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Bone mineral density and fractures

D E Beaton, M Vidmar, K B Pitzul, R Sujic, N K Rotondi, E R Bogoch, J E M Sale, R Jain, J Weldon
: We evaluated the impact of a more intensive version of an existing post-fracture coordinator-based fracture prevention program and found that the addition of a full-risk assessment improved treatment rates. These findings provide additional support for more intensive programs aimed at reducing the risk of re-fractures. INTRODUCTION: Evidence-based guidelines support coordinator-based programs to improve post-fracture osteoporosis guideline uptake, with more intensive programs including bone mineral density (BMD) testing and/or treatment being associated with better patient outcomes...
October 21, 2016: Osteoporosis International
C Tsentidis, D Gourgiotis, L Kossiva, A Marmarinos, A Doulgeraki, K Karavanaki
: Higher levels of Dickkopf-1, which is an inhibitor of Wnt/β-catenin bone metabolic pathway, could be indicative of downregulated Wnt system, with possible lower osteoblast activation and higher osteoclast signaling in type 1 diabetes mellitus children and adolescents. Dickkopf-1 could significantly contribute to diabetes osteopathy. INTRODUCTION: Increased fracture risk and elevated Dickkopf-1 levels, which is an inhibitor of Wnt/β-catenin bone metabolic pathway, have been documented in adult patients with type 2 diabetes mellitus (T2D), while no relevant data exist on childhood type 1 diabetes (T1D)...
October 20, 2016: Osteoporosis International
Kerry Dwan, Carrie A Phillipi, Robert D Steiner, Donald Basel
BACKGROUND: Osteogenesis imperfecta is caused by a genetic defect resulting in an abnormal type I collagen bone matrix which typically results in multiple fractures with little or no trauma. Bisphosphonates are used in an attempt to increase bone mineral density and reduce these fractures in people with osteogenesis imperfecta. This is an update of a previously published Cochrane Review. OBJECTIVES: To assess the effectiveness and safety of bisphosphonates in increasing bone mineral density, reducing fractures and improving clinical function in people with osteogenesis imperfecta...
October 19, 2016: Cochrane Database of Systematic Reviews
Mette H Hjorth, Maiken Stilling, Kjeld Søballe, Poul Torben Nielsen, Poul H Christensen, Søren Kold
Background and purpose - Short-term experimental studies have confirmed that there is superior fixation of cementless implants inserted with compaction compared to broaching of the cancellous bone. Patients and methods - 1-stage, bilateral primary THA was performed in 28 patients between May 2001 and September 2007. The patients were randomized to femoral bone preparation with broaching on 1 side and compaction on the other side. 8 patients declined to attend the postoperative follow-up, leaving 20 patients (13 male) with a mean age of 58 (36-70) years for evaluation...
October 19, 2016: Acta Orthopaedica
Jonathan Karnon, Ainul Shakirah Shafie, Nneka Orji, Sofoora Kawsar Usman
OBJECTIVE: Zoledronic acid and denosumab were funded by the Australian government for the management of osteoporosis at an equivalent price to alendronate. The price of alendronate has declined by around 65 %, but the price of the other two therapies has remained stable. Using data published since the listing, this paper reports current estimates of the value of denosumab compared to alendronate from an Australian health system perspective. METHODS: A cohort-based state transition model was developed that predicted changes in bone mineral density (BMD), and calibrated fracture probabilities as a function of BMD, age and previous fracture to estimate differences in costs and QALYs gained over a 10-year time horizon...
2016: Cost Effectiveness and Resource Allocation: C/E
Utku Kandemir, Safa Herfat, Mary Herzog, Paul Viscogliosi, Murat Pekmezci
OBJECTIVES: The goal of this study is to compare the fatigue strength of a locking intramedullary nail (LN) construct to a double locking plate (DLP) construct in comminuted proximal extra-articular tibia fractures. METHODS: Eight pairs of fresh frozen cadaveric tibias with low bone mineral density (Age: 80 ± 7 (SD) years, T-score: -2.3 ± 1.2) were used. One tibia from each pair was fixed with LN while the contralateral side was fixed with DLP for complex extra-articular multifragmentary, metaphyseal fractures (simulating OTA41-A3...
October 7, 2016: Journal of Orthopaedic Trauma
Hao Zhang, Hua Yue, Chun Wang, Weiwei Hu, Jiemei Gu, Jinwei He, Wenzhen Fu, Yunqiu Hu, Miao Li, Zhenlin Zhang
Osteogenesis imperfecta (OI) is an inherited connective tissue disorder characterized by brittle bone fractures. The aim of the present study was to investigate the pathogenic gene mutation spectrum and clinical manifestations of mutations in collagen type I, alpha 1 (COL1A1) and collagen type I, alpha 2 (COL1A2) genes in Chinese patients with OI. A total of 61 unrelated Chinese OI patients with COL1A1 and COL1A2 mutations were recruited. All the exons and the exon-intron boundaries of the COL1A1 and COL1A2 genes were amplified and directly sequenced and lumbar spine bone mineral density was measured by dual‑energy X‑ray absorptiometry...
