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  • Bone densitometry  (1)
  • Bone density  (1)
  • Hip fracture  (1)
  • Key words:Bone mineral density – Osteoporosis – TGF-β  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Osteoporosis international 9 (1999), S. 398-404 
    ISSN: 1433-2965
    Keywords: Key words:Bone mineral density – Osteoporosis – TGF-β
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Osteoporosis is a major public health problem characterized by low bone mineral density (BMD) that presently has no biochemical test useful for its diagnosis. The cytokine TGF-β has been postulated to play a role in controlling bone density by regulating the fine balance between bone matrix deposition by osteoblasts and its resorption by osteoclasts. We explored whether measurement of serum levels of different TGF-β isoforms could be useful as a clinical tool in osteoporosis. We measured the concentration of TGF-β1 antigen using the BDA19 capture sandwich enzyme-linked immunosorbent assay (ELISA), TGF-β2 antigen concentration using a Quantikine sandwich ELISA kit and TGF-β3 antigen concentration using a modified version of the TGF-β1 Quantikine sandwich ELISA kit. Subjects were 41 women with osteoporosis (with nontraumatic vertebral fracture or lumbar spine BMD Z-score 〈−1.5 SD) and a total of 199 control women from different sources. Serum concentrations of TGF-β1 and TGF-β2 were similar in all groups. However, detectable levels of TGF-β3 (〉0.2 ng/ml) were found in 35 of 41 patients with osteoporosis (median 7.2 (5.2–8.9) ng/ml) compared with 11 of 36 controls or 24 of 89 healthy women of unknown bone density. Differences among the groups could not be accounted for by age, weight, medications, use of hormone replacement therapy or the presence of osteoarthritis. Using the optimal cut-off of ≥2 ng/ml, the test was able to detect an individual with low spine BMD (Z-score 〈−1.5) with a sensitivity of 84% and a specificity of 53%, with similar results for the femoral neck. The odds ratio for osteoporosis associated with a positive test at this level was 5.93 (95% CI 2.41–11.59), and 4.1 (95% CI 1.66–10.11) using the WHO cut-off of T-score 〈−2.5. Serum TGF-β3 concentration is raised in osteoporotic women and the test appears to have potential as a marker for osteoporosis. The underlying mechanisms and the relationships between TGF-β3 and bone turnover and fractures remain to be explored.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-2965
    Keywords: Biochemical assay ; Bone densitometry ; Bone turnover ; Menopause ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A number of recent studies have suggested that non-invasive measures of bone turnover are associated with bone loss at the forearm in postmenopausal women. Whether bone turnover markers are predictive of bone loss from the clinically important sites of lumbar spine and femoral neck remain unclear, and was the aim of this 4-year prospective study. One hundred and forty-one normal, postmenopausal women (mean age 52.0±3.3 years, mean menopause duration 20.4±5.7 months) were recruited for the study in 1988. Fasting early morning samples of blood and urine were collected at the baseline visit and stored at −20 °C prior to analysis. Serum was assayed for osteocalcin, oestradiol, oestrone, oestrone sulphate, testosterone, sex hormone binding globulin, dehydroepiandrosterone sulphate and total alkaline phosphatase. Urine was assayed for calcium, hydroxyproline, oestrone glucuronide and the collagen cross-links pyridinoline and deoxypyridinoline using high-performance liquid chromatography. Bone density was measured at the lumbar spine and femoral neck using dual photon absorptiometry at time 0, 12, 24 and 48 months. The mean annual percentage change in bone density (SE) was −1.41% (0.18) at the lumbar spine and −0.86% (0.22) at the femoral neck. There was no evidence of bimodality or a fast loser subgroup as the rates of change were normally distributed. Both simple and multiple stepwise regression analyses revealed no significant correlation between the rates of change in bone density with any biochemical marker, either individually or in combination, despite the study having sufficient power (80%) to detect a correlation of 0.5 between any biochemical marker levels and bone loss. We conclude that single measurements of these markers of bone turnover and endogenous sex hormones appear unlikely to be clinically useful in predicting early postmenopausal bone loss from either the spine or the hip.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-2965
    Keywords: Epidemiology ; Hip axis length ; Hip fracture ; Osteoporosis ; Secular change
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to determine whether hip axis or femoral length has increased in women in the United Kingdom between the late 1950s and early 1990s. Such an observation would be of interest as it might explain the rise in age-specific incidence of hip fracture observed during these years. We studied two sets of antero-posterior pelvic radiographs of women aged 55–69 years taken during the course of population-based studies in the UK, one in 1958–60 and the other in 1989–91. One observer (S.G.) recorded the following measurements at the right hip: hip axis length (HAL), femoral length (FL) and femoral width (FW). Two summary ratios, HAL/FW and FL/FW were calculated to allow for differences in radiographic technique. HAL, FL and FW were greater in the 1989-91 films compared with those taken in 1958–60. Both HAL and FL expressed as a ratio to FW were also greater in the later films. FL/FW increased by 4.5% (p〈0.05); HAL/FW increased by 2.3%, though this was not statistically significant. We conclude that there has been a small apparent change in geometric measurements of the hip during the past 36 years. Cautious extrapolation suggests that such a change may explain up to one third of the increase in incidence of hip fracture observed during this period.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-2965
    Keywords: Bone density ; Fractures ; Hormone replacement ; Oestrogens ; Progestogens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It is now accepted that unopposed oestrogen therapy reduces osteoporotic fractures by about 50%. Although current regimes with added progestogens are thought to act similarly to unopposed oestrogens, no study has yet demonstrated an effect on fractures with the former. Using a retrospective cohort design we studied fracture rates in women attending a menopause clinic for hormone replacement therapy (HRT) and compared them with women derived from the general population. Data were analysed from 1075 women exposed to HRT and 1741 non-exposed postmenopausal women. In all 226 fractures were reported between 1977 and 1986, the commonest site being the distal radius, occurring in 28 of the HRT women and in 37 of the non-exposed women. The incidence density rate for fracture of the distal radius is 3.5/1000 woman-years (wy) in non-exposed women. This was similar to the rate in the HRT womenprior to HRT use, the rate falling by 30% after exposure from 3.2 to 2.2/1000 wy. The protective effect on osteoporotic fractures increased progressively with duration of use. After 5 years of use the relative risk fell to 0.5 (95% confidence interval, 0.2–1.2) for all osteoporotic fractures and for the distal radius to 0.18 (95% confidence interval, 0.05–1.3). No similar changes were seen for non-osteoporotic fractures. There were 6 (0.6/1000 wy) reported fractures of the hip in the non-exposed group compared with none in the HRT group (when 1.7 were expected based on non-exposed rates) (p=0.15). Although based on observational data, this study suggests that modern HRT regimes are effective in preventing distal radius fractures and potentially other osteoporotic fractures.
    Type of Medium: Electronic Resource
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