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Sample records for danish osteoporosis prevention

  1. Osteoporosis: diagnosis and prevention.

    PubMed

    Woodhead, G A; Moss, M M

    1998-11-01

    Osteoporosis affects about 8 million Americans, mostly women. The incidence and cost of the disease are rising as the population and its life expectancy increase. Each year 1.5 million individuals with osteoporosis suffer debilitating fractures of the spine, hip, or forearm. The primary health care provider is positioned to detect osteoporosis and its risk factors before signs and symptoms occur. Early detection can be achieved through any one of several diagnostic modalities, including bone mineral density tests and the use of biochemical markers. Once a clinician determines that a patient has many risk factors, bone mineral density testing should be performed. If the test results confirm the clinician's suspicion, therapeutic options should be discussed. Although treatment options exist, the most effective method of dealing with osteoporosis is prevention, including modification of risk factors (for example, diet and lifestyle) and the use of hormone replacement therapy, raloxifene, or alendronate therapy.

  2. [Prevention of osteoporosis].

    PubMed

    Dambacher, M A; Kissling, R; Neff, M

    1998-11-01

    The European Parliament presented June 10th in Brussels the 'Osteoporosis Report in EU--Means for Prevention'. It was emphasized that in the EU more than 3500 million Ecu have to be spent for hospitalization and that more than 500,000 hospitals beds are being used by osteoporotic patients. According to some calculations this number will double within the next 50 years. The EU has set up eight steps to be considered, e.g. have densitometric measurements available for persons with high risk and have these measurement paid by the insurances to further finance and support research for the very important areas of prevention and treatment. One distinguishes between primary, secondary and tertiary prevention of osteoporosis. Primary prevention aims at reaching at adolescent age a peak bone mass as high as possible. Secondary prevention aims at reducing bone loss peri- and postmenopausal. The tertiary prevention with manifest osteoporosis aims at preventing fractures. Emphasis of the primary prevention is, besides a sufficient calcium intake, to omit risk factors; with secondary prevention the use of medical treatments such as estrogens/gestagens, bisphosphonates, and recently also SERMs is applied. The tertiary prevention tries mostly to reduce the femur fractures. In addition to drugs such as vitamin D/calcium, vitamin D metabolites and bisphosphonates it is very important to create 'a fall-proof home'. Also very useful are hip protectors.

  3. Osteoporosis Prevention and Management.

    PubMed

    Pai, Muralidhar V

    2017-08-01

    Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis. Preventive strategy includes life style changes, exercise, intake of calcium and vitamin D, avoiding alcohol, smoking and excessive intake of salt. Estrogen therapy/estrogen+progesterone therapy (ET/EPT) is no longer recommended as a first-line therapy for the prevention of osteoporosis. They may be used in the therapy for osteoporosis in women under 60. Diagnosis and classification are made by assessment of BMD using DEXA or ultrasound and laboratory investigations. Management includes estimation of 10-year fracture risk using FRAX, life style and diet modification and pharmacological therapy. The drugs used in osteoporosis may be those that inhibit bone resorption-bisphosphonates, denosumab, calcitonin, SERMs, estrogen and progesterone-or that stimulate bone formation-PTH, Teriparatide. Combination therapies are not recommended as they do not have proven additional BMD/fracture benefits. No therapy should be indefinite in duration. There are no uniform recommendations to all patients. Duration decisions need to be individualized. While on treatment monitoring should be done with BMD assessment by DEXA/ultrasound and bone turnover markers.

  4. Translating Osteoporosis Prevention Guidelines.

    PubMed

    Brennan-Olsen, Sharon L; Hosking, Sarah M; Dobbins, Amelia G; Pasco, Julie A

    2017-04-01

    In Australia, the social gradient of chronic disease has never been as prominent as in current times, and the uptake of preventive health messages appears to be lower in discrete population groups. In efforts to re-frame health promotion from addressing behavior change to empowerment, we engaged community groups in disadvantaged neighborhoods to translate published preventive guidelines into easy-to-understand messages for the general population. Our research team established partnerships with older aged community groups located in disadvantaged neighborhoods, determined by cross-referencing addresses with the Australian Bureau of Statistics, to translate guidelines regarding osteoporosis prevention. We developed an oversized jigsaw puzzle that we used to translate recommended osteoporosis prevention guidelines. Successful participatory partnerships between researchers, health promotion professionals, and community groups in disadvantaged neighborhoods build capacity in researchers to undertake future participatory processes; they also make the best use of expert knowledge held by specific communities.

  5. Prevention and rehabilitation of osteoporosis.

    PubMed

    Kerschan-Schindl, Katharina

    2016-02-01

    Osteoporosis is a frequent disease in postmenopausal women. Despite the fact that fragility fractures cause many problems, osteoporosis is still underdiagnosed and undertreated. This manuscript outlines the topics diagnosis of osteoporosis, fracture risk prevention, and therapy after fracture. Regular physical activities, a sufficient intake of calcium, and a normal vitamin D level are important for bone health. Depending on the personal fracture risk, the patient may also be prescribed bone-specific medication to prevent fragility fractures. In case of a prevalent osteoporotic fracture, the initiation or adaptation of bone-specific therapy is indispensable. Since most osteoporotic fractures occur during a fall, fall risk reduction is an important measure to inhibit a new fracture. Rehabilitation of patients with fragility fractures varies with different localizations of the fracture and should be performed by a multidisciplinary team.

  6. [Nutritional factors in preventing osteoporosis].

    PubMed

    Martín Jiménez, Juan Antonio; Consuegra Moya, Belkis; Martín Jiménez, María Teresa

    2015-07-18

    Osteoporosis, main risk factor for suffering fragility fractures, is an important public health problem which has undoubted social, health and economic impact; but mainly causes pain, functional limitation and severe alterations in the patient's quality of life. Its current prevalence is very high and a further increase is expected due to a higher life expectancy and the progressive ageing of the population. In the prevention of osteoporosis, the main goal is to prevent fragility fractures; for this reason, it is necessary to: 1) promote bone formation in youth, to get sufficient bone mass peak, 2) reduce bone loss in adulthood, especially after menopause, 3) maintain bone health throughout life, and 4) prevent falls. There is enough evidence that multifactorial strategies (assessment of risk factors, healthy lifestyle habits, smoking cessation, moderation in alcohol consumption, physical exercise, outdoor activity with prudent exposure to sunlight, and a varied and balanced diet), are effective in the population at risk. Regarding factors for the prevention of osteoporosis, current recommendations are: increased consumption of calcium, phosphorus, magnesium and fluoride; provide adequate vitamin D (even with fortified food if necessary); consumption of foods rich in omega-3 acids; reduction of salt and prepared ready meals; sufficient but moderate intake of protein and, in the absence of intolerance, promote the consumption of milk and dairy products, especially yogurt and fermented milk products.

  7. Osteoporosis prevention, diagnosis, and therapy.

    PubMed

    The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Osteoporosis Prevention, Diagnosis, and Therapy. The statement provides state-of-the-art information and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas of study that deserve further investigation. The target audience of clinicians for this statement includes, but is not limited to, family practitioners, internists, gerontologists, orthopaedic surgeons, rheumatologists, obstetricians and gynecologists, and preventive medicine specialisits. A nonfederal, nonadvocate, 13-member panel representing the fields of internal medicine, family and community medicine, endocrinology, epidemiology, orthopaedic surgery, gerontology, rheumatology, obstetrics and gynecology, preventive medicine, and cell biology. In addition, 32 experts from these same fields presented data to the panel and a conference audience of approximately 700. The literature was searched using MEDLINE and an extensive bibliography of references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference

  8. Osteoporosis prevention, diagnosis, and therapy.

    PubMed

    2001-02-14

    To clarify the factors associated with prevention, diagnosis, and treatment of osteoporosis, and to present the most recent information available in these areas. From March 27-29, 2000, a nonfederal, nonadvocate, 13-member panel was convened, representing the fields of internal medicine, family and community medicine, endocrinology, epidemiology, orthopedic surgery, gerontology, rheumatology, obstetrics and gynecology, preventive medicine, and cell biology. Thirty-two experts from these fields presented data to the panel and an audience of 699. Primary sponsors were the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institutes of Health Office of Medical Applications of Research. MEDLINE was searched for January 1995 through December 1999, and a bibliography of 2449 references provided to the panel. Experts prepared abstracts for presentations with relevant literature citations. Scientific evidence was given precedence over anecdotal experience. The panel, answering predefined questions, developed conclusions based on evidence presented in open forum and the literature. The panel composed a draft statement, which was read and circulated to the experts and the audience for public discussion. The panel resolved conflicts and released a revised statement at the end of the conference. The draft statement was posted on the Web on March 30, 2000, and updated with the panel's final revisions within a few weeks. Though prevalent in white postmenopausal women, osteoporosis occurs in all populations and at all ages and has significant physical, psychosocial, and financial consequences. Risks for osteoporosis (reflected by low bone mineral density [BMD]) and for fracture overlap but are not identical. More attention should be paid to skeletal health in persons with conditions associated with secondary osteoporosis. Clinical risk factors have an important but poorly validated role in determining who should have BMD measurement, in

  9. Osteoporosis: primary prevention in the community.

    PubMed

    Loh, K Y; Shong, H K

    2007-10-01

    The incidence of osteoporosis is increasing worldwide. It has great impact on the life of the elderly population. The most significant medical consequence of osteoporosis is fragility fracture which without proper treatment will cause severe medical and psychosocial complications. The overall cost in managing osteoporosis and its related fractures is escalating. Using bone densitometry to measure bone mineral density is useful in the diagnosis of osteoporosis but it is costly and not feasible in the community. Drugs such as estrogen replacement, raloxifene and calcitonin are effective in prevention and treatment of osteoporosis but they are also expensive. Identifying modifiable risk factors such as smoking, lack of exercise, low dietary calcium and vitamin D intake and healthy life style remain strategy in the primary prevention of osteoporosis in the community.

  10. DXA, health beliefs, and osteoporosis prevention behaviors.

    PubMed

    Sedlak, Carol A; Doheny, Margaret O; Estok, Patricia J; Zeller, Richard A; Winchell, Janice

    2007-10-01

    This experimental longitudinal study was designed to examine the relationship between having a bone density through dual energy X ray absorptiometry (DXA) and osteoporosis preventing behaviors (OPB) among healthy postmenopausal women. Subjects were 203 healthy community-based women 50-65 years of age. Mediating variables were general knowledge of osteoporosis and revised health belief model variables. Treatment group women (n = 101) had a DXA screen and control group women (n = 102) did not. Study questionnaires were completed at three time points; initially and at 6 months and 12 months. Repeated measures ANOVA revealed treatment group women scored significantly higher on perceived susceptibility and calcium intake. Wilks's Lambda F revealed a significant difference in use of osteoporosis preventing medications. Personal knowledge gained from DXAs increased perceived susceptibility to osteoporosis, calcium intake, and use of osteoporosis preventing medications and appears to be an effective intervention in promoting OPB in younger postmenopausal women.

  11. Osteoporosis

    MedlinePlus

    Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is ... disease. Prevention is the best measure for treating osteoporosis by eating a recommended balanced diet including foods ...

  12. Prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Lewiecki, E Michael

    2008-06-01

    Osteoporosis is a common skeletal disease characterized by reduced bone strength and increased risk for fractures. Fragility fractures are associated with serious clinical consequences, including chronic pain, skeletal deformities, loss of independence, and increased mortality. Although osteoporosis is underdiagnosed and undertreated, many who are treated take medication incorrectly or do not continue it long enough to benefit. Measures to prevent osteoporosis include a healthy lifestyle, with regular physical activity, adequate intake of calcium and vitamin D, and avoidance of cigarette smoking and excess alcohol. Patients at risk for osteoporosis can be diagnosed with a simple bone density test before the first fracture occurs. Pharmacologic agents for patients at high risk for fracture can reduce the burden of osteoporotic fractures.

  13. Osteoporosis prevention, screening, and treatment: a review.

    PubMed

    Kling, Juliana M; Clarke, Bart L; Sandhu, Nicole P

    2014-07-01

    Osteoporosis, defined as low bone mass leading to increased fracture risk, is a major health problem that affects approximately 10 million Americans. The aging U.S. population is predicted to contribute to as much as a 50% increase in prevalence by 2025. Although common, osteoporosis can be clinically silent, and without prevention and screening, the costs of osteoporotic fracture-related morbidity and mortality will burden the U.S. healthcare system. This is a particularly relevant concern in the context of diminishing health care resources. Dual-energy X-ray absorptiometry is the most widely used, validated technique for measuring bone mineral density (BMD) and diagnosing osteoporosis. Cost-effectiveness analyses support early detection and treatment of high-risk patients with antiresorptive medications such as bisphosphonates. Moreover, optimization of bone health throughout life can help prevent osteoporosis. Current guidelines recommend screening women by age 65 years, but because no guidelines for screening intervals exist, decisions are made on the basis of clinical judgment alone. Although the recent literature provides some guidance, this review further explores current recommendations in light of newer evidence to provide more clarity on prevention, screening, and management strategies for patients with osteoporosis in the primary care setting.

  14. Osteoporosis Prevention, Screening, and Treatment: A Review

    PubMed Central

    Kling, Juliana M.; Clarke, Bart L.

    2014-01-01

    Abstract Osteoporosis, defined as low bone mass leading to increased fracture risk, is a major health problem that affects approximately 10 million Americans. The aging U.S. population is predicted to contribute to as much as a 50% increase in prevalence by 2025. Although common, osteoporosis can be clinically silent, and without prevention and screening, the costs of osteoporotic fracture–related morbidity and mortality will burden the U.S. healthcare system. This is a particularly relevant concern in the context of diminishing health care resources. Dual-energy X-ray absorptiometry is the most widely used, validated technique for measuring bone mineral density (BMD) and diagnosing osteoporosis. Cost-effectiveness analyses support early detection and treatment of high-risk patients with antiresorptive medications such as bisphosphonates. Moreover, optimization of bone health throughout life can help prevent osteoporosis. Current guidelines recommend screening women by age 65 years, but because no guidelines for screening intervals exist, decisions are made on the basis of clinical judgment alone. Although the recent literature provides some guidance, this review further explores current recommendations in light of newer evidence to provide more clarity on prevention, screening, and management strategies for patients with osteoporosis in the primary care setting. PMID:24766381

  15. Osteoporosis in elderly: prevention and treatment.

    PubMed

    Srivastava, Manish; Deal, Chad

    2002-08-01

    Osteoporosis is a major clinical problem in older women and men. Almost any bone can fracture as a result of the increased bone fragility of osteoporosis. These fractures are associated with higher health care costs, physical disability, impaired quality of life, and increased mortality. Because the incidence of osteoporotic fracture increases with advancing age, measures to diagnose and prevent osteoporosis and its complications assume a major public health concern. BMD is a valuable tool to identify patients at risk for fracture, to make therapeutic decisions, and to monitor therapy. Several other modifiable and nonmodifiable risk factors for osteoporosis have also been identified. Treatment of potentially modifiable risk factors along with exercise and calcium and vitamin D supplementation forms an important adjunct to pharmacologic management of osteoporosis. Improved household safety can reduce the risk of falls. Hip protectors have been found to be effective in nursing home population. The pharmacologic options include bisphosphonates, HRT, SERMs and calcitonin. PTH had received FDA advisory committee approval. Alendronate has been approved for treatment of osteoporosis in men, and other treatments for men are under evaluation.

  16. Better Bones Buddies: An Osteoporosis Prevention Program

    ERIC Educational Resources Information Center

    Schrader, Susan L.; Blue, Rebecca; Horner, Arlene

    2005-01-01

    Although osteoporosis typically surfaces in later life, peak bone mass attained before age 20 is a key factor in its prevention. However, most American children's diets lack sufficient calcium during the critical growth periods of preadolescence and adolescence to achieve peak bone mass. "Better Bones (BB) Buddies" is an educational…

  17. Better Bones Buddies: An Osteoporosis Prevention Program

    ERIC Educational Resources Information Center

    Schrader, Susan L.; Blue, Rebecca; Horner, Arlene

    2005-01-01

    Although osteoporosis typically surfaces in later life, peak bone mass attained before age 20 is a key factor in its prevention. However, most American children's diets lack sufficient calcium during the critical growth periods of preadolescence and adolescence to achieve peak bone mass. "Better Bones (BB) Buddies" is an educational…

  18. Osteoporosis

    MedlinePlus

    ... Prevention and Treatment The good news is that osteoporosis can often be prevented and treated. Healthy lifestyle choices such as proper diet, exercise, and treatment medications can help prevent further bone ...

  19. Preventing osteoporosis-related fractures: an overview.

    PubMed

    Gass, Margery; Dawson-Hughes, Bess

    2006-04-01

    Osteoporosis is a skeletal disorder characterized by compromised bone strength, which predisposes a person to increased risk of fracture. In the United States, 26% of women aged > or =65 years and >50% of women aged > or =85 years have osteoporosis. Over 1.5 million fractures per year are attributable to osteoporosis; these fractures result in 500,000 hospitalizations, 800,000 emergency room visits, 2.6 million physician visits, 180,000 nursing home placements, and 12 billion dollars to 18 billion dollars in direct healthcare costs each year. Fracture also results in loss of function and has a negative impact on psychological status. In recognition of the importance of bone health, the US Surgeon General has, for the first time, issued a comprehensive report on bone health and treatment. The report recommends a pyramidal approach to osteoporosis treatment that includes calcium and vitamin D supplementation, physical activity, and fall prevention as the first line in fracture prevention. The second level consists of treating secondary causes of osteoporosis; the third and top level consists of pharmacotherapy. Pharmacotherapeutic interventions (e.g., bisphosphonates, selective estrogen receptor modulators, calcitonin, and teriparatide) in women with postmenopausal osteoporosis provide substantial reduction in fracture risk over and above risk reduction with calcium and vitamin D supplementation alone. Despite the effectiveness of therapy, most patients who receive treatment do not remain on treatment for >1 year. An important approach to reducing the rate of fractures is first to target our treatments to patients at high risk for fracture and then to develop strategies to improve treatment continuation rates.

  20. Osteoporosis: incidence, prevention, and treatment of the silent killer.

    PubMed

    Parsons, Lynn C

    2005-03-01

    Osteoporosis is a nationwide health care concern affecting millions of Americans. Health care dollars to prevent and treat osteoporosis are needed. Osteoporosis-related injuries and resulting disabilities, and consequent admissions to hospitals, nursing homes, and long-term care facilities is costing billions of dollars for care and treatment. Healthy lifestyle choices including vitamin and mineral therapy; safe home environments; a diet replete with calcium, vitamin D, and protein; weight-bearing and resistance exercises; and fall prevention programs for home-bound and hospitalized elders are needed to prevent osteoporosis-related fractures and injuries. Nurses must educate the public on osteoporosis and osteoporosis-prevention activities. Research in nursing, pharmacy, and allied health fields such as physical therapy and nutrition must expand to improve understanding of the risks associated with osteoporosis and to evaluate health-promotion and disease- prevention activities. Interdisciplinary partnerships should be established to study the issues, prevention, and treatment modalities of this "silent killer."

  1. Osteoporosis - prevention and detection in general practice.

    PubMed

    Ewald, Dan

    2012-03-01

    Osteoporosis causes a large and growing health burden in Australia. Effective treatments are available, but these are inconsistently implemented. There is some inconsistency in expert advice on who should be recommended to have bone densitometry. This review draws on the available high level evidence for what works in prevention and discusses the rationale for using absolute risk estimations for decision making. Effective interventions for the prevention and early intervention of osteoporosis have not been delivered as widely as they should be. Efforts should be focused on offering treatment to those groups with the highest risk of fracture, particularly those that have had a fragility fracture. There is synergy in the lifestyle recommendations for bone health with other aspects of health, so these should be addressed as thoroughly as possible.

  2. Identification, diagnosis, and prevention of osteoporosis.

    PubMed

    Levine, Jeffrey P

    2011-05-01

    Prevention of osteoporotic fractures is of major importance from a public health perspective. Despite the large burden the disease exacts on individuals and society, not all patients with osteoporosis receive optimal treatment. Since only 1 in 3 patients with osteoporosis is diagnosed, clinicians need to improve their ability to identify patients who are candidates for bone mineral density (BMD) screening. Although limited data exist about the direct correlation between effective screening and fracture morbidity and mortality, it has been proved that increases in fractures are associated with increases in morbidity and mortality. Therefore, identifying patients at risk, making a timely diagnosis, implementing prevention measures (ie, calcium, vitamin D, exercise, fall precautions, etc), and initiating pharmacologic therapy for appropriate patients can all help to minimize fracture risk.

  3. Osteoporosis.

    PubMed

    Nieves, Jeri W; Mosner, Michelle; Silverstein, Shari

    2012-01-01

    Osteoporosis is a skeletal disorder characterized by compromised bone strength that predisposes a person to increased risk of fracture. Fractures have severe consequences, so fracture prevention is imperative. Risk factor assessment and bone density testing are important tools in the diagnosis of osteoporosis. Actions to promote strong bones include adequate intakes of calcium and vitamin D; being physically active; not smoking; and avoiding excessive alcohol use. There are several FDA-approved medications for the treatment of osteoporosis. The recent attention to osteonecrosis of the jaw (ONJ) and the association between dental and skeletal health speak to the importance of osteoporosis awareness for dental professionals.

  4. [Prevention of osteoporosis and its economic aspects].

    PubMed

    Blachier, C

    1999-01-01

    Osteoporosis is a skeletal disease which deteriorates bone tissue and lowers its density. Bone fragility induces fractures of the hip, vertebrae and distal radius. These fractures occur mainly to women after their menopause due to important postmenopausal changes in bone metabolism. Osteoporosis and related fractures are a major public health issue, as the upcoming population aging will sharply increase their incidence. For the time being prevention of osteoporosis is at a crossroads in France. One way would be to treat the entire postmenopause female population with hormone substitution to avoid the incidence to one third among them: the cost would be very high and, for the time being, the risk/benefit ratio is not well known (we do not know the risks of a treatment lasting 20 or 25 years). The other way would be to implement only reliable diagnostic programs without generalized hormone treatment: such an option might lead to a sharp increase of the disease incidence, causing a high cost both in social and financial terms.

  5. Prevention and treatment of postmenopausal osteoporosis

    PubMed Central

    Gallagher, J Christopher; Tella, Sri Harsha

    2014-01-01

    In the beginning, that is from the 1960's, when a link between menopause and osteoporosis was first identified; estrogen treatment was the standard for preventing bone loss, however there was no fracture data, even though it was thought to be effective. This continued until the Women's Health Initiative (WHI) study in 2001 that published data on 6 years of treatment with hormone therapy that showed an increase in heart attacks and breast cancer. Even though the risks were small, 1 per 1500 users annually, patients were worried and there was a large drop off in estrogen use. In later analyses the WHI study showed that estrogen reduced fractures and actually prevented heart attacks in the 50-60 year age group. Estrogen alone appeared to be safer to use than estrogen + the progestin medroxyprogesterone acetate and actually reduced breast cancer. PMID:24176761

  6. Rabbiteye blueberry prevents osteoporosis in ovariectomized rats.

    PubMed

    Li, Tao; Wu, Shou-Mian; Xu, Zhi-Yuan; Ou-Yang, Sheng

    2014-08-08

    It has been forecasted that the rabbiteye blueberry could inhibit osteoporosis. However, the inhibition and prevention of osteoporosis via rabbiteye blueberry are still elusive. This study was aim to evaluate the anti-osteoporosis effects of rabbiteye blueberry in ovariectomized rats. Thirty rats were randomly divided into three groups of ten rats each as follows: sham-operated group (SG), ovariectomized model control group (OMG), and ovariectomized rabbiteye blueberry treatment group (OBG). The blood mineral levels, the alkaline phosphatase (ALP) activity, and osteoprotegerin (OPG) level were determined. The expression analyses of type I collagen, integrin-β1, and focal adhesion kinase (FAK) were performed. Besides, the bone mineral density (BMD) and bone histomorphometry (BH) were measured. The ALP activity in SG and OBG was significantly lower than that in OMG. For the OPG level, the significant increase of OPG level in OBG was indicated compared with the other groups. The mRNA expression levels of type I collagen, integrin-β1, and FAK in OMG were significantly lower than those in other groups. The BMD in OMG were all significantly lower than those in SG and OBG. For BH, blueberry significantly improved the trabecular bone volume fraction, trabecular thickness, mean trabecular bone number, and bone formation rate, and decreased the trabecular separation, the percent of bone resorption perimeter, and mean osteoclast number in OBG compared with OMG. The rabbiteye blueberries had an effective inhibition in bone resorption, bone loss, and reduction of bone strength of ovariectomized rats and could improve the BMD, osteogenic activity, and trabecular bone structure.

  7. Rabbiteye blueberry prevents osteoporosis in ovariectomized rats

    PubMed Central

    2014-01-01

    Objective It has been forecasted that the rabbiteye blueberry could inhibit osteoporosis. However, the inhibition and prevention of osteoporosis via rabbiteye blueberry are still elusive. This study was aim to evaluate the anti-osteoporosis effects of rabbiteye blueberry in ovariectomized rats. Methods Thirty rats were randomly divided into three groups of ten rats each as follows: sham-operated group (SG), ovariectomized model control group (OMG), and ovariectomized rabbiteye blueberry treatment group (OBG). The blood mineral levels, the alkaline phosphatase (ALP) activity, and osteoprotegerin (OPG) level were determined. The expression analyses of type I collagen, integrin-β1, and focal adhesion kinase (FAK) were performed. Besides, the bone mineral density (BMD) and bone histomorphometry (BH) were measured. Results The ALP activity in SG and OBG was significantly lower than that in OMG. For the OPG level, the significant increase of OPG level in OBG was indicated compared with the other groups. The mRNA expression levels of type I collagen, integrin-β1, and FAK in OMG were significantly lower than those in other groups. The BMD in OMG were all significantly lower than those in SG and OBG. For BH, blueberry significantly improved the trabecular bone volume fraction, trabecular thickness, mean trabecular bone number, and bone formation rate, and decreased the trabecular separation, the percent of bone resorption perimeter, and mean osteoclast number in OBG compared with OMG. Conclusions The rabbiteye blueberries had an effective inhibition in bone resorption, bone loss, and reduction of bone strength of ovariectomized rats and could improve the BMD, osteogenic activity, and trabecular bone structure. PMID:25102951

  8. PIXE studies of osteoporosis preventive treatments

    NASA Astrophysics Data System (ADS)

    Ynsa, M. D.; Pinheiro, T.; Ager, F. J.; Alves, L. C.; Millán, J. C.; Gómez-Zubelbia, M. A.; Respaldiza, M. A.

    2002-04-01

    Particle induced X-ray emission (PIXE) and nuclear microprobe (NMP) have been used in an exploratory work to study elemental alterations in tissues of experimental animals submitted to osteoporosis preventive treatments. Osteopathologies have been associated with several factors, such as hormonal disturbances, metabolic aberrations, low dietary Ca and vitamin D intake, excess of iron, among other possible factors. Hormonal treatments seem to be beneficial to the incorporation of Ca in bone but breast and endometrial cancers constitute significant side effects that cannot be ignored. Wistar female rats were used to test the effect of estrogen therapy in osteoporosis progression. The variations of elemental concentrations in uterus and the Ca content of femoral bones of ovariectomised rats under estrogen therapy were investigated. PIXE, Rutherford backscattering spectrometry and secondary electron microscopy techniques were applied for the characterisation of biological materials, with respect to morphology and trace element distribution determination. The increase of Ca and Fe concentrations in uterus and the variations for Ca distribution patterns in bone of rats submitted to estrogen therapy were the major features observed.

  9. Osteoporosis.

    PubMed

    Ensrud, Kristine E; Crandall, Carolyn J

    2017-08-01

    Osteoporosis is a common systemic skeletal disorder resulting in bone fragility and increased fracture risk. However, management of osteoporosis and fracture prevention strategies are often not addressed by primary care clinicians, even in older patients with recent fractures. Evidence-based screening strategies will improve identification of patients who are most likely to benefit from drug treatment to prevent fracture. In addition, careful consideration of when pharmacotherapy should be started and choice of medication and duration of treatment will maximize the benefits of fracture prevention while minimizing potential harms of long-term drug exposure.

  10. Prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Tella, Sri Harsha; Gallagher, J Christopher

    2014-07-01

    In the beginning, that is from the 1960's, when a link between menopause and osteoporosis was first identified; estrogen treatment was the standard for preventing bone loss, however there was no fracture data, even though it was thought to be effective. This continued until the Women's Health Initiative (WHI) study in 2001 that published data on 6 years of treatment with hormone therapy that showed an increase in heart attacks and breast cancer. Even though the risks were small, 1 per 1500 users annually, patients were worried and there was a large drop off in estrogen use. In later analyses the WHI study showed that estrogen reduced fractures and actually prevented heart attacks in the 50-60 year age group. Estrogen alone appeared to be safer to use than estrogen+the progestin medroxyprogesterone acetate and actually reduced breast cancer. At the same time other drugs were being developed for bone that belong to the bisphosphonate group and the first generation of compounds showed moderate potency on bone resorption. The second and third generation compounds were much more potent and in a series of large trials were shown to reduce fractures. For the last 15 years the treatment of osteoporosis belonged to the bisphosphonate compounds, most of which reduce fracture rates by 50 percent. With the exception of gastrointestinal irritation the drugs are well tolerated and highly effective. The sophistication of the delivery systems now allow treatment that can be given daily, weekly, monthly and annually either orally or intravenously. Bone remodeling is a dynamic process that repairs microfractures and replaces old bone with new bone. In the last 10 years there has been a remarkable understanding of bone biology so that new therapies can be specifically designed on a biological basis. The realization that RANKL was the final cytokine involved in the resorption process and that marrow cells produced a natural antagonist called Osteoprotegerin (OPG) quickly led to two

  11. Osteoporosis.

    PubMed

    Nanes, Mark S; Kallen, Caleb B

    2014-01-01

    Osteoporotic fractures are common and result in extensive morbidity and mortality. It is possible to decrease the risk of fracture in postmenopausal, male, and glucocorticoid-induced osteoporosis with appropriate screening and treatment. The assessment of fracture risk, for which bone densitometry is only 1 component, should be the main focus of patient evaluation. Epidemiologically derived risk-assessment tools such as World Health Organization Fracture Risk Assessment Tool (FRAX) provide physicians with a way to determine the 10-year risk of osteoporotic fracture and effectively choose candidates for therapy. A number of potent skeletal antiresorptive and anabolic drugs have become available to treat osteoporosis and prevent up to 70% of fractures. Here, we provide a detailed update on clinical osteoporosis, the contribution of bone densitometry, and the approach to patients using risk assessment in the consideration of treatments. Progress in osteoporosis is an example of successful bench-to-bedside research benefitting populations worldwide.

