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  • 1
    Electronic Resource
    Electronic Resource
    Do current regimes of hormone replacement therapy protect against subsequent fractures? (1992)
    Springer
    Osteoporosis international 2 (1992), S. 219-224 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF01624144
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The Role of Serum TGF-β Isoforms as Potential Markers of Osteoporosis (1999)
    Springer
    Osteoporosis international 9 (1999), S. 398-404 
    Details
    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
    URL: http://dx.doi.org/10.1007/s001980050163
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    Paper (German National Licenses)
    Fulltext
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