Is bone mineral density advantage maintained long-term in previous weight lifters?

This cross-sectional study was done in order to ascertain whether there is a lifelong beneficial effect on bone mineral density (BMD) of early, long-lasting, and intense physical exercise. Forty-eight male ex-weight lifters, mean age 64 years (range 50–79) participated. They had followed a training program of an average of 10 hours/week (range 4–20) for an average of 13 years (range 1–34). They had all retired from competitive sport an average of 30 years (range 7–50) ago. Sixty-six age-matched volunteers served as controls. The bone mineral density (BMD, areal density, g/cm²) in the total body, spine, and hips and the fat content and lean body mass were measured with the LUNAR DPX bone mass scanner. In ex-weight lifters 50–64 years of age, the BMD was greater than in controls. After 65 years, no difference was found between the former weight lifters and their controls.     

The duration of exercise as a regulator of bone turnover

The relationship between duration of exercise and serum remodeling markers of bone turnover was evaluated by osteocalcin (OC), carboxy-terminal propeptide of type I collagen (PICP), total and bone-specific alkaline phosphatase (ALP) and carboxyterminal cross-linked telopeptide of type I collagen (ICTP) in 24 male premier league soccer players exercising 12 hours/week (range 8–18), 19 third league players exercising 8 hours/week (range 3–18) and 20 sixth league players exercising 6 hours/week (range 2–10). Twenty-seven volunteers served as controls. Forty-six former male soccer players (mean age 38 years, range 19–47), mean 15 years older than the current players, were compared with 41 matched controls. Data is presented as mean ± SEM. Active male players had 18 ± 4% higher OC, 37 ± 9% higher bone ALP and 36 ± 7% higher ICTP than controls (all P < 0.01). There were no differences in remodeling markers within the three groups of active players but each group had higher OC and ICTP than controls (both P < 0.05). Former players had no difference in bone remodeling markers compared to matched controls, but 39 ± 4% lower OC and 69 ± 8% lower ICTP than active players (both P < 0.001). Duration of activity was correlated with bone ALP and ICTP (both r = 0.3, P < 0.05) in individuals exercising 6 hours/week or less. No correlation was found in those exercising above this level. It seems as if the bone turnover, evaluated by serum bone remodeling markers, adapts to the current activity needed to maintain bone strength, and a duration of exercise above that level seems to confer no additional benefits.     

Bone mineral density in weight lifters

Summary The effect of intense physical training on the bone mineral content (BMC) and soft tissue composition, and the development of these values after cessation of the active career, was studied in 40 nationally or internationally ranked male weight lifters. Nineteen were active and 21 had retired from competition sports. Fifty-two age- and sexmatched nonweight lifters served as controls. The bone mineral density (BMD) in total body, spine, hip, and proximal tibial metaphysis was measured with a Lunar Dual-energy X-ray absorptiometry (DXA) apparatus and the BMD of the distal forearm was measured with single photon absorptiometry (SPA). Seventeen of the lifters had been measured earlier with SPA in the forearm and 23 in the tibial condyle during their active career in 1975. The BMD was significantly higher in the weight lifters compared with the controls (10% in the total body P<0.001, 12% in the trochanteric region P<0.001, and 13% in the lumbar spine P<0.001). All measured regions except the head showed significant higher bone mass in the weight lifters compared with the controls. In older lifters, the difference from the controls seemed to increase in total body and lumbar vertebrae (BMD), but remained unchanged in the hip. Significant correlation was found between the SPA measurements in 1975 and the corresponding measurements 15 years later in both the forearm (r=0.51, P<0.05 at the 1-cm level and r=0.87, P<0.001 at the 6-cm level) and in the tibial condyle (r=0.61, P<0.01). There was no difference in BMD for any region between active and retired weight lifters that was not explained by difference in age. The weight lifters were on average 5 cm shorter but of the same weight as the controls. In the weight lifters, the body mass index (BMI) was increased as was the lean body mass, but not the fat content.     

