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  • 1
    Electronic Resource
    Electronic Resource
    Cancellous bone loss during pregnancy is a consequence of high bone remodelling (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb09981_17.x
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  • 2
    Electronic Resource
    Electronic Resource
    The impact of subcutaneous oestradiol implants on biochemical markers of bone turnover and bone mineral density in postmenopausal women (2002)
    Oxford, UK : Blackwell Science Ltd
    BJOG 109 (2002), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the anabolic effect of oestrogen on bone by comparing the response of markers of bone formation (and resorption) and bone mineral density (BMD) to subcutaneous oestradiol implants.Design One year double-blind placebo controlled randomised study.Setting Clinical research unit within a teaching hospital.Population Twenty-one hysterectomised postmenopausal women were randomised to 25 mg oestradiol implants at baseline and at six months or to have a sham procedure at baseline and six months.Methods BMD and quantitative ultrasound (QUS) were assessed at baseline and one year. Bone alkaline phosphatase (bone ALP), procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), free deoxypyridinoline (iFDPD), N-telopeptide of type I collagen (NTX), serum oestradiol and intact parathyroid hormone (PTH) were measured at baseline, 4, 8, 12 and 24 weeks.Main outcome measures Percentage change markers of bone turnover and PTH and change in oestradiol levels over first six months and percentage of changes in DXA and QUS over one year.Results PINP, bone ALP and OC increased by 28%, 7% and 9%, respectively (P 〈 0.01) during the first four weeks of treatment and then decreased significantly. Lumbar spine (LS) and total hip (TH) BMD increased by 5.4% and 6.0% (P 〈 0.001), respectively, and femoral neck (FN) BMD by 3.7% (P 〈 0.05) during the first year of treatment compared with control subjects. The peak serum oestradiol level was achieved four weeks after implant insertion. Mean PTH levels increased significantly in subjects receiving subcutaneous oestradiol.Conclusion Subcutaneous oestrogen exerted an apparent anabolic effect on bone, which was initially reflected by an increase in bone formation markers and later by a large increase in BMD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2002.01177.x
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  • 3
    Electronic Resource
    Electronic Resource
    Identification of Vertebral Deformities in Men: Comparison of Morphometric Radiography and Morphometric X-ray Absorptiometry (1999)
    Springer
    Osteoporosis international 10 (1999), S. 167-174 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Absorptiometry – Deformity – Men – Reference values – Vertebrae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Osteoporotic vertebral deformities may be detected by morphometric radiography (MR) using spinal radiographs, and by morphometric X-ray absorptiometry (MXA) using dual-energy X-ray absorptiometry. Reference values for MR may not be appropriate for MXA, and reference values may be affected by gender and age. The aims of this study were to (1) compare mean deformity of vertebral height ratios for MR and MXA in men, (2) compare mean deformity for MXA in men and women, (3) compare mean wedge angle measured by MXA in men and women and (4) assess the effect of aging on MXA values in men. We studied a general practitioner sample of 115 men aged 22–81 years (mean 53 years) and 124 women aged 55–89 years (mean 68 years). Subjects had MXA of T4 to L4 using the Hologic QDR 4500A. Women and men over age 50 years had radiographs of the thoraco-lumbar spine. Scans and radiographs were marked in the same way by one operator and vertebral height ratios and mean deformity were calculated for MR and MXA. The mean wedge angle, θ, was calculated for MXA in all subjects. Mean wedge and biconcavity deformity and standard deviation (SD) in men were greater for MXA than for MR. The mean wedge and biconcavity deformity measured by MXA tended to be greater for men than for women. Vertebral deformity in men increased with age, and was associated with degenerative change seen on spinal radiographs. The mean wedge angle was greater for men than for women, and it increased with age in men. We conclude that sex- and age-specific reference ranges should be established separately for MXA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050212
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  • 4
    Electronic Resource
    Electronic Resource
    The effect of age on bone collagen turnover as assessed by pyridinium crosslinks and procollagen I C-terminal peptide (1993)
    Springer
    Osteoporosis international 3 (1993), S. 100-101 
    Details
    ISSN: 1433-2965
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Bone collagen turnover increases with age up to the ninth decade in women. This increase in bone turnover may result from secondary hyperparathyroidism and it could play a role in the pathogenesis of age-related bone loss.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01621877
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  • 5
    Electronic Resource
    Electronic Resource
    Prevalence and incidence of vertebral deformities (1993)
    Springer
    Osteoporosis international 3 (1993), S. 113-119 
    Details
    ISSN: 1433-2965