  12. Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention | NIH MedlinePlus the Magazine

    MedlinePlus

    ... on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table of Contents Osteoporosis ... exercise plan A healthy lifestyle Medications, if needed Prevention Nutrition A diet rich in calcium and vitamin ...

  13. A model of health education and management for osteoporosis prevention

    PubMed Central

    Wang, Liang; Xu, Xiaowen; Zhang, Yan; Hao, Hongxia; Chen, Liying; Su, Tianjiao; Zhang, Yan; Ma, Weifeng; Xie, Yuanyuan; Wang, Tiantian; Yang, Fan; He, Li; Wang, Wenjiao; Fu, Xuemei; Ma, Yuanzheng

    2016-01-01

    Osteoporosis, a chronic disease with no therapeutic cure, affects a growing number of people as the aging population in China rapidly increases. Therefore, developing an evidence-based model of health education and management for osteoporosis prevention is required. In the present study, an osteoporosis club was established, which is a novel model of health education and management for osteoporosis prevention. A unified management of membership was used based on a digitized database. A total of 436 patients with osteoporosis were randomly assigned to the osteoporosis club group or the self-management control group. For the osteoporosis club group, multiple activities of health education were performed, including monthly systematic health education lectures, exercise programs and communication parties once a year. For the control group, the participants took charge of their own musculoskeletal health. All data of the participants were collected and evaluated prior to and following intervention. In the pre-intervention assessment, no significant difference was identified in the health education between the two groups. Through the four-year intervention, the osteoporosis knowledge, health beliefs, living behavior, medication compliance, quality of life and bone mineral density of the osteoporosis club group were improved significantly compared with the control group (P<0.001), while the pain degree of the osteoporosis club group was relieved significantly more compared with the control group (P<0.001). The results in the present study suggest that setting up an osteoporosis club is an evidence-based model of health education and management for osteoporosis prevention in China. PMID:28105113

  14. Prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Hallworth, R B

    1998-10-01

    The purpose of the review is to outline the interventions, both pharmacological and non-pharmacological, available to prevent postmenopausal osteoporosis (PMO) and treat the established disease. Current suggested guidelines for the most cost-effective treatment and prophylactic strategies are included following a consideration of the available options. As life expectancy has increased so has the incidence of PMO which has major quality of life implications for the sufferers and economic implications for the authorities responsible for their treatment. PMO represents a significant public health problem and although more effective treatments are becoming available prevention of the disease by taking account of existing risk factors is preferable. Indeed, a population approach to prevention may be more cost effective than screening for the disease. Attention to dietary calcium intake and exercise regimes have been shown to be effective prophylactic measures premenopausally, while the treatment of choice is hormone replacement therapy (HRT). HRT treats other postmenopausal symptoms in addition to PMO and is available in many presentations, containing different hormones, at different doses intended for different routes of administration. The optimum treatment duration is controversial and may contribute to some of the risks associated with HRT such as endometrial and breast carcinoma and venous thromboembolism (VTE). Newer effective treatments include the bisphosphonates and novel formulations of calcitonin, but older approaches such as vitamin D, anabolic steroids and fluoride are still utilised in some circumstances. However, most promise has been shown by synthetic hormonal modulators currently being trialled.

  15. Prevention of osteoporosis after breast cancer.

    PubMed

    Reid, David M

    2009-09-20

    Breast cancer is a devastating illness but cure rates are increasing and as they do the secondary effects of breast cancer treatment on bone are becoming more prominent. Of particular concern is the increased fracture rates and dramatic bone loss seen in studies of patients undergoing therapy with aromatase inhibitors. Recently a UK Expert Group has drawn up guidelines for the prevention of bone loss. The main recommendations can be summarised as follows: Bone loss in women who experience a premature menopause due to treatment before the age of 45 or who are receiving ovarian suppression therapy is accelerated by the concomitant use of aromatase inhibitors. As they are at high risk of significant bone loss they should have a baseline dual energy X-ray absorptiometry (DXA) assessment of BMD. As randomised clinical trials in postmenopausal women indicate that bisphosphonates prevent the bone loss and accelerated bone turnover associated with aromatase inhibitor therapy their use as the main preventative therapy is recommended, along with a healthy lifestyle and adequate intake of calcium and vitamin D. Decisions on the initiation of treatment initiation should be based on a combination of risk factors for osteoporotic fracture and BMD levels. Due to the rate of bone loss associated with breast cancer treatments, and uncertainties about the interaction between aromatase inhibitor use and BMD for fracture risk, the thresholds for intervention have been set at a higher levels than generally recommended for postmenopausal osteoporosis.

  16. [Vitamin D intake and the prevention of osteoporosis].

    PubMed

    Nakamura, Kazutoshi

    2005-08-01

    The incidence of osteoporosis in Japan is increasing. Osteoporotic fractures have been causes of "bedridden" status among the elderly in recent years, and vitamin D has the potential to decrease the incidence of these health problems of osteoporosis. This article tried to clarify the preventive effect of increased vitamin D intake on osteoporosis in Japan. Vitamin D intake of 700-800 IU/day together with sufficient calcium intake is recommended to prevent fractures in the elderly, and vitamin D intake of 400 IU/day is recommended to prevent bone loss in adult women. The author also discusses the importance of increasing vitamin D intake in public health in Japan.

  17. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan.

    PubMed

    Moriwaki, K; Noto, S

    2017-02-01

    A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture.

  18. Diagnosing and managing post menopausal osteoporosis: opportunities for fracture prevention.

    PubMed

    McGarry, Kelly A; Tammaro, Dominick; Cyr, Michele G

    2003-01-01

    Osteoporosis is an asymptomatic disease until a fracture occurs. Management includes primary prevention, early detection through targeted screening, and implementation of appropriate treatment and monitoring strategies. This article explores these issues in depth.

  19. Prevention and treatment of osteoporosis in postmenopausal women: a review.

    PubMed

    Roush, Karen

    2011-08-01

    This article provides an overview of osteoporosis, describes current recommendations for its prevention and treatment, and discusses nursing implications. This is part two of a four-part series on postmenopausal health.

  20. Osteoporosis.

    PubMed

    Lane, J M; Russell, L; Khan, S N

    2000-03-01

    Osteoporosis is a disorder of decreased bone mass, microarchitectural deterioration, and fragility fractures. Osteoporosis is widespread and can affect people of all ethnic backgrounds and many older women and men. An essential element in preventing osteoporosis is the achievement of normal peak bone mass. Adequate nutrition, appropriate calcium and vitamin D intake, regular menstrual cycles and a well balanced exercise program of exercise are essential elements in achieving peak bone mass. At menopause women undergo accelerated bone loss. Thereafter, women and men gradually lose bone mass. A loss of one standard deviation give rise to an enhanced twofold risk of spine fractures or a 2.5 risk of hip fracture. Bone mass is determined by dual energy x-ray absorptiometry, quantitative computed tomography scan, and a peripheral ultrasound. Dual energy x-ray absorptiometry has outstanding precision (within 1% to 2%), and has the ability to show the efficacy of drug intervention. Peripheral measurements may identify osteoporosis but only have a 70% correlation with hip and spine bone mass. Dual energy x-ray absorptiometry determines bone mass in a patient but the bone collagen breakdown products (N-telopeptide crosslinks) establish the current rate of bone loss. Major risk factors leading to fragility fracture include low body weight, history of fracture, family history of osteoporosis, and smoking. All individuals should ingest adequate calcium and vitamin D, exercise, and prevent falls. Women with low bone mass, high urinary bone collagen breakdown products, and/or major risk factors should consider hormone replacement therapy or a selective estrogen receptor modulator (Evista), calcitonin and bisphosphonates (alendronate). These agents successfully increase bone mass and limit fracture risk. Men at risk for fragility fractures respond similarly as women to alendronate and calcitonin. Although vertebral compression fractures can occur spontaneously, hip fractures are

  1. Osteoporosis

    MedlinePlus

    ... Emergency Room? What Happens in the Operating Room? Osteoporosis KidsHealth > For Kids > Osteoporosis A A A What's ... you're in your mid-20s. What Is Osteoporosis? If someone has osteoporosis (say: oss-tee-oh- ...

  2. Osteoporosis

    MedlinePlus

    ... Too Tall or Too Short All About Puberty Osteoporosis KidsHealth > For Kids > Osteoporosis Print A A A ... you're in your mid-20s. What Is Osteoporosis? If someone has osteoporosis (say: oss-tee-oh- ...

  3. Current approaches to the prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Follin, Sheryl L; Hansen, Laura B

    2003-05-01

    Current approaches to the prevention, detection, treatment, and monitoring of postmenopausal osteoporosis are discussed. In the United States, 44 million men and women ages 50 years or older have low bone mass or osteoporosis. The most devastating consequence of this disease is fractures. The assessment of osteoporosis risk includes determining risk factors, conducting laboratory and physical examinations, and measuring bone density and bone-turnover markers. Once risk has been established, nonpharmacologic strategies, such as exercise, appropriate dietary habits, and discontinuing tobacco and alcohol use, are helpful. Fall prevention and adequate intake of calcium and vitamin D are critical. When pharmacologic therapy is warranted, bisphosphonates have shown the greatest benefit in preventing bone loss and lowering fracture rates. Selective estrogen-receptor modulators and calcitonin are also options for prevention or treatment of osteoporosis. Estrogen should not be used for the sole purpose of osteoporosis prevention; however, short-term use is acceptable for women with vasomotor symptoms or in whom the benefits outweigh the risks. Parathyroid hormone may offer another treatment alternative. A variety of pharmacologic options are available for patients with osteoporosis in whom lifestyle modifications have proven insufficient. Bisphosphonates are the mainstay of drug therapy.

  4. [Osteoporosis].

    PubMed

    Pilipović, N

    2001-01-01

    Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue, leading to enhanced bone fracture risk. Due to its increasing prevalence (affects more than 10 percent of population) and consequences (bone fractures), osteoporosis is a growing medical, social and economic problem. Of particular importance is hip fracture, with increasing incidence and lethal outcome in 20 percent, and less than 33 percent of patients with complete recovery. For better prevention of such undesired consequences, accurate diagnosis in the early phase of bone loss is necessary. Bone loss is a silent process, without signs and symptoms of the disease, and so active screening of persons at risk is needed, particulary among the postmenopausal women with some of the recognized risk factors for the development of osteoporotic bone fracture. In such persons, for early detection of bone mass loss, diagnostic measurement of bone density should be done, preferably dual-energy x-ray absorptiometry (DEXA). Prevention of osteoporosis is the best approach to the problem, and it should be started in early childhood with general measures (diet with sufficient calcium intake, life style with physical exercise) in a involved national program. Treatment of osteoporosis lasts for many years and includes general measures and medication with osteodensitometric assessment over a two-year period.

  5. UK clinical guideline for the prevention and treatment of osteoporosis.

    PubMed

    Compston, J; Cooper, A; Cooper, C; Gittoes, N; Gregson, C; Harvey, N; Hope, S; Kanis, J A; McCloskey, E V; Poole, K E S; Reid, D M; Selby, P; Thompson, F; Thurston, A; Vine, N

    2017-12-01

    In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds. The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

  6. Current approach to fracture prevention in postmenopausal osteoporosis.

    PubMed

    Kaplan, B; Hirsch, M

    2004-01-01

    The prevention and management of osteoporosis are becoming increasingly prominent concerns as the number of postmenopausal women reaching old age continues to grow. Often the first sign of osteoporosis is a fractured bone. It is important that women with low bone density be identified as early as possible and measures taken to reverse the process. These include proper diet and exercise, supplements of calcium and vitamin D, and in cases with proven osteoporosis, antiresorptive or anabolic agents to improve bone strength. Women should also be cautioned to avoid falling as much as possible.

  7. Knowledge about osteoporosis prevention among women screened by bone densitometry

    PubMed Central

    Firlej, Ewelina; Żołnierczuk-Kieliszek, Dorota; Dziedzic, Małgorzata

    2016-01-01

    Introduction Osteoporosis is an illness characterized by the handicapped endurance of the bones, causing an increased risk of fracture. Aim of the study Aim of the study was to establish the level of knowledge about osteoporosis prevention among women screened by bone densitometry and to answer the question whether the level of knowledge is dependent on socio-demographic factors. Material and methods The research was realized by means of a survey method, a poll technique in 2014. The study involved 292 women aged 51-83. The examined women were patients undergoing bone densitometry in the healthcare centres in Lublin. The osteoporosis knowledge test (OKT, revised 2011) by Phyllis Gendler was used as a research tool. Gathered material was subject to descriptive and statistical analysis. Tukey's test, t-Student test and variance analysis (ANOVA) were all applied. A statistical significance level was set at α = 0.05. Results and conclusions Respondents presented the basic exercise knowledge (M = 9.97) and low knowledge concerning risk factors, screening and treatment of osteoporosis (M = 7.87). The calcium knowledge remained on an average level (M = 14.03). Better educated women, city inhabitants as well as women having very good or good social and welfare conditions showed a significantly higher level of knowledge about osteoporosis prevention. Even women undergoing bone densitometry examination present insufficient knowledge about osteoporosis prevention. PMID:27582684

  8. Guidelines for the diagnosis, prevention and management of osteoporosis.

    PubMed

    Rossini, M; Adami, S; Bertoldo, F; Diacinti, D; Gatti, D; Giannini, S; Giusti, A; Malavolta, N; Minisola, S; Osella, G; Pedrazzoni, M; Sinigaglia, L; Viapiana, O; Isaia, G C

    2016-06-23

    Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management.

  9. Hormone replacement therapy and the prevention of postmenopausal osteoporosis.

    PubMed

    Gambacciani, Marco; Levancini, Marco

    2014-09-01

    Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR), is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC), is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

  10. Prescription drug therapies for prevention and treatment of postmenopausal osteoporosis.

    PubMed

    O'Connell, Mary Beth

    2006-07-01

    To characterize the changes in bone mass with age in women and men, explain the physiology and pathophysiology of the bone remodeling process, identify the targets for prescription osteoporosis drugs in this process, and provide details about the uses, efficacy, safety, and economics of prescription drug therapies for osteoporosis prevention and treatment. Preventing accelerated bone loss and decreasing age-related decreases in bone density are the primary goals of prescription drug therapy for osteoporosis. Bisphosphonates are the drugs of choice for preventing and treating postmenopausal osteoporosis. Alternatives for patients who cannot take bisphosphonates include raloxifene and calcitonin salmon. Menopause is accompanied by a rapid loss in bone mass that is followed by annual losses due to aging in women, which are similar to age-related bone mass decreases in men. Most prescription drug therapies for osteoporosis prevention or treatment reduce bone resorption by inhibiting osteoclast activation and activity, with only one medication class able to increase bone formation by stimulating osteoblasts. Denosumab, an investigational monoclonal antibody that inhibits nuclear factor kB ligand, would be a new class of anti-resorptive medications. Bisphosphonates currently are the drugs of choice for preventing and treating osteoporosis, with 7- and 10-year safety data available for risedronate and alendronate, respectively. Weekly and monthly regimens of bisphosphonates improve patient acceptance. Recently, an injectable form of ibandronate received U.S. Food and Drug Administration approval for once every 3 months administration. Raloxifene and calcitonin salmon are alternatives for patients who cannot take bisphosphonates because of contraindications or adverse effects. Teriparatide, a recombinant parathyroid hormone fragment, not only increases bone mineral density but also increases bone connectivity. Osteoporosis medications are usually safe, especially if used

  11. [Osteoporosis].

    PubMed

    Ziegler, R

    1994-09-20

    Liver cirrhosis may be accompanied by osteoporosis and, rarely, osteomalacia. Normal liver function is required for normal digestion and absorption of calcium-containing nutrients. The liver plays an important role for the metabolisation of vitamin D: the 25-hydroxylation takes place in the liver. However, the respective enzymatic capacity is not limited by liver diseases except for almost complete liver insufficiency. Therefore, true hypovitaminosis D only rarely plays a role in hepatic osteopenia, but direct toxic effects on bone forming cells (osteoblasts) are discussed: e.g. by bile salts. Coexisting hypogonadism leads to further bone loss. Patients with primary biliary cirrhosis in part present with osteoporosis and fractures. Bone histology reveals normal resorption, but decreased formation. Calcitropic hormones are generally normal. Chronic alcoholism induces the same histologic picture in bone, i.e. normal resorption and diminished formation. These changes are reversible after abstinence and as long as of cirrhosis has not yet developed. Patients undergoing liver transplantation due to end stage liver insufficiency including cirrhosis present with diminished bone mass before receiving a new liver, and they show further bone loss after the transplantation due to immunosuppressive treatment including glucocorticoids. There is no specific treatment of bone loss or osteoporosis due to liver cirrhosis. Preventive efforts should be devoted to the avoidance of suboptimal calcium and vitamin D supply, immobilization, and hypogonadism. Fluorides may increase bone mass after liver transplantation--perhaps they are also useful in liver cirrhosis. Antiresorption agents like calcitonins or bisphosphonates may be cautiously tried.

  12. Postmenopausal osteoporosis: fracture risk and prevention.

    PubMed

    Kaunitz, Andrew M; McClung, Michael R; Feldman, Robert G; Wysocki, Susan

    2009-11-01

    In the estrogen-regulated RANK ligand (RANKL)/RANK/osteoprotegerin (OPG) pathway, estrogen deficiency favors osteoclast maturation, leading to increased bone resorption compared with bone formation. Treatment of low bone mineral density (BMD) should be based on fracture risk, assessed using the WHO Fracture Risk Algorithm (FRAX(R)). Criteria for treatment are 10-year overall fracture risk ≥ 20% or 10-year hip fracture risk ≥ 3%. Vitamin D supplementation at levels higher than those traditionally recommended may be appropriate for healthy menopausal women. Multiple strategies are needed to effectively manage osteoporosis in postmenopausal women.

  13. Preventing and treating osteoporosis: strategies at the millennium.

    PubMed

    Sherman, S

    2001-12-01

    Osteoporosis has been defined as "a progressive systemic disease characterized by low bone density and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture." Osteoporosis and the consequences of compromised bone strength--particularly vertebral and hip fractures--are a significant cause of frailty, and increased morbidity and even mortality and hence are a serious and costly public health problem in the elderly population. However, due to remarkable advances in basic and clinical research and in drug design, development, and testing, a number of efficacious, evidence-based options are available for the prevention and treatment of osteoporosis. These options extend far beyond estrogen/progestin therapy and include lifestyle and dietary changes such as increasing weight-bearing activity, enhancing calcium and vitamin D intake, as well as incorporating pharmacologic agents such as the bisphosphonates and selective estrogen receptor modulators (SERMs) such as raloxifene. In addition to its efficacy in increasing bone mineral density and reducing vertebral fractures by almost 40% in women with osteoporosis, the SERM raloxifene appears to promote a cardioprotective profile and to offer some protection against breast cancer. The potential of raloxifene to prevent or delay the development of a number of chronic diseases of aging such as osteoporosis, cardiovascular disease, and perhaps even Alzheimer's disease has stimulated the development and refinement of subsequent generations of SERMs aimed at maximizing beneficial effects in a wide variety of tissues while eliminating deleterious outcomes and side effects.

  14. Management of postmenopausal osteoporosis and the prevention of fractures.

    PubMed

    Gambacciani, M; Levancini, M

    2014-06-01

    Postmenopausal osteoporosis affects millions of women, being estrogen deficiency the key factor in the pathogenesis of involutional osteoporosis. Fracture prevention is one of the public health priorities worldwide. Different treatments for osteoporosis are available. The various options are aimed to maintain bone health and decrease the risk of fractures. The majority of these drugs are antiresorptive agents, i.e., drugs that lower bone turnover, inhibiting osteoclastic bone resorption. Dietary sources of calcium intake and vitamin D are ideal, while pharmachological supplements should be used if diet alone cannot provide the recommended daily intake. Bisphosphonates are first-line therapy for patients with established osteoporosis at high risk of fracture. Some serious, but rare, adverse events have been associated with their long-term administration. The monoclonal antibody to RANKL, named denosumab, administered as a 60-mg subcutaneous injection every 6 months, is a valuable option for the treatment of postmenopausal osteoporosis in women at increased or high risk of fractures, who are unable to take other osteoporosis treatments. Teriparatide (PTH 1-34) is the only available osteoanabolic drugs for osteoporosis treatment at present. Its use is limited to severe osteoporosis because of the high cost of the treatment. In climacteric women, in different stages of menopausal transition, and beyond, hormone replacement therapy at different doses (HRT) rapidly normalizes turnover, preventing and/or treating osteoporosis. HRT is able to preserve and even increase BMD at all skeletal sites, leading to a significant reduction in vertebral and non-vertebral fractures. Selective estrogen modulators (SERMs) as raloxifene and bazedoxifene reduce bone turnover and maintains or increases vertebral and femoral BMDs in comparison to placebo and reduces the risk of vertebral and new vertebral fractures, in high risk women. The combination of a SERM with an estrogen has been

  15. The Role of Calcium in Prevention and Treatment of Osteoporosis.

    ERIC Educational Resources Information Center

    Heaney, Robert P.

    1987-01-01

    Osteoporosis results from several factors. Calcium deficiency is only one, and high calcium intake will prevent only those cases in which calcium is the limiting factor. Calcium cannot reverse, but only arrest, bone loss. A high calcium intake for every member of the population is advocated. (Author/MT)

  16. The Role of Calcium in Prevention and Treatment of Osteoporosis.

    ERIC Educational Resources Information Center

    Heaney, Robert P.

    1987-01-01

    Osteoporosis results from several factors. Calcium deficiency is only one, and high calcium intake will prevent only those cases in which calcium is the limiting factor. Calcium cannot reverse, but only arrest, bone loss. A high calcium intake for every member of the population is advocated. (Author/MT)

  17. Structural model for osteoporosis preventing behavior in postmenopausal women.

    PubMed

    Estok, Patricia J; Sedlak, Carol A; Doheny, Margaret O; Hall, Rosalie

    2007-01-01

    Osteoporosis prevention behaviors (OPBs) can prevent and delay bone deterioration; dual-energy X-ray absorptiometry (DXA) scan can identify osteoporosis and provide personal osteoporosis risk information that may promote prevention behaviors. This study was designed to estimate relationships between receiving personal knowledge of bone mineral density (gained through DXA scan), general knowledge of osteoporosis, health beliefs, and the two OPBs of calcium intake and weight-bearing exercise in healthy postmenopausal women 50 to 65 years. In this longitudinal, randomized clinical trial (including covariates), receipt of personal DXA information was manipulated by random assignment to the experimental or control group. The remaining antecedent and outcome variable measures were collected by questionnaire at three time points (initial [T1; pre-DXA], 6 months [T2], 12 months [T3]) and by bone density assessment from 203 women over an 18-month period in 2001-2003. The experimental manipulation (DXA results) had a direct positive effect (beta = .23, p < .05) on calcium intake at T2, and indirectly at T3 through T2. Women in the experimental group who were informed they had osteopenia or osteoporosis had a greater T1-T2 change in daily calcium intake than those with normal bone density (beta = .23, p < .05). However, providing DXA results did not relate to change in exercise. Health beliefs and general osteoporosis knowledge predicted initial calcium and exercise levels; there was tentative evidence that susceptibility beliefs partially mediate between DXA results and change in calcium intake. Personal knowledge of DXA results was related significantly to increases in calcium intake in postmenopausal women, but not to exercise. Directions for further study are discussed.

  18. Promoting successful aging through effective prevention and management of osteoporosis.

    PubMed

    Cavalieri, Thomas A; Noll, Donald R

    2013-02-01

    Successful aging has been described as having 3 components: a low probability of disease and disease-related disability, a capacity for high cognitive and physical function, and active engagement with social and productive activities. Osteopathic physicians play a critical role in the promotion of successful aging through the prevention, early detection, and management of osteoporosis. Not many years ago, osteoporosis was viewed as an age-related disorder for which there was a lack of effective approaches for early intervention and management. Now, that view has changed.

  19. Two single nucleotide polymorphisms in the CYP17 and COMT Genes--relation to bone mass and longitudinal bone changes in postmenopausal women with or without hormone replacement therapy. The Danish Osteoporosis Prevention Study.

    PubMed

    Tofteng, C L; Abrahamsen, B; Jensen, J E B; Petersen, S; Teilmann, J; Kindmark, A; Vestergaard, P; Gram, J; Langdahl, B L; Mosekilde, L

    2004-08-01

    Sex steroids are important physiologic regulators of bone mass, and genes regulating sex steroid production and metabolism are obvious as candidate genes for osteoporosis susceptibility. We present data from a study of 1795 recent postmenopausal women, assigned to either hormone replacement therapy (HRT) or no treatment and followed for 5 years. The association between bone mass measurements and two single nucleotide polymorphisms, a T (A1) to C (A2) transition in the 5'-UTR of the cytochrome P450c17alpha (CYP17) gene and a G (Val) to A (Met) transition in exon 4 of the catechol- O-methyltransferase (COMT) gene, was evaluated. Association with CYP17 genotype was modified by body mass index (BMI). In lean women, individuals homozygous for the CYP17 A2 allele were 1 cm shorter and had lower baseline BMD (bone mineral density), BMC, and CSA (cross sectional area) in the spine and femoral neck than did other women (BMD spine A2A2: 0.975 g/cm2 versus 1.011 g/cm2 in A1A1 + A1A2, P = 0.002). Conversely, an adverse association with A2A2 and bone loss over 5 years seemed present only in overweight women, but differences were small. Response to HRT was not dependent on CYP17 genotype. COMT genotype was not associated with bone mass at baseline, bone loss in untreated women, or response to HRT. In conclusion, the A2 allele of the CYP17 T(27)-C polymorphism is associated with reduced bone mass and bone size in lean perimenopausal women, whereas high BMI protects against this negative association. The COMT G(1947)-A polymorphism is not associated with bone parameters in this study.

  20. Prevention of osteoporosis: one step forward, two steps back.

    PubMed

    Stevenson, John C

    2011-12-01

    For many years, hormone replacement therapy (HRT) was the mainstay for osteoporosis prevention in postmenopausal women until a large randomized clinical trial raised serious safety concerns. This resulted in a big drop in HRT use and its demotion by regulatory authorities to second-line treatment. Many clinicians now feel that HRT is not safe to use, and recommend various alternatives for the treatment of osteoporosis. But how effective are these alternative therapies, are they any safer than HRT, and how do their costs compare? This review questions the validity of the safety concerns about HRT, and highlights the safety concerns about alternative therapies. It concludes that HRT is as safe as the other treatment options, and its efficacy and low cost demand that it be restored as a first-line treatment for the prevention of postmenopausal osteoporosis. Other therapies are available for use in osteoporosis, and the bisphosphonates are particularly effective for the treatment of the established disease. However, they must be used selectively and with caution, and are best restricted to those patients who are elderly or have severe disease. New treatments are emerging, but again caution must be taken until any long-term adverse effects have been identified.

  1. Osteoporosis

    MedlinePlus

    Osteoporosis is a disease that thins and weakens the bones. Your bones become fragile and break easily, ... United States, millions of people either already have osteoporosis or are at high risk due to low ...

  2. Osteoporosis

    SciTech Connect

    Riggs, B.L. Melton III, L.J. )

    1988-01-01

    This book contains 20 chapters. Some of the titles are: Radiology of asteoporosis; Quantitative computed tomography in assessment of osteoporosis; Nuclear medicine and densitometry; Assessment of bone turnover by histormorphometry in osteoporosis; and The biochemistry of bone.

  3. Tailored interventions to enhance osteoporosis prevention in women.

    PubMed

    Sedlak, Carol A; Doheny, Margaret O; Estok, Patricia J; Zeller, Richard A

    2005-01-01

    The purpose of this pilot study was to determine if tailored nursing interventions based on personal knowledge of bone mineral density from a dual-energy x-ray absorptiometry cause increases in knowledge of osteoporosis, health beliefs, or osteoporosis-prevention behaviors in postmenopausal women 50-65 years of age, 6 months after the intervention. The design for this pilot study was a two group quasi-experimental design. The treatment group received a tailored intervention; the control group did not. Outcome data were gathered at 6 months after dual-energy x-ray absorptiometry. The tailored intervention was designed and given to each woman via telephone using her dual-energy x-ray absorptiometry results and osteoporosis questionnaire data that addressed her knowledge of osteoporosis and osteoporosis-prevention behaviors of calcium intake, exercise, smoking, and alcohol use. A written mailed copy of the intervention followed the telephone interview. Six months after the intervention, the women were mailed another osteoporosis questionnaire to determine if the tailored intervention made a difference in the outcome variables. A total 124 women between the ages of 50 and 65 (101 control, 23 treatment) comprised the sample. There was no difference in knowledge between groups. On the average, there were significantly more perceived barriers to calcium in the tailored group (mean = 13.48) than in the nontailored group (mean = 11.55) (t = 2.147; df = 122; p = .034). There were significantly more perceived barriers to exercise in the tailored group (mean = 14.39) than in the nontailored group (mean = 12.21) (t = .144; df = 122; p = .034). Daily calcium intake increased in both the tailored and the nontailored groups. The tailored intervention increased women's daily calcium intake from 614.28 to 1039.10 mg (t = -2.896; df = 22; p = .008). The nontailored group daily calcium intake increased from 587.91 to 916.30 mg (t = -3.541; df = 100; p = .001); there was no significant

  4. Preventing and Treating Brittle Bones and Osteoporosis | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Javascript on. Feature: Osteoporosis Preventing and Treating Brittle Bones and Osteoporosis Past Issues / Winter 2011 Table of ... at high risk due to low bone mass. Bone and Bone Loss Bone is living, growing tissue. ...