Carbamazepine does not alter biochemical parameters of bone turnover in healthy male adults

It is still not completely clear whether or not carbamazepine (CBZ) causes alterations in vitamin D status and in bone metabolism. The objective of this study was therefore to investigate prospectively in healthy adults the effects of CBZ on serum levels of 25-hydroxyvitamin D (25OHD) and on biomarkers of bone formation and resorption. Twenty-one free-living male adults were taking 800 mg/day CBZ for 10 weeks. The study was performed from December 1997 until September 1998 at a geographic latitude of 51°N. Blood samples were collected before treatment (t₁), 33 days (SE 2.5) after starting treatment (t₂), and 70 days (SE 3.6) after starting treatment (t₃). In 13 out of the 21 subjects blood samples were also drawn 64 days (SE 9.0) after treatment had been terminated (t₄). Serum 25OHD levels remained constant during study periods t₁–t₃. 25OHD levels were, however, significantly higher at t₄ compared to t₁–t₃. Serum concentrations of intact osteocalcin, a bone formation marker, and C-telopeptide, a bone resorption marker, were similar during all examinations. Moreover, serum levels of parathyroid hormone, calcium, and inorganic phosphate did not change. Data indicate that CBZ per se does not alter bone metabolism and does not lead to decreased circulating 25OHD levels in young males without epilepsy. Variations in 25OHD levels are in line with the seasonal fluctuations in vitamin D status.     

Histomorphometric determination of formation rates of archaeological bone

Archaeological rib samples were subjected to quantitative histologic analysis to determine rates of cortical bone formation. Histologic features are usually well enough preserved to permit the determination of mean annual Haversian bone formation rate averaged over the life span of the individual. Moreover, gross estimates of aging archaeological bone correlate well with histologic parameters expected for particular ages. Age-associated changes in bone histomorphology in extinct populations have remained essentially unchanged for at least 1,600 years. Bone formation rates determined for these populations agree with age-matched values determined for extantHomo sapiens. A relatively high frequency of pathologic conditions reported by others for the Ledders population may be reflected by the wide range of histomorphometric parameters present in the ribs of these individuals. On the basis of morphophysiologic relationships in extant populations, it can be assumed that mean annual osteonal creation frequency, and mean annual Haversian bone formation rate can be reliably determined in extinct populations. To our knowledge, this is the first time a dynamic physiologic parameter has been measured in an extinct pupulation ofH. sapiens.     

Biochemical assessment of bone turnover and bone fragility in men

SUMMARY: Osteoporosis in men is less studied than in women. Few data concern biochemical bone turnover markers (BTM) in men and their potential use. METHODOLOGY: We evaluated papers concerning BTM in men cited on Medline. Selection of studies were based on the number of subjects, age range, group homogeneity, follow-up duration, number of BTM. RESULTS: BTM levels are high in young men, then decrease with age.In elderly men, bone resorption increases with age more than bone formation. Variability of individual values is high and their significance is unclear. In elderly men, BTM levels correlate negatively with bone mineral density suggesting that accelerated bone turnover underlies age-related bone loss. Data on the prediction of accelerated bone loss and fractures by BTM in men are scant. Testosterone treatment induces a decrease in bone resorption followed by a decrease in bone formation. Bisphosphonates and calcitonin decrease BTM levels in osteoporotic men. Parathyroid hormone 1-34 and growth hormone induce a rapid increase in bone turnover followed by a progressive slowdown. CONCLUSIONS: Few studies concern BTM in men. Currently available data are not sufficient to suggest guidelines for the practical use of BTM in the clinical management of the osteoporosis in elderly men.     

