Bone mineral content in women with Colles' fracture: effect of calcium supplementation.

The effect of dietary calcium supplementation on bone mineral content was studied in 40 postmenopausal women with Colles' fracture. The participants were divided into two groups which were given either placebo or 1 g of calcium per day. The bone mineral content of the femur was determined before and after 1 year of medication. Women with Colles' fracture were found to have the same mineral content in the femur as age-matched controls without fractures. Calcium supplementation had no significant effect on the bone mineral content.     

Bone mineral density of the radius in patients with Colles' fracture

To ascertain whether patients with Colles' fracture should be investigated for osteoporosis and the risk of future fractures, we measured the bone mineral density of the distal radius of the other arm in 31 women patients and compared the results with those of a control group of 289 normal women. We divided the patients into two groups, those younger than 66 years and those older. In 25 patients we found values for bone mineral density which were lower than one standard deviation below the mean value for their age. Younger patients had a deficit greater than that expected for their ages. We believe that women with Colles' fracture should be evaluated routinely for osteoporosis, particularly if they are under 66 years of age.     

Genetic determination of Colles' fracture and differential bone mass in women with and without Colles' fracture.

Osteoporotic fractures (OFs) are a major public health problem. Direct evidence of the importance and, particularly, the magnitude of genetic determination of OF per se is essentially nonexistent. Colles' fractures (CFs) are a common type of OF. In a metropolitan white female population in the midwestern United States, we found significant genetic determination of CF. The prevalence (K) of CF is, respectively, 11.8% (+/- SE 0.7%) in 2471 proband women aged 65.55 years (0.21), 4.4% (0.3%) in 3803 sisters of the probands, and 14.6% (0.7%) in their mothers. The recurrence risk (K0), the probability that a woman will suffer CF if her mother has suffered CF is 0.155 (0.017). The recurrence risk (Ks), the probability that a sister of a proband woman will suffer CF given that her proband sister has suffered CF is 0.084 (0.012). The relative risk lambda (the ratio of the recurrence risk to K), which measures the degree of genetic determination of complex diseases such as CF, is 1.312 (0.145; lambda 0) for a woman with an affected mother and 1.885 (0.276; lambda s) for a woman with an affected sister. A lambda-value significantly greater than 1.0 indicates genetic determination of CF. The terms lambda 0 and lambda s are related to the genetic variances of CF. These parameters translate into a significant and moderately high heritability (0.254 [0.118]) for CF. These parameters were estimated by a maximum likelihood method that we developed, which provides a general tool for characterizing genetic determination of complex diseases. In addition, we found that women without CF had significantly higher bone mass (adjusted for important covariates such as age, weight, etc.) than women with CF.     

Dental malocclusion is associated with reduced systemic bone mineral density in adolescents.

There is no published data about associations between the state of dentition and bone mass in adolescents. The objective of this study was to investigate whether the prevalence of caries and dental malocclusion is associated with bone mass during growth. In 123 healthy Caucasian subjects (72 males, 51 females) aged 14-18 yr, DMFT figures (decayed teeth, missing teeth, filled teeth) and presence of malocclusion, according to Angle classification, were determined. Participants completed a questionnaire regarding dental hygiene, physical activity level, and consumption of sweets. Anthropometry and pubertal stages were examined. Bone mineral density (BMD) was examined using dual energy X-ray absorptiometry (DXA) in the total body, head, and lumbar spine. No association was found between DMFT (mean+/-SD: 8.33+/-3.9) and BMD or Z-scores for BMD. Malocclusion was found in 49 subjects (39.8%) and was more prevalent in females than males. Malocclusion was associated with lower total BMD independently of body size (p=0.001; Z-scores: -0.21+/-0.27 vs +0.33+/-0.17; p=0.1) in males (but not females), producing odds ratio 1.6 (95% confidence interval: 1.09-2.34%; p=0.02). Head BMD was also lower in the males with malocclusion than in those without (p=0.004). Neither caries nor the tooth loss appear to be associated with BMD during growth. Boys with malocclusion are at higher risk of reduced BMD. This suggests that inadequate bone mass accrual in males coexists with impaired growth of the masticatory system in childhood and adolescence, however, the causal pathway is unknown. Factors that produce malocclusion may also affect bone mass or size but further prospective studies are needed to evaluate the relationship.     

Fat mass is negatively associated with bone mineral content in Koreans

Summary

Although obesity and osteoporosis are important public health problems, the effect of fat mass on bone mass remains controversial. This study demonstrated that fat mass was inversely related to bone mineral content, and abdominal obesity was significantly associated with bone mineral content independent of total fat mass.