  5. Osteoporosis and prostate cancer: a cross-sectional study of Danish men with prostate cancer before androgen deprivation therapy.

    PubMed

    Poulsen, Mads Hvid; Frost, Morten; Abrahamsen, Bo; Brixen, Kim; Walter, Steen

    2014-08-01

    The aim of this study was to analyse the prevalence of osteoporosis and risk factors of osteoporotic fractures before androgen deprivation in Danish men. Treatment and prognosis of prostate cancer necessitate management of long-term consequences of androgen deprivation therapy (ADT), including accelerated bone loss resulting in osteoporosis. Osteoporotic fractures are associated with excess morbidity and mortality. Patients with prostate cancer awaiting initiation of ADT were consecutively included. Half of the patients had localized disease and were referred for curative intended radiation, and the remaining patients had disseminated disease. Blood samples were collected, a questionnaire was administered and a dual-energy X-ray absorptiometry (DXA) scan was performed before initiating ADT. The patients were included between January 2010 and March 2012. The study was approved by the local ethics committee. None of the patients had received prior androgen deprivation or osteoporosis treatment. In total, 105 individuals were included. The mean age of the participants was 70 years (range 53-91 years, SD 6.3). The median prostate-specific antigen level was 30.5 g/l (1-5714 g/l). The average Gleason score was 7.8 (range 5-10, SD 1.1). Fifty patients had localized prostate cancer and the other 55 patients had disseminated disease. The prevalence of osteoporosis was 10% and the prevalence of osteopenia was 58% before ADT. There was no significant difference between the two subgroups concerning osteoporosis. Smoking use was the only factor that was significantly associated with an increased prevalence of osteoporosis in the study population. Two-thirds of patients with prostate cancer awaiting ADT had osteoporosis or reduced bone mass. Further awareness regarding osteoporosis and bone health in prostate cancer is needed. It is suggested that patients with prostate cancer undergo a DXA scan before starting ADT.

  6. Osteoporosis – a current view of pharmacological prevention and treatment

    PubMed Central

    Das, Subhajit; Crockett, Julie C

    2013-01-01

    Postmenopausal osteoporosis is the most common bone disease, associated with low bone mineral density (BMD) and pathological fractures which lead to significant morbidity. It is defined clinically by a BMD of 2.5 standard deviations or more below the young female adult mean (T-score =−2.5). Osteoporosis was a huge global problem both socially and economically – in the UK alone, in 2011 £6 million per day was spent on treatment and social care of the 230,000 osteoporotic fracture patients – and therefore viable preventative and therapeutic approaches are key to managing this problem within the aging population of today. One of the main issues surrounding the potential of osteoporosis management is diagnosing patients at risk before they develop a fracture. We discuss the current and future possibilities for identifying susceptible patients, from fracture risk assessment to shape modeling and in relation to the high heritability of osteoporosis now that a plethora of genes have been associated with low BMD and osteoporotic fracture. This review highlights the current therapeutics in clinical use (including bisphosphonates, anti-RANKL [receptor activator of NF-κB ligand], intermittent low dose parathyroid hormone, and strontium ranelate) and some of those in development (anti-sclerostin antibodies and cathepsin K inhibitors). By highlighting the intimate relationship between the activities of bone forming (osteoblasts) and bone-resorbing (osteoclasts) cells, we include an overview and comparison of the molecular mechanisms exploited in each therapy. PMID:23807838

  7. Are effects of MTHFR (C677T) genotype on BMD confined to women with low folate and riboflavin intake? Analysis of food records from the Danish osteoporosis prevention study.

    PubMed

    Abrahamsen, Bo; Madsen, Jonna Skov; Tofteng, Charlotte Landbo; Stilgren, Lis; Bladbjerg, Else Marie; Kristensen, Søren Risom; Brixen, Kim; Mosekilde, Leif

    2005-03-01

    We have previously found BMD and fracture risk to be significantly associated with the MTHFR (C677T) polymorphism in healthy postmenopausal women in the first years after menopause. Since then, other cohort studies have suggested that sufficient intake of riboflavin and/or folate may have the potential to prevent development of low BMD in women with the TT genotype. This could to some extent explain why this polymorphism is associated with low BMD or fracture in some study populations and not in others. It would also indicate that fractures associated with the TT genotype could be preventable by vitamin B supplementation. We have, therefore, reviewed baseline food record data from our original study to determine if BMD and fracture associations with the MTHFR genotype depended on the intake of folate, riboflavin, or other members of the vitamin B complex, associated with homocysteine metabolism. We analyzed genotype, BMD, and dietary records from 1700 healthy postmenopausal women who participated in the DOPS study. For the assessment of fracture risk, we used longitudinal observations from 854 women in the control group who remained compliant with their initial allocation of no treatment. Riboflavin intake was significantly correlated with femoral neck (FN) BMD in women with the TT genotype (r = 0.24, P < 0.01). FN and lumbar spine (LS) BMD were only associated with the MTHFR genotype in the lowest quartile of riboflavin intake. At the FN, similar threshold effects were shown for folate, vitamin B12, and vitamin B6. Among these vitamin B complex members, stepwise regression analysis identified riboflavin as the only significant predictor of FN BMD in the TT genotype. In conclusion, we confirm reports that BMD in the MTHFR TT genotype is only significantly reduced in the lowest quartile of riboflavin, B12, B6, and folate intake, at least at the time of menopause. Vitamin B supplementation would only be expected to benefit BMD in about 2% of the population, i

  8. Analysis of consumer information brochures on osteoporosis prevention and treatment.

    PubMed

    Meyer, Gabriele; Steckelberg, Anke; Mühlhauser, Ingrid

    2007-01-11

    Evidence-based consumer information is a prerequisite for informed decision making. So far, there are no reports on the quality of consumer information brochures on osteoporosis. In the present study we analysed brochures on osteoporosis available in Germany. All printed brochures from patient and consumer advocacy groups, physician and governmental organisations, health insurances, and pharmaceutical companies were initially collected in 2001, and updated in December 2004. Brochures were analysed by two independent researchers using 37 internationally proposed criteria addressing evidence-based content, risk communication, transparency of the development process, and layout and design. A total of 165 brochures were identified; 59 were included as they specifically targeted osteoporosis prevention and treatment. Most brochures were provided by pharmaceutical companies (n=25), followed by health insurances (n=11) and patient and consumer advocacy groups (n=11). Quality of brochures did not differ between providers. Only 1 brochure presented lifetime risk estimate; 4 mentioned natural course of osteoporosis. A balanced report on benefit versus lack of benefit was presented in 2 brochures and on benefit versus adverse effects in 8 brochures. Four brochures mentioned relative risk reduction, 1 reported absolute risk reduction through hormone replacement therapy (HRT). Out of 28 brochures accessed in 2004 10 still recommended HRT without discussing adverse effects. Transparency of the development process was limited: 25 brochures reported publication date, 26 cited author and only 1 references. In contrast, readability and design was generally good. The quality of consumer brochures on osteoporosis in Germany is utterly inadequate. They fail to give evidence-based data on diagnosis and treatment options. Therefore, the material is not useful to enhance informed consumer choice.

  9. Olives and Bone: A Green Osteoporosis Prevention Option.

    PubMed

    Chin, Kok-Yong; Ima-Nirwana, Soelaiman

    2016-07-26

    Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly.

  10. Olives and Bone: A Green Osteoporosis Prevention Option

    PubMed Central

    Chin, Kok-Yong; Ima-Nirwana, Soelaiman

    2016-01-01

    Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly. PMID:27472350

  11. [On "2015 Guidelines for Prevention and Treatment of Osteoporosis". CKD and osteoporosis].

    PubMed

    Yamada, Shinsuke; Inaba, Masaaki

    2015-09-01

    Many patients with osteoporosis have complicated with CKD. It was reported that the risk of hip and vertebral fracture is higher in osteoporosis patients with CKD than without CKD. Because the drugs for osteoporosis are excreted by kidney, there are no drugs that the efficacy and safety were established for the CKD patient. I give an outline about the relationship between CKD and osteoporosis, and the note on the medical care of osteoporosis patients with CKD.

  12. Osteoporosis

    MedlinePlus

    ... is at its highest level. After bone mass peaks, all adults start to lose some bone mass.Osteoporosis occurs if you lose too much bone or don't make enough bone to begin with.What are the risk factors for osteoporosis?The following things put you at ...

  13. The pathogenesis, treatment and prevention of osteoporosis in men.

    PubMed

    Mosekilde, Leif; Vestergaard, Peter; Rejnmark, Lars

    2013-01-01

    Testosterone stimulates longitudinal and appositional growth during childhood, whereas estrogen induces epiphysial closure. During adulthood, testosterone continues to stimulate periosteal growth, whereas estrogen is important for the maintenance of trabecular bone mass and structure. In males, testosterone is aromatized to estradiol. Both free and bioavailable plasma levels of testosterone and estradiol decrease with age in males, and fracture risk is associated with low estradiol levels. Testosterone may increase muscle mass and prevent fractures related to falls. Younger hypogonadal males should be treated with testosterone to attain peak bone mass and increase bone mineral density (BMD). Older hypogonadal males should be treated in cases of osteoporosis, reduced muscle strength and increased risk of falling. Secondary hyperparathyroidism caused by calcium and vitamin D insufficiency may reduce bone mass and strength and increase fracture risk and should be avoided. Since calcium supplementation has been associated with an increased risk of cardiovascular complications and renal stones, the dose should be tailored to the habitual daily calcium intake. Lifestyle-related risk factors (smoking, alcohol consumption, lack of physical activity and low body weight) should be addressed. The antifracture efficacy of antiresorptive and anabolic treatment for osteoporosis has not been documented in larger randomized controlled studies. However, changes in BMD and bone markers suggest similar effects in males and females of bisphosphonates (alendronate, risedronate, ibandronate, zoledronic acid), nasal calcitonin, denosumab and teriparatide (parathyroid hormone [1-34]). The antiresorptive drugs should be used in males with BMD T-score less than -2.5 and one or more risk factors, or with hip and vertebral fractures. It seems appropriate to recommend a higher cut-off T-score (e.g. less than -1.0 standard deviation [SD]) in glucocorticoid-induced osteoporosis and in patients

  14. Nutrition and osteoporosis prevention for the orthopaedic surgeon

    PubMed Central

    Higgs, Jennette; Derbyshire, Emma; Styles, Kathryn

    2017-01-01

    Osteoporosis is a prevalent and debilitating condition with no signs of subsiding. Rising numbers of people consuming nutrient-poor diets coupled with ageing populations and sedentary lifestyles appear to be the main drivers behind this. While the nutrients calcium and vitamin D have received most attention, there is growing evidence that wholefoods and other micronutrients have roles to play in primary and potentially secondary osteoporosis prevention. Until recently, calcium and vitamin D were regarded as the main nutrients essential to bone health but now there are emerging roles for iron, copper and selenium, among others. Fruit and vegetables are still not being eaten in adequate amounts and yet contain micronutrients and phytochemicals useful for bone remodelling (bone formation and resorption) and are essential for reducing inflammation and oxidative stress. There is emerging evidence that dried fruits, such as prunes, provide significant amounts of vitamin K, manganese, boron, copper and potassium which could help to support bone health. Just 50 g of prunes daily have been found to reduce bone resorption after six months when eaten by osteopaenic, postmenopausal women. Dairy foods have an important role in bone health. Carbonated drinks should not replace milk in the diet. A balanced diet containing food groups and nutrients needed for bone health across the whole lifecycle may help to prevent osteoporosis. Greater efforts are needed to employ preventative strategies which involve dietary and physical activity modifications, if the current situation is to improve. Cite this article: EFORT Open Rev 2017;2:300-308. DOI: 10.1302/2058-5241.2.160079 PMID:28736622

  15. Osteoporosis prevention and management: nonpharmacologic and lifestyle options.

    PubMed

    Christianson, Mindy S; Shen, Wen

    2013-12-01

    The purpose of this review is to evaluate current evidence regarding the use of dietary and exercise interventions to prevent fractures in postmenopausal women with osteoporosis. The key lifestyle modifications that can decrease risk of fracture in postmenopausal women include regular weight-bearing exercise and a balanced diet with adequate calcium and vitamin D intake. Other modifiable lifestyle factors critical to bone health and to decrease fracture risk include the avoidance of smoking, an excessively low body weight, excessive alcohol intake, and fall risks at home. Emerging modifiable factors may include B-vitamin, omega-3 fatty acid, soy isoflavone, and dehydroepiandrosterone supplementation.

  16. Comparing the effects of Osteoporosis Prevention Exercise Protocol (OPEP) versus walking in the prevention of osteoporosis in younger females

    PubMed Central

    Soomro, Rabail Rani; Ahmed, Syed Imran; Khan, Muhammad; Ali, Syed Shahzad

    2015-01-01

    Objective: The aim of this work was to evaluate the effectiveness of Osteoporosis Prevention Exercise Protocol (OPEP) in younger females. Methods: One hundred young female volunteers aged 20-30 were selected from IPM&R Dow University of Health Sciences. This was a comparative study in which 64 females participants were randomly assigned into two groups (32 in OPEP exercise group and 32 in walking group). The exercise session had three components 1) stretching 2) strengthening 3) high impact weight bearing exercises. Both interventional programs consisted of 3 sessions per week for twelve weeks under the supervision of physiotherapist. Pre and post intervention bone mass density (BMD) was measured on the lumbar spine (L1–L4), hip, femur, and distal forearm by using Dual-Energy X-ray Absorptiometry (DEXA) scan. Results: After twelve weeks of intervention BMD was found to be statistically insignificant at hip, femur, lumbar spine and wrist (p > 0.05) comparing the post results in the OPEP and exercise group. Moreover BMD at hip, femur, lumbar spine and wrist was unaltered in both groups comparing the results of pre and post intervention. Though significant changes were observed in BMI in the OPEP exercise group (p value =0.010) mean ± standard deviation pre and post found to be 20.2578 ± 3.11123 and 21.0942 ± 3.64203 but no variations in anthropometrics in walking group were found. Conclusion: The present study highlights the burden of osteopenia in younger females. The Osteoporosis Prevention Exercise Protocol formulated by author was not useful to bring any significant changes in BMD moreover it had no significant effects in comparison to walking group. However additional studies are needed to evaluate the efficacy of Osteoporosis Prevention Exercise Protocol on bone quality with long term effects. PMID:26101486

  17. Patient education in osteoporosis prevention: a systematic review focusing on methodological quality of randomised controlled trials.

    PubMed

    Morfeld, Jana-Carina; Vennedey, Vera; Müller, Dirk; Pieper, Dawid; Stock, Stephanie

    2017-02-24

    This review summarizes evidence regarding the effects of patient education in osteoporosis prevention and treatment. The included studies reveal mixed results on a variety of endpoints. Methodological improvem ent of future RCTs (e.g. with regard to randomization and duration of follow-up) might yield more conclusive evidence on the effects of patient education in osteoporosis INTRODUCTION: This review aims to evaluate the effects of patient education on osteoporosis prevention and treatment results.

  18. The roles of exercise in bone remodeling and in prevention and treatment of osteoporosis.

    PubMed

    Yuan, Yu; Chen, Xi; Zhang, Lingli; Wu, Juanni; Guo, Jianming; Zou, Dongchen; Chen, Binglin; Sun, Zhongguang; Shen, Chao; Zou, Jun

    2016-11-01

    With a rapid increase in the aging population, osteoporosis has become a global health problem. Although anti-resorption and anabolic drugs are available, osteoporosis cannot be completely cured. Exercise is an economical, efficacious, and safe way to prevent the development of osteoporosis. Recent studies have investigated the mechanisms by which exercise affects bone remodeling. Here we update the progress made on the effects of exercise on bone cells, including bone marrow mesenchymal stem cells, osteoblasts, osteocytes, and osteoclasts, as well as on bone mass, bone strength, and geometry, hoping to provide a theoretical basis to improve osteoporosis prevention and treatment with exercise.

  19. Zoledronic acid for prevention and treatment of osteoporosis.

    PubMed

    Recknor, Chris

    2011-04-01

    Osteoporosis (OP) is associated with a high risk of fracture and disability and with substantial medical costs. This paper is a review of the intravenous (i.v.) bisphosphonate zoledronic acid 5 mg (ZOL), used in the treatment and prevention of OP. This is a review of the scientific literature, between 2003 and 2010, on the use of ZOL in patients with low bone mass or OP. ZOL, given as a single infusion once yearly, has proven efficacy in reducing risk of vertebral and hip fractures in postmenopausal women with OP. In men and women with a recent hip fracture, ZOL has been shown to reduce the incidence of future clinical fractures. Data also demonstrate an increase in bone mineral density in postmenopausal women with osteopenia, in men with OP, and in patients at risk for glucocorticoid-induced osteoporosis. The ZOL clinical program has shown this agent to be safe and generally well tolerated. Acute flu-like symptoms may occur following the first infusion of ZOL, but these are generally mild and transient, and decrease in frequency with subsequent infusions. Patients must have adequate renal function (creatinine clearance ≥ 35 ml/min) and be adequately hydrated prior to infusion. With orally administered bisphosphonates, patient compliance and persistence with weekly or monthly dosing are frequently suboptimal. The ability to administer i.v. ZOL once yearly over 15 min for the treatment of OP provides the advantage of guaranteeing medication compliance for the duration of the dosing interval.

  20. Lasofoxifene for the prevention and treatment of postmenopausal osteoporosis

    PubMed Central

    Lewiecki, E Michael

    2009-01-01

    Lasofoxifene is a selective estrogen receptor modulator (estrogen agonist/antagonist) that has completed phase III trials to evaluate safety and efficacy for the prevention and treatment of osteoporosis and for the treatment of vaginal atrophy in postmenopausal women. In postmenopausal women with low or normal bone mineral density (BMD), lasofoxifene increased BMD at the lumbar spine and hip and reduced bone turnover markers compared with placebo. In women with postmenopausal osteoporosis, lasofoxifene increased BMD, reduced bone turnover markers, reduced the risk of vertebral and nonvertebral fractures, and decreased the risk of estrogen receptor-positive breast cancer. In postmenopausal women with low bone mass, lasofoxifene improved the signs and symptoms of vulvovaginal atrophy. Clinical trials show that lasofoxifene is generally well tolerated with mild to moderate adverse events that commonly resolve even with drug continuation. Lasofoxifene has been associated with an increase in the incidence of venous thromboembolic events, hot flushes, muscle spasm, and vaginal bleeding. It is approved for the treatment of postmenopausal women at increased risk for fracture in some countries and is in the regulatory review process in others. PMID:19898646

  1. [On "2015 Guidelines for Prevention and Treatment of Osteoporosis". Overview and the aim of the treatment of osteoporosis].

    PubMed

    Hagino, Hiroshi

    2015-09-01

    The prevention of fragility fractures is related to the aim of the treatment of osteoporosis which plays a central role in maintaining skeletal health. Diet therapy and exercise are regarded as a very important part of base therapy while intervention along with pharmaceutical treatment are a large part of the main therapy. As the prevalence of osteoporosis increases with age, criteria for initiation of pharmacological treatment are essential. The basis for assessing fracture risk was established when the Japanese guidelines for prevention and treatment of osteoporosis was first implemented. However, cost-effectiveness analysis was not included since little data was available. This should be an issue for inclusion in considering treatment in the future.

  2. Eurycoma longifolia: Medicinal Plant in the Prevention and Treatment of Male Osteoporosis due to Androgen Deficiency.

    PubMed

    Mohd Effendy, Nadia; Mohamed, Norazlina; Muhammad, Norliza; Naina Mohamad, Isa; Shuid, Ahmad Nazrun

    2012-01-01

    Osteoporosis in elderly men is now becoming an alarming health issue due to its relation with a higher mortality rate compared to osteoporosis in women. Androgen deficiency (hypogonadism) is one of the major factors of male osteoporosis and it can be treated with testosterone replacement therapy (TRT). However, one medicinal plant, Eurycoma longifolia Jack (EL), can be used as an alternative treatment to prevent and treat male osteoporosis without causing the side effects associated with TRT. EL exerts proandrogenic effects that enhance testosterone level, as well as stimulate osteoblast proliferation and osteoclast apoptosis. This will maintain bone remodelling activity and reduce bone loss. Phytochemical components of EL may also prevent osteoporosis via its antioxidative property. Hence, EL has the potential as a complementary treatment for male osteoporosis.

  3. Eurycoma longifolia: Medicinal Plant in the Prevention and Treatment of Male Osteoporosis due to Androgen Deficiency

    PubMed Central

    Mohd Effendy, Nadia; Mohamed, Norazlina; Muhammad, Norliza; Naina Mohamad, Isa; Shuid, Ahmad Nazrun

    2012-01-01

    Osteoporosis in elderly men is now becoming an alarming health issue due to its relation with a higher mortality rate compared to osteoporosis in women. Androgen deficiency (hypogonadism) is one of the major factors of male osteoporosis and it can be treated with testosterone replacement therapy (TRT). However, one medicinal plant, Eurycoma longifolia Jack (EL), can be used as an alternative treatment to prevent and treat male osteoporosis without causing the side effects associated with TRT. EL exerts proandrogenic effects that enhance testosterone level, as well as stimulate osteoblast proliferation and osteoclast apoptosis. This will maintain bone remodelling activity and reduce bone loss. Phytochemical components of EL may also prevent osteoporosis via its antioxidative property. Hence, EL has the potential as a complementary treatment for male osteoporosis. PMID:22844328

  4. Effective strategies for the prevention of osteoporosis across the life span.

    PubMed

    Dombrowski, H T

    2000-01-01

    Osteoporosis is generally considered an age-related reduction in the quantity and quality of bone, but it need not be considered an inevitable consequence of aging. Primary prevention of osteoporosis is clearly desirable, and all women should receive counseling regarding universal preventive measures such as dietary calcium and vitamin D, weight-bearing and resistance exercises, and smoking cessation. Perimenopausal and postmenopausal women should also be counseled about the potential benefits and risks of hormone prophylaxis. For individuals who are unable to take estrogens, other pharmacologic measures are available for prevention. Osteoporosis may also affect elderly men and patients receiving glucocorticoid therapy, and preventive measures should also be used for them.

  5. Eldecalcitol prevents endothelial dysfunction in postmenopausal osteoporosis model rats.

    PubMed

    Serizawa, Kenichi; Yogo, Kenji; Tashiro, Yoshihito; Takeda, Satoshi; Kawasaki, Ryohei; Aizawa, Ken; Endo, Koichi

    2016-02-01

    Postmenopausal women have high incidence of cardiovascular events as estrogen deficiency can cause endothelial dysfunction. Vitamin D is reported to be beneficial on endothelial function, but it remains controversial whether vitamin D is effective for endothelial dysfunction under the treatment for osteoporosis in postmenopausal women. The aim of this study was to evaluate the endothelial protective effect of eldecalcitol (ELD) in ovariectomized (OVX) rats. ELD (20  ng/kg) was orally administrated five times a week for 4 weeks from 1 day after surgery. After that, flow-mediated dilation (FMD) as an indicator of endothelial function was measured by high-resolution ultrasound in the femoral artery of living rats. ELD ameliorated the reduction of FMD in OVX rats. ELD inhibited the increase in NOX4, nitrotyrosine, and p65 and the decrease in dimer/monomer ratio of nitric oxide synthase in OVX rat femoral arteries. ELD also prevented the decrease in peroxisome proliferator-activated receptor gamma (PPARγ) in femoral arteries and cultured endothelial cells. Although PPARγ is known to inhibit osteoblastogenesis, ELD understandably increased bone mineral density of OVX rats without increase in PPARγ in bone marrow. These results suggest that ELD prevented the deterioration of endothelial function under condition of preventing bone loss in OVX rats. This endothelial protective effect of ELD might be exerted through improvement of endothelial nitric oxide synthase uncoupling, which is mediated by an antioxidative effect through normalization of vascular PPARγ/NF-κB signaling.

  6. Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

    ERIC Educational Resources Information Center

    Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.

    2014-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…

  7. Evaluation of Three Osteoporosis Prevention Programs for Young Women: Application of the Health Belief Model

    ERIC Educational Resources Information Center

    Lein, Donald H.; Turner, Lori; Wilroy, Jereme

    2016-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of theory-based osteoporosis prevention programs on calcium and vitamin D intakes and osteoporosis health beliefs in young women. Methods: Women (N = 152) aged 19 to 25 years were randomly assigned to one of 3 groups: a brochure group (n = 51), a computer-tailored program group…

  8. Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

    ERIC Educational Resources Information Center

    Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.

    2014-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…

  9. Evaluation of Three Osteoporosis Prevention Programs for Young Women: Application of the Health Belief Model

    ERIC Educational Resources Information Center

    Lein, Donald H.; Turner, Lori; Wilroy, Jereme

    2016-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of theory-based osteoporosis prevention programs on calcium and vitamin D intakes and osteoporosis health beliefs in young women. Methods: Women (N = 152) aged 19 to 25 years were randomly assigned to one of 3 groups: a brochure group (n = 51), a computer-tailored program group…

  10. Opinions and experiences in general practice on osteoporosis prevention, diagnosis and management.

    PubMed

    Taylor, J C; Sterkel, B; Utley, M; Shipley, M; Newman, S; Horton, M; Fitz-Clarence, H

    2001-01-01

    We determined to survey the general practice population regarding their attitudes to and knowledge of osteoporosis as a baseline prior to publication of national guidelines for the management of osteoporosis. All 2515 general practitioners registered in the 10 Health Authorities of the North Thames region, London, UK were surveyed by a postal questionnaire. Responses relating to epidemiology, public health and education on osteoporosis were analyzed. The overall response was 1153 (46%). General practitioners who responded were younger, predominantly female and in group practice. There is considerable awareness of the importance of preventing osteoporosis. General practitioners are active in identifying groups at risk, particularly those who are aged 40 years and older. A prevention strategy for osteoporosis is viewed as effective. However, two thirds of general practitioners remain unconvinced about the efficacy of drug therapy. Education on osteoporosis is considered inadequate. General practitioners would welcome further information on management issues and access to osteoporosis services. In conclusion, educational initiatives will be important both at undergraduate and postgraduate levels to increase awareness and knowledge of osteoporosis. General practitioners are aware of the public health impact of this condition and express a preference for educational material of direct relevance to the care of their patients. Therefore better cooperation between primary and secondary care should lead to ways of breaking down barriers to change in clinical practice and promoting fully integrated care of patients with osteoporosis.

  11. [Randomized controlled trials for the prevention and treatment of glucocorticoid-induced osteoporosis].

    PubMed

    Suzuki, Yasuo

    2006-11-01

    The effectiveness of drug therapy for the prevention or treatment of glucocorticoid-induced osteoporosis has been reported. Especially, the beneficial effects of bisphosphonates (etidoronate, alendronate, and risedronate) to prevent bone loss and fractures have been confirmed by the large-scale, multicenter, double-blind, randomized controlled trials in terms of both primary and secondary prevention. This article reviews the results of recent randomized prospective trials using bisphosphonates in glucocorticoid-induced osteoporosis.

  12. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 5. Physical activity as therapy for osteoporosis.

    PubMed Central

    Prior, J C; Barr, S I; Chow, R; Faulkner, R A

    1996-01-01

    OBJECTIVE: To examine exercise as a therapy for people with osteoporosis. OPTIONS: Immobilization, standing low-load and high-load physical activities. OUTCOMES: Risk of injury, quality of life, risk of falls and fractures, strength and posture and pain management. EVIDENCE: Relevant epidemiologic studies, clinical trials and reviews were examined, including the large-scale FICSIT trial in the United States, a prospective 4-year study of women enrolled in an exercise program in Toronto and the large-scale Study of Osteoporotic Fractures. VALUES: Minimizing risk of injury and increasing quality of life were given a high value. BENEFITS, HARMS, AND COSTS: Moderate physical activity in people with osteoporosis can reduce the risk of falls and fractures, decrease pain and improve fitness and overall quality of life. It may also stimulate bone gain and decrease bone loss. Its positive effects are an adjunct to other interventions, such as hormonal therapy. It may give patients the confidence to resume regular activity and can provide social interaction and support. During exercise programs, proper nutrition is necessary to prevent excessive weight loss and impaired immune function resulting from inadequate protein, vitamin and mineral intake. RECOMMENDATIONS: Immobilization should be avoided if possible in anyone with osteoporosis or at increased risk for osteoporosis. Regular, moderate physical activity is recommended for those with osteoporosis. Elderly people should be assessed for risk of falling to identify those in greatest need of an exercise program. Community group exercise programs are beneficial. Younger people with osteoporosis also need exercise that will preserve or improve bone mass, muscular strength, endurance and cardiovascular fitness. Weight loss as a result of physical activity should be avoided and adequate intake of protein, vitamins and minerals assured. Because the benefits of physical activity are independent of the effect of other therapies

  13. Osteoporosis.

    PubMed

    Sambrook, Philip; Cooper, Cyrus

    2006-06-17

    Osteoporosis is a serious public health issue. The past 10 years have seen great advances in our understanding of its epidemiology, pathophysiology, and treatment, and further advances are rapidly being made. Clinical assessment will probably evolve from decisions mainly being made on the basis of bone densitometry, to use of algorithms of absolute fracture risk. Biochemical markers of bone turnover are also likely to become more widely used. Bisphosphonates will probably remain the mainstay of therapy, but improved understanding of the optimum amount of remodelling suppression and duration of therapy will be important. At the same time, other diagnostic and therapeutic approaches, including biological agents, are likely to become more widespread.

  14. [Raloxifene - an unexploited possibility of prevention and treatment of postmenopausal osteoporosis].

    PubMed

    Štěpán, Jan; Rosa, Jan; Pavelka, Karel

    Long-term estrogen deficiency after menopause is responsible for different disorders, which not only make the quality of life in the older age worse but also are the major causes of womens mortality. It is especially the case for cardiovascular disease and osteoporosis. Aim of this review is to point at efficacy of raloxifene (a selective estrogen receptor modulator) in the long-term care of the women in their non-reproductive period of life, and namely in prevention and treatment of postmenopausal osteoporosis.Key words: bone turnover - breast cancer - postmenopausal osteoporosis - prevention - raloxifene.