引导性骨再生中成骨细胞来源的实验观察

目的 研究 长管骨引导性骨再生成骨细胞来源,进一步完善引导性骨再生理论。方法 将４２只成年雄性新西兰兔在双侧桡骨中段制作标准骨缺损不愈合模型,用硅胶膜呈管状包囊一侧骨缺损,另一侧作为对照侧。１只兔术后１￣１２周分别于每周进行Ｘ线检查;３０只兔,随机分为６组,分别于术后３天、１、２、３、４、５周外死取材,分别进行常规ＨＥ染色,ＳＰ方法ＢＭＰ、ＢＧ抗体的免疫组化染以。结果 隔膜在骨缺损局部生成隔离密闭     

Evaluation of bone turnover in type I osteoporosis using biochemical markers specific for both bone formation and bone resorption

The aims of the study were to evaluate the use of bone-specific biochemical markers of turnover in type I osteoporosis, to test for evidence of heterogeneity of bone turnover in this condition, and to attempt to devise an uncoupling index by using the relationship between bone-specific biochemical markers of bone formation and bone resorption. In women with type I osteoporosis (mean age 64 years, SD 5;n=63) the mean level of serum osteocalcin, a specific biochemical marker of bone formation, was 9.9 ng/ml (SD 2.0), which was higher than the level in normal postmenopausal women (mean age 65 years, SD 6;n=8.9 ng/ml (SD 2.0;p<0.01). The variance of serum osteocalcin levels in the two groups was similar. Compared with this 11% increase in the biochemical marker for bone formation, the markers of bone resorption, total urinary deoxypyridinoline (bone-specific), pyridinoline and hydroxyproline were increased by 40% (p<0.0001), 61% (p<0.0001) and 25% (p<0.01), respectively. Furthermore, these biochemical markers of bone resorption had greater variance in women in type I osteoporosis than in the normal postmenopausal women (p<0.001). The urinary excretion of the free crosslinks deoxypyridinoline, pyridinoline and glycosylated pyridinoline were increased by 26% (p<0.001), 17% (p<0.01) and 13% (NS) respectively. An uncoupling index was calculated for the difference between urinary deoxypyridinoline and serum osteocalcin using the results from the normal women and expressed asz-scores. We conclude that the pyridinium crosslinks of collagen enable better discrimination between normal and osteoporotic women than does hydroxyproline. In osteoporosis there appears to be heterogeneity of bone resorption. Finally, an uncoupling index indicated that in osteoporosis bone resorption was increased to a greater extent than bone formation as compared with normal postmenopausal women.     

Patellar tendon ruptures in weight lifters after local steroid injections

Introduction  Weight lifting is commonly associated with an increase in knee injury risk. Local steroid injection is thought to be associated with increased risk of spontaneous tendon rupture. The purpose of this report is to describe incidence of rupture of the patellar tendon after receiving multiple local steroid injections in weight lifters. Materials and methods  Seven weight lifters presented at the hospital with ruptured patellar tendon. All the patients had a history of multiple local steroid injections into the patellar tendon. Each patient received surgical treatment within 72 h after injury. Results  After an average follow-up time of 26 months, the mean postoperative Lysholm knee score was 94 and the mean Insall-Salvati measurement was 0.96. All seven athletes returned to weight lifting training at 1 year after the operation. They returned to full competition at 18 months after the surgery. Conclusion  For physicians who treat patellar tendonitis, especially in weight lifters, it is important to recognize the contributing factors for tendon rupture especially in those who have had multiple steroid injections. The functional prognosis of the knee improves if the normal length and strength of the injured tendon have been properly restored.     

