Characteristics and course of bone mineral densities among fast bone losers in a rural Japanese community: the Miyama Study

Abstract

The aim of this study was to clarify and compare the temporal course of bone mineral density (BMD) between fast bone losers and normal residents in Miyama Village, a rural Japanese community. BMD was measured over a 10-year period in a cohort study in Miyama Village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Subjects ( n=400) were selected by sex and age stratum from the full list of residents born in 1910-1949, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and proximal femur was measured using dual energy X-ray absorptiometry in 1990, 1993, 1997 and 2000. In the cohort, 171 men and 189 women completed the follow-up survey performed in 1993. After calculating the rate of bone loss between 1990 and 1993, the greatest tertile from the distribution of bone loss was categorized as fast bone losers, with the remainder considered as normal subjects. Changes in BMD were compared between normal subjects and fast bone losers over the 10-year period. Mean rate of change for BMD at both lumbar spine and femoral neck in fast bone losers recovered to levels similar to those in normal subjects over 7 years of observation. By contrast, BMD at the lumbar spine and femoral neck decreased steeply over the 10-year period in both groups, and mean BMD for fast bone losers was significantly lower than that of normal subjects ( P<0.05). These differences were apparent only at the lumbar spine in both men and women, even after adjusting for age. These results indicate that fast bone loss is a transient phenomenon rather than a fixed status, although individuals who have been categorized as fast bone losers at some stage continue to display low BMD in the lumbar spine.

A Meta-Analysis of the Association of Fracture Risk and Body Mass Index in Women

“…The Manitoba cohort is a referral population of all women attending for BMD measurements in the Province of Manitoba, Canada, where health services are provided to residents through a single public healthcare system . The Miyama study is a population‐based cohort drawn from inhabitants born in Miyama, Japan, between 1910 and 1949 . Of 1543 inhabitants, an age‐stratified sample of 400 men and women was drawn by birth decade.…”

From relative risk to absolute fracture risk calculation: The FRAX algorithm

“…France [28], the Study of Osteoporotic Fractures (SOF) in the United States [29], two cohorts from the Geelong study in Australia [30,31], the Osteoporosis Ultrasound Study (OPUS) drawn from fi ve European countries [32], the Prospective Epidemiological Risk Factors Study (PERF) from Denmark [33], the York cohort in the United Kingdom [34], the Health Improvement Network (THIN) research database from the United Kingdom [35], the Swiss Evaluation of Measurement of Osteoporotic Fracture Risk (SEMOF) Study in Switzerland [36], the Women's Health Initiative (WHI) from the United States [37], and the Miyama cohort from Japan [38].…”

Fracture risk prediction using FRAX®: a 10-year follow-up survey of the Japanese Population-Based Osteoporosis (JPOS) Cohort Study

“…The FRAX® model was developed using nine cohort studies, including the Japanese Hiroshima cohort [6], and validated with 11 independent cohort studies, including the Japanese Miyama cohort [4,7]. In the Miyama cohort, the gradient of osteoporotic fracture risk [relative risk per standard deviation (SD) in estimated probability] for hip fracture among men and women aged 70 years was significantly larger than that obtained by the FRAX® model [4], suggesting that the model underestimates fracture risk in the Japanese population.…”