  15. [Recommended soy and soy products intake to prevent bone fracture and osteoporosis].

    PubMed

    Uenishi, Kazuhiro

    2005-08-01

    Soy contains isoflavones, which are phytoestrogens, and its intake may help to prevent some diseases including menopausal disorder, osteoporosis, and breast cancer. Natto, a fermented soy product, is rich in vitamin K, which also contributes to bone health. In this report, we overviewed peer-reviewed papers showing relationship between soy product intake and risks of bone fracture and osteoporosis. It is suggested that that intake of soy products is not strongly enough to conclude but possible to be efficient in prevention of bone fracture and osteoporosis.

  16. Patient assessment in the diagnosis, prevention, and treatment of osteoporosis.

    PubMed

    Lata, Paul F; Elliott, Mary E

    2007-06-01

    Assessment of the patient with osteoporosis includes history and physical examination, laboratory testing, and imaging studies. Information gathered during this assessment assists clinicians in targeting strategies to prevent fractures. The medical history should contain items such as personal and family history of fractures, lifestyle, intake of substances such as vitamin D, calcium, corticosteroids, and other medications. The physical examination can reveal relevant information such as height loss and risk of falls. Bone mineral density (BMD), most commonly determined by dual-energy x-ray absorptiometry, best predicts fracture risk in patients without previous fracture. BMD testing is most efficient in women over 65 years old but is also helpful for men and women with risk factors. Serial BMD tests can identify individuals losing bone mass, but clinicians should be aware of what constitutes a significant change. Laboratory testing can detect other risk factors and can provide clues to etiology. Selection of laboratory tests should be individualized, as there is no consensus regarding which tests are optimal. Biochemical markers of bone turnover have a potential role in fracture risk assessment and in gauging response to therapy, but are not widely used at present. Clinicians should be aware of problems with vitamin D measurement, including seasonal variation, variability among laboratories, and the desirable therapeutic range. Careful assessment of the osteoporotic patient is essential in developing a comprehensive plan that reduces fracture risk and improves quality of life.

  17. Skeletal calcium homeostasis and countermeasures to prevent disuse osteoporosis.

    PubMed

    Schneider, V S; McDonald, J

    1984-01-01

    Maintenance of a skeleton capable of resisting the stresses of everyday life is dependent on the mechanical forces applied to the skeleton during normal activity in a 1-G environment. When the effects of 1-G on the longitudinal skeleton are removed, as with space travel or inactivity, bone and bone mineral are lost because bone resorption is greater than bone formation. Ninety healthy young men were studied during 5-36 weeks of continuous bed rest. During inactivity, urinary calcium increases rapidly and by the sixth week of bed rest, output has risen by 100 mg/day, plateaus for several weeks, and then decreases but remains above ambulatory baseline thereafter. This occurred even though they received vitamin D supplements throughout the study. Calcium balance becomes negative after 2 weeks and by the end of the first month, 200 mg/day is lost. The loss continues at this rate for at least 36 weeks. Calcaneal mineral loses 5% of its mass each month. Attempts to prevent disuse osteoporosis with both mechanical and biochemical means, including exercise, skeletal compression, increased hydrostatic pressure to the lower body, supplemental calcium and/or phosphorus, calcitonin, or etidronate were not successful.

  18. Fracture prevention service to bridge the osteoporosis care gap

    PubMed Central

    Ruggiero, Carmelinda; Zampi, Elena; Rinonapoli, Giuseppe; Baroni, Marta; Serra, Rocco; Zengarini, Elisa; Baglioni, Gregorio; Duranti, Giuliana; Ercolani, Sara; Conti, Francesco; Caraffa, Auro; Mecocci, Patrizia; Brandi, Maria Luisa

    2015-01-01

    Background A care gap exists between the health care needs of older persons with fragility fractures and the therapeutic answers they receive. The Fracture Prevention Service (FPS), a tailored in-hospital model of care, may effectively bridge the osteoporosis care gap for hip-fractured older persons. The purpose of this study was to evaluate the efficacy of the FPS in targeting persons at high risk of future fracture and to improve their adherence to treatment. Methods This was a prospective observational study conducted in a teaching hospital with traumatology and geriatric units, and had a pre-intervention and post-intervention phase. The records of 172 participants were evaluated in the pre-intervention phase, while data from 210 participants were gathered in the post-intervention phase. All participants underwent telephone follow-up at 12 months after hospital discharge. The participants were patients aged ≥65 years admitted to the orthopedic acute ward who underwent surgical repair of a proximal femoral fracture. A multidisciplinary integrated model of care was established. Dedicated pathways were implemented in clinical practice to optimize the identification of high-risk persons, improve their evaluation through bone mineral density testing and blood examinations, and initiate an appropriate treatment for secondary prevention of falls and fragility fractures. Results Compared with the pre-intervention phase, more hip-fractured persons received bone mineral density testing (47.62% versus 14.53%, P<0.0001), specific pharmacological treatments (48.51% versus 17.16%, P<0.0001), and an appointment for evaluation at a fall and fracture clinic (52.48% versus 2.37%, P<0.0001) in the post-intervention phase. Independent of some confounders, implementation of the FPS was positively associated with recommendations for secondary fracture prevention at discharge (P<0.0001) and with 1-year adherence to pharmacological treatment (P<0.0001). Conclusion The FPS is an

  19. Role of nutritional zinc in the prevention of osteoporosis.

    PubMed

    Yamaguchi, Masayoshi

    2010-05-01

    Zinc is known as an essential nutritional factor in the growth of the human and animals. Bone growth retardation is a common finding in various conditions associated with dietary zinc deficiency. Bone zinc content has been shown to decrease in aging, skeletal unloading, and postmenopausal conditions, suggesting its role in bone disorder. Zinc has been demonstrated to have a stimulatory effect on osteoblastic bone formation and mineralization; the metal directly activates aminoacyl-tRNA synthetase, a rate-limiting enzyme at translational process of protein synthesis, in the cells, and it stimulates cellular protein synthesis. Zinc has been shown to stimulate gene expression of the transcription factors runt-related transcription factor 2 (Runx2) that is related to differentiation into osteoblastic cells. Moreover, zinc has been shown to inhibit osteoclastic bone resorption due to inhibiting osteoclast-like cell formation from bone marrow cells and stimulating apoptotic cell death of mature osteoclasts. Zinc has a suppressive effect on the receptor activator of nuclear factor (NF)-kappaB ligand (RANKL)-induced osteoclastogenesis. Zinc transporter has been shown to express in osteoblastic and osteoclastic cells. Zinc protein is involved in transcription. The intake of dietary zinc causes an increase in bone mass. beta-Alanyl-L: -histidinato zinc (AHZ) is a zinc compound, in which zinc is chelated to beta-alanyl-L: -histidine. The stimulatory effect of AHZ on bone formation is more intensive than that of zinc sulfate. Zinc acexamate has also been shown to have a potent-anabolic effect on bone. The oral administration of AHZ or zinc acexamate has the restorative effect on bone loss under various pathophysiologic conditions including aging, skeletal unloading, aluminum bone toxicity, calcium- and vitamin D-deficiency, adjuvant arthritis, estrogen deficiency, diabetes, and fracture healing. Zinc compounds may be designed as new supplementation factor in the prevention and

  20. Osteoporosis in postmenopausal women: considerations in prevention and treatment: (women's health series).

    PubMed

    Sanders, Suzanne; Geraci, Stephen A

    2013-12-01

    Osteoporosis, the most common human bone disease, affects 8 million American women and has significant morbidity and mortality. Screening is important in older women and younger postmenopausal women with additional risk factors for osteoporosis/fracture. Preventive measures include avoiding smoking, excessive alcohol/caffeine intake, and falls in addition to maintaining adequate calcium/vitamin D intake and exercise. Estrogen/hormone therapy may be considered in some patients. Various medications have proven efficacy in treating postmenopausal osteoporosis; however, potential adverse effects such as hypocalcemia, worsening of renal impairment, and osteonecrosis of the jaw must be considered. The optimal duration of therapy requires further investigation.

  1. In Situ Sensor Advancements for Osteoporosis Prevention, Diagnosis, and Treatment.

    PubMed

    Liu, Luting; Webster, Thomas J

    2016-12-01

    Osteoporosis is still a serious issue in healthcare, and will continue to increase due to the aging and growth of the population. Early diagnosis is the key to successfully treating many diseases. The earlier the osteoporosis is diagnosed, the more quickly people can take action to stop bone deterioration. Motivated by this, researchers and companies have begun developing smart in situ bone sensors in order to dramatically help people to monitor their bone mass density (BMD), bone strain or bone turnover markers (BTMs); promptly track early signs of osteoporosis; and even monitor the healing process following surgery or antiresorptive therapy. This paper focuses on the latest advancements in the field of bone biosensing materials and sensor technologies and how they can help now and in the future to detect disease and monitor bone health.

  2. [Osteoporosis: diagnosis, prevention and treatment in outpatient setting].

    PubMed

    Rubin, M P; Chechurin, R E

    2011-01-01

    Early diagnosis and adequate treatment are main components in prophylaxis of osteoporosis and ruptures. We examined 8578 postmenopausal and elderly women for osteoporosis. A total of 26084 examinations were made: x-ray absorptiometry, bone ultrasonometry, DEXA of low spine bones and proximal bone for mineral density led us to the conclusion that it is necessary to make regular prophylactic examinations of 45-50-year-old women in peri- and postmenopause with following monitoring on demand for detection of initial signs of systemic osteopenia.

  3. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 4. Calcium nutrition and osteoporosis.

    PubMed Central

    Murray, T M

    1996-01-01

    OBJECTIVE: To recommend appropriate levels of calcium intake in light of the most recent studies. OPTIONS: Dietary calcium intake, calcium supplementation, calcium and vitamin D supplementation; ovarian hormone therapy in postmenopausal women. OUTCOMES: Fracture and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures and improved quality of life associated with osteoporosis prevention. EVIDENCE: Relevant clinical studies and reports were examined, in particular those published since the 1988 Osteoporosis Society of Canada position paper on calcium nutrition. Only studies in humans were considered, including controlled, randomized trials and prospective studies, using bone mass and fractures as end-points. Studies in early and later phases of skeletal growth were noted. The analysis was designed to eliminate menopause as a confounding variable. VALUES: Preventing osteoporosis and maximizing quality of life were given a high value. BENEFITS, HARMS AND COSTS: Adequate calcium nutrition increases bone mineral density during skeletal growth and prevents bone loss and osteoporotic fractures in the elderly. Risks associated with high dietary calcium intake are low, and a recent study extends this conclusion to the risk of kidney stones. Lactase-deficient patients may substitute yogurt and lactase-treated milk for cow's milk. True milk allergy is probably rare; its promotion of diabetes mellitus in susceptible people is being studied. RECOMMENDATIONS: Current recommended intakes of calcium are too low. Revised intake guidelines designed to reduce bone loss and protect against osteoporotic fractures are suggested. Canadians should attempt to meet their calcium requirements principally through food sources. Pharmaceutical calcium supplements and a dietician's advice should be considered where dietary preferences or lactase deficiency restrict consumption of dairy foods. Further research is necessary before recommending the general use

  4. Prevention and treatment of osteoporosis in chronically ill children.

    PubMed

    Munns, C F; Cowell, C T

    2005-01-01

    Osteoporosis secondary to chronic disease in children has emerged as a major health issue. As the severity of a child's illness increases, so too does the number of factors affecting their bone health. Determinants of bone health in children include level of mobility, exposure to osteotoxic medication, nutritional status, calcium and vitamin D intake, chronic inflammation and pubertal development.

  5. Project Healthy Bones: An Osteoporosis Prevention Program for Older Adults.

    ERIC Educational Resources Information Center

    Klotzbach-Shimomura, Kathleen

    2001-01-01

    Project Healthy Bones is a 24-week exercise and education program for older women and men at risk for or who have osteoporosis. The exercise component is designed to improve strength, balance, and flexibility. The education curriculum stresses the importance of exercise, nutrition, safety, drug therapy, and lifestyle factors. (SK)

  6. Zoledronic acid infusion for prevention and treatment of osteoporosis.

    PubMed

    Sunyecz, John A

    2010-10-14

    Osteoporotic fractures are associated with significant morbidity, reduced quality of life, increased mortality, and high health care costs. Bisphosphonates are standard therapy for treatment of osteoporosis. However, patient compliance and persistence with oral weekly or monthly bisphosphonate therapy are suboptimal and may lead to reduced effectiveness. Zoledronic acid (ZOL) is an intravenous bisphosphonate that is given once yearly for the treatment of osteoporosis via a medically supervised 15-minute infusion. This ensures compliance for a full 12 months. In clinical trials, an annual infusion of ZOL 5 mg has shown sustained efficacy in reducing hip and spine fractures in postmenopausal women with osteoporosis. It has also been shown to increase bone density in postmenopausal women with osteopenia (low bone mass) and in men with osteoporosis. Transient flu-like symptoms are the most common adverse effects following ZOL infusion, and these can generally be managed with acetaminophen. The availability of an intravenous bisphosphonate that ensures compliance over a long dosing interval may help to overcome barriers to efficacy resulting from poor long-term compliance with oral agents.

  7. Project Healthy Bones: An Osteoporosis Prevention Program for Older Adults.

    ERIC Educational Resources Information Center

    Klotzbach-Shimomura, Kathleen

    2001-01-01

    Project Healthy Bones is a 24-week exercise and education program for older women and men at risk for or who have osteoporosis. The exercise component is designed to improve strength, balance, and flexibility. The education curriculum stresses the importance of exercise, nutrition, safety, drug therapy, and lifestyle factors. (SK)

  8. Nutritional education in the primary prevention of osteoporosis in perimenopausal and postmenopausal women

    PubMed Central

    Sobczyk, Karolina

    2014-01-01

    Osteoporosis affects millions of people in the whole world and brings about far-reaching physical and psycho-social consequences for patients and financial ones for the health care system, and therefore it is classified as one of public health problems and treated as a social disease. Women belong to the increased osteoporosis illness risk group due to lower top bone mass reached earlier in life as compared to men and due to hormonal changes occurring in the menopausal period, which affect loss of the bone mineral density (BMD). Limitation of the osteoporosis-related financial and social costs increase requires efficient preventive actions on the level of early, primary, secondary or tertiary prevention. At all the four osteoporosis prevention phases, the crucial role is played by health education and nutrition education, the latter being the key element of the former one. The nutritional education purpose is to acquaint patients with nutrition recommendations that are the basic element of the osteoporosis prevention and to make them change their nutrition habits, which will improve their osseous metabolism. The education should be based on results of the latest scientific researches and focus on recommendations relating to proper supplementing of calcium and vitamin D, simultaneously including all the other nutrition components, necessary to decrease the osteoporosis risk. The primary prevention oriented to a specific group at risk for osteoporosis, including peri- or postmenopausal women, should be provided in cooperation with the different levels’ medical professionals and it should focus on causing positive changes in patients both as regards nutrition habits and physical activities. PMID:26327830

  9. Osteoporosis knowledge, health beliefs, and preventive behavior: a comparison between younger and older women living in a rural area.

    PubMed

    Aree-Ue, Suparb; Petlamul, Monrudee

    2013-01-01

    Osteoporosis is widely recognized as one of the major health problems in postmenopausal and older women. Raising awareness about osteoporosis is an important step in examining how much people know about the disease and their attitudes toward preventive behaviors. The aims of the present study were to examine the differences in osteoporosis knowledge, health beliefs, and preventive behaviors between younger and older Thai women, and to examine the relationship between their osteoporosis knowledge, health beliefs, and preventative behaviors. An understanding of these variables measured in younger and older women is essential for the development and delivery of effective age-tailored intervention programs.

  10. Progress in osteoporosis and fracture prevention: focus on postmenopausal women

    PubMed Central

    2009-01-01

    In the past decade, we have witnessed a revolution in osteoporosis diagnosis and therapeutics. This includes enhanced understanding of basic bone biology, recognizing the severe consequences of fractures in terms of morbidity and short-term re-fracture and mortality risk and case finding based on clinical risks, bone mineral density, new imaging approaches, and contributors to secondary osteoporosis. Medical interventions that reduce fracture risk include sufficient calcium and vitamin D together with a wide spectrum of drug therapies (with antiresorptive, anabolic, or mixed effects). Emerging therapeutic options that target molecules of bone metabolism indicate that the next decade should offer even greater promise for further improving our diagnostic and treatment approaches. PMID:19849819

  11. [Osteoporosis].

    PubMed

    Reza-Albarrán, Alfredo Adolfo

    2016-09-01

    Calcium intake has a role on the development of peak bone mass, and has a mild impact on the maintenance of bone mass during adulthood and the reduction of bone loss rate in postmenopausal women and the elderly in both genders. Calcium dietary intake should be privileged over supplementation. Dairy products are the main calcium dietary sources. Prospective studies have not clearly demonstrated an effect on the prevention of fractures, because of the practical difficulties of a long follow-up in order to get to solid conclusions; however the physiological rationale is that an adequate calcium intake and 25(OH) vitamin D levels exceeding 20 ng/ml is beneficial for bone health and may decrease to certain extent the risk of fractures.

  12. Building healthy bones throughout life: an evidence-informed strategy to prevent osteoporosis in Australia.

    PubMed

    Ebeling, Peter R; Daly, Robin M; Kerr, Deborah A; Kimlin, Michael G

    2013-10-07

    Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions — to ensure people have adequate calcium intake, vitamin D levels and appropriate physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, muscle strengthening exercises and challenging balance/mobility activities should be conducted in a safe environment.

  13. Prevention of space flight induced soft tissue calcification and disuse osteoporosis

    NASA Technical Reports Server (NTRS)

    Schneider, Victor S.; Leblanc, Adrian; Huntoon, Carolyn L.

    1990-01-01

    Medical complications such as renal stone formation, increased uric acid output, and disuse osteoporosis are discussed. A series of experiments was conducted in order to study and eventually reduce these flight hazards. Attempts to prevent the negative calcium balance and loss of calcaneal density during prolonged bed rest had only a limited success. Of the five biochemical regiments tested, only diphosphonate applied in a high dose had a positive effect in elliminating mineral losses. It is found that clodronate can prevent disuse osteoporosis and that fluoride can enhance bone formation. It is concluded that exercises, combined with pharmaceutical agents, are beneficial during long-duration space missions.

  14. Hormone replacement therapy and prevention of osteoporosis: risk assessment and practical advice.

    PubMed

    Balogh, A; Bettembuk, P

    1997-02-01

    A review of the Debrecen Regional Osteoporosis Program (DROP) in Hungary is given, with special reference to the detection of postmenopausal osteoporosis (PMOP) and its treatment by hormone replacement therapy (HRT). The new definition of osteoporosis by focusing on bone mineral density (BMD) measurements has the major advantage of practical usefulness. The algorithm of managing osteoporotic patients can be easily constructed from the result of bone densitometry as the primary diagnostic tool. The DROP serves a total population of 550,000, is equipped with a DXA bone densitometer, a bone metabolism laboratory and backed by a multidisciplinary team of clinicians from gynecology, radiology, rheumatology, internal medicine, and orthopedic surgery. In 1995 the total number of patients undergoing densitometry was 3170. In 2045 patients T scores of -1 or below were found. From this total number, 348 patients received HRT for 1 year or longer. The results of the treatment showed a positive response (i.e. no bone loss, or net gain) in 65%, while half of the 'non responders' proved in fact non compliant. The contradiction between risk assessment and early diagnosis is explained and replacing 'risk assessment' by 'selection criteria for bone densitometry' is proposed. 'Prevention of osteoporosis' is also to be replaced by 'prevention of complications', i.e. osteoporotic fractures. One of these measures is HRT. Its rational use in the prevention and treatment of osteoporosis and its relation to other treatment methods in the authors' own experience is discussed.

  15. [BREAST FEEDING AS PREVENTIVE FACTOR FOR OSTEOPOROSIS IN ADULT WOMEN].

    PubMed

    Jiménez-Arreola, Jazmín; Aguilera Barreiro, Ma de los Angeles

    2015-12-01

    Introducción: la lactancia materna es considerada protectora de osteoporosis, por cambios endocrinos, como el aumento de absorción intestinal de calcio y la conservación renal del mismo; sin embargo, otros estudios demuestran que con más de un hijo presentan pérdida de densidad mineral ósea (DMO) (2-9%). Objetivo: determinar si la lactancia materna es un factor protector o de riesgo en osteoporosis en mujeres queretanas. Sujetos y métodos: estudio retrospectivo de casos y controles. 114 mujeres de 35-60 años divididas en grupo control (sin lactar) y grupo mujeres que lactaron. Diagnóstico de DMO por densitometría ósea de dos regiones: cadera (fémur) y lumbar. Se aplicó historia clínica. Criterios de inclusión: edad 35-60 años. Criterios de exclusión: consumo: calcio, terapia hormonal de reemplazo; tratamiento para osteoporosis: lactando o embarazadas. Se realizaron pruebas de tendencia central, T pareada, correlaciones, Chi2 y razón de momios. Resultados: se encontró como factor de protección la lactancia con 0,903 OR (0,768-1,000). Correlación inversamente proporcional del IMC/DMO cadera y lumbar en mujeres que no lactaron frente a las que si lactaron; en ambos grupos se determinó una mayor edad de embarazo con mayor DMO en cadera y mayor talla del hijo, solo en las mujeres que lactaron. Siendo la obesidad factor protector de las mujeres que lactaron. Sin embargo, se encontró una correlación inversamente proporcional entre edad/DMO en las tres regiones de mujeres que lactaron, frente a las que no lactaron específicamente en DMOlumbar. Conclusión: la lactancia materna es beneficiosa para la madre, ya que es un factor protector contra la osteoporosis, siempre y cuando lleve a cabo los primeros seis meses, así como para el recién nacido, ya que proporciona un crecimiento lineal óptimo.

  16. [Calcium in the prevention and treatment of osteoporosis].

    PubMed

    Burckhardt, P

    1991-02-01

    Calcium intake improves the development of bone mass in adolescence and the preservation of bone mass in adulthood, slows down the postmenopausal bone loss and improves bone density also later on. These are recent data obtained from prospective studies. They justify dietary supervision of adolescents, of women during pregnancy, lactation, and after menopause, and of elderly persons of both sexes. They also justify the prescription of about 500 mg of calcium in the case of calcium-poor nutrition in these groups. Above all, they document the necessity of the simultaneous prescription of at least 500 mg of calcium in the treatment of osteoporosis with estrogens, fluor, calcitonin and bisphosphonates.

  17. Hibernating bears as a model for preventing disuse osteoporosis

    USGS Publications Warehouse

    Donahue, S.W.; McGee, M.E.; Harvey, K.B.; Vaughan, M.R.; Robbins, C.T.

    2006-01-01

    The hibernating bear is an excellent model for disuse osteoporosis in humans because it is a naturally occurring large animal model. Furthermore, bears and humans have similar lower limb skeletal morphology, and bears walk plantigrade like humans. Black bears (Ursus americanus) may not develop disuse osteoporosis during long periods of disuse (i.e. hibernation) because they maintain osteoblastic bone formation during hibernation. As a consequence, bone volume, mineral content, porosity, and strength are not adversely affected by annual periods of disuse. In fact, cortical bone bending strength has been shown to increase with age in hibernating black bears without a significant change in porosity. Other animals require remobilization periods 2-3 times longer than the immobilization period to recover the bone lost during disuse. Our findings support the hypothesis that black bears, which hibernate for as long as 5-7 months annually, have evolved biological mechanisms to mitigate the adverse effects of disuse on bone porosity and strength. ?? 2005 Elsevier Ltd. All rights reserved.

  18. The Development of an Osteoporosis Prevention Education Intervention: Its Effectiveness, Conclusions, and Recommendations

    ERIC Educational Resources Information Center

    Nguyen, Vu H.; Wang, Ze; Waigandt, Alexander C.

    2012-01-01

    Background: Osteoporosis prevention education interventions have been found to be ineffective. Purpose: To determine the effectiveness of a developed intervention based on the health belief model, which emphasized its visible severity and proximal time of onset. Method: A sample of 109 college women were randomly assigned to either a treatment or…

  19. [Selective Estrogen Receptor Modulators (SERMs) for prevention and treatment of postmenopausal osteoporosis].

    PubMed

    Birkhäuser, Martin

    2012-03-01

    The three modern Selective Estrogen Receptor Modulators (SERMs) Raloxifene, Lasoxifene and Bazedoxifene registered in Europe reduce in postmenopausal women with a high risk for osteoporosis the incidence of vertebral fractures by 30 - 50 %, depending on the subgroup they belong to. Solid prospective fracture data for risk reduction in non-vertebral fractures, including the hip, are missing for Raloxifene and Bazedoxifene. However, a post hoc analysis suggests that the risk for non-vertebral fractures is significantly reduced by Raloxfene in women with severe osteoporosis. The simultaneous decrease of the incidence of ER-positive invasive breast cancer in Raloxifene users is highly relevant for clinicians. Unfortunately, Raloxifene and Bazedoxifene are, in the EU and in Switzerland, only labelled for the use in the prevention and treatment of postmenopausal osteoporosis. SERMs may induce or augment vasomotor symptoms. Therefore, SERMs are not a first line therapy in early postmenopause. Looking at other hormonal options, Hormone Replacement Therapy (HRT) remains the first line therapy for fracture reduction in the peri- and early postmenopause. SERMs are an appropriate choice for the continuation of fracture prevention after an initial HRT, particularly for the prevention of vertebral fractures. SERMs are safe if (as in oral HRT) the slightly increased risk for venous thrombo-embolism is respected. In conclusion, SERMs have today their well established place in the prevention and treatment of postmenopausal osteoporosis, particularly in women with a simultaneously increased breast cancer risk.

  20. The Development of an Osteoporosis Prevention Education Intervention: Its Effectiveness, Conclusions, and Recommendations

    ERIC Educational Resources Information Center

    Nguyen, Vu H.; Wang, Ze; Waigandt, Alexander C.

    2012-01-01

    Background: Osteoporosis prevention education interventions have been found to be ineffective. Purpose: To determine the effectiveness of a developed intervention based on the health belief model, which emphasized its visible severity and proximal time of onset. Method: A sample of 109 college women were randomly assigned to either a treatment or…

  1. [Postmenopausal and steroid-induced osteoporosis guideline-orientated prevention and treatment].

    PubMed

    Pfeilschifter, J

    2005-05-01

    Prevention of osteoporosis and osteoporotic fractures consists of non-drug and drug therapy. Components of non-drug therapy include improvement of muscle strength and coordination, treatment of modifiable causes of falls, a diet rich in calcium and sufficient in calories, adequate supply of vitamin D and a careful approach towards drugs known to increase falls or osteoporosis. Assessment of clinical risk factors in combination with bone mineral density measurements can identify persons at high risk of fracture who benefit most from pharmacological treatment. Particular attention should be paid to patients with previous fragility fractures and long-term oral glucocorticoid therapy.

  2. [Hormone replacement therapy in the management of postmenopausal osteoporosis and prevention of fracture risk].

    PubMed

    Ribot, Claude; Trémollières, Florence

    2006-10-01

    The consequences to the bone of estrogen deficiency are early and irreversible. Effective prevention of postmenopausal osteoporosis at the individual level requires early screening of women at risk of fractures and their early treatment. Hormone treatment prevents bone loss and has been proven effective in preventing fractures, even in situations of low risk. The benefit/risk ratio of hormone treatment can be optimized by the choice of the 'right moment' and the 'right treatment'. HRT, administered early and for a limited period, must be integrated into a strategy of long-term osteoporosis prevention that includes using the (drug and nondrug) means most appropriate to the patient's age and clinical condition and choosing the 'right moment' and 'right treatment.'

  3. [Mechanism of weightlessness osteoporosis and preventive and therapeutic effect of traditional Chinese medicine].

    PubMed

    Zhu, Bin; Guo, Hua; Hao, Xi-Juan; Fu, Qian; Hu, Su-Min

    2012-07-01

    Weightlessness environment can lead to the muscle atrophy and body fluid distribution upward,which can cause the bone calcium metabolism disorder and always accompanied by the loss of bone microstructure and increased rate of bone fracture. Under microgravity,the astronauts are much easier to decrease the Ca2+ ion in bone, which can cause serious osteoporosis. However the bone lost is not equilibrium, it is especially serious in the mechanism loading bone and the recovery process is more difficult. These are very different from the osteoporosis in older people and postmenopausal osteoporosis. It is necessary to find an optimal method to due with it. In traditional Chinese medicine theory,the kidney stores "Jing" and dominates the bone, thus a lot of bone related diseases can be treated through the kidney. A lot of clinical practices have also proved that the Chinese herbs used under the guidance of basic Chinese medicine theory are always good at the treatment of common osteoporosis. In simulated weightlessness experiment, people found that the kidney nourishment drugs do can prevent the decrease of BMD. So in this article we want to review the causes of weightlessness and the potentials applications of tradition Chinese medicine in the treatment of weightlessness osteoporosis.

  4. [Current prevention and treatment strategies for osteoporosis. Fracture-oriented, effective, low side effects and inexpensive].

    PubMed

    Bartl, R; Bartl, C

    2015-12-01

    Osteoporosis is still an underdiagnosed and insufficiently therapied widespread disease in Germany. Of the estimated 7 million osteoporosis patients only 1.5 million receive a guideline conform diagnosis and even less receive appropriate treatment. Some 90 % of patients are provided with analgesics but only 10 % receive an effective therapy, although efficacious, well-tested and affordable medications are available. In addition, approximately one half of the patients terminate treatment after only 1 year although according to the results of recent studies the duration of therapy should be at least 3-5 years. In view of the increasing average life expectancy, a consistent management for prevention of fractures associated with osteoporosis is always most important for society, even if only for reasons of costs. Achievement of this target depends on four circumstances: clarification of the origin of osteoporosis and fractures (bone consciousness), prophylaxis of bone loss and fractures (primary prevention), consistent guideline conform diagnostics and therapy (secondary and tertiary prevention) and cooperation of all disciplines in medicine (bone is everybody's business). This article describes the current state of diagnostics (bone density measurement with dual X-ray absorptiometry, FRAX®), prophylaxis of fractures (screening program) and therapy (use of economic and effective medications with low side effects). Novel medications are already undergoing clinical testing and a "healing" of bone reduction with restoration of the normal bone structure is to be expected.