Hypophosphatemic osteomalacia: a report of five cases and evaluation of bone markers

In this study, we analyzed the changes in biochemical markers of bone turnover in five patients with hypophosphatemic osteomalacia. The following bone markers were evaluated: among bone formation markers, total alkaline phosphatase (TAP), bone alkaline phosphatase (BAP), osteocalcin (bone Gla protein, BGP) and procollagen type I N propeptide (PINP); among bone resorption markers, serum C-terminal cross-linked telopeptide of type I collagen (s-CTx), urinary hydroxyproline (HYP), and N-terminal and and C-terminal cross-linked telopeptides of collagen (NTx and - and -CTx). In addition, the /-CTx ratio was evaluated. TAP and BAP were the markers with the highest increase in both frequency and magnitude. Conversely, BGP values were low in all patients. Collagen-related markers were slightly increased in nearly half of the patients. Among them, PINP showed the highest proportion of increased values. The /-CTx ratio was within normal values in all patients. In conclusion, TAP and BAP seem to be the best bone markers in the diagnostic evaluation of hypophosphatemic osteomalacia. In addition, their high values associated with low levels of BGP provide an even more reliable biochemical profile of this disorder, when associated with the classic mineral and skeletal homeostasis abnormalities.     

Glucocorticoid-induced inhibition of osteoblastic bone formation in ewes: A biochemical and histomorphometric study

The mechanisms underlying glucocorticoid-induced osteoporosis in humans are a defect in bone formation associated with increased bone resorption. The latter may be due to elevated parathyroid hormone (PTH) levels induced by the impairment of intestinal calcium absorption caused by corticosteroids. In this study we analysed the effects of corticosteroids in old ewes, a potential model for the study of human bone turnover. Two groups of seven 9-year-old female sheep were selected. The first group was injected intramuscularly with a daily dose of 30 mg methylprednisone (MP) during the first 2 months and 15 mg during the last month. After 2 and 3 months of treatment, blood samples were taken. At the end of the experiment the animals were slaughtered and the iliac crest kept for bone histomorphometry. Serum osteocalcin (sOC) rapidly and markedly decreased in the MP-treated group compared with controls (–77%;p<0.01). In contrast, at the end of the experiment serum calcium and PTH levels were similar in both groups. Histomorphometric analysis showed a significant reduction in the wall width of trabecular packets. Dynamic parameters reflecting bone formation at the tissue and cell levels were significantly lower in the MP-treated group than in controls, with a highly significant decrease in the mineralization rate (MAR: –63%,p<0.05) and double-labeled perimeter (dLPm/B.Pm: –92%p<0.05). The bone formation rate (BFR/B.Pm) also decreased by 84% and the adjusted apposition rate (Aj.AR) by 80%. The increase in the total formation period was mainly due to an increase in the inactive period. Significant correlations were found between sOC and MAR, dLPm/B.Pm and BFR/B.Pm (withr respectively 0.67, 0.76 and 0.51). In conclusion, the effects of corticosteroid on ewe bone remodeling are essentially characterized by a major bone formation defect without evidence of secondary hyperparathyroidism, although this cannot be totally excluded by our results. Ewes treated with glucocorticoids could represent a good model for evaluating the effects of drugs candidates for all bone conditions characterized by reduced bone formation resulting from osteoblastic depression.     

Independent effect of endogenous dehydroepiandrosterone-sulphate levels and birth weight on bone turnover parameters in young adults

Data indicate that bone turnover is higher in young adults born with a low birth weight (LBW). Moreover, several data support the presence of altered adrenal hormone production in this population. The aim of our study was to investigate whether there is any connection between altered bone homeostasis and adrenal hormone levels. Bone mineral density (BMD), serum osteocalcin (OC), and urinary deoxypyridinoline (DPD) excretion were related to dehydroepiandrosterone-sulphate (DHEAS), cortisol, estradiol, testosterone, and sex-hormone binding globulin (SHBG) levels in 47 healthy young women (of those, 33 were LBW) and 65 healthy young men (of those, 49 were LBW). The age of the subjects was 19–21 years. BMD values were normal and did not correlate with any of the factors investigated. Cortisol did not have any independent effect on bone turnover parameters in either men or women. In women, birth weight, DHEAS levels, and free estradiol index were responsible for almost 50% (corrected r² = 0.45) of serum OC variability. Independent positive associations were observed between DHEAS and OC, and between DHEAS and DPD excretion. In men, birth weight and DHEAS levels together were responsible for more than one-third (corrected r² = 0.36) of the variability of serum OC. In contrast with women, DHEAS and OC were inversely correlated in men. Our results suggest that bone turnover depends on the subjects' birth weight. Moreover, DHEAS is also an independent determinant. The effect of DHEAS on bone turnover is different in women and men. DHEAS increases bone turnover in fertile women, while it decreases this in men.     

