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  • Vitamin D  (3)
  • Bone  (2)
  • Ultrasound  (2)
  • Aging  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Relationship between bone fluoride content and histological evidence of calcification defects in osteoporotic women treated long term with sodium fluoride (1993)
    Springer
    Osteoporosis international 3 (1993), S. 204-208 
    Details
    ISSN: 1433-2965
    Keywords: Bone ; Bone fluoride content ; Calcification defects ; Osteoporosis ; Sodium fluoride treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fluoride treatment is used to increase bone formation and cancellous bone mass in patients suffering from postmenopausal osteoporosis with vertebral fractures. Patients submitted to similar therapeutic protocols have shown various histological responses to the treatment, some developing calcification defects and others not. In fact, the bone histological response to fluoride salts depends on the cumulative uptake of fluoride by bone. To clarify the relationship between the presence of calcification defects (identified by the presence of mottled bone and linear formation defects) and the bone fluoride content, a retrospective study was performed on 29 women with type 1 osteoporosis and treated for several months (11–24) with sodium fluoride (50 mg/day), calcium and vitamin D. Bone fluoride content always significantly increased after treatment, but it was significantly higher in patients showing calcification defects than in those having no defects. These differences between the two groups of patients were not due to differences in clinical details (no significant differences concerning age, duration of treatment, total amount of fluoride ingested, renal function) or in their bone remodelling activity. Thus, it may be hypothesized that the high bone fluoride uptake is due to different individual responses from one patient to another concerning the bioavailability of the same dose of fluoride. This is difficult to predict, except by testing the individual bioavailability of the compound to be used in each patient before starting long-term treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623677
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  • 2
    Electronic Resource
    Electronic Resource
    Can we stop bone loss and prevent hip fractures in the elderly? (1994)
    Springer
    Osteoporosis international 4 (1994), S. S71 
    Details
    ISSN: 1433-2965
    Keywords: Calcium ; Hip fracture ; Osteoporosis ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The two main determinants of hip fractures are falls and bone loss leading to an intrinsic femoral fragility. Substantial femoral bone loss continues throughout old age, with a continuous and exponential increase in the risk of hip fracture; thus any reduction or arrest of this loss will induce an important reduction in the incidence of hip fracture. Preventive measures may be achieved during childhood by increasing peak bone mass with calcium and exercise, by using long-term estrogen replacement therapy after menopause, but also by using vitamin D and calcium supplements for late prevention in the elderly. Vitamin D insufficiency and a deficit in calcium intake are very common in the elderly living either in institutions or at home and the cumulative response to these deficits is a negative calcium balance which stimulates parathyroid hormone secretion. This senile secondary hyperparathyroidism is one of the determinants of femoral bone loss and can be reversed by calcium and vitamin D supplements. We have shown in a 3-year controlled prospective study that the daily use of supplements (1.2 g calcium and 800 IU vitamin D3) given in a large population of 3270 elderly ambulatory women living in nursing homes reduced the number of hip fractures by 23% (intention-to-treat analysis). In parallel, serum parathyroid hormone concentrations were reduced by 28% and low baseline serum 25-hydroxy vitamin D concentration returned to normal values. After 18 months of treatment the bone density of the total proximal femoral region had increased by 2.7% in the vitamin D3-calcium group and decreased by 4.6% in the placebo group (p〈0.001). This prevention is safe and can be recommended for people living in institutions. It could also be useful in other elderly subjects at particular risk due to a low calcium intake, an absence of solar exposure, a low femoral bone density, a high serum parathyroid hormone concentration, a low serum 25-hydroxyvitamin D concentration and a previous history of falls. Prospective studies are needed for further evaluation of these risk factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623440
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of anthropometric parameters on ultrasound measurements of os calcis (1995)
    Springer
    Osteoporosis international 5 (1995), S. 371-376 
    Details
    ISSN: 1433-2965
