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  • 1
    Electronic Resource
    Electronic Resource
    The effects of menopause on longitudinal bone loss from the spine (1993)
    Springer
    Calcified tissue international 52 (1993), S. 340-343 
    Details
    ISSN: 1432-0827
    Keywords: Bone loss ; Menopause ; Dual photon absorptiometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary Two hundred and thirty women aged 45–66 years were divided into three groups according to their menopausal status and were followed to assess the changes in vertebral bone mineral density (BMD). These included 71 premenopausal, 42 perimenopausal, and 117 postmenopausal women. Menopausal status was assessed through menstrual history and plasma concentrations of 17β estradiol and luteinizing hormone. BMD was measured by dual photon absorptiometry between 2 and 5 times over an average period of 27 months, and annual rates of changes were calculated by linear regression. BMD decreased significantly (P〈0.0001) in the three groups during the follow-up. Mean (±SD) annual rate of change was-0.79±1.5% for premenopausal,-2.35±1.5% for perimenopausal, and-1.24±1.5% for postmenopausal women. There was no difference in the rates of bone loss between the perimenopausal group and the postmenopausal group within 3 years after menopause (1–2 years:-2.34±2.1%; 2–3 years:-1.9±1.5%). Thereafter, rates decreased exponentially with time since menopause to fall out at the same level as the premenopausal level. These longitudinal data indicate that vertebral bone loss begins before menopause and accelerates sharply during menopause to decline exponentially with time after 3 years.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00310195
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  • 2
    Electronic Resource
    Electronic Resource
    Spine and femur densitometry at the menopause: Are both sites necessary in the assessment of the risk of osteoporosis? (1993)
    Springer
    Calcified tissue international 52 (1993), S. 344-347 
    Details
    ISSN: 1432-0827
    Keywords: Bone mineral measurement ; Osteoporosis ; Menopause
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary The aim of our study was to compare the results provided by the measurement of vertebral and femoral bone mineral density (BMD) for assessing the individual risk of osteoporosis as defined by either low BMD and/or rapid bone loss. Vertebral and femoral BMD were measured twice at a mean interval of 21 months in 85 normal, early post-menopausal women who had passed a natural menopause 6 months to 3 years previously. According to the measurement site, 36% (spine), 29% (femoral neck), 35% (Ward's triangle), and 25% (trochanter) fall in the “at risk” category, defined by a BMD value of 1 SD or more below the normal values for premenopausal women. Based on vertebral BMD, 39–48% of the women at risk had a normal femoral BMD. On the other hand, 24–37% of the women classified at risk based on femoral BMD maintained a low risk at the vertebral level. The annual rate of bone loss was significantly greater for the Ward's triangle (-2.7±3.8%) and femoral neck (-2.1±2.5%) than for the spine (-1.5±2.1%) and trochanter (-1.5±3.4%). There was a significant relationship between the rate of loss measured at the spine and femoral levels (r=0.34–0.58). Among the 21 women with a rapid vertebral bone loss, 48–67% had a low bone loss at the femoral level and vice versa. The ratio between mean rate of loss and the precision of the measurement sites was greater for the spine (1.6) compared with the femur (1.1–0.71). Our results indicate that vertebral and femoral BMD measurements produce discordant results in assessing the individual risk for osteoporosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00310196
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  • 3
    Electronic Resource
    Electronic Resource
    Ultrasound measurements on the os calcis in a prospective multicenter study (1994)
    Springer
    Calcified tissue international 55 (1994), S. 94-99 
    Details
    ISSN: 1432-0827
    Keywords: Broadband ultrasound attenuation ; Speed-of-sound ; Stiffness index ; Interunit precision
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Ultrasonic assessment is a new approach to assess both quality and density. Two ultrasonic parameters are measured on the os calcis: the attenuation or broadband ultrasound attenuation (BUA) and the velocity or speed of sound (SOS). The interunit variations in vitro and in vivo of an ultrasound instrument, the Lunar AchillesR system, used in a French multicenter study named EPIDOS, were calculated and the stability of these intruments over a 12-month period was evaluated. A third parameter called “stiffness index”, calculated from the SOS and BUA, was also used in this study. The average CV in vitro for the BUA and SOS was 0.92% and 0.12%, respectively, and the average CV in vivo for the BUA, the SOS, and the stiffness index was 1.83%, 0.23%, and 1.9%, respectively. The interunit (or inter-machines) variations were calculated by a one-way analysis of variance. We detected small but significant measurement differences among centers on a phantom for both SOS (maximum significant difference 0.4%) and stiffness (maximum significant difference 3.5%) but not for BUA. Similar diffrences were found in vivo. The precision over 12 months of the interunit variations in vitro was evaluated by measuring a single phantom traveling from one center to another several times. The range of the CV for the BUA (1.54–0.51%), for the SOS (0.25–0.14%), and for the stiffness index (2.26–1.10%) are explained in part by technical failures. The variation among the five Achilles was estimated by the combined CV which was 1.42% for the BUA, 0.32% for the SOS, and 2.33% for the stiffness index. In conclusion, our findings indicate that equipment from one manufacturer appears to be consistent between machines for the BUA, but not completely for the SOS. The results for this stiffness index are necessarily influenced by both SOS and BUA. The shortterm and long-term interunit precision is good, both in vitro and in vivo. Such results provide increased confidence in multicenter clinical trials where ultrasonic data are pooled.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00297182
