Low bone mass and fast rate of bone loss at menopause: equal risk factors for future fracture. A 15-year follow-up study

Riis, Bente Juel; Hansen, M.A.; Jensen, Alexandria; Overgaard, Karsten; Christiansen, Claus

doi:10.1016/s0378-5122(97)88490-3

Cited by 62 publications

(88 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…[64][65][66] BMD is a function of peak bone mass and the rate of subsequent bone loss, which are risk factors for fracture later in life. 66 Thus, an intervention in childhood to maximize peak bone mass in high-risk individuals could have potential long-term beneficial effects in adults by minimizing the impact of later bone loss. 67 As the costs of osteoporosis and related fractures currently exceed $6 billion per year in the United States, 68,69 successful interventions could have substantial economic implications.…”

Section: Discussionmentioning

confidence: 99%

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Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Ryan¹,

Teach²,

Singer

et al. 2012

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Forearm fractures are unique injuries which are associated with lower bone mineral density in adults and white children. The relationships among bone mineral density, 25-hydroxyvitamin D status, and risk for forearm fracture have not been investigated in African American children. WHAT THIS STUDY ADDS:Our data support an association between both lower bone mineral density and vitamin D deficiency and increased odds of forearm fracture in African American children. Promotion of bone health is indicated in this population.abstract OBJECTIVE: To determine whether African American children with forearm fractures have decreased bone mineral density and an increased prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D level #20 ng/mL) compared with fracture-free control patients. METHODS:This case-control study in African American children, aged 5 to 9 years, included case patients with forearm fracture and control patients without fracture. Evaluation included measurement of bone mineral density and serum 25-hydroxyvitamin D level. Univariable and multivariable analyses were used to test for associations between fracture status and 2 measures of bone health (bone mineral density and 25-hydroxyvitamin D level) while controlling for other potential confounders. RESULTS:The final sample included 76 case and 74 control patients. There were no significant differences between case and control patients in age, gender, parental education level, enrollment season, outdoor play time, height, or mean dietary calcium nutrient density. Cases were more likely than control patients to be overweight (49.3% vs 31.4%, P = .03). Compared with control patients, case patients had lower whole body z scores for bone mineral density (0.62 6 0.96 vs 0.98 6 1.09; adjusted odds ratio 0.38 [0.20-0.72]) and were more likely to be vitamin D deficient (47.1% vs 40.8%; adjusted odds ratio 3.46 [1.09-10.94]). CONCLUSIONS:These data support an association of lower bone mineral density and vitamin D deficiency with increased odds of forearm fracture among African American children. Because suboptimal childhood bone health also negatively impacts adult bone health, interventions to increase bone mineral density and correct vitamin D deficiency are indicated in this population to provide short-term and long-term benefits. Pediatrics 2012;130:e553-e560

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Ryan¹,

Teach²,

Singer

et al. 2012

Pediatrics

View full text Add to dashboard Cite

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“…Estrogen deficiency at menopause induces a phase of rapid bone loss over 5 to 10 years that is prevented by exogenous estrogen therapy [34]. Postmenopausal bone loss is associated with an increased bone turnover, reflected by an increase in biochemical markers of bone turnover [24,59]. In a large cohort of healthy and ambulatory elderly women, the levels of serum estradiol (E2) and sex hormone-binding globulin (SHBG) were predictors of hip fracture, but this association was dependent on body weight [7].…”

Section: Discussionmentioning

confidence: 99%

Trabecular Bone Mechanical Properties in Patients with Fragility Fractures

Kreider

Goldstein

2009

Clinical Orthopaedics &Amp; Related Research

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Fragility fractures are generally associated with substantial loss in trabecular bone mass and alterations in structural anisotropy. Despite the high correlations between measures of trabecular mass and mechanical properties, significant overlap in density measures exists between individuals with osteoporosis and those who do not fracture. The purpose of this paper is to provide an analysis of trabecular properties associated with fragility fractures. While accurate measures of bone mass and 3-D orientation have been demonstrated to explain 80% to 90% of the variance in mechanical behavior, clinical and experimental experience suggests the unexplained proportion of variance may be a key determinant in separating high-and low-risk patients. Using a hierarchical perspective, we demonstrate the potential contributions of structural and tissue morphology, material properties, and chemical composition to the apparent mechanical properties of trabecular bone. The results suggest that the propensity for an individual to remodel or adapt to habitual damaging or nondamaging loads may distinguish them in terms of risk for failure.