  5. Denosumab for prevention of fractures in postmenopausal women with osteoporosis.

    PubMed

    Cummings, Steven R; San Martin, Javier; McClung, Michael R; Siris, Ethel S; Eastell, Richard; Reid, Ian R; Delmas, Pierre; Zoog, Holly B; Austin, Matt; Wang, Andrea; Kutilek, Stepan; Adami, Silvano; Zanchetta, Jose; Libanati, Cesar; Siddhanti, Suresh; Christiansen, Claus

    2009-08-20

    Denosumab is a fully human monoclonal antibody to the receptor activator of nuclear factor-kappaB ligand (RANKL) that blocks its binding to RANK, inhibiting the development and activity of osteoclasts, decreasing bone resorption, and increasing bone density. Given its unique actions, denosumab may be useful in the treatment of osteoporosis. We enrolled 7868 women between the ages of 60 and 90 years who had a bone mineral density T score of less than -2.5 but not less than -4.0 at the lumbar spine or total hip. Subjects were randomly assigned to receive either 60 mg of denosumab or placebo subcutaneously every 6 months for 36 months. The primary end point was new vertebral fracture. Secondary end points included nonvertebral and hip fractures. As compared with placebo, denosumab reduced the risk of new radiographic vertebral fracture, with a cumulative incidence of 2.3% in the denosumab group, versus 7.2% in the placebo group (risk ratio, 0.32; 95% confidence interval [CI], 0.26 to 0.41; P<0.001)--a relative decrease of 68%. Denosumab reduced the risk of hip fracture, with a cumulative incidence of 0.7% in the denosumab group, versus 1.2% in the placebo group (hazard ratio, 0.60; 95% CI, 0.37 to 0.97; P=0.04)--a relative decrease of 40%. Denosumab also reduced the risk of nonvertebral fracture, with a cumulative incidence of 6.5% in the denosumab group, versus 8.0% in the placebo group (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01)--a relative decrease of 20%. There was no increase in the risk of cancer, infection, cardiovascular disease, delayed fracture healing, or hypocalcemia, and there were no cases of osteonecrosis of the jaw and no adverse reactions to the injection of denosumab. Denosumab given subcutaneously twice yearly for 36 months was associated with a reduction in the risk of vertebral, nonvertebral, and hip fractures in women with osteoporosis. (ClinicalTrials.gov number, NCT00089791.) 2009 Massachusetts Medical Society

  6. Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview

    PubMed Central

    Al-Anazi, Abdullah Foraih; Qureshi, Viquar Fatima; Javaid, Khalida; Qureshi, Shoeb

    2011-01-01

    Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been rampantly used to recompense for the bone loss, but the procedure is coupled with severe adverse effects. Hence, there is a boost in the production of newer synthetic products to ward off the effects of menopause-related osteoporosis. As of today, there are several prescription products available for the treatment of postmenopause osteoporosis; most of these are estrogenic agents and combination products. Nevertheless, in view of the lack of effect and/or toxicity of these products, majority of the postmenopausal women are now fascinated by highly publicized natural products. This is an offshoot of the generalized consensus that these products are more effective and free from any adverse effects. Recently, certain plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes, flavonoids) and many more novel estrogen-like compounds in plants have been immensely used to prevent menopause-related depletion in bone mineral density (BMD). Although, a number of papers are published on menopause-related general symptoms, sexual dysfunction, cardiovascular diseases, Alzheimer's disease, diabetes, colon, and breast cancers, there is paucity of literature on the accompanying osteoporosis and its treatment. In view of the controversies on synthetic hormones and drugs and drift of a major population of patients toward natural drugs, it was found worthwhile to investigate if these drugs are suitable to be used in the treatment of postmenopausal osteoporosis. Preparation of this paper is an attempt to review the (a) epidemiology of postmenopausal osteoporosis, (b) treatment modalities of postmenopausal osteoporosis by hormones and synthetic drugs and the associated drawbacks and adverse effects, and (c) prevention and treatment of postmenopausal osteoporosis by phytoestrogens, their drawbacks and toxicity

  7. Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview.

    PubMed

    Al-Anazi, Abdullah Foraih; Qureshi, Viquar Fatima; Javaid, Khalida; Qureshi, Shoeb

    2011-07-01

    Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been rampantly used to recompense for the bone loss, but the procedure is coupled with severe adverse effects. Hence, there is a boost in the production of newer synthetic products to ward off the effects of menopause-related osteoporosis. As of today, there are several prescription products available for the treatment of postmenopause osteoporosis; most of these are estrogenic agents and combination products. Nevertheless, in view of the lack of effect and/or toxicity of these products, majority of the postmenopausal women are now fascinated by highly publicized natural products. This is an offshoot of the generalized consensus that these products are more effective and free from any adverse effects. Recently, certain plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes, flavonoids) and many more novel estrogen-like compounds in plants have been immensely used to prevent menopause-related depletion in bone mineral density (BMD). Although, a number of papers are published on menopause-related general symptoms, sexual dysfunction, cardiovascular diseases, Alzheimer's disease, diabetes, colon, and breast cancers, there is paucity of literature on the accompanying osteoporosis and its treatment. In view of the controversies on synthetic hormones and drugs and drift of a major population of patients toward natural drugs, it was found worthwhile to investigate if these drugs are suitable to be used in the treatment of postmenopausal osteoporosis. Preparation of this paper is an attempt to review the (a) epidemiology of postmenopausal osteoporosis, (b) treatment modalities of postmenopausal osteoporosis by hormones and synthetic drugs and the associated drawbacks and adverse effects, and (c) prevention and treatment of postmenopausal osteoporosis by phytoestrogens, their drawbacks and toxicity

  8. The Development and Validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia

    PubMed Central

    Wong, Kok Thong; Low, Bee Yean

    2015-01-01

    Objectives To develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia. Methods The OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women ≥50 years of age and pharmacists were included in the study. Results A total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean±SD accuracy rate was 0.60±0.22 (range: 0.26-0.94). The Cronbach’s α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman’s rho: 0.761-0.990, p<0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9±8.7vs63.6±17.4, p<0.001), indicating that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients. Conclusion The OPAAT was found to be a valid and reliable instrument for assessing patient’s knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention. PMID:25938494

  9. The Development and Validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia.

    PubMed

    Toh, Li Shean; Lai, Pauline Siew Mei; Wu, David Bin-Chia; Wong, Kok Thong; Low, Bee Yean; Anderson, Claire

    2015-01-01

    To develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia. The OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women ≥ 50 years of age and pharmacists were included in the study. A total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean ± SD accuracy rate was 0.60 ± 0.22 (range: 0.26-0.94). The Cronbach's α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman's rho: 0.761-0.990, p < 0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9 ± 8.7 vs 63.6 ± 17.4, p < 0.001), indicating that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients. The OPAAT was found to be a valid and reliable instrument for assessing patient's knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention.

  10. [Healthy habits and osteoporosis prevention in perimenopausal women from rural areas].

    PubMed

    Pérez-Fernández, M Reyes; Almazán Ortega, Raquel; Martínez Portela, José M; Alves Pérez, M Teresa; Segura-Iglesias, M Carmen; Pérez-Fernández, Román

    2014-01-01

    The probability of developing osteoporosis decreases with an adequate supply of vitamin D, a balanced diet, and increased physical activity. In this study, we evaluated whether an educational intervention improves osteoporosis-related behavior in perimenopausal women from rural areas. A randomized experimental evaluation was performed of an educational intervention. The variables were physical activity, calcium intake and sun exposure in women from rural areas aged 45-54 years (n=216) at time 0 and 12 months after the educational intervention. In the control group (n=106), the information was sent by surface mail (month 0). In the intervention group (n=110), two interactive workshops were given (month 0). The topic of the workshops and the information sent by surface mail was healthy habits for osteoporosis prevention. After 12 months, the intervention group, but not the control group, had increased their physical activity (p=0.006), sun exposure (p=0.029), and calcium intake (53% to 64%). A simple educational intervention in perimenopausal women from rural areas improved healthy habits for osteoporosis prevention. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. [Educational intervention for the prevention of osteoporosis in a rural primary healthcare service].

    PubMed

    Pérez Fernández, María Reyes; Almazán Ortega, Raquel; Martínez Portela, José María; Alves Pérez, M Teresa; Segura Iglesias, M Carmen; Pérez Fernández, Román

    2013-12-21

    The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1=110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2=106): information by post. After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P<.001) and decreased the Ca (P ≤.048) and PTH (P<.001) levels. The control group increased its BMI (P<.001) and its BMD (P ≤.048), maintained its Ca levels and decreased the PTH values (P=.01). The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  12. Inter-correlation of knowledge, attitude, and osteoporosis preventive behaviors in women around the age of peak bone mass

    PubMed Central

    2014-01-01

    Background As silent and preventable in nature, postmenopausal osteoporosis awareness should be raised among young women prior to an irreversible period of declining bone mass. We therefore decided to assess the inter-correlation of knowledge, attitude and osteoporosis preventive behaviors in women around the age of peak bone mass. Methods A cross-sectional study was conducted in 430 women aged 20–35 years. The participants’ knowledge, attitude and behaviors concerning osteoporosis prevention were assessed along with demographic data using a four-part questionnaire. The items in this questionnaire were established by extensive literature review, including the Guideline for Management of Osteoporosis of the Thai Osteoporosis Foundation (TOPF) 2010. The content was validated by experts in osteoporosis and reliability was obtained with a Cronbach’s alpha score of 0.83. Results The mean age of women in this study was 29.4 ± 4.6 years. Half of the participants (49.5%) had heard about osteoporosis, mostly from television (95.3%, n = 203/213) and the internet (72.8%, n = 155/213). Most women had certain knowledge (85.2%) and positive attitude towards osteoporosis (53.3%). Nevertheless, 80% of the studied population did not have appropriate osteoporosis behaviors. We found significant correlation between the level of attitudes and osteoporosis behaviors (adjusted odd ratio = 3.3 with 95% confidence interval of 1.9-5.7); attitude and educational level (adjusted odd ratio = 2.2 with 95% confidence interval of 1.4-3.4); and attitude and knowledge (adjusted odd ratio = 3.5 with 95% confidence interval of 1.8-6.8). Conclusion Despite having certain knowledge about osteoporosis, the young women did not seem to have appropriate osteoporosis preventive behaviors. Developing a right attitude towards osteoporosis may be a key determinant to improving health practices in order to prevent osteoporosis. PMID:24588970

  13. Du-zhong (Eucommia ulmoides) prevents disuse-induced osteoporosis in hind limb suspension rats.

    PubMed

    Pan, Yalei; Niu, Yinbo; Li, Chenrui; Zhai, Yuankun; Zhang, Rong; Guo, Xin; Mei, Qibing

    2014-01-01

    Du-Zhong has a long history of being used in traditional Chinese formulas to treat bone related diseases. The objective of the present study is to systematically investigate the effects of Du-Zhong cortex extract (DZCE) on disuse-induced osteoporosis. Rats were randomly divided into four groups, and three groups were treated with hind limb suspension (HLS). Control and HLS group received deionized distilled water, while the other two groups received alendronate (2.0 mg/kg/day) and DZCE (300 mg/kg/day) respectively by intragastric gavage for six weeks (two weeks prior to and during the four weeks of HLS). Dual-energy X-ray absorptiometry, assay of biochemical markers, and three-point bending test were employed to determine the effect of various treatments on bone mass, turnover, and strength. The trabecular bone microarchitecture was assessed by microCT analysis. DZCE could effectively prevent the bone loss induced by HLS, which was indicated by decreased levels of bone turnover markers as well as the changes in urinary calcium and phosphorus. The DZCE treatment also enhanced the biomechanical strength of bone and prevented the deterioration of trabecular bone microarchitecture. DZCE administration was able to prevent disuse-induced osteoporosis by regulating the bone metabolism, suggesting that DZCE could be used as an alternative therapy for the prevention of disuse-induced osteoporosis.

  14. Virgin Coconut Oil Supplementation Prevents Bone Loss in Osteoporosis Rat Model

    PubMed Central

    Hayatullina, Zil; Muhammad, Norliza; Mohamed, Norazlina; Soelaiman, Ima-Nirwana

    2012-01-01

    Oxidative stress and free radicals have been implicated in the pathogenesis of osteoporosis. Therefore, antioxidant compounds have the potential to be used in the prevention and treatment of the disease. In this study, we investigated the effects of virgin coconut oil (VCO) on bone microarchitecture in a postmenopausal osteoporosis rat model. VCO is a different form of coconut oil as it is rich with antioxidants. Three-month-old female rats were randomly grouped into baseline, sham-operated, ovariectomized control (Ovx), and ovariectomized rats fed with 8% VCO in their diet for six weeks (Ovx+VCO). Bone histomorphometry of the right femora was carried out at the end of the study. Rats supplemented with VCO had a significantly greater bone volume and trabecular number while trabecular separation was lower than the Ovx group. In conclusion, VCO was effective in maintaining bone structure and preventing bone loss in estrogen-deficient rat model. PMID:23024690

  15. Virgin coconut oil supplementation prevents bone loss in osteoporosis rat model.

    PubMed

    Hayatullina, Zil; Muhammad, Norliza; Mohamed, Norazlina; Soelaiman, Ima-Nirwana

    2012-01-01

    Oxidative stress and free radicals have been implicated in the pathogenesis of osteoporosis. Therefore, antioxidant compounds have the potential to be used in the prevention and treatment of the disease. In this study, we investigated the effects of virgin coconut oil (VCO) on bone microarchitecture in a postmenopausal osteoporosis rat model. VCO is a different form of coconut oil as it is rich with antioxidants. Three-month-old female rats were randomly grouped into baseline, sham-operated, ovariectomized control (Ovx), and ovariectomized rats fed with 8% VCO in their diet for six weeks (Ovx+VCO). Bone histomorphometry of the right femora was carried out at the end of the study. Rats supplemented with VCO had a significantly greater bone volume and trabecular number while trabecular separation was lower than the Ovx group. In conclusion, VCO was effective in maintaining bone structure and preventing bone loss in estrogen-deficient rat model.

  16. Collaboration of a model osteoporosis prevention and management program in a faith community.

    PubMed

    Forster-Burke, Diane; Ritter, Laura; Zimmer, Stephanie

    2010-01-01

    This article describes the collaborative efforts of a parish nurse, family nurse practitioner, and a registered dietitian in a faith-based setting to address the women's health issue of osteoporosis. A model for education and treatment including lifestyle changes, nutrition, and pharmacological therapies is discussed. The whole person perspective of prevention and management for women with this chronic disease is explored. Implications for practice and education for women across the life span are described.

  17. Self-reported osteoporosis prevention in inhaled corticosteroid users in community pharmacy setting

    PubMed Central

    Chan, Valerie; Cave, Andrew J

    2015-01-01

    Objectives: The use of inhaled corticosteroids is the standard maintenance therapy in asthma therapy and as adjunct therapy in moderate to severe chronic obstructive pulmonary disease. A dose-related increase in fracture risk is associated with inhaled corticosteroid use; there is an inverse relationship between bone mineral density and duration and cumulative dose of inhaled corticosteroid. Adequate intake of calcium and vitamin D are cornerstones of osteoporosis prevention. The objectives are to assess whether the proportion of patients receiving inhaled corticosteroids are taking calcium and vitamin D; the association between long-term inhaled corticosteroid use and abnormal bone mineral density or fractures; and how many qualified patients received bone mineral density scans. Methods: Patients who filled a prescription for inhaled corticosteroids at selected community pharmacies across Alberta were recruited for a survey of their osteoporosis prevention activities. Results: A total of 256 patients from 12 community pharmacies were included. The average age was 60 ± 17.4 years with 65% female. There were 21%, 51%, and 28% of patients on high, medium, and low dose inhaled corticosteroids, respectively. Only 17% of patients >50 years old received recommended calcium and vitamin D supplementation and 87 (73%) of the qualified patients received bone mineral density scan. Conclusion: Osteoporosis prevention in inhaled corticosteroid users is currently poorly addressed. More promotion is needed to raise pharmacist awareness of the risks of inhaled corticosteroids. PMID:26770786

  18. The effect of a prevention program based on health belief model on osteoporosis.

    PubMed

    Khani Jeihooni, Ali; Hidarnia, Alireza; Kaveh, Mohammad Hossein; Hajizadeh, Ebrahim

    2015-01-01

    Osteoporosis is one of the most common metabolic bone diseases. The purpose of this study was to investigate the effect of a prevention program based on health belief model on osteoporosis among women. In this quasi-case study, 120 patients (60 cases and 60 control), registered under the health centers in Fasa City, Fars Province, Iran were selected in 2014. A questionnaire consisting of demographic information, Health Belief Model (HBM) constructs was used to measure nutrition and walking performance for prevention of osteoporosis before, immediately after the intervention and six months later. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and six months after intervention. Data were analyzed using SPSS19 via chi-square test, independent t-test, and Repeated Measures ANOVA at significance level of 0.05. Immediately and six months after the intervention, the case group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, internal cues to action, nutrition and walking performance compared to the control group. Six months after the intervention, the value of lumbar spine BMD T-Score in the case group increased to 0.127, while in the control group it reduced to -0.043. The value of the Hip BMD T-Score in the intervention group increased to 0.125 but it decreased to -0.028 in the control group. This study showed the effectiveness of knowledge, walking and diet on bone mass by HBM model. Hence, these models can act as a framework for designing and implementing educational interventions for the osteoporosis prevention.

  19. Prevention of disuse osteoporosis: Effect of sodium fluoride during five weeks of bed rest

    NASA Technical Reports Server (NTRS)

    Schneider, Victor S.

    1987-01-01

    An attempt was made to modify factors which promote disuse osteoporosis and thereby prevent it from occurring. Since fluoride is currently used to enhance bone formation in the treatment of low turnover osteoporosis, it was hypothesized that if the fluoride ion was available over a long period of time that it would slow the demonstrated loss of calcium by inhibiting bone resorption and enhancing bone formation. This study was used to determine whether oral medication with sodium F will modify or prevent 5 weeks of bed rest induced disuse osteoporosis, to determine the longitudinal effects of 5 weeks of bed rest on PTH, CT and calcitriol, to measure muscle volume changes and metabolic activity by magnetic resonance imaging and magnetic resonance spectroscopy during prolonged bed rest, to measure changes in peak muscle strength and fatigability, and to measure bone turnover in bone biopsies. Subjects were studied during 1 week of equilibration, 4 weeks of control ambulation, 5 weeks of bed rest, and 1 week of reambulation.

  20. Evaluation of osteoporosis prevention by adlay using a tissue culture model.

    PubMed

    Yang, Rong Sen; Chiang, Wenchang; Lu, Yi Hsiang; Liu, Shing Hwa

    2008-01-01

    Adlay (Coix lachryma-jobi L. var. ma-yuen Stapf ) is a grass crop, which has been used in traditional Chinese medicine and also as a nourishing food. Recently, some studies have indicated that adlay possesses some pharmacological effects including anti-allergic, anti-mutagenic, hypolipemic, and anti-diabetic effects. However, the effect of adlay on osteoporosis is still unknown. In this study, we investigated and evaluated the effect of adlay seed on the osteoporosis prevention. The methods of in vitro cultures of neonatal rat calvaria tissues or adult rat femoral metaphyseal tissues of bones isolated from normal or ovariectomized female rats were used for further investigation. Treatment with water extract of adlay seed could reverse the decreased alkaline phosphatase activities and calcium levels and increased tartrate-resistant acidic phosphatase activities induced by parathyroid hormone in cultured metaphyseal tissues. In ovariectomized rats, the alkaline phosphatase activities and calcium levels were significantly decreased and tartrate-resistant acidic phosphatase activities were increased in femoral metaphyseal tissues as compared with sham-control. Treatment with water extract of adlay seed could counteract these effects in ovariectomized rats. Taken together, these findings imply that adlay is capable of reversing the osteoporotic status in rats, and may be a helpful healthy food for osteoporosis prevention.

  1. Role of Ca(2+) and vitamin D in the prevention and treatment of osteoporosis.

    PubMed

    Rodríguez-Martínez, M A; García-Cohen, E C

    2002-01-01

    Osteoporosis is defined as a progressive systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The clinical relevance of osteoporosis derives from the fractures that it produces. More than one-third of the adult women will suffer one or more osteoporotic fractures in their lifetime. The lifetime risk in men is approximately one-half that in women. The decrease of the bone mineral density is the most important cause of risk fracture. Among other factors, Ca(2+) and vitamin D deficiencies are important risk factors for a decrease in bone mineral density, consequently inducing osteoporosis. The high prevalence of vitamin D deficiency in healthy elderly people living mainly in southern European countries increase the risk of osteoporotic fractures in these populations above those anticipated for the general elderly population of the European community. In addition, the ageing of the European population will double the number of osteoporotic fractures over the next 50 years, unless adequate preventative measures are undertaken. The efficacy and safety of Ca(2+) and vitamin D supplements at preventing bone loss and reducing the risk of hip and other fractures have been assessed in different clinical trials, which are extensively discussed in this review.

  2. Activity of gallium on prevention of fatal cage-layer osteoporosis.

    PubMed

    Chen, Xiuxia; Wang, Chao

    2009-12-01

    The prevention of fatal cage-layer osteoporosis of gallium was studied in this paper. One-day-old hens were fed up to 68 weeks on a control diet and diets containing gallium. Plasma variables were measured during lay. End-of-lay trabecular and medullary bone volumes in the proximal tarsometatarsus and free thoracic vertebra were measured by histomorphometry. Medullary and trabecular bone volumes were increased significantly by supplementation with gallium. The experiment confirmed that dietary gallium supplementation was an effective way to enhance the egg production and reduce mortality percentage. The beneficial effects of gallium supplementation over the lifetime of the hens were attributable mainly to improved cage-layer osteoporosis.

  3. Osteogenic effects of resveratrol in vitro: potential for the prevention and treatment of osteoporosis.

    PubMed

    Mobasheri, Ali; Shakibaei, Mehdi

    2013-07-01

    There are a number of pharmacological agents for the treatment of bone mineral loss and osteoporosis. Hormone replacement therapy (HRT) with estrogen is an established treatment, but it has several adverse side effects and can increase the risk of cancer, heart disease, and stroke. There is increasing interest in nutritional factors and naturally occurring phytochemical compounds with the potential for preventing age-related and postmenopausal bone loss. Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a polyphenolic phytoestrogen with osteogenic and osteoinductive properties. It can modify the metabolism of bone cells and has the capacity to modulate bone turnover. This paper provides an overview of current research on resveratrol and its effects on bone cells in vitro, highlighting the challenges and opportunities facing this area of research, especially in the context of providing nutritional support for postmenopausal women who may not benefit from HRT and older patients with various forms of arthritis, metabolic bone disease, and osteoporosis.

  4. [Exercise for prevention of osteoporosis and other lifestyle-related diseases].

    PubMed

    Suzuki, Takao

    2011-05-01

    The prevalence of lifestyle-related diseases including hypertension, dyslipidemia (hyperlipidemia) and diabetes increases with aging, and all these conditions are risk factors of arteriosclerotic diseases such as cerebrovascular event (stroke) and myocardial infarction. The term "metabolic domino" has been used to describe the collective concept of the development and progression of these lifestyle-related diseases, the sequence of events, and the progression process of complications. Like the first tile of a domino toppling game, undesirable lifestyle such as overeating and underexercising first triggers obesity, and is followed in succession by onset of an insulin resistance state (underlied by a genetic background indigenous to Japanese) , hypertension, hyperlipidemia, and further postprandial hyperglycemia (the pre-diabetic state) , the so-called metabolic syndrome, at around the same time. On the other hand, apart from the other lifestyle-related diseases, the prevalence of osteoporosis also increases rapidly accompanying aging. Osteoporosis is known to be strongly related to disorders due to the metabolic domino such as arteriosclerosis and vascular calcification, and a new disease category called "osteo-vascular interaction" has attracted attention recently. Regarding "osteo-vascular interaction" , a close relation between bone density loss or osteoporotic changes and vascular lesion-associated lifestyle-related diseases such as hypertension, dyslipidemia and diabetes has been reported. Therefore, as a common preventive factor for bone mass loss or osteoporosis and lifestyle-related diseases including hypertension, dyslipidemia and diabetes (osteo-vascular interaction) , exercise has been recognized anew as an important non-pharmaceutical therapy that should take top priority. This article overviews the evidence of exercise therapy for the prevention of osteoporosis and other lifestyle-related diseases, from the viewpoint of health promotion, especially of

  5. Chlorogenic Acid Prevents Osteoporosis by Shp2/PI3K/Akt Pathway in Ovariectomized Rats

    PubMed Central

    Zuo, Hui Ling; Yao, Fen Fen; Ruan, Hui Bing; Xu, Jin; Song, Wei; Zhou, Yi Cheng; Wen, Shi Yao; Dai, Jiang Hua; Zhu, Mei Lan; Luo, Jun

    2016-01-01

    Cortex Eucommiae is used worldwide in traditional medicine, various constituents of Cortex Eucommiae, such as chlorogenic acid (CGA), has been reported to exert anti-osteoporosis activity in China, but the mechanism about their contribution to the overall activity is limited. The aims of this study were to determine whether chlorogenic acid can prevent estrogen deficiency-induced osteoporosis and to analyze the mechanism of CGA bioactivity. The effect of CGA on estrogen deficiency-induced osteoporosis was performed in vivo. Sixty female Sprague-Dawley rats were divided randomly among a sham-operated group and five ovariectomy (OVX) plus treatment subgroups: saline vehicle, 17α-ethinylestradiol (E2), or CGA at 9, 27, or 45 mg/kg/d. The rats’ femoral metaphyses were evaluated by micro-computed tomography (μCT). The mechanism of CGA bioactivity was investigated in vitro. Bone mesenchymal stem cells (BMSCs) were treated with CGA, with or without phosphoinositide 3-kinase (PI3K) inhibitor LY294002. BMSCs proliferation and osteoblast differentiation were assessed with 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and alkaline phosphatase, with or without Shp2 interfering RNA (RNAi). The results display that CGA at 27 and 45 mg/kg/day inhibited the decrease of bone mineral density (BMD) that induced by OVX in femur (p< 0.01), significantly promoted the levels of bone turnover markers, and prevented bone volume fraction (BV/TV), connectivity density (CoonD), trabecular number (Tb.N), trabecular thickness (Tb.Th) (all p< 0.01) to decrease and prevented the trabecular separation (Tb.Sp), structure model index (SMI)(both p< 0.01) to increase. CGA at 1 or 10 μM enhanced BMSC proliferation in a dose-dependent manner. CGA at 0.1 to 10 μM increased phosphorylated Akt (p-Akt) and cyclin D1. These effects were reversed by LY294002. CGA at 1 or 10 μM increased BMSC differentiation to osteoblasts (p< 0.01), Shp2 RNAi suppressed CGA-induced osteoblast

  6. The Effect of an Educational Program Based on Health Belief Model on Preventing Osteoporosis in Women

    PubMed Central

    Jeihooni, Ali Khani; Hidarnia, Alireza; Kaveh, Mohammad Hossein; Hajizadeh, Ebrahim; Askari, Alireza

    2015-01-01

    Background: Osteoporosis is the most common metabolic bone disease. The study's objective is to investigate the effect of an educational program based on Health Belief Model (HBM) on preventing osteoporosis in women. Methods: In this quasi-experimental study, 120 patients (60 experimental and 60 control) who were registered under the health centers in Fasa City, Fars Province, Iran, were selected in 2014. A questionnaire consisting of demographic information, HBM constructs was used to measure nutrition and walking performance for the prevention of osteoporosis before, immediately after intervention, and 6 months later. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and 6 months after intervention. Results: The mean age of women participated in the study was 41.75 ± 5.4 years for the experimental group, and 41.77 ± 5.43 years for the control group. The mean body mass index was 22.44 ± 3.30 for the experimental group and 22.27 ± 3.05 for the control group. The average number of women deliveries for the experimental group was 2.57 ± 1.47 and 2.50 ± 1.19 for the control group. There is no significant difference between the two groups in education level (P = 0.771), marital status (P = 0.880), occupation (P = 0.673), breastfeeding (P = 0.769), smoking (P = 0.315), history of osteoporosis in the family (P = 0.378), history of special diseases (P = 0.769), and records of bone densitometry (P = 0.543). Immediately and 6 months after intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, internal cues to action, nutrition, and walking performance compared to the control group. Six months after intervention, the value of lumbar spine BMD T-score in the experimental group increased to 0.127, while in the control group it reduced to −0.043. The value of the hip BMD T-score in the intervention group increased

  7. Clinical utility of clodronate in the prevention and management of osteoporosis in patients intolerant of oral bisphosphonates

    PubMed Central

    Muratore, Maurizio; Quarta, Eugenio; Grimaldi, Antonella; Calcagnile, Fabio; Quarta, Laura

    2011-01-01

    Bisphosphonates have a long history in the treatment of osteoporosis and bone-related disease. This review focuses on the use of a specific nonaminobisphosphonate, clodronate, which appears to be much better tolerated than other bisphosphonates and free of high-risk contraindications. Specifically, this paper reviews its use in the prevention of osteoporosis in postmenopausal women, taking into account its tolerability profile and recent safety issues arising regarding the use of bisphosphonates. PMID:22087064

  8. Enzyme replacement prevents neonatal death, liver damage, and osteoporosis in murine homocystinuria.

    PubMed

    Majtan, Tomas; Hůlková, Helena; Park, Insun; Krijt, Jakub; Kožich, Viktor; Bublil, Erez M; Kraus, Jan P

    2017-08-16

    Classical homocystinuria (HCU) is an inborn error of sulfur amino acid metabolism caused by deficient activity of cystathionine β-synthase (CBS), resulting in an accumulation of homocysteine and a concomitant decrease of cystathionine and cysteine in blood and tissues. In mice, the complete lack of CBS is neonatal lethal. In this study, newborn CBS knockout (KO) mice were treated with recombinant polyethyleneglycolylated human truncated CBS (PEG-CBS). Full survival of the treated KO mice, along with a positive impact on metabolite levels in plasma, liver, brain, and kidneys, was observed. The PEG-CBS treatment prevented an otherwise fatal liver disease characterized by steatosis, death of hepatocytes, and ultrastructural abnormalities of endoplasmic reticulum and mitochondria. Furthermore, treatment of the KO mice for 5 mo maintained the plasma metabolite balance and completely prevented osteoporosis and changes in body composition that characterize both the KO model and human patients. These findings argue that early treatment of patients with HCU with PEG-CBS may prevent clinical symptoms of the disease possibly without the need of dietary protein restriction.-Majtan, T., Hůlková, H., Park, I., Krijt, J., Kožich, V., Bublil, E. M., Kraus, J. P. Enzyme replacement prevents neonatal death, liver damage, and osteoporosis in murine homocystinuria. © FASEB.