Influence of weight and weight change on bone loss in perimenopausal and early postmenopausal Scottish women

Weight is recognized as an important factor in determining an individuals risk of osteoporosis. However, little is known about whether weight or weight change influences bone loss around the time of the menopause, and the relationship with energy intake and physical activity level remains largely undefined. Healthy premenopausal women (1,064 selected from a random population of 5,119 women aged 45–54 years at baseline) each had bone mineral density (BMD), weight and height measurements, and completed a food frequency and physical activity questionnaire. Of the original participants, 907 women (85.2%) returned 6.3 ± 0.6 years later for repeat BMD measurements, and 896 women completed the questionnaires. Bone loss at the hip (FN) and spine (LS) occurred before the menopause. Weight change rather than weight was associated with FN BMD loss (r=0.102, p=0.002), but weight at follow-up was associated with LS BMD change (r=0.105, p=0.002). Although an increase in physical activity level (PAL) appeared to be beneficial for FN BMD in women who were heavy weight gainers, PAL was associated with increased LS BMD loss in women who lost weight. For current HRT users, neither weight nor weight change was associated with change in BMD. Postmenopausal women not taking HRT should be made aware that low body weight or losing weight during this particularly vulnerable period may worsen bone loss.     

A prospective study of changes in bone turnover and bone density associated with regaining weight in women with anorexia nervosa

Anorexia nervosa (AN) is a condition of self-induced weight loss, associated with an intense fear of gaining weight. Previous studies have shown that bone density may increase with regaining and maintaining normal weight; however, relatively little is known about the changes in bone metabolism that occur during weight restoration. We describe the effect of weight restoration and maintenance of weight over 1 year on bone mineral density (BMD) and bone turnover. We recruited women from the eating disorders services at the South West London and St Georges Mental Health NHS Trust, and the Priory and Charter Nightingale Hospitals in London, UK. Details of their AN, fracture history, menstrual history and exercise were obtained by interview and case note review. Morning samples of blood and second void urine were taken for biochemical analysis. BMD was measured by DXA at the lumbar spine (LS), femoral neck (FN), distal radius (RD) and total body bone mineral content (BMC). Patients then entered the treatment program, which includes re-feeding, dietary education and psychotherapy. Over a period of 42 months, we recruited 55 women who agreed to participate in this study and underwent baseline investigations. Of these, 15 (27%) subjects achieved and then maintained their target weight for the duration of the study. At baseline for all subjects ( n =55) estradiol levels were lower than the normal reference ranges (both follicular and luteal phases) in 91% of the women. Bone specific alkaline phosphatase (BSAP) concentrations were lower than the premenopausal reference range in 55% of women, and urinary deoxypyridinoline (DPD) was above the premenopausal reference range in 78% of women. Baseline lumbar spine BMD was positively related to BMI (Pearsons r =0.29, P =0.04) and inversely related to bone turnover markers: urinary DPD (Pearsons r =–0.39, P =0.01 and serum BSAP (Pearsons r =–0.3, P =0.06). The 15 patients who regained and maintained weight were followed-up for a mean duration of 69 weeks (SD 7.3, range 54 to 84 weeks). Mean BMI increased from 14.2 (1.7) to 20.2 (0.77) kg/m² and remained stable throughout follow-up. Menstruation resumed in 8 of the 15 women. Total body BMC and LS BMD increased significantly over the duration of follow-up (by 4.3% each), but FN BMD and distal radius remained stable. Lumbar spine bone area also increased significantly, whereas FN and distal radius did not. These changes were associated with a significant increase in BSAP ( P =0.01), and a non-significant trend for a decrease in DPD ( P =0.10). Our findings suggest that when women are at low body weight they are in a hypo-estrogenic state, which is associated with imbalance of bone turnover (high bone resorption and low bone formation). This is reversed with weight gain and persists as target weight is maintained and is associated with increases in BMC and BMD.There was no conflict of interest.     

