001).

Conclusions

Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.     

Depression and low bone mineral density: a meta-analysis of epidemiologic studies

Summary

The association between depression and loss of bone mineral density (BMD) has been reported inconsistently. This meta-analysis, which pooled results from 14 qualifying individual studies, found that depression was associated with a significantly decreased BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression.

Introduction

The reported association between depression and loss of BMD has been controversial. This meta-analysis was conducted to determine whether depression and BMD are associated and to identify the variation in some subgroups.

Methods

English-language articles published before October 2008 were used as the data source. A total of six case-controlled and eight cross-sectional studies met prestated inclusion criteria (N?=?10,523). Information on study design, participant characteristics, measurements of BMD and depression, and control for potential confounders was abstracted independently by two investigators using a standardized protocol.

Results

Overall, depression was associated with a significant decrease in mean BMD of spine (?0.053 g/cm² [95% confidence interval {CI} ?0.087 to ?0.018 g/cm²]) and hip (?0.052 g/cm² [95% CI ?0.083 to ?0.022 g/cm²]). A substantially greater BMD decrease was observed in depressed women (?0.076 g/cm² in spine; ?0.059 g/cm² in hip) and in cases of clinical depression (?0.074 g/cm² in spine; ?0.080 g/cm² in hip).

Conclusion

Depression is associated with low BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.     

Role of bone mineral density in predicting morphometric vertebral fractures in patients with HIV infection

Summary

This study investigated the bone of HIV patients both in terms of quantity and quality. It was found that HIV-infected patients did fracture independently of the degree of bone demineralization as in other forms of secondary osteoporosis.

Introduction

We aimed to determine the prevalence of vertebral fractures (VFs) in HIV patients who were screened by bone mineral density (BMD) and to explore possible factors associated with VFs.

Methods

This is a cross-sectional study that included HIV-infected patients recruited in the Clinic of Infectious and Tropical Diseases and that underwent BMD measurement by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and hip (Lunar Prodigy, GE Healthcare). For the assessment of VFs, anteroposterior and lateral X-ray examinations of the thoracic and lumbar spines were performed and were centrally digitized. Logistic regression models were used in the statistical analysis of factors associated with VFs.

Results

One hundred thirty-one consecutive patients with HIV infection (93 M, 38 F, median age 51 years; range, 36-75) underwent BMD measurement: 25.2 % of patients showed normal BMD, while 45 % were osteopenic and 29.7 % osteoporotic. Prevalence of low BMD (osteopenia and osteoporosis) was higher in females as compared to males (90 vs 69 %) with no significant correlation with age and body mass index. VFs occurred more frequently in patients with low BMD as compared to patients with normal BMD (88.5 vs. 11.4 %; p?p?=?0.073). VFs were significantly associated with older age and previous AIDS events.

Conclusions

These results suggest a BMD 相似文献   

Osteopontin regulates anabolic effect in human menopausal osteoporosis with intermittent parathyroid hormone treatment

Summary

In this pilot study, we demonstrated that women with osteopontin (OPN) over-expression show less resistance to postmenopausal osteoporosis than women with normal OPN levels. We hypothesized that the levels of plasma OPN could be used as a treatment indicator for intermittent parathyroid hormone (PTH)-treated menopausal osteoporosis. We demonstrated that plasma OPN levels could be used as a biomarker for early treatment response.

Introduction

Animal studies indicate that OPN-deficient mice are resistant to ovariectomy induced osteoporosis. Our pilot study also demonstrated women with OPN over expression may show less resistance to postmenopausal osteoporosis. The role of plasma OPN in PTH1-34-treated osteoporosis remains unclear.

Methods

From September 2005 to September 2006, 31 menopausal women over 45?years of age with severe osteoporosis were enrolled in our study. Subjects were treated with PTH1-34 subcutaneously at a dose of 20???g/day. Plasma OPN levels and BMD of the lumbar spine and hip were measured using ELISA and dual-energy X-ray absorptiometry at baseline, 3, 6, and 9?months. Response to the treatment was assessed by the sequential change in bone mineral density and OPN expression using a general linear mixed model.

Results

The plasma OPN decreased sequentially and significantly throughout the 9-month treatment course from 20.75?±?5.36 to 11.2?±?4.37?ng/ml (p?<?0.001). The sequential improvement in the T-score and Z-score was significant in the lumbar spine but not in the hip area. In the lumbar spine, when the plasma OPN decreased by 1?ng/ml the T-score increased by 0.0406 and the Z-score increased by 0.0572 of lumbar spine.

Conclusion

OPN levels are related to the anabolic effect of PTH in human postmenopausal osteoporosis. Plasma OPN levels could be used as a biomarker for early treatment response.