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  • 1
    Electronic Resource
    Electronic Resource
    Influence of age and body mass on the effects of vitamin d on hip fracture risk (1995)
    Springer
    Osteoporosis international 5 (1995), S. 450-454 
    Details
    ISSN: 1433-2965
    Keywords: Body mass index ; Hip fracture ; Sunlight ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The role of vitamin D in the prevention of hip fracture is controversial and protective effects appear to be confined to the institutionalized and elderly population. The aim of this study was to assess the interaction of age and body mass index (BMI) on the effects of vitamin D on the risk of hip fracture in the community. We studied 1634 women with low-energy fractures of the hip aged 50 years or older, and 3532 age-matched controls from 14 centres in six Mediterranean countries (the MEDOS study), with a structured retrospective questionnaire. The use of vitamin D supplements was associated with a modest and non-significant decrease in the risk of hip fracture (RR=0.74; 95% confidence interval (CI) 0.53–1.03;p=0.07). The risk reduction was influenced by age and body mass. Women aged above 80 years had a significant decrease in the relative risk of hip fracture (RR=0.63; 95% CI 0.40–0.98) as did women with a BMI below 20 kg/m2 (RR=0.45; 95% CI 0.24–0.84). Elderly women were more likely to have a low BMI but the elderly did not appear to benefit from vitamin D where their BMI was 20 kg/m2 or higher. The findings could not be explained by differences in sun exposure or in physical exercise. We conclude that the use of vitamin D for the prevention of hip fracture might usefully be targeted to the frail and elderly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01626607
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  • 2
    Electronic Resource
    Electronic Resource
    The variable incidence of hip fracture in Southern Europe: The MEDOS study (1994)
    Springer
    Osteoporosis international 4 (1994), S. 253-263 
    Details
    ISSN: 1433-2965
    Keywords: Doubling time ; Excess female morbidity ; Gonadal function ; Hip fracture ; Incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed the incidence of hip fracture and ecological correlates in residents of 14 communities in six countries of Southern Europe. Hip fracture cases were recorded prospectively in defined catchment areas over a 1-year interval. A retrospective questionnaire was used to assess ecological differences between communities. During a 1-year period of observation a total of 3629 men and women over the age of 50 years were identified with hip fracture from a catchment of 3 million. In all communities the fracture rate increased exponentially with age. There were large and significant differences between centres in the doubling time for hip fracture risk with age and in crude and age-standardized rates. Greater than 4-fold and 13-fold differences in age-standardized risk were found amongst men and women respectively. The lowest rates were observed from Turkey and the highest from Seville, Crete and Porto. Fractures were significantly more frequent among women than men with the exception of three rural Turkish centres. Indeed, in rural Turkey the normal female/male ratio was reserved. Variations in incidence between regions were greater than the differences within centres between sexes, and there was a close and significant correlation between incidence rates for men and those for women in the regions studied. Excess female morbidity increased progressively from the age of 50 years but attained a plateau after the age of 80 years, suggesting a finite duration of the effect of the menopause. The retrospective questionnaire completed by 80% of cases suggested that differences in incidence between the communities studied could not be explained by differences in gonadal status in women. In both men and women cross-cultural associations were found with factors related to age or socioeconomic prosperity, the majority of which disappeared after adjustment for age. We conclude that there are marked and sizeable differences in the incidence rates of hip fracture throughout Southern Europe. The reasons for these differences are not known but affect both men and women, and are likely to be related to lifestyle or genetic factors rather than to differences in endocrine status.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623349
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  • 3
    Electronic Resource
    Electronic Resource
    The apparent incidence of hip fracture in Europe: A study of national register sources (1992)
    Springer
    Osteoporosis international 2 (1992), S. 298-302 
    Details
    ISSN: 1433-2965
    Keywords: Epidemiology ; Hip fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to examine the apparent incidence of hip fracture from discharge rates in European countries. A request was sent to the Ministries of Health in all European countries, asking for the number of hip fracture patients by age and sex, between the years 1983 and 1985. Seventeen countries responded. As expected, hip fracture was most frequently found amongst the elderly, particularly women. The incidence of hip fracture rose exponentially with age in both sexes. It was higher in women than men and there was a three-fold range between countries in the female to male sex ratio. There was an eleven-fold range in apparent incidence amongst women and a seven-fold range amongst men between the various countries. The highest incidence was found in the northern part of Europe and the lowest in the Mediterranean area. There was a significant positive correlation between the age-standardized incidence rates reported in men from each country and that in women. There was a larger difference in incidence between countries than between sexes, which suggests important genetic or environmental factors in the causation of hip fracture. The extent to which this reflects imperfect capture of data is uncertain but will be important to determine in order to identify reasons for differences and to enable confident projections of the future magnitude of this disorder.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623186
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  • 4
    Electronic Resource
    Electronic Resource
    The hospital burden of vertebral fracture in Europe: A study of national register sources (1997)
    Springer
    Osteoporosis international 7 (1997), S. 138-141 
    Details
    ISSN: 1433-2965
    Keywords: Hip fracture ; Osteoporosis ; Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aims of this study were to quantify the hospital burden of vertebral fracture in Europe and to compare this with that of hip fracture. Information on hospital discharges was sought by age and sex from Ministries of Health in Europe. Discharge rates for vertebral fracture, available from 12 countries, varied by more than 4-fold between countries, which was greater than the differences between sexes. Where the discharge rate was high for vertebral fracture the incidence of hip fracture was also high. Since nearly all cases of hip fracture are hospitalized, this suggests a relationship between hip and vertebral fracture risk that is not explained by different admission policies for vertebral fracture in different European countries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623689
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  • 5
    Electronic Resource
    Electronic Resource
    Acute effects of deflazacort and prednisone on rates of mineralization and bone formation (1995)
    Springer
    Calcified tissue international 56 (1995), S. 109-112 
    Details
    ISSN: 1432-0827
    Keywords: Glucocorticoid ; Histomorphometry ; Bone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract The aims of this study were to determine (1) whether acute suppression of bone formation could be evaluated after the administration of corticosteroids in man by quantitative bone histomorphometry; and (2) whether there were significant differences between the effects of prednisone and its analog deflazacort. Thirteen patients who needed high-dose corticosteroid therapy were randomly allocated to two groups of treatment (prednisone or deflazacort). Quantitative bone histomorphometry, using the technique of triple labeling, and biochemical measurements of bone turnover were studied. There were no differences in biochemical indices of bone turnover between prednisone and deflazacort at the beginning and end of the 15 days of treatment course. During corticosteroid treatment, there were no significant changes in biochemical indices of bone turnover but a significant decline in total alkaline phosphatase (P〈0.01). Histomorphometric indices, as revealed by measurements of tetracycline interval and extent of labeling, showed no significant differences in either mineral apposition rate or bone formation rate in the two groups. We conclude that the acute glucocorticoid suppression of bone turnover by glucocorticoids is not detectable within the first 2 weeks of treatment by histomorphometric techniques. No differences in bone effects of prednisone and deflazacort were detected in this short-term study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296340
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    Paper (German National Licenses)
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