Increased bone resorption precedes increased bone formation in the ovariectomized rat

This study describes an increase in biochemical and histomorphometric markers of bone resorption prior to increased bone formation and trabecular bone loss in the ovariectomized rat. Six-month-old, female Sprague Dawley rats were either sham operated or ovariectomized (Ovx) and killed at 0, 6, 9, 15, 18, 21, and 42 days postOperation when femora were collected and trabecular bone volume (BV/TV) was determined from von Kossa silver-stained sections using the Quantimet 520 image analysis system in the distal region. A number of these sections were also examined unstained for fluorochrome labels, and stained for acid phosphatase to detect osteoclast-like cells (ACP surface). At 18 days postoperation, lumbar vertebrae were examined. Blood and urine specimens were analyzed for bone-related biochemical variables. ACP surface was significantly greater in Ovx rats compared with sham at 6 days postoperation (mean ACP surface (%TS) ± SEM: sham 36.4 ± 1.9; Ovx 40.3 ± 1.2,P < 0.05) as was urinary hydroxyproline excretion. Serum osteocalcin and alkaline phosphatase activity were not elevated in Ovx rats compared with Sham until 9 days postoperation. Mineral apposition rate (MAR) was increased at 12 days after ovariectomy (mean MAR (Μm/day) ± SEM: sham 0.85 ± 0.06; Ovx 1.23 ± 0.06,P < 0.05). Trabecular bone volume (BV/TV) at a specific site in the metaphyseal-diaphyseal core area was significantly lower at 15 days postoperation (mean (%) ± SEM: Sham 7.40 ± 1.23, Ovx 4.25 0 0.65,P < 0.05). There was no difference in lumbar vertebral BV/TV between the two groups at 18 days postoperation, however, ACP surface was elevated in the Ovx rats (P < 0.05). A systemic increase in bone resorption at 6 days postovariectomy precedes increased formation whereas the length of time required for the dissolution of trabeculae postoperation is determined locally.     

年龄、体重、体重指数对青岛市居民骨密度的影响

目的探讨年龄、体重和体重指数对骨密度的影响。方法双能骨密度仪(DEXA)测定269例50~80岁青岛常住人口腰椎前后位和髋部骨密度,记录年龄,测量身高、体重,计算出体重指数,并进行统计学分析。结果高龄、低体重和低体重指数者骨密度均较其他组低,差异有显著性。男性和女性骨密度随年龄、体重和体重指数的变化模式不同。结论年龄、体重和体重指数是影响骨密度的重要因素。年龄、体重和体重指数对男性和女性骨密度的影响结果不同。     

Normal bone particles are preferentially resorbed in the presence of osteocalcin-deficient bone particlesIn vivo