    Keywords: Epidemiology ; Incidence ; Osteoporosis ; Prevalence ; Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is a need to identify vertebral fractures from radiographs taken at a single point in time, but considerable controversy surrounds the methods to be used. We extended a data set to comprise baseline radiographs of the thoracic and lumbar spine on an age-stratified random sample of 762 Rochester, Minnesota, women and used revised methods to define vertebral deformities morphometrically. Changes in the method of measuring vertebral heights, changes in the source of normal values for vertebral measurements and changes in the criteria for assessing vertebral deformity had little impact on estimated prevalence and incidence in this population. The prevalence of any vertebral deformity was estimated at 25.3 per 100 Rochester women aged 50 years and over (95% CI, 22.3–28.2), while the incidence of a new deformity in this group was estimated at 17.8 per 1000 person-years (95% CI, 16.0–19.7). Projected nationally, these data suggest that over 500 000 white women in the United States develop vertebral deformities for the first time each year and that over 7 million white women aged 50 years and over might be affected at any given time. These estimates are limited by the absence of a reliable ‘gold standard’ with which to determine false positive and false negative rates associated with this or any other morphometric method. Information on the health consequences of vertebral deformities of various sorts would be most helpful in choosing between alternative approaches to defining them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623271
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  • 6
    Electronic Resource
    Electronic Resource
    Evaluation of bone turnover in type I osteoporosis using biochemical markers specific for both bone formation and bone resorption (1993)
    Springer
    Osteoporosis international 3 (1993), S. 255-260 
    Details
    ISSN: 1433-2965
    Keywords: Bone remodelling ; Collagen ; Osteocalcin ; Osteoporosis ; Pyridinium crosslinks
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aims of the study were to evaluate the use of bone-specific biochemical markers of turnover in type I osteoporosis, to test for evidence of heterogeneity of bone turnover in this condition, and to attempt to devise an ‘uncoupling index’ by using the relationship between bone-specific biochemical markers of bone formation and bone resorption. In women with type I osteoporosis (mean age 64 years, SD 5;n=63) the mean level of serum osteocalcin, a specific biochemical marker of bone formation, was 9.9 ng/ml (SD 2.0), which was higher than the level in normal postmenopausal women (mean age 65 years, SD 6;n=8.9 ng/ml (SD 2.0;p〈0.01). The variance of serum osteocalcin levels in the two groups was similar. Compared with this 11% increase in the biochemical marker for bone formation, the markers of bone resorption, total urinary deoxypyridinoline (bone-specific), pyridinoline and hydroxyproline were increased by 40% (p〈0.0001), 61% (p〈0.0001) and 25% (p〈0.01), respectively. Furthermore, these biochemical markers of bone resorption had greater variance in women in type I osteoporosis than in the normal postmenopausal women (p〈0.001). The urinary excretion of the free crosslinks deoxypyridinoline, pyridinoline and glycosylated pyridinoline were increased by 26% (p〈0.001), 17% (p〈0.01) and 13% (NS) respectively. An ‘uncoupling index’ was calculated for the difference between urinary deoxypyridinoline and serum osteocalcin using the results from the normal women and expressed asz-scores. We conclude that the pyridinium crosslinks of collagen enable better discrimination between normal and osteoporotic women than does hydroxyproline. In osteoporosis there appears to be heterogeneity of bone resorption. Finally, an uncoupling index indicated that in osteoporosis bone resorption was increased to a greater extent than bone formation as compared with normal postmenopausal women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623829
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  • 7
    Electronic Resource
    Electronic Resource
    Randomized Trial of the Effects of Risedronate on Vertebral Fractures in Women with Established Postmenopausal Osteoporosis (2000)
    Springer
    Osteoporosis international 11 (2000), S. 83-91 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bisphosphonates – Bone mineral density – Osteoporosis – Postmenopausal women – Risedronate – Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The purpose of this randomized, double-masked, placebo-controlled study was to determine the efficacy and safety of risedronate in the prevention of vertebral fractures in postmenopausal women with established osteoporosis. The study was conducted at 80 study centers in Europe and Australia. Postmenopausal women (n= 1226) with two or more prevalent vertebral fractures received risedronate 2.5 or 5 mg/day or placebo; all subjects also received elemental calcium 1000 mg/day, and up to 500 IU/day vitamin D if baseline levels were low. The study duration was 3 years; however, the 2.5 mg group was discontinued by protocol amendment after 2 years. Lateral spinal radiographs were taken annually for assessment of vertebral fractures, and bone mineral density was measured by dual-energy X-ray absorptiometry at 6-month intervals. Risedronate 5 mg reduced the risk of new vertebral fractures by 49% over 3 years compared with control (p〈0.001). A significant reduction of 61% was seen within the first year (p= 0.001). The fracture reduction with risedronate 2.5 mg was similar to that in the 5 mg group over 2 years. The risk of nonvertebral fractures was reduced by 33% compared with control over 3 years (p= 0.06). Risedronate significantly increased bone mineral density at the spine and hip within 6 months. The adverse-event profile of risedronate, including gastrointestinal adverse events, was similar to that of control. Risedronate 5 mg provides effective and well-tolerated therapy for severe postmenopausal osteoporosis, reducing the incidence of vertebral fractures and improving bone density in women with established disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050010