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  • 4
    Electronic Resource
    Electronic Resource
    Accuracy and Precision of In Vivo Bone Mineral Measurements in Sheep Using Dual-Energy X-ray Absorptiometry (2000)
    Springer
    Calcified tissue international 66 (2000), S. 70-73 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Sheep — DXA — Osteoporosis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. We evaluated the precision and accuracy of in vivo measurements of spine bone mineral density (BMD) and bone mineral content (BMC) in five ewes using dual-energy X-ray absorptiometry (DXA, Lunar DPX-L). The short-term in vivo reproducibility expressed as the coefficient of variation (CV) varied from 0.9 to 1.6% for spine BMD and from 1 to 3.1% for spine BMC. The ex vivo measurements, performed in 20 cm of water to simulate soft tissue thickness, correlated closely with the in vivo measurements, yielding an r value of 0.98 and 0.97 for spine BMD and BMC, respectively. The accuracy was determined by comparing the total BMC of each vertebra measured in vivo with the corresponding ash weight. The correlation coefficient between the two measurements was r = 0.98, with an accuracy error of 5.6%. We concluded that the DXA allows a precise and accurate measurement of spine bone mineral in live ewes using the methodology designed for humans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002230050014
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  • 5
    Electronic Resource
    Electronic Resource
    Effects of cyclical etidronate therapy on bone loss in early postmenopausal women who are not undergoing hormonal replacement therapy (1997)
    Springer
    Osteoporosis international 7 (1997), S. 213-218 
    Details
    ISSN: 1433-2965
    Keywords: Bone mineral density ; Dual-energy X-ray absorptiometry ; Etidronate ; Postmenopausal osteoporosis ; Postmenopausal bone loss
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was carried out to investigate the effectiveness and tolerability of cyclical etidronate therapy in the prevention of bone loss occurring in early postmenopausal women who are not undergoing hormone replacement therapy (HRT). A total of 109 Caucasian women aged 45–60 years were treated with etidronate 400 mg/day or placebo for 14 days followed by calcium supplementation 500 mg/day for 77 days. Ninety-one women completed the 2 years of the study. After 2 years, the estimated difference between the two groups as regards lumbar spine bone mineral density (BMD) was 2.53% (SEM 1.07%;p=0.01); BMD of the hip and wrist were not significantly different between treatment groups. A clear reduction in bone turnover was obtained as evidenced by a significant decrease in serum alkaline phosphatase level and in urinary N-telopeptide/creatinine ratio in the etidronate group; the difference between the two groups was −12%±3.2% for serum alkaline phosphatase level (p=0.019) and −22.9%+13.7% for the urinary N-telopeptide/creatinine ratio (p=0.047). There was no statistically significant difference between the two groups in terms of the serum osteocalcin levels and urinary hydroxyproline/creatinine and calcium/creatinine ratios. Etidronate was generally well tolerated and its adverse event profile was similar to that of placebo. The results of this study indicate that cyclic etidronate therapy can prevent trabecular bone loss, with no deleterious effect on cortical bone, in the first 5 years of menopause and that it has a very high safety margin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01622291
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  • 6
    Electronic Resource
    Electronic Resource
    Fluoride therapy in postmenopausal osteopenic women: Effect on vertebral and femoral bone density and prediction of bone response (1991)
    Springer
    Osteoporosis international 1 (1991), S. 103-109 
    Details
    ISSN: 1433-2965
    Keywords: Fluoride ; Osteoporosis ; Absorptiometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifty-two postmenopausal women (mean age 60±5 years) with low BMD (〈-2SD of young adult values) but who had not experienced previous crush fracture were treated with 50 mg of sodium fluoride (NaF), 1 g of calcium and 400 IU of vitamin D2 per day for 2 years. Repeated vertebral and femoral BMD measurements were made and compared with those of a control group consisting of 16 untreated women. Serum alkaline phosphatase and osteocalcin, blood and urinary fluoride levels were measured regularly to determine their predictive value on bone response. 18 of 52 (35%) of the treated patients experienced side effects (29% gastric, 4% lower extremity pain syndrome) but only in 6 cases (12%) was it necessary to discontinue treatment. In neither of the two groups was any fracture recorded (vertebral or otherwise). Among the 43 women who were treated for at least 2 years, 21 (49%) were considered to have responded (i.e., with an increase of vertebral BMD〉0.043 g/cm2). There was a mean linear increase in BMD in this group of 0.0041 g/cm2 per month (i.e., 5.5% per year). On the other hand in the non-responder group and in the control group, vertebral BMD either remained stable or decreased. However no difference was detected between the two groups (treated and controls) at the femoral site after 2 years; both groups showed a significant decrease in BMD. The responders had a lower initial osteocalcin level and treatment led to a relatively greater increase in osteocalcin. Moreover basal and post-treatment levels of alkaline phosphatase and blood and urinary fluoride did not differ significantly between the two groups. An increase in serum osteocalcin of more than 50% had the best predictive value for bone response. However, this increase did not allow bone response to be predicted any earlier than direct bone measurement; the majority of responses being identified after 12–18 months of therapy. This study shows the ability of NaF to increase vertebral BMD without altering femoral density in women with low vertebral BMD but no fracture. However it is impossible to predict to what extent this increase in BMD will modify the ultimate risk of fractures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01880451
