Body mass index and bone loss among postmenopausal women: the 10-year follow-up of the OSTPRE cohort

Obesity protects against osteoporosis, but the magnitude of this association has been difficult to assess from cross-sectional or short term studies. We examined the time course of bone loss as a function of body mass index (BMI) in early and late postmenopausal women. Our study population (n = 300) was a random sample of the population-based Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study, Finland. We excluded women without complete BMD results, premenopausal women during the second bone densitometry and women who had used hormone replacement therapy, bisphosphonates or calcitonin. BMI along with femoral neck and spinal bone mineral density (BMD) were assessed three times by dual-energy X-ray absorptiometry during a mean follow-up of 10.5 years (SD 0.5). The mean baseline age was 53.6 years (SD 2.8), time since menopause 2.9 years (SD 4.3) and BMI 27.3 kg/m² (SD 4.4). The data was analyzed by linear mixed models. Thus, we were able to approximate the bone loss up to 20 postmenopausal years. To illustrate, a woman with a baseline BMI of 20 kg/m² became osteopenic 2 (spine) and 4 (femoral neck) years after menopause, while obesity (BMI of 30 kg/m²) delayed the incidence of osteopenia by 5 (spine) and 9 (femoral neck) years, respectively. The delay was due to high baseline BMD of the obese, while bone loss rate was similar for both lean and obese subjects. This lean versus obese difference may also be partly due to altered X-ray attenuation due to fat mass.     

Epidemiology and treatment of the metabolic syndrome

Recent definitions of the metabolic syndrome from the World Health Organization (WHO) and National Cholesterol Education Program (NCEP) have given us a clearer picture of the prevalence of the metabolic syndrome and the risks it poses for cardiovascular disease and type 2 diabetes. Solid epidemiological and trial evidence support lifestyle changes as the main modifiable risk factors, including abdominal obesity, sedentary lifestyle and a diet rich in saturated fat and low in fiber content, in the treatment of individual components of the metabolic syndrome. Physical activity may prevent the metabolic syndrome as defined by the WHO and NCEP, but the evidence for lifestyle changes using these definitions is still sparse. No trials on the treatment of the metabolic syndrome to prevent diabetes have been published. However, both the Finnish Diabetes Prevention Study and the Diabetes Prevention Program found that moderate lifestyle interventions in persons with impaired glucose tolerance, a condition related to the metabolic syndrome, decreased the incidence of type 2 diabetes by 58%. Some drugs may also prevent diabetes. Further research on lifestyle modifications in the prevention and treatment of the metabolic syndrome, and on how best to promote lifestyle changes, is needed. In the meantime, efforts to curb obesity and overweight, increase physical activity and improve compliance with current dietary recommendations should continue.     

Effects of Postmenopausal Hormone Replacement Therapy With and Without Vitamin D3 on Circulating Levels of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D

The effects of postmenopausal hormone replacement therapy (HRT) and vitamin D₃ on vitamin D metabolites (25OHD and 1,25(OH)₂D) were studied in a population-based prospective 1-year study. The serum concentrations of intact parathyroid hormone (PTH), calcium, and phosphate were also studied. A total of 72 women were randomized into four treatment groups: HRT group (sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate), Vit D₃ group (vitamin D₃ 300 IU/day + calcium lactate 500 mg/day), HRT + Vit D₃ group (both above) and placebo group (calcium lactate 500 mg/day). Serum samples were taken in March–April, when vitamin D formation from sunlight in Finland is minimal after the dark winter. Serum concentrations of 25OHD increased in the Vit D₃ group (33.5%, P < 0.001) and in the HRT + Vit D₃ group (38.2%, P < 0.001) but had not changed significantly in the HRT and placebo groups at the 1-year follow-up examination. Serum concentrations of calcitriol (1,25(OH)₂D) increased, however, only in the HRT group (23.7%, P < 0.05), and remained unchanged in other groups. Serum concentrations of PTH decreased by 23.2% (P < 0.05) in the placebo group, but did not change significantly in the other three groups. The concentrations of serum calcium increased in the nonhormone groups (P < 0.001), whereas serum phosphate concentrations decreased in the hormone groups (P < 0.05 and 0.001). Our results confirm the positive effect of 1 year of HRT on serum calcitriol. Vitamin D₃ supplementation increased 25OHD concentrations, but did not affect calcitriol concentrations even though the initial levels were low. Interestingly, the combination of HRT and vitamin D₃ did not increase serum calcitriol concentrations as much as HRT alone. Received: 14 June 1996 / Accepted: 17 June 1997     

Strain on the back in concrete reinforcement work.