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“…(4) Urinary cross-link excretion, especially deoxypyridinoline, correlates with bone turnover in patients with vertebral osteoporosis (7,8) and fracture risk. (9,10) These markers are now being used to assess efficacy of treatment for metabolic bone diseases (11)(12)(13)(14)(15) and fracture risk. (9,10,16) Osteocalcin is a low molecular weight protein produced by active osteoblasts during bone formation.…”

Section: Introductionmentioning

confidence: 99%

“…(9,10) These markers are now being used to assess efficacy of treatment for metabolic bone diseases (11)(12)(13)(14)(15) and fracture risk. (9,10,16) Osteocalcin is a low molecular weight protein produced by active osteoblasts during bone formation. It is incorporated primarily into the mineralizing matrix, but a small amount is released into circulation.…”

Section: Introductionmentioning

confidence: 99%

Implant Design Affects Markers of Bone Resorption and Formation in Total Hip Replacement

Qureshi

Virdi

DiDonna

et al. 2002

Journal of Bone and Mineral Research

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Concentrations of the bone resorption markers pyridinoline and deoxypyridinoline and the bone formation marker osteocalcin were measured in 24-h urine collections from 30 subjects who underwent unilateral total hip replacements for monoarticular symptomatic osteoarthrosis and 10 controls. The patient groups were divided based on the femoral implant type (cemented cobalt alloy stem, cementless porous coated cobalt alloy stem, and cementless porous coated titanium alloy stem). Urine collections were performed before surgery and then at 3, 6, 12, 24, and 36 months. There were significant changes over time in the three patient groups for pyridinoline, deoxypyridinoline, and the ratio of osteocalcin to deoxypyridinoline (p < 0.01), but the control group values did not change over time. The resorption markers tended to peak at 3 months and the osteocalcin to deoxypyridinoline ratio was more variable, having depressed values in the cementless cobalt alloy group and elevated values in the other two groups compared with baseline. The cementless cobalt alloy group had higher resorption marker levels than the cemented cobalt alloy group at 6, 12, 24, and 36 months and higher levels than the cementless titanium alloy group at all postoperative times (p < 0.05). The osteocalcin to deoxypyridinoline ratio was lower in the cementless cobalt alloy group than in the cemented cobalt alloy group at 3, 6, and 24 months and the cementless titanium alloy group at 6, 12, and 24 months (p < 0.05). For the cemented cobalt chrome group, the baseline-normalized resorption marker values at 3 months and 6 months were correlated with the severity of radiographically assessed bone loss at 36 months (0.749 < r < 0.840; p < 0.05). For the cementless titanium alloy group, baseline-normalized osteocalcin/ deoxypyridinoline ratios at 3 months and 6 months were related inversely to radiographic bone loss at 36 months (0.687 < r < 0.749; p < 0.05). Thus, body fluid markers of bone metabolism change after total hip replacement. In addition, the changes in the marker concentrations were sensitive to implant design and were correlated with subsequent stress-shielding-induced bone loss. (J Bone Miner Res 2002;17:800 -807)

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Low bone mass and fast rate of bone loss at menopause: equal risk factors for future fracture. A 15-year follow-up study

Cited by 62 publications

References 0 publications

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Trabecular Bone Mechanical Properties in Patients with Fragility Fractures

Implant Design Affects Markers of Bone Resorption and Formation in Total Hip Replacement

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