Summary In anin vivo model of osteoclastic bone resorption, we previously showed that osteocalcin-deficient bone particles (BPs), derived from warfarin-treated rats, were resorbed 50% as well as normal BPs and that they recruited fewer osteoclastic cells with decreased tartrate-resistant acid phosphatase (TRAP) activity. In order to determine the specificity of the resorption response, we evaluated the fate of implanted mixtures of normal and osteocalcin-deficient BPs. Normal and warfarin-treated donor rats were prelabeledin vivo with oxytetracycline to permit identification of BPs from either source. Normal, osteocalcin-deficient, and 50∶50 mixtures of BPs (either labeled or unlabeled) were implanted into normal rats and recovered 12 days later for enzymatic (TRAP) and nondecalcified histomorphometric analyses. The incorporated oxytetracycline had no signficant effect on resorption of bone particles. The recovered osteocalcin-deficient BPs were surrounded by fewer osteoclastic cells, were resorbed less, and contained less extractable TRAP activity than normal BPs. In mixed BP implants with normal and osteocalcin-deficient BPs, each type of bone particle elicited the same tissue response as when implanted separately. Remarkably, the different particles evoked dissimilar osteoclastic responses and were resorbed to different extents, even when adjacent within the same implant. These data suggest that osteocalcin may act as a substrate signal for resorption and that osteocalcin in the normal BPs does not influence the cellular response to adjacent osteocalcin-deficient BPs.     

Postoophorectomy bone loss is associated with reduced bone Gla protein serum levels: A possible effect of osteoblastic insufficiency

Summary To further investigate the relationship between oophorectomy (OF) and mineral bone loss, 15 women who underwent total hysterectomy and bilateral oophorectomy were studied for 12 months after surgery. Mineralometric and metabolic data were obtained before and after 3, 6, and 12 months. The women lost bone mineral content (measured by single photon absorptiometry) at the same rate they lost cortical and trabecular bone, suggesting that bone loss after OF is a generalized phenomenon. Our data also show that in increase in bone resorption takes place only in the first period after OF; the persistency of a negative bone balance up to 12 months, accompanied by a reduction of osteocalcin serum levels, may be dependent on a reduced bone formation, probably due to osteoblastic insufficiency.     

Osteocalcin and bone morphometric parameters in adults without bone disease

Summary Serum bone Gla-protein (s-BGP or osteocalcin) and other serum biochemical parameters were measured in 19 subjects (8 women and 11 men, aged 20–82 years) without any bone disease. Each subject simultaneously underwent an iliac crest biopsy; tetracycline double-labeling was performed in 11 subjects, allowing correlations between s-BGP and bone histomorphometric parameters. s-BGP was significantly correlated with static bone parameters: trabecular bone volume (r=0.74;P<0.001), osteoid surfaces (r=0.69;P<0.001), osteoblastic surfaces (r=0.68;P<0.002); dynamic bone formation parameters: total labeled surfaces (r=0.72;P<0.01); and the bone formation rate (r=0.69;P<0.01). We conclude that s-BGP is a valuable marker for evaluating bone formation in healthy adult subjects.     

Relation of height and weight to the regional variations in bone mass among Japanese-American men and women

We examined the magnitude of regional variations in bone mass among elderly, Japanese-American men and women. All subjects had bone measurements at the calcaneus, and at the distal and proximal radius sites. A subset of the women had, in addition, spine bone mass measurements. To provide a common measurement scale, the bone measurements were converted to age- and sex-specificZ-scores. TheZ-scores between pairs of bone sites were then subtracted to yield the differences in bone mass between bone sites (expressed inZ-score units). For most individuals the differences were less than 1.0Z-score; however, 12%–20% of the differences were at least 1Z-score apart. The most similar sites were the distal and proximal radius: different regions within the same bone. Among the other bone pairs, the calcaneus and spine were the most similar to one another. The magnitudes of the differences in bone mass were associated with height and weight. Heavier subjects, for instance, had greater calcaneus than radius bone mass measurements, and greater spine than radius measurements. The spine and calcaneus are more weight-bearing than the radius sites. Associations were observed up to 0.25Z-score per 10 kg difference in weight. Height was associated with bone mass differences in an opposite direction to weight. Taller subjects had greater bone mass at the radius sites than expected from their calcaneus or spine bone measurements (0.1 to 0.2Z-score difference per 5 cm difference in height). Bone width partly explained the associations with height; that is, adjusting the radius widths reduced the associations with height. Overall, our results indicate that small to moderate differences between bone sites were common among our study population, and that the magnitudes of the differences were associated with height and weight.