    Keywords: Anthropometric parameters ; BUA ; SOS ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Few data have been published concerning the influence of height, weight and body mass index (BMI) on broadband ultrasound attenuation (BUA), speed of sound (SOS) and Lunar “stiffness” index, and always in small population samples. The first aim of the present cross-sectional study was to determine whether anthropometric factors have a significant influence on ultrasound measurements. The second objective was to establish whether these parameters have real effect on bone or whether their infuence is due only to measurement errors. We measured, in 271 healthy French women (mean age 77±11 years; range 31–97 years), the following parameters: age, height, weight, lean and fat body mass, heel width, foot length, knee height and height of the external malleolus (HEM). Simple linear regression analyses between ultrasound and anthropometric parameters were performed. Age, height and heel width were significant predictors of SOS; age, height, weight, foot length, heel width, HEM, fat mass and lean mass were significant predictors of BUA; age, height, weight, heel width, HEM, fat mass and lean mass were significant predictors of stiffness. In the multiple regression analysis, once the analysis had been adjusted for age, only heel width was a significant predictor for SOS (p=0.0007), weight for BUA (p=0.0001), and weight (p=0.0001) and heel width (p=0.004) for the stiffness index. Besides their statistical meaning, the regression coefficients have a more clinically relevant interpretation which is developed in the text. These results confirm the influence of anthropometric factors on the ultrasonic parameter values, because BUA and SOS were in part dependent on heel width and weight. The influence of the position of the transducer on the calcaneus should be taken into account to optimize the methods of measurement using ultrasound.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01622259
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  • 4
    Electronic Resource
    Electronic Resource
    Bone loss after cardiac transplantation: Effects of calcium, calcidiol and monofluorophosphate (1993)
    Springer
    Osteoporosis international 3 (1993), S. 322-329 
    Details
    ISSN: 1433-2965
    Keywords: Calcium ; Cardiac transplantation ; Fluoride ; Glucocorticoid-induced osteoporosis ; Parathyroid hormone ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Of 203 patients who underwent cardiac transplantation and were given long-term treatment with cyclosporine and 0.3 mg/kg per day prednisone, 123 were studied prospectively for at least 6 months and 46 for up to 2 years to evaluate the effects on lumbar bone mineral density (BMD) and calcium metabolism of a combined therapy with calcium, calcidiol and disodium monofluorophosphate (MFP). The population was arbitrarily assigned to one of two groups. Group I consisted of patients who had a lumbar spine BMDZ score above −1.5 SD as compared with an age-and sex-matched population and no vertebral fractures. They received daily 1 g elemental calcium and 25 µg (1000 IU) calcidiol. Group II consisted of patients who received daily the same doses of calcium and calcidiol combined with 200 mg MFP, and was divided into two subgroups: (a) osteopenic subjects who had a lumbar spine BMD Z score below −1.5 SD without vertebral fractures and (b) osteoporotic subjects with vertebral fractures. If serum creatinine was higher than 140 µmol/l the daily dose of MFP was tapered to 100 mg. Fifty-four and 27 patients from group I and 38 and 19 patients from group II were followed respectively for 12 and 24 months. In both groups serum parathyroid hormone levels were significantly reduced from the twelfth month in parallel with a significant increase in serum 25-OHD levels. No decline in lumbar BMD occurred in non-osteopenic and non-osteoporotic patients (group I) who received the calcium and calcidiol supplement. In group II, where MFP was added, a significant and linear increase in lumbar BMD was observed. The average increase reached 12.5% after 12 months and 29.5% after 24 months (p〈0.0001). The magnitude of the response was similar to the response previously reported in patients suffering from vertebral fractures due to postmenopausal osteoporosis and treated with the same daily dose of MFP. Because osteoporosis and fractures are not rare in patients after cardiac transplantation, these pilot results may be useful for further prevention and treatment trials of bone loss in this condition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637318
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  • 5
    Electronic Resource
    Electronic Resource
    Gastrointestinal calcium absorption and dietary calcium load: Relationships with bone remodelling in vertebral osteoporosis (1995)
    Springer
    Osteoporosis international 5 (1995), S. 14-22 
    Details
    ISSN: 1433-2965
    Keywords: Bone histomorphometry ; Calcium-47 ; Calcium absorption ; Osteoporosis ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with vertebral osteoporosis have a wide range of bone loss rates, bone remodelling rates and capacities for gastrointestinal (GI) calcium absorption. To test the hypothesis that variations in GI absorptive capacity determine rates of bone loss or remodelling, we have sought relationships betwen calcium absorption or vitamin D metabolite levels on the one hand and rates of cancellous and cortical bone loss (measured by serial quantiative computed tomography in the radius;n=25) or indices of bone remodelling in tetracycline-prelabelled transiliac biopsies (n=41) on the other, in a sequential untreated group. Calcium absorption (net and true) was measured in 18-day balances and by a two-isotope deconvolution method (fractional absorption and maximum absorption rate, MAR). There was no significant seasonal effect on any of these four measures of calcium absorption (variance ratio,F=0.52–1.61,p〉0.1) or on 1,25-dihydroxyvitamin D levels (F=0.13,p〉0.1; range 11–69 pg/ml), notwithstanding the expected seasonal effect on 25-hydroxyvitamin D levels (mean 18.7 ng/ml, zenith mid July, semi-amplitude 7.5 ng/ml;F=6.82,p〈0.01). Neither this metabolite nor 1,25-dihydroxyvitamin D correlated with any index of calcium absorption (p〉0.1). No measure of calcium absorption (or intake) had a significant relationship with radial cortical or cancellous bone loss (p all 〉0.1) but cancellous bone loss was associated with the rate of endogenous calcium excretion (r=0.50,p〈0.05). A positive relationship between 25-hydroxyvitamin D and unlabelled osteoid surface (a marker of reduced blast vigour) persisted after adjustment for season (Student'st=2.70,p〈0.01) but did not reflect 1,25-dihydroxyvitamin D levels. This study did not address the question of whether reduced GI calcium absorption has a uniform effect on bone remodelling in osteoporosis. However, variations in capacity for calcium absorption are unlikely to be responsible for the heterogeneity in bone loss and remodelling rates seen in vertebral osteoporosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623653