October 12, 2016: Molecular Medicine Reports
H S Choi, J H Park, S H Kim, S Shin, M J Park
: Bone mineral density (BMD) of offspring was significantly associated with their parents' BMD. Parental BMD Z-score ≤-1 was a significant predictor for BMD Z-score ≤-1 in their offspring. Peak bone mass acquisition during early adulthood is more substantially influenced by genetic factors rather than lifestyle or environmental factors. INTRODUCTION: A person's BMD is affected by both genetic and environmental factors. Family history of osteoporosis or fragility fracture is a well-known risk factor for low bone mass or fracture...
October 17, 2016: Osteoporosis International
David R Weber, George Schwartz
The skeleton is adversely affected by type 1 diabetes (T1D). Patients with T1D of both sexes have an increased risk of fracture that begins in childhood and extends across the entire lifespan. T1D is characterized by mild to modest deficits in bone density, structure, and microarchitecture. Current evidence suggests that the observed bone deficits in T1D are the result of impaired bone formation rather than increased bone resorption. There is emerging data that bone quality is impaired in T1D, which may explain the findings that fracture risk is elevated out of proportion to the degree of bone mineral deficit...
October 15, 2016: Current Osteoporosis Reports
Ursula Heilmeier, Janina M Patsch
Skeletal fragility has been recognized as an important feature of diabetes mellitus type 1 (T1D) and type 2 (T2D). While patients with DM1 typically display low bone mineral density (BMD) and concomitant increases in fracture risk, T2D bone disease is more complex and less understood. Although BMD is often normal or even slightly elevated, the risk of fragility fractures is disproportionally high. Alterations in bone quality (i.e., bone microstructure and matrix properties) have been reported by independent groups of researchers...
July 2016: Seminars in Musculoskeletal Radiology
Carmelo Messina, Luca Maria Sconfienza, Michele Bandirali, Giuseppe Guglielmi, Fabio Massimo Ulivieri
Several imaging methods for the diagnosis and management of osteoporosis exist. Dual-energy X-ray absorptiometry (DXA) is the most widely available and commonly used for measuring bone mineral density (BMD). Central DXA has several advantages: It has very good reproducibility, administers a negligible radiation dose to the patient, and BMD values obtained by DXA relate to fracture risk. Nevertheless, DXA has some technical limitations that should be recognized by those physicians who interpret and report this examination...
July 2016: Seminars in Musculoskeletal Radiology
Pernille Svendsen, Nitesh Shekhrajka, Kasper Lindblad Nielsen, Peter Vestergaard, Mette Østergaard Poulsen, Anders Krog Vistisen, Peter Svenssen Munksgaard, Marianne Tang Severinsen, Paw Jensen, Hans Erik Johnsen, Lasse Hjort Jakobsen, Martin Bøgsted, Jens Brøndum Frøkjær, Tarec Christoffer El-Galaly
Treatment of diffuse large B-cell lymphoma (DLBCL) with R-CHOP(-like) regimens include large cumulative doses of prednisolone. In this retrospective study, we evaluated changes in vertebral bone density (VD) in DLBCL patients by measuring CT-ascertained Hounsfield units (HU) at the L3 level. In total, 111 patients diagnosed from 2007 to 2012 and response assessed following first line treatment were included. Post-treatment VD was significantly reduced to 86% of pretreatment VD on average (p < .001). Neither female sex nor high age (>70 years) were significantly associated with greater post-treatment VD reduction...
October 13, 2016: Leukemia & Lymphoma
David Scott, Markus Seibel, Robert Cumming, Vasi Naganathan, Fiona Blyth, David G Le Couteur, David J Handelsman, Louise M Waite, Vasant Hirani
Body composition and muscle function have important implications for falls and fractures in older adults. We aimed to investigate longitudinal associations between sarcopenic obesity and its components with bone mineral density (BMD), and incident falls and fractures, in Australian community-dwelling older men. 1,486 men aged ≥70 years from the Concord Health and Ageing in Men Project (CHAMP) study were assessed at baseline (2005-2007), 2 year follow-up (2007-2009; N = 1,238), and 5 year follow-up (2010-2013; N = 861)...