To investigate the long term effect of heavy construction work on the back the occurrence of postures, lifting, carrying, and accidents in concrete reinforcement work and in maintenance house painting were measured. The 32 620 observations covering 272 work hours showed that reinforcement work necessitated stooped postures and heavy lifting more often than did painting. Reported minor back accidents were more than ten times as common in reinforcement work than in painting (1.3 compared with 0.11 accidents per man-year, p less than 0.001). Accidents of the musculoskeletal system, registered by the insurance companies, were also several times more common in reinforcement work (81 compared with 25 per 1000 man-years, p less than 0.001). The premature development of lumbar degeneration detected in the clinical study of the reinforcement workers was evidently due to the occupational strain on the back. The different types of hazardous back loads probably potentiate the effects of each other.     

An outbreak of Bacillus cereus food-poisoning in Finland associated with boiled rice.

A food-poisoning outbreak caused by Bacillus cereus occurred in a Finnish industrial plant in January 1975. Eighteen of the 36 persons who ate a lunch including boiled rice, meat and vegetables became ill. The disease pattern was similar to previously reported short incubation time B. cereus food-poisonings associated with cooked rice. The median incubation time was two hours, the main symptoms being nausea, abdominal pain and vomiting. Rice and certain seasonings were the contaminated raw materials. Gas chromatographic fatty acid analysis of a bacterial cell was used as a diagnostic method as well as to identify a certain strain of B. cereus.     

Plasma testosterone concentrations in alcoholics.

Plasma testosterone concentrations were normal in 17 hospitalized alcoholics after a large dose of alcohol and in 16 Skid Row alcoholics. The findings fail to support the idea that the direct effects of alcohol on steroid metabolism cause gynecomastia and testicular atrophy.     

Effect of glucan, a macrophage activator, on murine hemopoietic cell proliferation in diffusion chambers in mice

Pretreatment of mice with glucan, a potent macrophage activator, resulted in enhanced myeloid cluster and colony formation by bone marrow cells in diffusion chambers implanted into the peritoneal cavity. Simultaneously, erythroid colony formation was also augmented. In some experiments the plasma clots formed inside the chambers were dissolved, and the number of hematopoietic cells was determined. An increased yield of early proliferative cells, granulocytes, and macrophages was found in glucan-treated hosts. Concomitantly, higher leukocyte counts were noted in the peripheral blood of treated animals. These results suggest that glucan has a strong stimulatory effect on hematopoiesis. This stimulation is probably mediated by humoral factors of host animal origin rather than by direct interaction with proliferating hematopoietic precursors enclosed within the chambers.     

Quantitative evaluation of the metabolic formation of methylhydrazine from acetaldehyde-N-methyl-N-formylhydrazone,the main poisonous compound of Gyromitra esculenta

The amounts of methylhydrazine in the peritoneal fluids of mice treated orally with acetaldehyde-N-methyl-N-formylhydrazone, the main poisonous compound of the mushroom Gyromitra esculenta Fr. ex. Pers., were determined in order to estimate quantitatively the metabolic formation of methylhydrazine from this compound. For the experiments 2.0 ml of saline was injected into the peritoneal cavities of experimental animals immediately after the dosing. The animals were sacrificed at different time points and their peritoneal cavities flushed with saline. From this fluid methylhydrazine was determined as benzaldehyde-N-methylhydrazone by gas liquid chromatography. For comparison, an identical test procedure was carried out on mice treated orally with methylhydrazine. The results indicate that more than 25%, or a toxicologically significant amount of acetaldehyde-N-methyl-N-formylhydrazone is metabolically hydrolysed to methylhydrazine.     

Radioprotective potential of primitive hematopoietic precursors forming colonies in diffusion chambers in mice

Abstract: The purpose of this study was to determine the radioprotective ability of primitive hematopoietic precursors which form colonies in diffusion chambers in mice (CFU-D). Thirty-two lethally irradiated female ICR mice were injected with 5 to 7 male ICR mouse bone marrow-derived CFU-D colonies each. Fourteen of these mice survived over 30 days and were sacrificed at intervals up to a year. As a control, 20 lethally irradiated female ICR mice received cells from intercolony areas. All of these mice died before day 20. DNA samples obtained from hematopoietic organs and liver from 8 sacrificed mice were analyzed for the presence of CFU-D colony-derived cells. Only in 1 ICR mouse was CFU-D colony origin DNA detected by Southern analysis in all hematopoietic organs: bone marrow, spleen, thymus and lymph nodes. In 6 mice, only selected hematopoietic organs were repopulated by CFU-D colony-derived cells as judged by Southern analysis. In some of these mice, the remaining hematopoietic organs contained small CDU-D-derived cell populations which could be detected by more sensitive polymerase chain reaction (PCR). In 1 mouse, the presence of CFU-D-derived cells in all hematopoietic organs was only demonstrated by PCR. These findings suggest that lethally irradiated mice can be rescued by CFU-D-derived daughter cells. They appear to have the potential to give rise to clones containing lymphoid and myeloid cells in all hematopoietic organs, at least temporarily. Thus, it can be concluded that CFU-D represents a very primitive hematopoietic precursor cell with radioprotective capability.