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  • 7
    Electronic Resource
    Electronic Resource
    Variability of vertebral and femoral postmenopausal bone loss: A longitudinal study (1996)
    Springer
    Osteoporosis international 6 (1996), S. 320-324 
    Details
    ISSN: 1433-2965
    Keywords: Menopause ; Osteoporosis ; Rate of bone loss
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The rate of postmenopausal bone loss varies considerably between individuals and it has been suggested that about 1 in 3 women loses significant amount of bone mineral in the forearm. The rate of vertebral and femoral bone loss was determined by dual-energy X-ray absorptiometry throughout two consecutive 22-month periods, in 93 healthy women who had passed a natural menopause 6–60 months earlier. In all cases the bone changes were normally distributed, ranging from −6.9% to +2.8% per year in the spine and from −7% to +4.8% per year in the femur. No significant relationship was found between the two fractional rates of bone loss. When the women were stratified into three groups according to their individual rate of bone loss, we found that only 20%–47% retained their first classification during the second period of follow-up. In particular, less than 10% of the women showed a rapid rate of bone loss throughout the study. We conclude that spontaneous vertebral and femoral bone loss exhibit a great variability within the first postmenopausal years and that only a small minority of women sustain a fast rate of bone loss over several years. These results raise the question as to whether the evaluation of individual rates of bone loss at menopause might be useful in the identification of women at higher risk of osteoporosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623392
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  • 8
    Electronic Resource
    Electronic Resource
    Prevention of post-menopausal bone loss with 1α-hydroxy vitamin D3 a three-year prospective study (1992)
    Springer
    Clinical rheumatology 11 (1992), S. 492-497 
    Details
    ISSN: 1434-9949
    Keywords: Osteoporosis ; Prevention ; 1α-Hydroxy ; Vitamin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An open and controlled prospective study was used to assess the preventive efficiency of 1α-hydroxy vitamin D3 (1α (OH) Vit. D3) on post-menopausal vertebral bone loss. Of the 36 patients included in the study, 25 completed two years of treatment with 1 μg/day of 1α (OH) Vit. D3 and 500 mg of calcium. The vertebral bone mineral density measured by dual photon absorptiometry did not vary in the treated group, whereas it decreased significantly in the control group at the end of the 2 years. At two years, withdrawal of treatment led to a signficant bone loss, whereas bone mass remained stable in a subgroup of patients who underwent a third year of treatment with 1α (OH) Vit. D3. Overall, tolerance was satisfactory. However, urinary calcium increased significantly during treatment and one third of the patients developed hypercalciuria ≥7.5 mmoles/24 h. No variation in either serum calcium or creatinine levels was noted. These results indicate that 1α (OH) Vit. D3 could be useful in preventing post-menopausal bone loss provided it was complemented by regular monitoring of urinary calcium excretion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02283104
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  • 9
    Electronic Resource
    Electronic Resource
    Comparison of the bone mineral content of the lower limbs in men with ischaemic atherosclerotic disease (1994)
    Springer
    Clinical rheumatology 13 (1994), S. 611-614 
    Details
    ISSN: 1434-9949
    Keywords: Osteoporosis ; Atherosclerotic Disease of the Lower Limbs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a previous study, the authors demonstrated that in 17 men with ischaemic atherosclerotic disease the bone mineral density (BMD) of the femoral neck was lower than in matched control subjects. The patients with arterial disease were thinner and were heavier smokers than the controls. Osteoporosis and arterial disease of the lower limbs were perhaps due to common risk factors: tobacco consumption and a low body build index. In order to demonstrate the direct effect of atherosclerosis on bone mineral content (BMC), the authors studied by dual-energy X-ray absorptiometry the BMC of both legs in 18 men presenting symptomatic arterial disease of the lower limbs quantified by measurement of distal systolic indexes by doppler ultrasonography. The mean BMC of the leg more severely affected by arterial disease was significantly lower than the mean BMC of the leg less affected by arterial disease (512±76 g versus 495±80 g: p=0.003). In 13 of the 18 patients, the BMC was lower in the leg more severely affected by arterial disease; in 4 of 18 the difference between the BMC of the left and right legs was less than 1%, and in a single patient the BMC was higher in the leg more affected by arterial disease. Arterial disease of the lower limbs could lead to bone mineral loss.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02243003
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  • 10
    Electronic Resource
    Electronic Resource
    Bone and thyroid hormones (1989)
    Springer
    Clinical rheumatology 8 (1989), S. 116-118 
    Details
    ISSN: 1434-9949
    Keywords: Bone Loss ; Thyroid Hormone ; Menopause ; Hypothyroidism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02207245
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