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  • 1
    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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  • 2
    Electronic Resource
    Electronic Resource
    Fluoride-induced bone changes in lambs during and after exposure to sodium fluoride (1991)
    Springer
    Osteoporosis international 2 (1991), S. 26-33 
    Details
    ISSN: 1433-2965
    Keywords: Bone fluoride content ; Bone remodeling ; Fluoride ; Histomorphometry ; Lambs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The evolution of bone changes induced by fluoride after the end of exposure was investigated in lambs. Sodium fluoride (NaF) was given orally at a dose of 3.5 mg/kg per day to 14 animals for 120 days. A group of 7 control and 7 treated lambs was slaughtered at the end of NaF administration (T120) and another group 120 days after the end of NaF exposure (T240). At T120, the bone fluoride content (BFC) was very significantly increased in treated animals. The histomorphometric analysis confirmed that fluoride induces an increase in bone formation (the osteoid perimeter and area were 3-fold and 4.5-fold higher respectively in treated than in control animals). The number of osteoblasts was significantly augmented. Serum osteocalcin level was twice as high in treated animals compared with controls. The bone formation rate at the tissue level (BFR) doubled after treatment, but the apposition rate (Aj.AR) was half that in the control group. The mineralization lag time (Mlt) was 120 days in treated animals compared with 42 days in controls. At T240, BFC had decreased by 50% compared with the level at T120, but it was still significantly higher than in controls. The osteoid and osteoblastic parameters were 2 and 1.3 times higher than in control animals. BFR remained significantly increased in treated animals, but Aj.AR and Mlt were similar in control and treated animals. In conclusion, after 4 months of NaF exposure fluoride induced an increase in osteoblast natality and bone formation at the tissue level, associated with a toxic effect at the individual cell level. Four months after the end of NaF exposure, positive effects on bone formation were still present but the evidence of cellular toxicity had disappeared.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01627075
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  • 3
    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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  • 4
    Electronic Resource
    Electronic Resource
    Mean wall thickness and formation periods of trabecular bone packets in corticosteroid-induced osteoporosis (1983)
    Springer
    Calcified tissue international 35 (1983), S. 410-417 
    Details
    ISSN: 1432-0827
    Keywords: Bone remodeling ; Histomorphometry ; Corticosteroid therapy ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary We have compared the mean wall thickness (MWT) and active formation periods (sigmaf(A)) of trabecular bone packets in iliac crest biopsies from 20 patients (7 male, 13 female) with corticosteroid-induced osteoporosis (CS-OP) and 20 age- and sex-matched controls. The trabecular bone volume (TBV) of the CS-OP patients (9.6%±2.2% [SD]) was significantly reduced compared to controls (19.3%±5.1%). The MWT of CS-OP patients (32.7±4.3 µm) was also significantly lower than the control value (48.0±6.2 µm). There was a positive correlation between MWT and TBV in both groups. The mineralization rate (M) of the CS-OP patients (0.54±0.25 µm/day) was within the normal range, and since there was no increase in osteoid seam thickness, so therefore was the osteoblastic appositional rate (OAR). The active formation period of trabecular bone packets (sigmaf(A)=MWT/M) was significantly lower in the CS-OP patients (55.9 ± 14.4 days) than in the control group (68.1 ± 9.4 days). MWT and sigmaf(A) both decreased with age in the control group, whereas in the CS-OP group they were independent of age. We conclude that corticosteroid therapy results in a reduction of the MWT of trabecular bone packets and, consequently, of TBV. In these patients, where the OAR was normal, the reduction in MWT was apparently caused by a shortening of the lifespan of the active osteoblastic population at the basic multicellular unit (BMU) level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02405069
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  • 5
    Electronic Resource
    Electronic Resource
    Mean wall thickness and formation periods of trabecular bone packets in idiopathic osteoporosis (1981)
    Springer
    Calcified tissue international 33 (1981), S. 199-204 
    Details
    ISSN: 1432-0827
    Keywords: Bone remodeling ; Histomorphometry ; Trabecular bone ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary The mean wall thickness (MWT) and duration of formation periods (sigmaf) of trabecular bone packets have been measured in iliac crest biopsies following double tetracycline labeling from 9 women having primary osteoporosis, with vertebral crush fractures and reduced trabecular bone volume (TBV), and 9 age- and sex-matched controls. The MWT of the osteoporotic biopsies was significantly less than that of the controls and was negatively correlated with age in the latter. There was also a positive correlation between MWT and TBV in the controls but not in the osteoporotics. Sigmaf, in days, showed a tendency to decline with age in the control biopsies and was further decreased in the osteoporotic patients. These results suggest that a major contribution to the negative skeletal balance existing in both primary osteoporosis and physiological osteopenia is a decrease in bone formation, caused by a reduction in the life span of the osteoblastic population at the basic multicellular unit (BMU) level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02409438
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    Paper (German National Licenses)
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