Introduction

Obesity and osteoporosis, two disorders of body composition, have become increasingly important public health problems throughout the world. However, the effect of fat mass on bone mass remains controversial. This study investigates the effect of fat mass and regional fat distribution on bone mass within a community-dwelling cohort.

Methods

A total of 3,042 subjects (1,284 men, 362 premenopausal women, and 1,396 postmenopausal women) were studied. Fat mass, percent fat mass, lean mass, percent lean mass, and bone mineral content (BMC) were measured by dual energy X-ray absorptiometry.

Results

Fat mass and percent fat mass decreased significantly across increasing tertiles of BMC in all three subgroups (men, premenopausal and postmenopausal women). In contrast, lean mass and percent lean mass increased significantly across tertiles of BMC in men, and a similar trend was also identified in postmenopausal women. Interestingly, although correlation analysis showed a positive association between fat mass and BMC (p?p?p?Conclusion This study demonstrated that fat mass was inversely related to BMC after removing the mechanical loading effect in Korean men and women. Moreover, abdominal obesity as measured by WC was significantly associated with BMC independent of total fat mass.     

Strain rate and mineral content in fracture models of bone

I reanalysed data from my previous work to determine the extent to which a model for the loading-rate dependence of the fracture of cortical bone, put forward by Carter and Caler, fits this independently derived data set. In particular, the extent to which the generality of the model is vitiated by its ignoring the effect of mineralisation on strength was tested. The model was rather strongly corroborated. In addition, the reanalysed data show that yield strain is strongly strain-rate dependent, but that Young's modulus is rather unvarying over physiological strain rates. The implications of this for hypotheses concerning fracture of bone are discussed.     

Using clinical risk factors and bone mineral density to determine who among patients undergoing bone densitometry should have vertebral fracture assessment

Summary  

Vertebral fracture assessment (VFA) is a new method for imaging thoracolumbar spine on bone densitometer. Among patients referred for bone densitometry, the selection of patients for VFA testing can be optimized using an index derived from clinical risk factors and bone density measurement.     

Bone mineral content of transilial biopsies in patients with hip fracture

In a survey of 125 patients with hip fracture vitamin D deficiency was frequently observed, but overt osteomalacia was not found in the bone biopsies (Lips et al., 1982). In order to detect a possible hypomineralization in these vitamin D-deficient patients, we measured the bone mineral content in 64 transilial biopsies, embedded in methylmethacrylate for histomorphometric evaluation. The results were compared with those of 18 bone samples obtained at autopsy from subjects who did not suffer from metabolic bone disease. The calcium:hydroxyproline ratio, the phosphorus:hydroxyproline ratio, and the calcium:phosphorus ratio were similar in the two groups. The magnesium:hydroxyproline ratio was higher in the hip fracture group than in the controls. The ratios did not correlate with serum concentrations of the vitamin D metabolites. The results are not consistent with a decreased bone mineralization in patients with hip fracture.     

Bone mineral loss after Colles' fracture. Plaster case and external fixation equivalent

The bone mineral content of the radius and ulna was analyzed in 31 postmenopausal women with displaced Colles' fractures. Sixteen fractures were treated with a below-the-elbow plaster case and 15 with primary external fixation. The bone mineral content of the forearm bones was measured with a photon absorptiometer 9 (6-24) months later. There was a mean 15 percent mineral decrease in the radius, but no difference between the two treatment groups. The decrease did not correlate with the age of the patient, nor was there any correlation with grip strength or range of wrist motion. The more severe fractures, according to the Frykman classification, had a more pronounced mineral loss than the simpler fractures.     

Bone mineral content and bone mass in patients with spinal stenosis

The bone mineral content in the distal end of the forearm was measured in 45 patients with spinal stenosis. In men, there was a significant increase in bone mineral content but only in the distal end of the forearm, where the measurement included mainly trabecular bone. The cortical bone more proximally in the forearm did not deviate in this respect nor could any differences be found in the small group of women included in the study. The implications are that an increased bone mineral content indicative of a greater than average bone mass may be one factor in the pathogenesis of spinal stenosis.     

The bone mineral content and cortical thickness in young women with femoral neck fracture

The bone mineral content in the shafts of the forearm in 17 women with cervical fracture of the upper end of the femur was low. The cortex of the femoral neck was also lower than normal. Thus women with hip fractures at an early age may have lower than average total skeletal tissue density. This may be due not simply to systemic osteoporosis but possibly to constitutionally thin bone cortices.     