October 13, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Åshild Bjørnerem, Ali Ghasem-Zadeh, Xiaofang Wang, Minh Bui, Susan P Walker, Roger Zebaze, Ego Seeman
Estrogen deficiency associated with menopause is accompanied by an increase in the rate of bone remodeling and the appearance of a remodeling imbalance; each of the greater number of remodeling transactions deposits less bone than was resorbed resulting in microstructural deterioration. The newly deposited bone is also less completely mineralized than the older bone resorbed. We examined whether breastfeeding, an estrogen deficient state, compromises bone microstructure and matrix mineral density. Distal tibial and distal radial microarchitecture were quantified using high-resolution peripheral quantitative computed tomography in 58 women prior, during and after breastfeeding, and in 48 controls during one to five years follow-up...
October 13, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Joseph A Gil, Steven F DeFroda, Kunal Sindhu, Aristides I Cruz, Alan H Daniels
Osteogenesis imperfecta is caused by qualitative or quantitative defects in type I collagen. Although often considered a disease with primarily pediatric manifestations, more than 25% of lifetime fractures are reported to occur in adulthood. General care of adults with osteogenesis imperfecta involves measures to preserve bone density, regular monitoring of hearing and dentition, and maintenance of muscle strength through physical therapy. Surgical stabilization of fractures in these patients can be challenging because of low bone mineral density, preexisting skeletal deformities, or obstruction by instrumentation from previous surgeries...
October 13, 2016: Orthopedics
Agnieszka Świat, Agata Wasilewska, Izabela Bachniak, Krzysztof Fyderek
In this review issues concerning bone metabolism are presented. The diagnostic criteria of decreased mineral bone density is discussed with the significance of densitometry. The necessity of presence of low-trauma fracture to diagnosed the osteoporosis in children is signified. The paper reviews most common chronic gastrointestinal tract condition associated with the altered bone metabolism. The diagnostic and early treatment of decreased mineral bone density in children, who are before obtaining peak bone mass is crucial to prevent the risk of osteoporosis in adulthood...
July 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
S Farmer, V V Shanbhogue, S Hansen, C I Stahlberg, H Vestergaard, A P Hermann, H Frederiksen
: In this cross-sectional study of 45 patients with myeloproliferative neoplasms, we found no evidence of secondary osteoporosis. INTRODUCTION: Patients with essential thrombocythemia (ET) and polycythaemia vera (PV) are at increased risk of fractures but the underlying mechanisms have not been settled. We conducted a study to assess bone mineral density, microarchitecture, estimated bone strength and global bone turnover in 45 patients with ET or PV. METHODS: Patients were evaluated in a cross-sectional study with dual energy X-ray absorptiometry (DXA) at the hip and spine; high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia; and biochemical markers of bone turnover including pro-collagen type 1 N-terminal pro-peptide, osteocalcin, C-terminal cross-linking telopeptide of type 1 collagen and bone-specific alkaline phosphatase...
October 13, 2016: Osteoporosis International
Trine Herland, Ellen M Apalset, Geir Egil Eide, Grethe S Tell, Sverre Lehmann
AIM: To investigate whether airflow limitation is associated with bone mineral density (BMD) and risk of hip fractures. METHODS: A community sample of 5,100 subjects 47-48 and 71-73 years old and living in Bergen was invited. Participants filled in questionnaires and performed a post-bronchodilator spirometry measuring forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). All attendants were invited to have a BMD measurement of the hip. During 10 years of follow-up, information on death was collected from the Norwegian Cause of Death Registry, and incident hip fractures were registered from regional hospital records of discharge diagnoses and surgical procedure codes...
2016: European Clinical Respiratory Journal
Ville-Valtteri Välimäki, Outi Mäkitie, Renata Pereira, Christine Laine, Katherine Wesseling-Perry, Jorma Määttä, Mikko Kirjavainen, Heli Viljakainen, Matti J Välimäki
CONTEXT: We previously identified two Finnish families with dominantly inherited, low-turnover osteoporosis caused by mutations in WNT1 or PLS3. OBJECTIVE: Design and Setting: This prospective, longitudinal, uncontrolled study was undertaken to evaluate whether patients with these mutations respond to teriparatide treatment. PATIENTS AND INTERVENTION: We recruited six adults (median age 54); three with a WNT1 missense mutation c.652T>G and three with a PLS3 splice mutation c...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
Olivier Lamy, Elena Gonzalez-Rodriguez, Delphine Stoll, Didier Hans, Bérengère Aubry-Rozier
CONTEXT: Denosumab inhibits bone resorption, increases bone mineral density (BMD), and reduces fracture risk. Denosumab was approved for the treatment of osteoporosis and the prevention of bone loss in some oncologic situations. Denosumab discontinuation is associated with a severe bone turnover rebound (BTR) and a rapid loss of BMD. The clinical consequences of the BTR observed after denosumab discontinuation are not known. Cases description: We report 9 women who presented 50 rebound-associated vertebral fractures (RAVFs) after denosumab discontinuation...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
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