  9. Systemic Mesenchymal Stromal Cell Transplantation Prevents Functional Bone Loss in a Mouse Model of Age-Related Osteoporosis

    PubMed Central

    Kiernan, Jeffrey; Hu, Sally; Grynpas, Marc D.

    2016-01-01

    Age-related osteoporosis is driven by defects in the tissue-resident mesenchymal stromal cells (MSCs), a heterogeneous population of musculoskeletal progenitors that includes skeletal stem cells. MSC decline leads to reduced bone formation, causing loss of bone volume and the breakdown of bony microarchitecture crucial to trabecular strength. Furthermore, the low-turnover state precipitated by MSC loss leads to low-quality bone that is unable to perform remodeling-mediated maintenance—replacing old damaged bone with new healthy tissue. Using minimally expanded exogenous MSCs injected systemically into a mouse model of human age-related osteoporosis, we show long-term engraftment and markedly increased bone formation. This led to improved bone quality and turnover and, importantly, sustained microarchitectural competence. These data establish proof of concept that MSC transplantation may be used to prevent or treat human age-related osteoporosis. Significance This study shows that a single dose of minimally expanded mesenchymal stromal cells (MSCs) injected systemically into a mouse model of human age-related osteoporosis display long-term engraftment and prevent the decline in bone formation, bone quality, and microarchitectural competence. This work adds to a growing body of evidence suggesting that the decline of MSCs associated with age-related osteoporosis is a major transformative event in the progression of the disease. Furthermore, it establishes proof of concept that MSC transplantation may be a viable therapeutic strategy to treat or prevent human age-related osteoporosis. PMID:26987353

  10. Systemic Mesenchymal Stromal Cell Transplantation Prevents Functional Bone Loss in a Mouse Model of Age-Related Osteoporosis.

    PubMed

    Kiernan, Jeffrey; Hu, Sally; Grynpas, Marc D; Davies, John E; Stanford, William L

    2016-05-01

    Age-related osteoporosis is driven by defects in the tissue-resident mesenchymal stromal cells (MSCs), a heterogeneous population of musculoskeletal progenitors that includes skeletal stem cells. MSC decline leads to reduced bone formation, causing loss of bone volume and the breakdown of bony microarchitecture crucial to trabecular strength. Furthermore, the low-turnover state precipitated by MSC loss leads to low-quality bone that is unable to perform remodeling-mediated maintenance--replacing old damaged bone with new healthy tissue. Using minimally expanded exogenous MSCs injected systemically into a mouse model of human age-related osteoporosis, we show long-term engraftment and markedly increased bone formation. This led to improved bone quality and turnover and, importantly, sustained microarchitectural competence. These data establish proof of concept that MSC transplantation may be used to prevent or treat human age-related osteoporosis. This study shows that a single dose of minimally expanded mesenchymal stromal cells (MSCs) injected systemically into a mouse model of human age-related osteoporosis display long-term engraftment and prevent the decline in bone formation, bone quality, and microarchitectural competence. This work adds to a growing body of evidence suggesting that the decline of MSCs associated with age-related osteoporosis is a major transformative event in the progression of the disease. Furthermore, it establishes proof of concept that MSC transplantation may be a viable therapeutic strategy to treat or prevent human age-related osteoporosis. ©AlphaMed Press.

  11. [Hormone replacement and selective estrogen receptor modulators (SERMS) in the prevention and treatment of postmenopausal osteoporosis].

    PubMed

    Pfeilschifter, J

    2001-07-01

    For many years, hormone replacement therapy (HRT) has been regarded as one of the most reliable means of prophylaxis and treatment for postmenopausal osteoporosis. As HRT ameliorates menopausal symptoms, it is widely prescribed among early postmenopausal women. A variety of different modes of replacement that suit each individual requirement are available in terms of schedule (cyclic or combined application of gestagens) and route of application (oral or transdermal). HRT effectively prevents spinal bone loss and delays bone loss at the hip up to a very old age. With continued use after menopause, HRT might theoretically halve the incidence of vertebral and hip fractures. However, long-term use or use of HRT in old age is rarely practiced, and the actual benefit of a transient use for future fracture prevention remains unclear. Raloxifene is the first member of the novel class of selective estrogen receptor modulators (SERMs) that has been approved for the prophylaxis and treatment of postmenopausal osteoporosis. It combines the positive effects of estrogen on the skeleton with estrogen-antagonistic effects on sex tissues. Thus, raloxifene maintains bone mass and decreases the incidence of vertebral fractures in osteoporotic women, but avoids many of the side effects that are responsible for the poor long-term compliance to HRT such as resumption or continuation of regular menses, breast tenderness, or breast cancer. It even markedly reduces the risk of breast cancer. Both estrogen and raloxifene are characterized by a large number of extraskeletal effects that have to be taken into account when counseling postmenopausal women on the use of these agents for the prevention or treatment of osteoporosis.

  12. Exercise, Eating, Estrogen, and Osteoporosis.

    ERIC Educational Resources Information Center

    Brown, Jim

    1986-01-01

    Osteoporosis affects millions of people, especially women. Three methods for preventing or managing osteoporosis are recommended: (1) exercise; (2) increased calcium intake; and (3) estrogen replacement therapy. (CB)

  13. Exercise, Eating, Estrogen, and Osteoporosis.

    ERIC Educational Resources Information Center

    Brown, Jim

    1986-01-01

    Osteoporosis affects millions of people, especially women. Three methods for preventing or managing osteoporosis are recommended: (1) exercise; (2) increased calcium intake; and (3) estrogen replacement therapy. (CB)

  14. Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis. Executive summary.

    PubMed

    1998-01-01

    This report describes evidence for the diagnosis, prevention, and treatment of osteoporosis in postmenopausal healthy white women. Osteoporosis is becoming an increasingly important public health problem as our population ages. Although it is partially preventable, fractures related to osteoporosis are still common. Because of the economic and social burdens, comprehensive prevention programs are needed. Insufficient data prevent development of comparable analyses for men or nonwhite women. Discussed are the effectiveness, risks, and costs of diagnostic tests and treatments, the probabilities that women will have osteoporosis-related fractures, and the effects of various factors on these probabilities. Hormone replacement therapy is considered most cost-effective; women who refuse hormone replacement can consider bisphosphonates (alendronate) and calcitonin. Nomograms are presented for guiding treatment and testing decisions for individual patients. The following public health measures are recommended: Ensure that adults receive the optimal daily intake of calcium--between 1000 mg and 1500 mg; ensure that people at risk for vitamin D deficiency receive 400 IU to 800 IU of vitamin D daily; inform people that exercise, in addition to its other benefits, should help prevent osteoporosis; and discourage people from smoking.

  15. [A role of exercise and sports in the prevention of osteoporosis.

    PubMed

    Iwamoto, Jun

    Physical activity plays an important role in maintaining or enhancing bone health. Jumping exercise increases bone mineral content(BMC)in prepubescent children(premenarcheal girls). Bone mineral density(BMD)is higher in adolescent athletes who are engaged in weight-bearing activities. Jumping exercise, muscle strengthening exercise, and weight-bearing plus muscle strengthening exercises increase BMD in young adults and premenopausal women. Walking, aerobic weight-bearing exercise, muscle strengthening exercise, and weight-bearing plus muscle strengthening exercises maintain or increase BMD in postmenopausal women. Proper exercise and sports activity at each life stage are important strategies for preventing osteoporosis.

  16. [Argentine guidelines for the diagnosis, prevention and treatment of osteoporosis, 2015].

    PubMed

    Schurman, León; Galich, Ana M; González, Claudio; González, Diana; Messina, Osvaldo D; Sedlinsky, Claudia; Uñas, Claudia R; Sánchez, Ariel

    2017-01-01

    Osteoporosis is an evolving disease which affects over 200 million people worldwide. Our recommendations are guidelines for its diagnosis, prevention and treatment, but they do not constitute standards for clinical decisions in individual cases. The physician must adapt them to individual special situations, incorporating personal factors that transcend the limits of these guidelines and are dependent on the knowledge and art of the practice of Medicine. These guidelines should be reviewed and updated periodically as new, better and more effective diagnostic and therapeutic tools become available.

  17. Treating osteoporosis

    PubMed Central

    Gupta, Akhil; March, Lyn

    2016-01-01

    summary Osteoporotic fractures are common resulting in increased morbidity and mortality. Exercise can help prevent osteoporosis. It can also benefit patients with osteoporosis, but the exercises must be tailored to the patient. Most Australians should be able to obtain adequate calcium in their diet and vitamin D from the sun. Supplements may be needed in some patients and they are recommended for use with other drugs for osteoporosis. Bisphosphonates, and in some patients denosumab, are first-line drugs for osteoporosis. Raloxifene and strontium ranelate can be considered in patients who cannot take bisphosphonates or denosumab. Teriparatide is reserved for patients with severe osteoporosis and the use of strontium ranelate is declining because of cardiovascular safety concerns. PMID:27340321

  18. The development and validation of the Satisfaction Questionnaire for Osteoporosis Prevention in Malaysia

    PubMed Central

    Toh, Li Shean; Lai, Pauline Siew Mei; Wu, David Bin-Chia; Wong, Kok Thong; Low, Bee Yean; Tan, Alexander Tong Boon; Anderson, Claire

    2014-01-01

    Purpose To develop and validate the English version of the Satisfaction Questionnaire for Osteoporosis Prevention (SQOP) in Malaysia. Methods The SQOP was modified from the Osteoporosis Patient Satisfaction Questionnaire and developed based on literature review and patient interviews. Face and content validity were established via an expert panel. The SQOP consists of two sections: clinical services and types of counseling. There were 23 items in total, each with a five-point Likert-type response. Satisfaction score was calculated by converting the total score to a percentage. A higher score indicates higher satisfaction. English speaking, non-osteoporotic, postmenopausal women aged ≥50 years were included in the study. Participants were randomized to either the control or intervention group. Intervention participants were provided counseling, whereas control participants received none. Participants answered the SQOP at baseline and 2 weeks later. Results A total of 140 participants were recruited (control group: n=70; intervention group: n=70). No significant differences were found in any demographic aspects. Exploratory factor analysis extracted seven domains. Cronbach’s α for the domains ranged from 0.531–0.812. All 23 items were highly correlated using Spearman’s correlation coefficient 0.469–0.996 (P<0.05), with no significant change in the control group’s overall test–retest scores, indicating that the SQOP achieved stable reliability. The intervention group had a higher score than the control group (87.91±5.99 versus 61.87±8.76; P<0.05), indicating that they were more satisfied than control participants. Flesch reading ease was 62.9. Conclusion The SQOP was found to be a valid and reliable instrument for assessing patients’ satisfaction towards an osteoporosis screening and prevention service in Malaysia. PMID:25328386

  19. Impact of the fracture risk assessment on patient and physician behavior in osteoporosis prevention.

    PubMed

    McConaha, Jamie L; Berdine, Hildegarde J; Skomo, Monica L; Laux, Robert V; Higginbotham, Suzanne K; O'Neil, Christine K

    2014-02-01

    To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior. Postmenopausal women 45 to 65 years with Achilles T score <-1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants. A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups (P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity. Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.

  20. Bu-Shen-Ning-Xin decoction suppresses osteoclastogenesis via increasing dehydroepiandrosterone to prevent postmenopausal osteoporosis.

    PubMed

    Gui, Yuyan; Qiu, Xuemin; Xu, Yingping; Li, Dajin; Wang, Ling

    2015-06-01

    Bu-Shen-Ning-Xin decoction (BSNXD), a traditional Chinese medicine, has been used to prevent and treat age-related diseases such as postmenopausal osteoporosis (PMO) for decades. This study sought to investigate the underlying mechanisms of BSNXD in terms of receptor activation of nuclear factor κB ligand (RANKL)-induced osteoclastogenesis in vitro because of the critical roles of bone resorption in the development and progression of osteoporosis. In mice, serum levels of dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), and 17-β-estradiol (E2) were evaluated with an enzyme immunoassay kit after ovariectomy. Levels of DHEA and DHEAS increased significantly following administration of BSNXD while the level of E2 did not. In addition, tartrate-resistance acid phosphatase staining showed that DHEA profoundly inhibited RANKL-induced osteoclastogenesis in vitro in a dose-dependent manner via estrogen receptor α (ERα) but not via estrogen receptor β or androgen receptors. Cytotoxicity was not detected in the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. These data suggest that BSNXD prevents PMO by increasing DHEA via the ERαpathway to suppress osteoclastogenesis.

  1. Efficacy of optimization of vitamin D in preventing osteoporosis and osteoporotic fractures: A systematic review.

    PubMed

    Nakamura, Kazutoshi; Iki, Masayuki

    2006-07-01

    Increased intake or supplementation of vitamin D is often recommended for normal bone health; however, its preventive effect on osteoporosis has not been fully evaluated. The aim of this review is to gather evidence of the efficacy of the optimization of vitamin D nutrition in preventing osteoporosis and osteoporotic fractures. PubMed was used for searching the relevant literature using the MeSH terms "Bone Density (limited to "human", "female", and "English" literature)" or "Fractures (limited to "human", "age ≥45 years", and "English" literature)", and "Vitamin D". The searches yielded 19 randomized controlled trials (RCTs), nine cohort studies, 19 case-control studies, 19 cross-sectional studies, and one meta-analysis. We attempted to answer three questions: 1) does increased vitamin D intake prevent bone loss in peri- and postmenopausal women?, 2) does increased vitamin D intake prevent osteoporotic fractures in the elderly?, and 3) does increased vitamin D in take positively affect peak bone mass attainment in young women? The answer to questions 1 and 2 is that a vitamin D intake of 10-17.5 μg/day (400-700 IU/day) or more is effective in preventing bone loss in late postmenopausal women and an intake of 17.5-20 μg/day (700-800 IU/day) or more together with a calcium supplement reduces the risk of osteoporotic fractures. For question 3, some lines of evidence support the negative effect of low vitamin D nutrition on the attainment of peak bone mass in young women. Further studies are needed to clarify the effect of vitamin D in this age group.

  2. Screening for osteoporosis: an update for the U.S. Preventive Services Task Force.

    PubMed

    Nelson, Heidi D; Haney, Elizabeth M; Dana, Tracy; Bougatsos, Christina; Chou, Roger

    2010-07-20

    This review updates evidence since the 2002 U.S. Preventive Services Task Force recommendation on osteoporosis screening. To determine the effectiveness and harms of osteoporosis screening in reducing fractures for men and postmenopausal women without known previous fractures; the performance of risk-assessment instruments and bone measurement tests in identifying persons with osteoporosis; optimal screening intervals; and the efficacy and harms of medications to reduce primary fractures. Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2009), MEDLINE (January 2001 to December 2009), reference lists, and Web of Science. Randomized, controlled trials of screening or medications with fracture outcomes published in English; performance studies of validated risk-assessment instruments; and systematic reviews and population-based studies of bone measurement tests or medication harms. Data on patient populations, study design, analysis, follow-up, and results were abstracted, and study quality was rated by using established criteria. Risk-assessment instruments are modest predictors of low bone density (area under the curve, 0.13 to 0.87; 14 instruments) and fractures (area under the curve, 0.48 to 0.89; 11 instruments); simple and complex instruments perform similarly. Dual-energy x-ray absorptiometry predicts fractures similarly for men and women; calcaneal quantitative ultrasonography also predicts fractures, but correlation with dual-energy x-ray absorptiometry is low. For postmenopausal women, bisphosphonates, parathyroid hormone, raloxifene, and estrogen reduce primary vertebral fractures. Trials are lacking for men. Bisphosphonates are not consistently associated with serious adverse events; raloxifene and estrogen increase thromboembolic events; and estrogen causes additional adverse events. Trials of screening with fracture outcomes, screening intervals, and medications to reduce primary

  3. Secondary prevention of osteoporosis following fragility fractures of the distal radius in a large health maintenance organization.

    PubMed

    Benzvi, Lior; Gershon, Adam; Lavi, Idit; Wollstein, Ronit

    2016-01-01

    A retrospective study evaluated a large health maintenance organization for secondary prevention of osteoporosis following fragility fractures of the distal radius. Our population remained undiagnosed and untreated despite the ability of the system to provide adequate care. These patients specifically should be targeted for a comprehensive multidisciplinary effort at prevention. Osteoporotic wrist fractures carry a high risk for subsequent fragility fractures. Despite therapeutic options and systems that can provide secondary prevention, patients are not always treated appropriately. Our purpose was to evaluate the treatment afforded following a distal radius fragility fracture in our health system. A retrospective review of fractures following surgery was performed. Radiographs and mechanism of injury defined fragility fractures. Demographic data, other fractures, and secondary prevention measures were documented. Eighty-two patients were evaluated. The average age was 64 (10.2) years. The follow-up period following the index fracture was 25.2 months (SD = 4.6). Twenty-eight percent of patients had a second fragility fracture. Seven sustained a subsequent fracture within the follow-up period (8.5 %), and 16 (19.5 %) fractured prior to the index fracture. Mean time from primary to index fracture was 50 (42) months. Forty-seven percent of patients with an additional fracture carried the chart diagnosis of osteoporosis or osteopenia while 24.6 % of patients without an additional fracture carried this diagnosis (p = 0.049). No patients were referred for prevention or an endocrinologist at discharge. Twenty-one percent of patients were treated for osteoporosis at any point. Patients were unlikely to receive appropriate evaluation and treatment for secondary prevention of fragility fractures in our system. A system-based treatment plan for the prevention of osteoporosis should be implemented. Since distal radius fractures occur early in osteoporosis, these

  4. [Postmenopausal osteoporosis].

    PubMed

    László, Adám

    2004-01-04

    Due to its incidence and clinical consequences osteoporosis followed by vertebral, hip, and forearm fractures represents an outstanding problem of nowadays' health care. Because of its high mortality rate hip fractures are of special interest. The number of fractures caused by postmenopausal osteoporosis increases with age. Costs of examinations and treatment of women with postmenopausal osteoporosis and fractures are also increasing and represent a significant amount all over the world. Organization of Osteoporosis Centres in Hungary was founded in 1995 and has been since functioning, however, only the one-sixth of osteoporotic patients are treated. Several risk factors are known in the pathogenesis of osteoporosis, first of all the lack of sufficient calcium and vitamin D intake, age, genetic factors, and circumstances known to predispose falling. Estrogen deficiency is the most likely cause of postmenopausal osteoporosis. Osteodensitometry by DEXA is the most important method to evaluate osteoporosis, since decrease in bone mineral density strongly correlates with fracture incidence. Physical, radiologic, and laboratory examination are also required at the first visit and during follow-up. The quantity of bone can hardly be influenced after the 35th year of age, thus prevention of osteoporosis has special significance: appropriate calcium and vitamin D supplementation, weight-bearing sports and physical activity can prevent fractures. According to the results from studies fulfilling the criteria of evidence-based medicine, first choice treatment of osteoporosis involves hormone replacement therapy, bisphosphonates, the tissue specific tibolone, raloxifen and calcitonin. Calcium and vitamin D supplementation are always necessary to be added to any antiporotic treatment. Other combinations of different antiporotic drugs are useless and make the treatment more expensive. Other treatments like massage, physiotherapy, hip-protecting pants, etc. as well as

  5. Developing interprofessional collaboration: a longitudinal case of secondary prevention for patients with osteoporosis.

    PubMed

    Hjalmarson, Helene Victoria; Ahgren, Bengt; Kjölsrud, Margaretha Strandmark

    2013-03-01

    The aim of this study was to explore the development of interprofessional collaboration aiming to improve secondary prevention of osteoporosis by studying this topic expansively from the perspectives of different stakeholders. The method used was a longitudinal single case study with both qualitative and quantitative data sources. The findings elucidate that the bottom-up structure used triggers a freedom to act for the professionals and a changed leadership. Such an approach seems to make managers aware of the need for a horizontal organizational focus that, in this case, was crucial for developing interprofessional collaboration. Furthermore, the study shows that continuous feedback was central to motivate professionals to collaborate. Constructive feedback was created by interprofessional and patient-centered interaction skills, facilitated by confirming leadership promoting ability to recognize the efficacy of joint collaboration. The interprofessional collaboration resulted in an improved chain of care with increased transparency and collective control with benefits for both patients and providers. Outcomes at the system level showed an appreciable increase in patients investigated for osteoporosis: 88% were followed up in primary care and nearly half had improved their health behavior. The implementation of a bottom-up structure where leaders and professionals are developing interdependency, measuring collective performance and using feedback loops generated, in this case, motivational forces for interprofessional collaboration. It is reasonable to assume that these findings could be transferable to similar healthcare settings.

  6. Prevention of osteoporosis in mice after ovariectomy via allograft of microencapsulated ovarian cells.

    PubMed

    Guo, Xiao-Xia; Zhou, Jin-Ling; Xu, Qing; Lu, Xin; Liang, Yuan-Jing; Weng, Jing; Shi, Xiao-Lin

    2010-02-01

    It is believed that estrogen deficiency is one of the major risk factors associated with osteoporosis. To investigate the effects of the transplantation of microencapsulated ovarian cells in estrogen-deficient mice, ovarian cells from female Kunming (KM) mice (6-weeks old) were separated, cultured, and microencapsulated with alginic acid-polylysine-alginic acid. Female KM mice (8-weeks old) were randomly separated into three groups: intact (normal), ovariectomized (OVX), and treatment (OVX+ implantation). Microencapsulated ovarian cells were found to secrete estrogen at normal levels in vitro. Ninety days after transplantation, serum estradiol levels in the OVX group were significantly lower, and the trabecular bone amount and volume were decreased when compared with the normal group. The expression of alkaline phosphatase in chondrocytes appeared lower, while the expression of matrix metalloproteinase 9 (MMP-9) in the bone matrix was higher. The ratio of MMP-9-positive chondrocytes and osteoblasts to osteoclasts was significantly lower than that of the normal group. The concentrations of hydroxyproline (Hyp), Ca, and P in the left femurs of the OVX group were lower than those of the normal group. However, the aforementioned changes were not seen in the treatment group. In conclusion, microencapsulated ovarian cells survive well after transplantation and secrete estrogen in vivo, and they can prevent in some degree osteoporosis caused by ovariectomy. 2009 Wiley-Liss, Inc.

  7. The effectiveness of education using the health belief model in preventing osteoporosis among female students.

    PubMed

    Sanaeinasab, H; Tavakoli, R; Karimizarchi, A; Amini, Z Haji; Farokhian, A; Najarkolaei, F Rahmati

    2014-01-09

    This study was conducted to determine the impact of education using the Health Belief Model on preventing osteoporosis among female students. This interventional study (quasi-experimental) was performed on 45 female students aged 15-16 years old who resided in a town near Tehran. The females participated in a threeweek educational programme based on the Health Belief Model. The data collection instrument was a validated and reliable questionnaire in five sections: demographics, knowledge, Health Belief Model constructs, physical activity and consumption of foods containing calcium. The mean scores of students' knowledge were significantly different before and after the educational intervention (P < 0.05). The mean scores of some Health Belief Model structures changed significantly after the intervention (P < 0.05). Also post-intervention, physical activity increased (P = 0.041) but calcium intake did not. The use of an educational intervention on osteoporosis seems to improve knowledge and health beliefs and may positively impact physical activity-related behaviour.

  8. Testing an intervention for preventing osteoporosis in postmenopausal breast cancer survivors.

    PubMed

    Waltman, Nancy L; Twiss, Janice J; Ott, Carol D; Gross, Gloria Jean; Lindsey, Ada M; Moore, Timothy E; Berg, Kris

    2003-01-01

    To test a 12-month multicomponent intervention for preventing or treating osteoporosis in 21 postmenopausal women who had completed treatment (except Tamoxifen) for breast cancer, and for whom hormone replacement therapy (HRT) was contraindicated. Pilot intervention study. The intervention consisted of home-based strength and weight training exercises, 5 or 10 mg alendronate per day, 1500 mg calcium per day, 400 IU vitamin D per day, education on osteoporosis, and facilitative strategies to promote adherence to the intervention. Outcome measures were: adherence to the intervention, dynamic balance, muscle strength, and bone mineral density (BMD) of the hip, spine, and forearm. Adherence to calcium, vitamin D, and alendronate therapy was above 95%, and adherence to strength training exercises was above 85%. Over the 12 months, the 21 participants had significant improvements in dynamic balance, muscle strength for hip flexion, hip extension, and knee flexion, and BMD of the spine and hip. Participants had a significant decrease in BMD of the forearm. Three of the 21 women who had measurable bone loss at baseline had normal BMD after 12 months of the intervention.

  9. [Effect of kanggusong in prevention and treatment of retinoic acid induced osteoporosis in rats].

    PubMed

    Wu, B; Xu, B; Huang, T Y

    1996-01-01

    Retinoic acid 70 mg/kg.d was given by gastrogavage to Wistar rat for 14 days to induce osteoporosis. Kanggusong (KGS), a mixture of extracts from 8 traditional Chinese drugs, was given to 3 test groups of rats simultaneously in various dosage. Results showed that the KGS displayed obvious action in preventing osteoporosis, the trabecular loss of tibiae and bone loss of compact bone were lowered markedly in KGS groups with high (3.0 g/kg.d) or middle (1.0 g/kg.d) dosage in comparing with control model group, the trabecular area percentage and compact bone area percentage were increased significantly (P < 0.05) which approached to the level of normal control group. KGS could also improve the pathological changes in microstructure of bone, increase the thickness of trabecula and cortex (P < 0.05), reduce the trabecular gap and bone marrow cavity (P < 0.05). The mechanism of KGS might be relevant with its action of suppressing the osteoclast activity and activating osteoblast, resulting a positive balance of bone metabolism, increasing the blood concentration of calcium and estrogen as well as its antagonistic action against the injury of sex glands by retinoic acid.

  10. Regulatory mechanism of food factors in bone metabolism and prevention of osteoporosis.

    PubMed

    Yamaguchi, Masayoshi

    2006-11-01

    Aging induces a decrease in bone mass, and osteoporosis with its accompanying decrease in bone mass is widely recognized as a major public health problem. Bone loss with increasing age may be due to decreased bone formation and increased bone resorption. Pharmacologic and nutritional factors may prevent bone loss with aging, although chemical compounds in food and plants which act on bone metabolism are poorly understood. We have found that isoflavones (including genistein and daidzein), which are contained in soybeans, have a stimulatory effect on osteoblastic bone formation and an inhibitory effect on osteoclastic bone resorption, thereby increasing bone mass. Menaquinone-7, an analogue of vitamin K(2) which is abundant in fermented soybeans, has been demonstrated to stimulate osteoblastic bone formation and to inhibit osteoclastic bone resorption. Of various carotenoids, beta-cryptoxanthin, which is abundant in Satsuma mandarin (Citrus unchiu MARC), has a stimulatory effect on osteoblastic bone formation and an inhibitory effect on osteoclastic bone resorption. The supplementation of these factors has a preventive effect on bone loss induced by ovariectomy in rats, which are an animal model of osteoporosis, and their intake has been shown to have a stimulatory effect on bone mass in humans. Factors with an anabolic effect on bone metabolism were found in extracts obtained from wasabi leafstalk (Wasabi japonica MATSUM), the marine alga Sargassum horneri, and bee pollen Cistus ladaniferus. Phytocomponent p-hydroxycinnamic acid was also found to have an anabolic effect on bone metabolism. Food chemical factors thus play a role in bone health and may be important in the prevention of bone loss with increasing age.

  11. Middle School-Aged Child Enjoyment of Food Tastings Predicted Interest in Nutrition Education on Osteoporosis Prevention

    ERIC Educational Resources Information Center

    Cheng, Feon W.; Monnat, Shannon M.; Lohse, Barbara

    2015-01-01

    Background: "NEEDs for Bones" (NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11- to 14-year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. Methods:NFB was administered by teachers as part of standard practice and evaluated after the fourth…

  12. Middle School-Aged Child Enjoyment of Food Tastings Predicted Interest in Nutrition Education on Osteoporosis Prevention

    ERIC Educational Resources Information Center

    Cheng, Feon W.; Monnat, Shannon M.; Lohse, Barbara

    2015-01-01

    Background: "NEEDs for Bones" (NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11- to 14-year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. Methods:NFB was administered by teachers as part of standard practice and evaluated after the fourth…

  13. 1994 C. H. McCloy Research Lecture: Does Physical Activity Play a Role in Preventing Osteoporosis?

    ERIC Educational Resources Information Center

    Drinkwater, Barbara L.

    1994-01-01

    Review considers problems encountered in relating women's physical activity to increases in bone mass, noting the implications of recommending exercise to help prevent osteoporosis based on that information. Research indicates that for the full benefit of exercise on skeletal health, there must be adequate gonadal hormone levels. (SM)

  14. 1994 C. H. McCloy Research Lecture: Does Physical Activity Play a Role in Preventing Osteoporosis?

    ERIC Educational Resources Information Center

    Drinkwater, Barbara L.

    1994-01-01

    Review considers problems encountered in relating women's physical activity to increases in bone mass, noting the implications of recommending exercise to help prevent osteoporosis based on that information. Research indicates that for the full benefit of exercise on skeletal health, there must be adequate gonadal hormone levels. (SM)

  15. The quest for new drugs to prevent osteoporosis-related fractures.

    PubMed

    de Villiers, T J

    2017-04-01

    There is a need for the development of new drugs to prevent osteoporosis-related fractures. Fractures are projected to increase and the present drugs have modest efficacy, significant side-effects and poor compliance. To illustrate the difficulties in the development of new drugs, the author reviews the fate of several drugs that have failed to gain regulatory approval. These drugs include arzoxifene, lasofoxifene, MK-5442, roncalceret and odanacatib. Romosozumab and abaloparatide are the only new drugs presently in phase-3 development. It is anticipated that ongoing studies of the mechanisms and signaling pathways involved in the regulation of bone remodeling will open up new opportunities for targeted pharmacological interventions to increase bone strength. However, the perfect drug is still a long way off and will face many obstacles before approval.