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  • 8
    Electronic Resource
    Electronic Resource
    Workshop session V. Management of corticosteroid-induced osteoporosis (1996)
    Springer
    Osteoporosis international 6 (1996), S. 36-37 
    Details
    ISSN: 1433-2965
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01625245
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  • 9
    Electronic Resource
    Electronic Resource
    Prevention of Bone Loss with Risedronate in Glucocorticoid-Treated Rheumatoid Arthritis Patients (2000)
    Springer
    Osteoporosis international 11 (2000), S. 331-337 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bisphosphonates – Glucocorticoid-induced osteoporosis – Rheumatoid arthritis – Risedronate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The aim of the study was to assess risedronate’s effect on bone mineral density in postmenopausal women with rheumatoid arthritis receiving glucocorticoids. We carried out a two center, 2 year, double-masked, placebo-controlled trial with a third year of nontreatment follow-up. We studied 120 women requiring long-term glucocorticoid therapy at 〉2.5 mg/day prednisolone randomized to treatment with daily placebo; daily 2.5 mg risedronate; or cyclical 15 mg risedronate (2 out of 12 weeks). At 97 weeks, bone mineral density was maintained at the lumbar spine (+1.4%) and trochanter (+0.4%) in the daily 2.5 mg risedronate group, while significant bone loss occurred in the placebo group (–1.6%, p= 0.03; and 4.0%, p〈0.005, respectively). At the femoral neck, there was a nonsignificant bone loss in the daily 2.5 mg risedronate group (–1.0%) while in the placebo group bone mass decreased significantly (–3.6%, p〈0.001). The difference between placebo and daily 2.5 mg risedronate groups was significant at the lumbar spine (p= 0.009) and trochanter (p= 0.02) but did not reach statistical significance at the femoral neck. Although not significantly different from placebo at the lumbar spine, the overall effect of the cyclical regimen was similar to that of the daily 2.5 mg risedronate regimen. Treatment withdrawal led to bone loss in the risedronate groups that was significant at the lumbar spine. A similar number of patients experienced adverse events (including upper gastrointestinal events) across treatment groups and risedronate was generally well tolerated. Thus risedronate preserves bone mass in postmenopausal women with rheumatoid arthritis receiving glucocorticoids while patients receiving a placebo have significant bone loss.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980070122
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  • 10
    Electronic Resource
    Electronic Resource
    Ethnic and Gender Differences in Bone Mineral Density and Bone Turnover in Young Adults: Effect of Bone Size (2000)
    Springer
    Osteoporosis international 11 (2000), S. 512-517 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bone density – Bone remodeling – Ethnic groups – Sex
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Generally, the incidence of osteoporotic fracture is lower in black populations and in men. These effects of ethnicity and gender may result from differences in peak bone mineral density (PBMD) and bone turnover (BT), which in turn are affected by bone size. Therefore, the aims of this study were to examine the effects of ethnicity and gender on bone mineral density (BMD) and BT in young African-Caribbean and Caucasian adults, and to adjust for the effect of bone size on BMD and BT. BMD was measured at the lumbar spine, L2–L4 (LS), total body (TB) and femoral neck (FN) by dual-energy X-ray absorptiometry in 44 blacks (16 men, 28 women) and 59 whites (28 men, 31 women) ages 20–37 years. We measured serum bone-specific alkaline phosphatase (BAP) and serum osteocalcin (OC) as markers of bone formation and urinary immunoreactive free deoxypyridinoline (ifDpd) and crosslinked N-telopeptide of type I collagen (NTx) as markers of bone resorption. To adjust the data for any differences in bone size, we calculated: (a) bone mineral apparent density (BMAD), an estimated volumetric bone density which attempts to normalize BMD measurements for bone size; and (b) bone resorption markers as a ratio to total body bone mineral content (TB BMC). Two-way analysis of variance was used to compare the effects of race and gender, and to test for any interaction between these two factors. Blacks had higher BMD compared with whites at the TB (p〈0.001), LS (p= 0.0001) and FN (p= 0.0005). This increase remained significant at the LS only after calculating BMAD. Men had higher BMD at all sites (except at the LS). This increase was no longer significant at the FN after calculating BMAD, and LS BMAD was actually greater in women (p〈0.0001). Blacks and whites had similar concentrations of turnover markers, but men had higher bone turnover markers than women (BAP, p〈0.0001; OC, p= 0.002; ifDpd, p= 0.03; NTx, p〈0.0001). This increase in bone resorption markers was no longer significant after adjusting for TB BMC (except for NTx in whites). We conclude that the skeletal advantage in blacks during young adulthood is not explained by bone size. However, it seems probable that bone size effects partially explain gender differences in BMD and bone turnover.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980070094
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