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  • 6
    Electronic Resource
    Electronic Resource
    Age-related changes in os calcis ultrasonic indices: A 2-year prospective study (1995)
    Springer
    Osteoporosis international 5 (1995), S. 478-483 
    Details
    ISSN: 1433-2965
    Keywords: Aging ; Bone loss ; Bone mineral density ; Broadband ultrasound attenuation ; Speed of sound ; Stiffness index ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed repeated ultrasound measurements approximately 2 years apart (average 23 months ±3 months) on the os calcis of 113 healthy postmeno-pausal women recruited from two large prospective cohort studies named OFELY and EPIDOS. Group A (from OFELY) consisted of 88 women aged 52–72 (63±5) years, randomly selected from a large insurance company, and group B (from EPIDOS) consisted of 25 women aged 75–88 (80±4) years, randomly selected from the voting lists. We obtained broadband ultrasonic attenuation (BUA) and speed of sound (SOS) measurements, as well as the Stiffness index, with a Lunar Achilles ultrasound machine. We performed dual energy X-ray absorptiometry (DXA) measurements of femoral neck bone mineral density (neck BMD) with a Hologic QDR 2000 for group A and with a Lunar DPX Plus for group B. The decrease that we observed over 2 years was on average ±1 SD: −1.01±4.6 dB/MHz (p=0.02) for BUA (which is approximately equal to the long-term precision error in vitro), −11.3±9.2 m/s (p=0.0001) for SOS (approximately 5 times the precision error), −3.8±4.2 %YA (p=0.0001) for Stiffness (2.5 times the precision error) and −0.01±0.03 g/cm2 (p=0.0001) for neck BMD (approximately equal to the precision error). In terms of percentage change this represents: −1.0%±4.3% for BUA, −0.8%±0.6% for SOS and −1.85%±4.4% for neck BMD. At the individual level, most SOS and Stiffness values were consistent with a decrease, whereas BUA and neck BMD values were spread out above and below the zero line of no change. The decreases in SOS and Stiffness were significantly larger in the early postmenopause (⩽20 years since menopause [YSM]) than in the late postmenopause (〉20 YSM). We observed a similar trend for BUA and BMD but this did not reach statistical significance. We found a weak but significant correlation between changes in ultrasound variables and changes in neck BMD. However, the 2-year changes observed in SOS were not significantly correlated with changes in BUA. This study suggests that the heel ultrasound measurements of SOS and Stiffness are valuable indices of postmenopausal bone loss, and could be used for follow-up in therapeutic trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01626612
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  • 7
    Electronic Resource
    Electronic Resource
    Trabecular and endocortical bone remodeling in postmenopausal osteoporosis: Comparison with normal postmenopausal women (1990)
    Springer
    Osteoporosis international 1 (1990), S. 41-49 
    Details
    ISSN: 1433-2965
    Keywords: Bone ; Histomorphometry ; Osteoporosis ; Osteoblasts ; Osteocalcin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the bone turnover abnormalities which characterize postmenopausal osteoporosis with vertebral fractures (PMOp), a transiliac bone biopsy was performed after double labeling of the mineralizing front with tetracycline in 50 untreated PMOp patients who were compared with 13 healthy age-matched volunteer females. The analysis of bone remodeling and structure parameters demonstrated that PMOp is a disease affecting both the cancellous and the endocortical envelopes and characterized by increased resorption and by a marked decrease in the osteoblastic apposition rate due to a reduced duration of bone formation. This induces a decrease in the width of both individual osteons and trabeculae. In PMOp, the wide spectrum of bone turnover as compared with the controls, associated with the typical bimodal distribution of cancellous osteoid perimeter, allowed us to identify two subsets, one with normal turnover (NT) and one with high turnover (HT) representing 30% of the cases. When compared to NT, HT was characterized by increased osteoclast number, lower bone volume, thinner osteons, increased formation at the tissue-level and markedly decreased duration of formation. In HT the marked decrease in the duration of activity of osteoblasts and the markedly increased number of osteoclasts induced a greater decrease in bone volume, despite the increase of bone formation at the tissue level. These subsets could not be distinguished by any clinical or biochemical parameter except for serum bone gla protein (osteocalcin) which was significantly higher (as a group) in HT than in NT. The underlying cause for these two subsets is unknown. We conclude that PMOp affects the cancellous and the endocortical bone. Bone loss results from a wide spectrum of bone turnover abnormalities, with two distinct subsets, one with normal turnover and one with high turnover.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01880415
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