  16. The relevance of biomaterials to the prevention and treatment of osteoporosis.

    PubMed

    Arcos, D; Boccaccini, A R; Bohner, M; Díez-Pérez, A; Epple, M; Gómez-Barrena, E; Herrera, A; Planell, J A; Rodríguez-Mañas, L; Vallet-Regí, M

    2014-05-01

    Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. In order to analyze this scenario and propose alternatives to overcome it, the Spanish and European Network of Excellence for the Prevention and Treatment of Osteoporotic Fractures, "Ageing", was created. This network integrates three communities, e.g. clinicians, materials scientists and industrial advisors, tackling the same problem from three different points of view. Keeping in mind the premise "living longer, living better", this commentary is the result of the thoughts, proposals and conclusions obtained after one year working in the framework of this network.

  17. SERMs in the prevention and treatment of postmenopausal osteoporosis: an update

    PubMed Central

    Júnior, Jaime Kulak; Kulak, Carolina Aguiar Moreira; Taylor, Hugh S.

    2011-01-01

    SUMMARY Selective estrogen receptor modulators (SERMs) have the ability to bind the estrogen receptor (ER) and are known to confer ER agonist or antagonist effects depending on the target tissue. A number of newer SERMs, including bazedoxifene, lasofoxifene and ospemifene, are currently under clinical development for the prevention and treatment of postmenopausal osteoporosis and for other indications. Although the possibility of developing a single agent that has all of the desired characteristics of an ideal SERM seems to be unlikely, progress in the clinical development of SERMs targeted to the ER suggests that these newer compounds may have attributes that represent an improvement relative to existing SERMs. A new approach to menopausal therapy is the tissue selective estrogen complex or the pairing of a selective estrogen receptor modulator with estrogens. Further investigation will help to clarify relative benefits/risks of novel SERMs in development within specific indications. PMID:20485909

  18. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

    PubMed

    Buckley, Lenore; Guyatt, Gordon; Fink, Howard A; Cannon, Michael; Grossman, Jennifer; Hansen, Karen E; Humphrey, Mary Beth; Lane, Nancy E; Magrey, Marina; Miller, Marc; Morrison, Lake; Rao, Madhumathi; Robinson, Angela Byun; Saha, Sumona; Wolver, Susan; Bannuru, Raveendhara R; Vaysbrot, Elizaveta; Osani, Mikala; Turgunbaev, Marat; Miller, Amy S; McAlindon, Timothy

    2017-08-01

    To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. This guideline provides direction for clinicians and patients making treatment decisions. Clinicians

  19. Abandoned Acid? Understanding Adherence to Bisphosphonate Medications for the Prevention of Osteoporosis among Older Women: A Qualitative Longitudinal Study

    PubMed Central

    Salter, Charlotte; McDaid, Lisa; Bhattacharya, Debi; Holland, Richard; Marshall, Tarnya; Howe, Amanda

    2014-01-01

    Background There is significant morbidity and mortality caused by the complications of osteoporosis, for which ageing is the greatest epidemiological risk factor. Preventive medications to delay osteoporosis are available, but little is known about motivators to adhere to these in the context of a symptomless condition with evidence based on screening results. Aim To describe key perceptions that influence older women's adherence and persistence with prescribed medication when identified to be at a higher than average risk of fracture. Design of Study A longitudinal qualitative study embedded within a multi-centre trial exploring the effectiveness of screening for prevention of fractures. Setting Primary care, Norfolk. United Kingdom Methods Thirty older women aged 70–85 years of age who were offered preventive medication for osteoporosis and agreed to undertake two interviews at 6 and 24 months post-first prescription. Results There were no overall predictors of adherence which varied markedly over time. Participants' perceptions and motivations to persist with medication were influenced by six core themes: understanding adherence and non-adherence, motivations and self-care, appraising and prioritising risk, anticipating and managing side effects, problems of understanding, and decision making around medication. Those engaged with supportive professionals could better tolerate and overcome barriers such as side-effects. Conclusions Many issues are raised following screening in a cohort of women who have not previously sought advice about their bone health. Adherence to preventive medication for osteoporosis is complex and multifaceted. Individual participant understanding, choice, risk and perceived need all interact to produce unpredictable patterns of usage and acceptability. There are clear implications for practice and health professionals should not assume adherence in any older women prescribed medication for the prevention of osteoporosis. The beliefs

  20. [Daily practice using guidelines for prevention and treatment of osteoporosis. Risk factors for fracture and guideline for prevention of fracture].

    PubMed

    Fujiwara, Saeko

    2008-08-01

    In 2006, a set of guidelines was released in Japan regarding the initiation of medical treatment to prevent fragility fracture with risk factors considered. In February this year, a WHO working group announced the development of the Fracture Risk Assessment Tool (FRAX), which estimates fracture risk based on age, sex, bone density at the femoral neck (body mass index if bone density is not available), previous fragility fracture in adulthood, parental fracture history at the femoral neck, current smoking, steroid use, secondary osteoporosis/rheumatoid arthritis, and alcohol consumption. And then, the NOF released guidelines incorporating FRAX in the US. WHO recommends that the threshold of medical treatment should be set based on each country's medical circumstances and healthcare economic situation.

  1. The safety and tolerability profile of therapies for the prevention and treatment of osteoporosis in postmenopausal women.

    PubMed

    Komm, Barry S; Morgenstern, Diana; A Yamamoto, Luis; Jenkins, Simon N

    2015-01-01

    At a time when the prevalence of osteoporosis and related fractures is increasing, initiation and continuation of pharmacologic therapies for prevention and treatment of postmenopausal osteoporosis have declined. This decline has been at least in part attributable to concerns about safety of these agents, such as atypical fractures with bisphosphonates and breast cancer with estrogen/progestin therapy, particularly when they are used long term by older women. However, in many cases, absolute risk of serious adverse effects is small and should be balanced against the larger potential for fracture reduction. Here, we review the safety and tolerability of available therapies for postmenopausal osteoporosis. Taking into consideration their relative efficacy, we also provide strategies for optimization of the risk:benefit ratio.

  2. Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy.

    PubMed

    Bell, Jennifer M; Shields, Michael D; Watters, Janet; Hamilton, Alistair; Beringer, Timothy; Elliott, Mark; Quinlivan, Rosaline; Tirupathi, Sandya; Blackwood, Bronagh

    2017-01-24

    Corticosteroid treatment is considered the 'gold standard' for Duchenne muscular dystrophy (DMD); however, it is also known to induce osteoporosis and thus increase the risk of vertebral fragility fractures. Good practice in the care of those with DMD requires prevention of these adverse effects. Treatments to increase bone mineral density include bisphosphonates and vitamin D and calcium supplements, and in adolescents with pubertal delay, testosterone. Bone health management is an important part of lifelong care for patients with DMD. To assess the effects of interventions to prevent or treat osteoporosis in children and adults with DMD taking long-term corticosteroids; to assess the effects of these interventions on the frequency of vertebral fragility fractures and long-bone fractures, and on quality of life; and to assess adverse events. On 12 September 2016, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL Plus to identify potentially eligible trials. We also searched the Web of Science ISI Proceedings (2001 to September 2016) and three clinical trials registries to identify unpublished studies and ongoing trials. We contacted correspondence authors of the included studies in the review to obtain information on unpublished studies or work in progress. We considered for inclusion in the review randomised controlled trials (RCTs) and quasi-RCTs involving any bone health intervention for corticosteroid-induced osteoporosis and fragility fractures in children, adolescents, and adults with a confirmed diagnosis of DMD. The interventions might have included oral and intravenous bisphosphonates, vitamin D supplements, calcium supplements, dietary calcium, testosterone, and weight-bearing activity. Two review authors independently assessed reports and selected potential studies for inclusion, following standard Cochrane methodology. We contacted study authors to obtain further information for clarification on published

  3. Implementation of program of prevention and early detection of osteoporosis among women of Primorsko-goranska County.

    PubMed

    Janković, Suzana; Kresina, Helena Glibotić; Zezelj, Sandra Pavicić; Kresina, Sandro

    2011-09-01

    The aim of this paper is to present preliminary data of Program of prevention and early detection of osteoporosis among women in Primorsko-goranska County. Osteoporosis is recognized as a public health problem for which clearly preventive measures are defined. Measurement of bone density was done by ultrasound densitometry of the calcaneus among women aged from 45 to 69 years old. 688 women were examined and they were classified in five five-year age groups. The women with the osteoporosis (T-score < or = 2.5) were 141; osteopenia (T-score from -2.5 to -1) were found in 400 women, and those with normal range of T-score were 147. All of five groups of women had T-score in range of osteopenia (T-score < or = 1). A statistically significant difference was between the first and fourth groups of women (p = 0.002) and the second and fourth groups (p = 0.001). After examination, depending on the value of T-score, women were recommended to visit family doctor and they also got educative booklet with advices for healthy nutrition and physical activity. Implementation of this program indicated the importance of proper lifestyle in the prevention of osteoporosis. Average T-scores of all five groups of women show that osteopenia occurs also in the youngest ones. This indicates the need for a systematic approach to preventing osteoporosis through education of women including younger ones and creating conditions for organized physical activities at the community level.

  4. Efficacy of low-intensity pulsed ultrasound in the prevention of osteoporosis following spinal cord injury.

    PubMed

    Warden, S J; Bennell, K L; Matthews, B; Brown, D J; McMeeken, J M; Wark, J D

    2001-11-01

    Ultrasound (US), a high-frequency acoustic energy traveling in the form of a mechanical wave, represents a potential site-specific intervention for osteoporosis. Bone is a dynamic tissue that remodels in response to applied mechanical stimuli. As a form of mechanical stimulation, US is anticipated to produce a similar remodeling response. This theory is supported by growing in vitro and in vivo evidence demonstrating an osteogenic effect of pulsed-wave US at low spatial-averaged temporal-averaged intensities. The aim of this study was to investigate whether low-intensity pulsed US could prevent calcaneal osteoporosis in individuals following spinal cord injury (SCI). Fifteen patients with a 1-6 month history of SCI were recruited. Active US was introduced to one heel for 20 min/day, 5 days/week, over 6 weeks. The contralateral heel was simultaneously treated with inactive US. Patients were blind to which heel was being actively treated. Active US pulsed with a 10 microsec burst of 1.0 MHz sine waves repeating at 3.3 kHz. The spatial-averaged temporal-averaged intensity was set at 30 mW/cm(2). Bone status was assessed at baseline and following the intervention period by dual-energy X-ray absorptiometry and quantitative US. SCI resulted in significant bone loss. Bone mineral content decreased by 7.5 +/- 3.0% in inactive US-treated calcanei (p < 0.001). Broadband US attenuation and speed of sound decreased by 8.5 +/- 6.9% (p < 0.001) and 1.5 +/- 1.3% (p < 0.001), respectively. There were no differences between active and inactive US-treated calcanei for any skeletal measure (p > 0.05). These findings confirm the negative skeletal impact of SCI, and demonstrate that US at the dose and mode administered was not a beneficial intervention for SCI-induced osteoporosis. This latter finding may primarily relate to the inability of US to effectively penetrate the outer cortex of bone due to its acoustic properties.

  5. [Osteoporosis treatment].

    PubMed

    Uebelhart, B; Rizzoli, R

    2006-01-04

    As for any chronic disease, adherence to osteoporosis treatment is low. Folates and vitamin B12 decrease hip fracture risk in elderly Japanese with stroke. Raloxifene (Evista) decreases the incidence of positive estrogen receptor breast cancer and could prevent cardiovascular events in patients at high risk. Strontium ranelate (Protélos) prevents hip fracture in elderly women. The action of alendronate (Fosamax) on bone mineral density and markers of bone remodelling is of higher amplitude than that of risedronate (Actonel). Once monthly ibandronate (Bonviva) increases bone mineral density in post menopausal women with osteoporosis. Excessive suppression of bone remodelling and osteonecrosis of the yaws could be related to bisphosphonate intake.

  6. Cross-sectional survey of women in Taiwan with first-degree relatives with osteoporosis: knowledge, health beliefs, and preventive behaviors.

    PubMed

    Chang, Shu-Fang; Hong, Chin-Ming; Yang, Rong-Sen

    2007-09-01

    No previous investigation has explored preventive behaviors among women with First-Degree Relatives (FDRs) diagnosed with osteoporosis, particularly Asian women. This study investigates osteoporosis knowledge, health beliefs and preventive behaviors of women with a family history of osteoporosis, and the different knowledge and health beliefs regarding preventive behaviors of women with such a history. Women were recruited at a large public health center in northern Taiwan. A questionnaire was administered to women with FDRs with osteoporosis with a focus on osteoporosis knowledge, health beliefs and preventive behaviors. Descriptive analysis was initially conducted. Correlation and differences between demographics, knowledge, health beliefs and preventive behaviors were rated for continuous variables, and the chi2 test was performed for categorical variables. A total of 251 who women satisfied the sampling criteria were invited to engage in the study. Two hundred and one women agreed to take part in the study, and the participation rate was around 80%. This work stresses the insufficiency of information on osteoporosis, constraining beliefs and ignorance of healthy preventive behaviors among women with FDRs with osteoporosis. Overall, the likelihood that women would take positive preventive behaviors is associated with their demographics and knowledge. The variables most strongly correlated with preventive behaviors for community-dwelling women are, in order, knowledge, number of children, educational level, knowledge of osteoporosis, experience of bone density examination, and whether or not women believed they had kyphosis. The results of this work can be applied to provide effective implementation guidelines for preventing osteoporosis, especially for women with a family history of the disease.

  7. [Adequacy of treatment for osteoporosis in primary prevention. Quantitative and qualitative study].

    PubMed

    Vedia Urgell, Cristina; Massot Mesquida, Mireia; Valles Fernandez, Roser; Garcia Vicente, Juan Antonio; Franzi Siso, Alicia; Muñoz Ortiz, Laura; Vilaró Jaques, Laia; Bosch Peligero, Maite

    2017-04-14

    Quantitative study: To assess the prevalence of inadequacy of treatment for osteoporosis in primary prevention (OPP) in women aged 60-74years. Qualitative study: To evaluate the diagnostic and treatment criteria of the OPP and it's variability in primary care physicians (PC) and specialists. Quantitative study: observational, cross-sectional and retrospective study. women aged 60-74years with active treatment for OPP (n=424) in May 2012. Inadequacy if they had ≤2 risk factors with a DXA or DXA T-score ≥-2.4. Qualitative study: Delphi technique (15items) and two rounds of consultation. March-April 2014. PC physicians, rheumatologists and orthopaedic surgeons (n=251). Random sampling. Quantitative study: degree of inadequacy is 63.4%. In 43.2% isn't mention a diagnosis of osteoporosis. In 82.3% there isn't mention of risk factors. bisphosphonate 40.3% and calcium +vitaminD 47.9%. Qualitative study: 23% respond to the first round, and of these 67% the second round. Items with higher agreement were the important of the evaluation of risk factors for diagnosis and bisphosphonates for treatment. Items with fewer consensuses were using the FRAX and densitometry and treatment with only calcium +vitaminD. The percentage of inadequacy is high. The degree of registration in medical history is low. The Delphi method is useful for detecting discrepancies between recommendations of clinical practice guidelines and results. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  8. The role of healthy diet in the prevention of osteoporosis in perimenopausal period

    PubMed Central

    Kostecka, Małgorzata

    2014-01-01

    Objective: The aim of the study was to assess the diet for its effect on normal bone mineralization and qualitative analysis of dietary supplements used in the prevention of osteoporosis. Methods: Research data were acquired based on a questionnaire developed by the author. A 24-hour diet recall method was used with the involvement of Dieta 5.0 software developed by the National Food and Nutrition Institute in Warsaw in Poland. The second part of the study involved an analysis of the most popular dietary supplements available over the counter. Complexometric titration was used to separate and identify calcium. Results: The results of a 24-hour diet recall indicate that 47% of the respondents consumed 550-750 mg of calcium daily, and only 21% of the subjects consumed more than 1200 mg of calcium every day. The results give cause for concern: none of the analyzed diets supplied the recommended daily amounts of vitamin D, and only 29% of the respondents admitted taking vitamin D supplements. The results of the survey indicate that consumers have insufficient knowledge about lifestyle diseases, including osteoporosis. Conclusion: Diet of large part of society is not properly balanced which can cause abnormalities in achieving proper bone mineralization. Long-term deficiencies in calcium and vitamin D in daily diet are the cause for taking dietary supplements. Unfortunately, some preparations on the market do not have adequate storage. It happens that these preparations are poorly absorbed and the amount of active compound is too low. Changes in the nutritional regimen are required already during childhood because nutritional mistakes are the main cause of diet-related diseases in adulthood. PMID:25097513

  9. Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment.

    PubMed

    Lanham-New, Susan A

    2008-05-01

    Throughout the life cycle the skeleton requires optimum development and maintenance of its integrity to prevent fracture. Bones break because the loads placed on them exceed the ability of the bone to absorb the energy involved. It is now estimated that one in three women and one in twelve men aged >55 years will suffer from osteoporosis in their lifetime and at a cost in the UK of > 1.7 pounds x 10(9) per year. The pathogenesis of osteoporosis is multifactorial. Both the development of peak bone mass and the rate of bone loss are determined by key endogenous and exogenous factors. Ca supplements appear to be effective in reducing bone loss in women late post menopause (>5 years post menopause), particularly in those with low habitual Ca intake (<400 mg/d). In women early post menopause (<5 years post menopause) who are not vitamin D deficient, Ca supplementation has little effect on bone mineral density. However, supplementation with vitamin D and Ca has been shown to reduce fracture rates in the institutionalised elderly, but there remains controversy as to whether supplementation is effective in reducing fracture in free-living populations. Re-defining vitamin D requirements in the UK is needed since there is evidence of extensive hypovitaminosis D in the UK. Low vitamin D status is associated with an increased risk of falling and a variety of other health outcomes and is an area that requires urgent attention. The role of other micronutrients on bone remains to be fully defined, although there are promising data in the literature for a clear link between vitamin K nutrition and skeletal integrity, including fracture reduction.

  10. Strategies for the prevention and treatment of osteoporosis during early postmenopause.

    PubMed

    Delaney, Miriam F

    2006-02-01

    During the perimenopause, both the quantity and quality of bone decline rapidly, resulting in a dramatic increase in the risk of fracture in postmenopausal women. Although many factors are known to be associated with osteoporotic fractures, measures to identify and treat women at risk are underused in clinical practice. Consequently, osteoporosis is frequently not detected until a fracture occurs. Identification of postmenopausal women at high risk of fracture therefore is a priority and is especially important for women in early postmenopause who can benefit from early intervention to maintain or to increase bone mass and, thus, reduce the risk of fracture. Most authorities recommend risk-factor assessment for all postmenopausal women, followed by bone mineral density measurements for women at highest risk (ie, all women aged > or =65 years, postmenopausal women aged <65 years with > or =1 additional risk factors for osteoporosis, and postmenopausal women with fragility fractures). All postmenopausal women can benefit from nonpharmacologic interventions to reduce the risk of fracture, including a balanced diet with adequate intake of calcium and vitamin D, regular exercise, measures to prevent falls or to minimize their impact, smoking cessation, and moderation of alcohol intake. Several pharmacologic agents, including the bisphosphonates (eg, alendronate, risedronate, and ibandronate) and the selective estrogen receptor modulator, raloxifene, have been shown to increase bone mass, to reduce fracture risk, and to have acceptable side-effect profiles. Women who have discontinued hormone therapy are in particular need of monitoring for fracture risk, in light of the accelerated bone loss and increased risk of fracture that occurs after withdrawal of estrogen treatment.

  11. Glucocorticoid-induced osteoporosis in growing mice is not prevented by simultaneous intermittent PTH treatment.

    PubMed

    Postnov, Andrei; De Schutter, Tineke; Sijbers, Jan; Karperien, Marcel; De Clerck, Nora

    2009-12-01

    Glucocorticoids (GCs) are widely used in medicine for treatment of chronic diseases. Especially in children, prolonged treatment causes growth retardation and early onset of osteoporosis. Human parathyroid hormone (PTH) has an anabolic effect on bone when administrated intermittently. The aim of the present study was to examine whether a combined therapy of dexamethasone (DEX) and PTH could prevent the detrimental effects of GC on cortical and trabecular bone in the femur and vertebrae of growing mice. Three-week-old female FVB mice were treated with control, DEX, PTH, or a combination of DEX and PTH by daily subcutaneous injections. After 4 weeks, animals were killed and the femur and L5 vertebra were isolated. Cortical and trabecular bone parameters and relative calcium density were measured by high-resolution X-ray micro-computed tomography (micro-CT). In the femur, PTH can reverse the effects of DEX on bone volume to control. However, it cannot reverse the undermineralization, which most likely is a strong contributor to bone fragility. In the vertebra, PTH improves bone volume to some extent but does not restore the values to normal. It augments the negative effect of DEX on mineralization. We conclude that the detrimental effects of DEX in the growing skeleton cannot be prevented by simultaneous PTH treatment.

  12. Preventive effects of Eleutherococcus senticosus bark extract in OVX-induced osteoporosis in rats.

    PubMed

    Lim, Dong Wook; Kim, Jae Goo; Lee, Youngseok; Cha, Seok Ho; Kim, Yun Tai

    2013-07-08

    Eleutherococcus senticosus (Siberian ginseng), has been used as a powerful tonic herb with an impressive range of health benefits. This medicinal herb has been commonly used to treat bone metabolism diseases due to its traditional Korean medicine use to strengthen muscle and bone. This study was conducted to investigate prevention of bone loss by a standardized extract of dried E. senticosus stem bark in an ovariectomized (OVX) rat model of osteoporosis. The OVX groups were divided into five groups treated with distilled water, 17β-estradiol (E2 10 μg/kg, once daily, i.p) and dried stem bark of E. senticosus extracts (DES 10, 30, and 100 mg/kg, once daily, p.o) for eight weeks, respectively. After eight weeks of treatments, the femur bone mineral density of the 100 mg/kg DES-treated group was significantly higher than that of the OVX-control group (16.7%, p < 0.01) without affecting the body, organs, and uterus weights, and serum estradiol levels. Additionally, bone markers such as serum ALP, CTx, and OC levels were significantly decreased in the DES 100 mg/kg treated group. These results show that DES is able to prevent OVX-induced in bone loss without the influence of hormones such as estrogen.

  13. Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis?

    PubMed

    Bolland, M J; Grey, A; Reid, I R

    2015-01-01

    Systematic reviews of randomized, controlled trials (RCTs) are considered the highest level of evidence to inform clinical practice. Meta-analyses of large RCTs of calcium and/or vitamin D supplements completed in the last 15 years provide strong evidence for clinical recommendations. These meta-analyses with data for > 50,000 older adults reported that calcium with or without vitamin D has only weak, inconsistent effects on fracture, and that vitamin D without calcium has no effect on fracture. Only one RCT of co-administered calcium and vitamin D in frail, institutionalized, elderly women with low dietary calcium intake and vitamin D levels showed significant reductions in fracture risk. These RCTs have also reported previously unrecognized adverse events of calcium supplements including kidney stones, myocardial infarction, hypercalcemia, and hospitalization with acute gastrointestinal symptoms. The small risk of these important adverse effects, together with the moderate risk of minor side-effects such as constipation, probably outweighs any benefits of calcium supplements on fracture. These data suggest the role for calcium and vitamin D supplements in osteoporosis management is very limited. Neither calcium nor vitamin D supplements should be recommended for fracture prevention in community-dwelling adults, although vitamin D should be considered for prevention of osteomalacia in at-risk individuals.

  14. Observational study of compliance and continuance rates of raloxifene in the prevention and treatment of osteoporosis

    PubMed Central

    Zanchetta, José R.; Hakim, Carina; Lombas, Carola

    2004-01-01

    Abstract Background: Medical practitioners face the challenge of noncompliance with prescriptions, particularly in chronic, asymptomatic, diseases such as osteoporosis. Objective: The aim of this study was to assess the raloxifene compliance and continuance rates and adverse effects over 24 months in clinical practice. Methods: Using a retrospective study of clinical histories obtained from a database at the Metabolic Research Institute, University of El Salvador School of Medicine, Buenos Aires, Argentina, as well as telephone interviews, we assessed compliance and continuance with raloxifene therapy in post-menopausal patients who had received prescriptions for raloxifene to prevent or treat osteoporosis. Patients were contacted by telephone 24 months after they had received a prescription for raloxifene. Compliance and continuance rates were calculated based on the data provided by the patients. Results: Data from 419 patients (mean [SD] age, 61.4 [7.4] years [range, 42–90 years]) were included in the study. At the time of the telephone interview, 225 (53.7%) were still receiving raloxifene, 105 (25.1%) had stopped treatment at their own discretion, 59 (14.1%) had not started treatment, and 30 (7.2%) had discontinued treatment as a result of advice from a physician. The reasons for not starting treatment were fear of thrombolytic events (21 patients [35.6%]); lack of interest in starting treatment (12 [20.3%]); other physician's advice (11 [18.6%]); family problems (3 [5.1%]); dissatisfaction with the prescribing physician, treatment cost, health problems unrelated to osteoporosis, and mistrust in the prescription (each, 2 [3.4%]); and advice from family/friends, fear of breast cancer, belief that raloxifene is hormonal, and that the patient was already polymedicated (each, 1 [1.7%]). Eleven of the 59 patients (18.6%) who had not started therapy were advised by a physician other than the prescribing physician not to start treatment and were excluded from the

  15. Postmenopausal osteoporosis.

    PubMed

    Eastell, Richard; O'Neill, Terence W; Hofbauer, Lorenz C; Langdahl, Bente; Reid, Ian R; Gold, Deborah T; Cummings, Steven R

    2016-09-29

    Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population. Postmenopausal osteoporosis, resulting from oestrogen deficiency, is the most common type of osteoporosis. Oestrogen deficiency results in an increase in bone turnover owing to effects on all types of bone cells. The imbalance in bone formation and resorption has effects on trabecular bone (loss of connectivity) and cortical bone (cortical thinning and porosity). Osteoporosis is diagnosed using bone density measurements of the lumbar spine and proximal femur. Preventive strategies to improve bone health include diet, exercise and abstaining from smoking. Fractures may be prevented by reducing falls in high-risk populations. Several drugs are licensed to reduce fracture risk by slowing down bone resorption (such as bisphosphonates and denosumab) or by stimulating bone formation (such as teriparatide). Improved understanding of the cellular basis for osteoporosis has resulted in new drugs targeted to key pathways, which are under development.

  16. Osteoporosis Prevention in College Women: Application of the Expanded Health Belief Model.

    ERIC Educational Resources Information Center

    Wallace, Lorraine Silver

    2002-01-01

    Examined personal characteristics and expanded health belief model (EHBM) constructs associated with osteoporosis- protective behaviors among college women. Survey results indicated that the EHBM was useful in evaluating osteoporosis- protective behavior. High numbers of women did not meet current exercise and calcium guidelines. Exercise…

  17. Osteoporosis Prevention in College Women: Application of the Expanded Health Belief Model.

    ERIC Educational Resources Information Center

    Wallace, Lorraine Silver

    2002-01-01

    Examined personal characteristics and expanded health belief model (EHBM) constructs associated with osteoporosis- protective behaviors among college women. Survey results indicated that the EHBM was useful in evaluating osteoporosis- protective behavior. High numbers of women did not meet current exercise and calcium guidelines. Exercise…

  18. Preventive effects of Polygonum multiflorum on glucocorticoid-induced osteoporosis in rats.

    PubMed

    Zhou, Manru; Li, Jin; Wu, Jingkai; Yang, Yajun; Zeng, Xiaobing; Lv, Xiaohua; Cui, Liao; Yao, Weimin; Liu, Yuyu

    2017-09-01

    In Traditional Chinese Medicine, Polygonum multiflorum (PM) is known for its anti-aging properties. A previous study by our group showed that extracts of PM were able to prevent and treat bone loss in vivo, and the active components emodin and 2,3,5,4,-tetrahydroxystilbene-2-O-β-glucoside (TSG) promoted the osteogenic differentiation of mesenchymal stem cells in vitro. The aim of the present study was to investigate the preventive effects of PM on glucocorticoid-induced osteoporosis (GIO) in rats. A crude extract of PM was prepared with 75% ethanol, purified and enriched using a D-101 macroresin column and elution with 30% ethanol, and the material obtained was assessed by high-performance liquid chromatography. Male or female Sprague Dawley rats (n=180) were randomly divided into nine groups: Control, prednisone, prednisone plus calcitriol (CAL), prednisone plus 30% ethanolic eluate of PM [high (H), medium (M) and low (L) dose] and prednisone plus crude extract of PM (H, M and L dose). Prednisone was orally administered to the osteoporosis model rats for 21 weeks, alongside which they received PM extracts. The weight of the viscera, anterior tibial muscle and other tissues was recorded at the end of the experiment. The femur and lumbar vertebra were collected for the measurement of three-dimensional microarchitecture by micro-computed tomography scanning, assessment of biomechanical properties and determination of bone mineral density (BMD). In the 30% ethanolic eluate of the PM extract, the content of TSG and combined anthraquinone was 9.20 and 0.15%, respectively, and that in the crude extract of PM was 2.23 and 0.03%, respectively. Over 6 weeks, the weight of the rats the in prednisone group decreased (P<0.05), while the weight of rats treated with M and H doses of 30% ethanolic eluate was increased compared with that in the prednisone group (P<0.05). Rats exposed to prednisone exhibited a deteriorated bone microarchitecture, low BMD, decreased bone volume

  19. Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary.