甲亢患者骨矿含量降低的治疗观察

报道１５８例骨矿含量低于正常值１个标准差（Ｓ）的青壮年（２０～４０岁）甲亢患者的治疗结果。在用１３１碘或抗甲状腺药或手术治疗的同时，使用维生素Ｄ３、维生素Ａ＋Ｄ、葡萄糖酸钙片、肾骨胶丸、饮食含钙丰富的食品等进行综合治疗。结果骨面密度有明显提高，男患者由０．５８４±０．１１～０．６０２±０．１２ｇ／ｃｍ２提高到０．６９８±０．１１～０．７０４±０．１３ｇ／ｃｍ２；女患者由０．５３７±０．０９～０．５６０±０．０９ｇ／ｃｍ２提高到０．６６２±０．１０～０．６７８±０．１１ｇ／ｃｍ２，其差别非常显著（Ｐ＜０．０１）。骨矿恢复正常的百分率：单纯１３１碘治疗组，男３７．５％（６／１６），女３５．７／（１０／２８）；１３１碘加综合治疗组，男６６．６％（１２／１８），女７３％（１９／２６）；抗甲状腺药加综合治疗组，男８１．２％（１３／１６），女８０．５％（２９／３６）；手术加综合治疗组，男７５％（６／８），女７０％（７／１０）。说明青壮年甲亢患者的骨矿物质丢失是可逆的。经过治疗，随着甲亢的治愈，骨矿含量大部分都得到恢复。     

影响维持性血液透析患者骨密度相关因素分析

目的观察维持性血液透析患者骨质疏松现状,研究骨密度及骨代谢指标间关系,讨论影响骨质疏松的危险因素。方法选取维持性血液透析患者125例,收集一般资料及透析相关信息,检测25羟维生素D,骨源性碱性磷酸酶,跟骨骨密度,进行横断面研究。应用SPSS19.0软件,P0.05为差异有统计学意义。结果维持性血液透析患者骨质疏松发生率为48%,25羟维生素D缺乏为30.4%。不同性别间骨质疏松患病率差异无统计学意义。绝经女性骨密度显著低于未绝经女性(P0.001)。女性25羟维生素D水平显著低于男性(P=0.026)。肾小管间质性疾病者骨密度明显低于慢性肾小球肾炎者(P=0.001)。不运动者骨密度明显低于运动者(P0.001)。骨密度与年龄,透析龄显著负相关(r=-0.387,P0.001,r=-0.190 P=0.034)。老龄、绝经、轻体重、不运动、肾移植是维持性透析患者骨质疏松的危险因素。结论维持性血液透析患者骨质疏松和25羟维生素D缺乏发生率高,但二者间无相关性。老龄、绝经、轻体重、不运动、肾移植后应用激素及免疫抑制剂是终末期肾病维持性透析患者骨质疏松的危险因素。     

Comparison of various biochemical measurements with bone mineral densitometry and quantitative ultrasound for the assessment of vertebral fracture

We have retrospectively studied postmenopausal elderly Japanese women (n = 288; age range, 60–75 years, 65.8 ± 4.5 [mean ± SD]) for the evaluation of biochemical measurements in assessment of bone mass and vertebral fracture, comparing with several bone mineral measurements and quantitative ultrasound (QUS) measurement. Several biochemical parameters [red cell count (RBC), hemoglobin (HB), albumin (ALB), and cholesterol (CHO)] positively correlated with bone mass parameters, but only serum cholesterol showed association with the presence of vertebral fracture. Urinary deoxypyridinoline (DPYD) and n-telopeptide (NTx) showed moderate negative correlation with bone mass parameters, and DPYD showed association with vertebral fracture. All bone mineral measurements (lumbar spine, total body, femoral neck by DXA, calcaneal bone by SXA, distal radius by pQCT) and QUS measurement (os calcaneus by two different QUS machines) showed a higher odds ratio and high χ² value in logistic regression analysis for association with vertebral fracture. Thus, bone mass measurement is the principal method for assessment of fracture risk, and biochemical measurement should be used for motivation of further bone mass measurement. In biochemical measurements, measurement of serum cholesterol is cheap and easy, and thus might have an advantage, although further study is necessary. Received: July 1, 1999 / Accepted: Oct. 18, 1999     

Impending fracture associated with bone destruction.

In the patient with metastatic bone disease, destruction of bone threatens the structural support of the skeletal system. Osteoporosis, stress-risers, and the open-section effect result in pain, immobilization, and fractures. The establishment of more clear-cut indications for prophylactic fixation will lessen the morbidity associated with a pathologic fracture.