    PubMed

    Hwang, Jawl-Shan; Chan, Ding-Cheng; Chen, Jung-Fu; Cheng, Tien-Tsai; Wu, Chih-Hsing; Soong, Yung-Kuei; Tsai, Keh-Sung; Yang, Rong-Sen

    2014-01-01

    Osteoporosis is recognized as a major public health problem worldwide and in Taiwan. However, many patients with osteoporotic fractures do not receive appropriate assessments or treatments. This guideline, proposed by the Taiwanese Osteoporosis Association, is to serve as a quick reference for healthcare providers to improve the assessment of osteoporosis and development of optimal strategies for osteoporotic management in Taiwan. To review and update osteoporosis management, the guideline is constituted with Taiwan-specific osteoporosis epidemiological data, medication protocols, and the 10-year FRAX(®). The guideline is based on evidence-based medicine and public health considerations. Recommendations are not limited to the reimbursement regulations permitted by the National Health Insurance of Taiwan.

  20. Immunization with FSHβ fusion protein antigen prevents bone loss in a rat ovariectomy-induced osteoporosis model

    SciTech Connect

    Geng, Wenxin; Yan, Xingrong; Du, Huicong; Cui, Jihong; Li, Liwen Chen, Fulin

    2013-05-03

    Highlights: •A GST-FSH fusion protein was successfully expressed in E. coli. •Immunization with GST-FSH antigen can raise high-titer anti-FSH polyclonal sera. •Anti-FSH polyclonal sera can neutralize osteoclastogenic effect of FSH in vitro. •FSH immunization can prevent bone loss in a rat osteoporosis model. -- Abstract: Osteoporosis, a metabolic bone disease, threatens postmenopausal women globally. Hormone replacement therapy (HTR), especially estrogen replacement therapy (ERT), is used widely in the clinic because it has been generally accepted that postmenopausal osteoporosis is caused by estrogen deficiency. However, hypogonadal α and β estrogen receptor null mice were only mildly osteopenic, and mice with either receptor deleted had normal bone mass, indicating that estrogen may not be the only mediator that induces osteoporosis. Recently, follicle-stimulating hormone (FSH), the serum concentration of which increases from the very beginning of menopause, has been found to play a key role in postmenopausal osteoporosis by promoting osteoclastogenesis. In this article, we confirmed that exogenous FSH can enhance osteoclast differentiation in vitro and that this effect can be neutralized by either an anti-FSH monoclonal antibody or anti-FSH polyclonal sera raised by immunizing animals with a recombinant GST-FSHβ fusion protein antigen. Moreover, immunizing ovariectomized rats with the GST-FSHβ antigen does significantly prevent trabecular bone loss and thereby enhance the bone strength, indicating that a FSH-based vaccine may be a promising therapeutic strategy to slow down bone loss in postmenopausal women.

  1. Gaining perspective: the effects of message frame on viewer attention to and recall of osteoporosis prevention print advertisements.

    PubMed

    O'Malley, Deborah A; Latimer-Cheung, Amy E

    2013-11-01

    This study examined how framed messages affect viewer attention to and cognitive processing of osteoporosis prevention print ads. Attention was measured with eye tracking technology. Cognitive processing was assessed through masked recall. A total of 60 college-aged women viewed 12 gain-framed, 12 loss-framed, and 12 neutral-framed ads. Number of fixations, dwell time, and recall of gain-framed osteoporosis prevention ads were higher than loss-framed or neutral-framed ads, p < .01. Message recall was positively correlated with the number of fixations and dwell time for the gain-framed and neutral-framed messages, p < .01. These findings provide preliminary insight into potential mechanisms underlying message framing effects.

  2. [Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial].

    PubMed

    Benevolenskaia, L I; Toroptsova, N V; Nikitinskaia, O A; Sharapova, E P; Korotkova, T A; Rozhinskaia, L Ia; Marova, E I; Dzeranova, L K; Molitvoslovova, N N; Men'shikova, L V; Grudinina, O V; Lesniak, O M; Evstigneeva, L P; Smetnik, V P; Shestakova, I G; Kuznetsov, S Iu

    2004-01-01

    To investigate efficacy, tolerance and safety of the drug vitrum osteomag one tablet of which contains 600 mg calcium (1500 mg calcium carbonate), 200 IU of cholecalcepherol, 40 mg of magnesium, zinc (7.5 mg), copper (1 mg), manganese (1.8 mg) and boron (250 mcg) in women with osteopenia for prevention of osteoporosis. A multicenter comparative open trial of vitrum osteomag influence on mineral bone density (MBD), change of pain syndrome in bones, index of calcium-phosphorous metabolism covered 334 postmenopausal women with osteopenia. MBD was measured in low-back spine and proximal part of the hip with DEXA method. All the patients were divided into 3 groups: 125 women taking 2 tablets of vitrum osteomag daily for 12 months (group 1); 111 women taking 1500 mg calcium carbonate (group 2); 96 women--control group (only observation). Vitrum osteomag relieved pain in the back and joints, had a positive effect on bone density (+1.5%) and proximal parts of the hip (0.6-0.93%) exceeding the effect of calcium carbonate only which preserves the initial MBD in low back spine but does not prevent bone loss in the hip. MBD dynamics in patients given vitrum osteomag differs essentially from one in the control group (from -1.9 to -2.91%) which demonstrates a reliable preventive anti-osteoporotic effect of this medication. The drug increases the level of general and ionized calcium in blood but does not cause hypercalcemia lowering the level of parathormone in blood. The rate of side effects in group 1 was 14.4% and did not differ much from that in group 2 (16.2%). The results of the study allow to recommend vitrum osteomag for prophylaxis of a rapid loss of bone tissue mineral density.

  3. Osteoporosis guidelines.

    PubMed

    Barlow, D H

    2007-10-01

    The Position Statement from the International Menopause Society (IMS) in 2004 recommends the use of hormone therapy for the 'avoidance of bone-wasting and fractures'. It also states that 'prevention, not treatment, is the most feasible goal'. In updating the Statement, this paper considers the relevance of Osteoporosis Guidelines. Relevant documents will be of two broad types. These may be consensus statements/position statements that summarize the 'state of the art' for practitioners, based on the work of expert groups, or they may be formal Guidelines generated through formal 'evidence-based' methodology. The former approach is generally used by Societies and can be generated through relatively efficient consensus processes. The latter approach will normally involve extensive work and cost, necessarily becomes very detailed, involving systematic review and technology appraisal and can lead to highly specific recommendations on intervention thresholds. For the revision of the general IMS Position Statement, the specific IMS Paper on Postmenopausal Osteoporosis (2005) must be a key reference document. This provides a description of the international consensus on the management of osteoporosis up to late 2004 and which remains relevant today. Additionally, other consensus statements and systematic guidelines need to be considered. Across these documents providing guidance, the substantial influence of the International Osteoporosis Foundation/National Osteoporosis Foundation Position Paper, defining a 'New approach to the development of assessment guidelines for osteoporosis', can be seen. This flagged the importance of a shift from guidance, tying the diagnostic threshold to the intervention threshold, and instead advised linking the intervention threshold to estimated fracture risk probability. This moves the intervention decision away from a simple bone density threshold to a more complex, but more realistic, threshold estimate, taking into account a range of

  4. Treadmill running exercise prevents senile osteoporosis and upregulates the Wnt signaling pathway in SAMP6 mice

    PubMed Central

    Chen, Xi; Li, Lihui; Guo, Jianmin; Zhang, Lingli; Yuan, Yu; Chen, Binglin; Sun, Zhongguang; Xu, Jiake; Zou, Jun

    2016-01-01

    This study examined the effects of different exercise intensities and durations on bone mineral density (BMD) and bone strength in senescence-accelerated mouse prone 6 (SAMP6) and determined the involvement of the Wnt signaling pathway in exercise-induced osteogenesis. Three-month-old male SAMP6 mice were randomly assigned to different speeds of treadmill running exercise representing low, medium and high intensity, with the duration of five and nine weeks, respectively. We showed that medium-intensity exercise had positive effects on skeletal health, including BMD and bone strength, and the efficacy was higher than that of low-intensity exercise. Interestingly, high-intensity exercise can maintain or even increase bone strength, despite its negative effects on bone mass. Nine weeks of exercise was superior to 5 weeks of exercise, particularly for low-intensity exercise. Furthermore, these effects of exercise-induced osteogenesis are accompanied by activation of the Wnt signaling pathway. Taken together, these results suggest that the positive effects of exercise on osteoporosis prevention are intensity and duration-dependent, and may involve the regulation of Wnt signaling pathways. PMID:27661008

  5. Treadmill running exercise prevents senile osteoporosis and upregulates the Wnt signaling pathway in SAMP6 mice.

    PubMed

    Chen, Xi; Li, Lihui; Guo, Jianmin; Zhang, Lingli; Yuan, Yu; Chen, Binglin; Sun, Zhongguang; Xu, Jiake; Zou, Jun

    2016-11-01

    This study examined the effects of different exercise intensities and durations on bone mineral density (BMD) and bone strength in senescence-accelerated mouse prone 6 (SAMP6) and determined the involvement of the Wnt signaling pathway in exercise-induced osteogenesis. Three-month-old male SAMP6 mice were randomly assigned to different speeds of treadmill running exercise representing low, medium and high intensity, with the duration of five and nine weeks, respectively. We showed that medium-intensity exercise had positive effects on skeletal health, including BMD and bone strength, and the efficacy was higher than that of low-intensity exercise. Interestingly, high-intensity exercise can maintain or even increase bone strength, despite its negative effects on bone mass. Nine weeks of exercise was superior to 5 weeks of exercise, particularly for low-intensity exercise. Furthermore, these effects of exercise-induced osteogenesis are accompanied by activation of the Wnt signaling pathway. Taken together, these results suggest that the positive effects of exercise on osteoporosis prevention are intensity and duration-dependent, and may involve the regulation of Wnt signaling pathways.

  6. The Determination of Predictive Construct of Physical Behavior Change on Osteoporosis Prevention Women Aged 30-50: A Trans-theoretical Method Study

    PubMed Central

    Malekshahi, Farideh; Hidarnia, Alireza; Niknami, Shamseddin; Aminshokravi, Frakhondeh

    2016-01-01

    Osteoporosis is a major public health priority in Iran and throughout the world. The prevention of osteoporosis has recently become the ultimate goal of many health professionals. Behavior change is one of the most powerful strategies to prevent osteoporosis. This study aimed to determine the predictive construct of physical preventive behavior of osteoporosis in women aged 30-50 in Khorramabad, west of Iran. This study included 269 women selected from all the health centers of Khorramabad city according to the inclusion criteria of the study and through random cluster and systematic sampling. The data gathering tools were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and physical activity. Data were analyzed using descriptive and inferential statistics. The mean of the subjects’ age was 38.72±7.003, and the mean of light weekly physical activity was 38.83±56.400. The results showed that the construct of self-efficacy had the highest predictive power of the preventive behavior. The results also showed that self-efficacy among the constructs of the Trans-theoretical Model was the only predictive construct for osteoporosis prevention behavior. Therefore, the findings of this study can serve as a base for educational interventions in behavioral changes to prevent of osteoporosis by health authorities. PMID:26493413

  7. The Determination of Predictive Construct of Physical Behavior Change on Osteoporosis Prevention Women Aged 30-50: A Trans-Theoretical Method Study.

    PubMed

    Malekshahi, Farideh; Hidarnia, Alirezad; Niknami, Shamseddin; Aminshokravi, Frakhondeh

    2015-07-27

    Osteoporosis is a major public health priority in Iran and throughout the world. The prevention of osteoporosis has recently become the ultimate goal of many health professionals. Behavior change is one of the most powerful strategies to prevent osteoporosis. This study aimed to determine the predictive construct of physical preventive behavior of osteoporosis in women aged 30-50 in Khorramabad, west of Iran. This study included 269 women selected from all the health centers of Khorramabad city according to the inclusion criteria of the study and through random cluster and systematic sampling. The data gathering tools were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and physical activity. Data were analyzed using descriptive and inferential statistics. The mean of the subjects' age was 38.72±7.003, and the mean of light weekly physical activity was 38.83±56.400. The results showed that the construct of self-efficacy had the highest predictive power of the preventive behavior. The results also showed that self-efficacy among the constructs of the Trans-theoretical Model was the only predictive construct for osteoporosis prevention behavior. Therefore, the findings of this study can serve as a base for educational interventions in behavioral changes to prevent of osteoporosis by health authorities.

  8. The level of physical activity in patients with osteoporosis in relation to the risk and prevention of falls.

    PubMed

    Lewczuk, Emilia; Białoszewski, Dariusz

    2006-08-31

    Background. Thanks to modern methods of diagnosis, treatment and rehabilitation, we currently possess the means to counteract the consequences of osteoprosis and limit the number of falls in osteoporotic patients. Material and methods. Based on an original questionnaire, we analyzed a group of 54 patients (48 women and 6 men) under treatment for osteoporosis in order to assess the level of physical activity and the reasons for its reduction in patients with osteoporosis, to determine the situations mostly endangered by falls, and to survey the opinion of patients regarding the need for a rehabilitation program to prevent falls. Results. 68.5% of the patients stated that osteoporosis has reduced their everyday physical activity. Among these patients, 54% reported a fall during the last year. The most common reasons for reduced activity were fear of falling and incurring a fracture (38.8%)and pain (34.7%). The activity most likely to cause a fall was slow walking (51.6%). 92.6% of the surveyed patients were willing to participation in rehabilitation classes to reduce the risk of a fall; of these patients, 50% reported reduced physical activity, 20% significantly reduced, and 30% no change. Conclusions. Falls and consequent fractures, both prior and anticipated, are the most common reason for reduced physical activity in patients with osteoporosis. Pain was a major cause of reduced everyday activity among patients who had already incurred osteoporotic fractures and had symptoms of osteoporosis for more than 6 years. According to patients, the activity bearing the greatest risk of a fall is walking.

  9. Role of zoledronic acid in the prevention and treatment of osteoporosis

    PubMed Central

    Räkel, Agnès; Boucher, Andrée; Ste-Marie, Louis-Georges

    2011-01-01

    Taken once a year, intravenous zoledronic acid (Zol) (Reclast® or Aclasta®) is a third-generation nitrogen-containing bisphosphonate that is effective compared with placebo in reducing the risk of fractures in patients with postmenopausal osteoporosis and recent low-trauma hip fracture. In glucocorticoid-induced osteoporosis, there is no significant difference between Zol and risedronate for new fractures. Improvements in bone mineral density and early reduction of bone remodeling markers are observed in postmenopausal osteoporosis, recent low-trauma hip fracture, and glucocorticoid-induced osteoporosis. Given that Zol is generally well tolerated and very convenient, it is an interesting therapeutic option for aging patients who take multiple oral drugs, who have adherence or gastrointestinal tolerance issues, and who have an indication for oral bisphosphonates. Zol is not recommended for patients with severe renal impairment. Vitamin D deficiency should be corrected before the administration of Zol. PMID:21594000

  10. Alpha-1 antitrypsin gene therapy prevented bone loss in ovariectomy induced osteoporosis mouse model

    USDA-ARS?s Scientific Manuscript database

    Osteoporosis is a major healthcare burden affecting mostly postmenopausal women characterized by compromised bone strength and increased risk of fragility fracture. Although pathogenesis of this disease is complex, elevated proinflammatory cytokine production is clearly involved in bone loss at meno...

  11. Use of decision rules for osteoporosis prevention and treatment: implications for nurse practitioners.

    PubMed

    Anders, Michael; Turner, Lori; Wallace, Lorraine Silver

    2007-06-01

    To describe the current literature regarding the benefits of bone mineral density (BMD) screening and to discuss clinical decision rules for BMD screening. Extensive review of the scientific literature regarding osteoporosis, BMD screening, and current clinical decision rules. Osteoporosis is a disease characterized by deterioration of bone and increased susceptibility to fractures, crippling, and disfigurement. BMD testing is the best predictor for osteoporosis and associated fractures; however, routine global BMD testing is cost-prohibitive. A need exists for a selective and practical clinical decision rule for referral for testing. Several effective clinical decision rules are presented, and their uses and applications are described. The osteoporosis self-assessment tool is recommended by the authors because of its predictive power and ease of use.

  12. Osteoporosis Overview

    MedlinePlus

    ... supported by your browser. Home Osteoporosis Osteoporosis Basics Osteoporosis Overview Publication available in: PDF (23 KB) Related ... products. NIH Pub. No. 15-AR-8004 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 ...

  13. Calcitonin for the long-term prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Body, J-J

    2002-05-01

    Calcitonin is a powerful inhibitor of osteoclast activity that exerts a rapid, transient, and reversible inhibition of bone resorption. Prolonged administration of parenteral calcitonin, by injections of 100 IU every 1 or 2 days, can prevent postmenopausal or postovariectomy bone loss, and is also able to increase trabecular bone mass among patients presenting an established osteoporosis. Prolonged treatment with calcitonin injections is, however, difficult to maintain over the long run. In addition to the ease of administration compared with the injectable forms, nasal calcitonin is much better tolerated, the side effects being rare and generally negligible. A prolonged administration of 200 IU intranasal calcitonin acutely inhibits parameters of bone resorption and can increase lumbar spine bone mineral density (BMD) by 1.7%-3.3% after 1 year. Lower doses also appear to be efficient to prevent early postmenopausal bone loss, but the data are conflictual. The results are more consistent in patients who already suffer from established osteoporosis. The increase in lumbar spine BMD is in the order of 1%-2% after 1 year with 200 IU daily. A therapeutic benefit of calcitonin at the level of the cortical bone has been less well demonstrated than for the trabecular bone. As for other antiosteoporotic therapies, the effect of calcitonin on the reduction of fracture risk has been examined less than the beneficial effect on trabecular bone mass. Currently, there is still no prospective, placebo-controlled study with a sufficient number of patients that demonstrates that long-term parenteral calcitonin administration reduces the risk of osteoporotic fractures. The efficacy of nasal calcitonin treatment to reduce vertebral fracture rate has been best examined in the PROOF (Prevent Recurrence of Osteoporotic Fractures) study. This was a prospective 5-year, placebo-controlled, dose-response study of nasal calcitonin (100, 200, or 400 IU daily). The increase in lumbar spine BMD

  14. Surveillance of deaths on board Danish merchant ships, 1986-93: implications for prevention.

    PubMed Central

    Hansen, H L

    1996-01-01

    OBJECTIVE: To describe and analyse the types and circumstances of all natural and non-natural deaths among seamen on board Danish merchant ships. METHODS: Data on 147 cases were obtained from maritime authorities, an insurance company, shipping companies, hospitals, death registers, and death certificates in the period from 1986-93. RESULTS: The 53 natural deaths were dominated by cardiovascular diseases and infectious diseases. Insufficient treatment on board was identified as a contributing factor for death in some cases. Medical advice was not always sought and the advice given was in some cases insufficient. 73 fatal accidents were identified. The incidence of accidents of 5.29/10,000 person-years was 11.5 times higher than the incidence of 0.46/10,000 for the Danish male workforce ashore. 23 accidents (31%) were due to maritime casualties and 26 (36%) were occupational accidents. The remaining 24 (33%) were accidents during off duty hours including six self intoxications. Rough weather, inadequate awareness of safety, lack of use of personal protection devices, and inexperience were associated with many of the fatal injuries directly related to work. Alcohol played a major part in 12 out of 18 fatal injuries occurring during off duty hours. CONCLUSIONS: The maritime workplace was identified as a high risk workplace and in many aspects differs from the conditions ashore. Acute diseases and serious injuries pose special risks to seamen because of a lack of direct access to professional medical care at sea. Primary prevention of certain diseases is needed and possible. Improved training, improved systems of work, improved safety awareness, and greater use of personal protection devices are needed to prevent fatal injuries. Medical training of ships' officers providing medical care on board and specific training of doctors giving medical advise to ships should be improved to meet the needs. PMID:8664966

  15. [Falls and osteoporotic fractures prevention units: proposed Osteoporosis, Falls and Fractures Group of the Spanish Society of Geriatrics and Gerontology].

    PubMed

    Duaso, Enric; Casas, Alvaro; Formiga, Francesc; Lázaro Del Nogal, Montserrat; Salvà, Antoni; Marcellán, Teresa; Navarro, Carmen

    2011-01-01

    Since forming the Osteoporosis, Falls and Fractures Group of the Spanish Society (GOCF) of Geriatrics and Gerontology (SEGG) a review was performed of the epidemiology of falls, along with a description of measures that have shown a degree of effectiveness in prevention. We also present the proposal of a common basic model of action in fall prevention units, mainly addressed to the community. Finally, a consensus model falls register is presented, common to community level and institutional areas, with the objective of being useful and easy to fill in at any care level.

  16. An update for the obstetrician-gynecologist on advances in the diagnosis, prevention, and treatment of postmenopausal osteoporosis.

    PubMed

    Ettinger, B

    1993-06-01

    Improvements in bone densitometry and new biochemical tests allow early detection and prevention of postmenopausal bone loss. Interventions for osteoporosis-prone women include correction of adverse habits and lifestyles, optimization of calcium and vitamin D intake, and prescription of estrogen. Recent studies indicate that elderly women may still obtain significant benefit from estrogen. Calcitonin is an approved alternative to estrogen, and recent studies confirm its ability to prevent bone loss and fractures, even when administered intranasally. This review also summarizes clinical investigation of newer, yet unapproved, methods of treatment; the most promising of these treatments are the bisphosphonates, fluoride, and tamoxifen.

  17. Bone density testing: an under-utilised and under-researched health education tool for osteoporosis prevention?

    PubMed

    Winzenberg, Tania; Oldenburg, Brian; Jones, Graeme

    2010-09-01

    Feedback of fracture risk based on bone mineral density (BMD) is an under-explored potential osteoporosis education intervention. We performed a randomised controlled trial of either an osteoporosis information leaflet or small group education (the Osteoporosis Prevention and Self-Management Course (OPSMC)), combined with individualised fracture risk feedback in premenopausal women over two years. Women with a mean T-score at spine and hip of <0 were informed they were at higher risk of fracture in later life and those with T-score ≥ 0 were informed they were not. Women receiving feedback of high fracture risk had a greater increase in femoral neck, but not lumbar spine, BMD compared to the low risk group (1.6% p.a. vs. 0.7% p.a., p = 0.0001). Participation in the OPSMC had no greater effect on BMD than receiving the leaflet. Femoral neck BMD change was associated with starting calcium supplements (1.3% p.a., 95% CI +0.49, +2.17) and self-reported physical activity change (0.7% p.a., 95% CI +0.22, +1.22). Mother's report of increasing their children's calcium intake was associated with receiving the OPSMC (OR 2.3, 95% CI 1.4, 3.8) and feedback of high fracture risk (OR 2.0, 95% CI 1.2, 3.3). Fracture risk feedback based on BMD could potentially make an important contribution to osteoporosis prevention but confirmation of long-term benefits and cost effectiveness is needed before implementation can be recommended.

  18. Alendronate prevents glucocorticoid-induced osteoporosis in patients with rheumatic diseases: A meta-analysis.

    PubMed

    Kan, Shun-Li; Yuan, Zhi-Fang; Li, Yan; Ai, Jie; Xu, Hong; Sun, Jing-Cheng; Feng, Shi-Qing

    2016-06-01

    Glucocorticoid-induced osteoporosis (GIOP) is a serious problem for patients with rheumatic diseases requiring long-term glucocorticoid treatment. Alendronate, a bisphosphonate, has been recommended in the prevention of GIOP. However, the efficacy and safety of alendronate in preventing GIOP remains controversial. We performed a meta-analysis to investigate the efficacy and safety of alendronate in preventing GIOP in patients with rheumatic diseases.We retrieved randomized controlled trials from PubMed, EMBASE, and the Cochrane Library. Two reviewers extracted the data and evaluated the risk of bias and quality of the evidence. We calculated the risk ratio (RR) with a 95% confidence interval (CI) for dichotomous outcomes, and the mean difference (MD) with a 95% CI for continuous outcomes using Review Manager, version 5.3.A total of 339 studies were found, and 9 studies (1134 patients) were included. Alendronate was not able to reduce the incidence of vertebral fractures (RR = 0.63, 95% CI: 0.10-4.04, P = 0.62) and nonvertebral fractures (RR = 0.40, 95% CI: 0.15-1.12, P = 0.08). Alendronate significantly increased the percent change in bone mineral density (BMD) at the lumbar spine (MD = 3.66, 95% CI: 2.58-4.74, P < 0.05), total hip (MD = 2.08, 95% CI: 0.41-3.74, P < 0.05), and trochanter (MD = 1.68, 95% CI: 0.75-2.61, P < 0.05). Significant differences were not observed in the percent change in BMD at the femoral neck (MD = -0.33, 95% CI: -2.79 to 2.13, P = 0.79) and total body (MD = 0.64, 95% CI: -0.06 to 1.34, P = 0.07). No significant differences in the adverse events were observed in patients treated with alendronate versus the controls (RR = 1.00, 95% CI: 0.94-1.07, P = 0.89). The odds of gastrointestinal adverse events were significantly reduced (RR = 0.77, 95% CI: 0.62-0.97, P < 0.05).Our analysis suggests that alendronate can increase the percent change in BMD at the lumbar spine, total hip, and

  19. [QOL evaluation for osteoporosis].

    PubMed

    Endo, Naoto

    2012-06-01

    It is important to evaluate the Health Related QOL (HRQOL) in the treatment of the patients with osteoporosis. In 1999, the Japanese Society for Bone and Mineral Research made Japanese Osteoporosis Quality of Life Questionnaire (JOQOL) to evaluate the osteoporosis specific HRQOL of the Japanese patients. This JOQOL 1999-version was revised in 2000. JOQOL 2001 version consists of six domain 38 items, using five-point scale ranging from 0 to 4, scored from 0 to 152. Osteoporosis is a bone disorder with decreased bone strength, resulting in bone fragility and consequently fractures. The vertebral fractures cause a change in the spinal column (kyphosis) and the decline of the physical function due to the back pain. This is the decrease in QOL of the patients with osteoporosis compared to cases without osteoporosis. Therefore, assessment of QOL are recommended in the prevention and treatment for osteoporosis.

  20. Naringin prevents ovariectomy-induced osteoporosis and promotes osteoclasts apoptosis through the mitochondria-mediated apoptosis pathway

    SciTech Connect

    Li, Fengbo; Sun, Xiaolei; Ma, Jianxiong; Ma, Xinlong; Zhao, Bin; Zhang, Yang; Tian, Peng; Li, Yanjun; Han, Zhe

    2014-09-26

    Highlights: • Naringin possesses many pharmacological activities, promotes the proliferation of osteoblast. • Undecalcified histological obtain dynamic parameters of callus formation and remodeling. • Naringin regulate osteoclast apoptosis by mitochondrial pathway. - Abstract: Naringin, the primary active compound of the traditional Chinese medicine Rhizoma drynariae, possesses many pharmacological activities. The present study is an effort to explore the anti-osteoporosis potential of naringin in vivo and in vitro. In vivo, we used ovariectomized rats to clarify the mechanisms by which naringin anti-osteoporosis. In vitro, we used osteoclasts to investigate naringin promotes osteoclasts apoptosis. Naringin was effective at enhancing BMD, trabecular thickness, bone mineralization, and mechanical strength in a dose-dependent manner. The result of RT-PCR analysis revealed that naringin down-regulated the mRNA expression levels of BCL-2 and up-regulated BAX, caspase-3 and cytochrome C. In addition, naringin significantly reduced the bone resorption area in vitro. These findings suggest that naringin promotes the apoptosis of osteoclasts by regulating the activity of the mitochondrial apoptosis pathway and prevents OVX-induced osteoporosis in rats.

  1. Osteoporosis: Therapeutic Options.

    PubMed

    Ivanova, Stefka; Vasileva, Liliya; Ivanova, Stanislava; Peikova, Lily; Obreshkova, Danka

    2015-01-01

    The definition of osteoporosis was originally formulated at a conference of the World Health Organization (WHO) in 1993 as 'a systemic skeletal disease characterized by decreased bone mass and altered micro-architecture of bone tissue, leading to enhanced bone fragility and risk of fractures'. Osteoporosis is characterized by low bone mineral density (BMD) and loss of the structural and bio-mechanical properties that are required to maintain bone homeostasis. This review aims to address the currently available options in prevention and treatment of osteoporosis. Management of osteoporosis includes non-pharmacological treatment - diet rich of calcium and vitamin D, healthy lifestyle, proper exercise plan, and pharmacological therapy. Combination of non-pharmacological and pharmacological treatment options have to be considered for prevention of osteoporosis and minimization of the risk of fractures. Given the heterogeneity of osteoporosis syndrome and lack of significant number of comparative studies, the choice of a pharmacological agents should be individualized.

  2. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis.

    PubMed

    Beck, Belinda R; Daly, Robin M; Singh, Maria A Fiatarone; Taaffe, Dennis R

    2017-05-01

    Osteoporotic fractures are associated with substantial morbidity and mortality. Although exercise has long been recommended for the prevention and management of osteoporosis, existing guidelines are often non-specific and do not account for individual differences in bone health, fracture risk and functional capacity. The aim of the current position statement is to provide health practitioners with specific, evidence-based guidelines for safe and effective exercise prescription for the prevention or management of osteoporosis, accommodating a range of potential comorbidities. Position statement. Interpretation and application of research reports describing the effects of exercise interventions for the prevention and management of low bone mass, osteoporosis and osteoporotic fracture. Evidence from animal and human trials indicates that bone responds positively to impact activities and high intensity progressive resistance training. Furthermore, the optimisation of muscle strength, balance and mobility minimises the risk of falls (and thereby fracture), which is particularly relevant for individuals with limited functional capacity and/or a very high risk of osteoporotic fracture. It is important that all exercise programs be accompanied by sufficient calcium and vitamin D, and address issues of comorbidity and safety. For example, loaded spine flexion is not recommended, and impact activities may require modification in the presence of osteoarthritis or frailty. Specific guidelines for safe and effective exercise for bone health are presented. Individual exercise prescription must take into account existing bone health status, co-morbidities, and functional or clinical risk factors for falls and fracture. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Pyrroloquinoline quinone prevents testosterone deficiency-induced osteoporosis by stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption

    PubMed Central

    Wu, Xuan; Li, Jie; Zhang, Hengwei; Wang, Hui; Yin, Guoyong; Miao, Dengshun

    2017-01-01

    Accumulating evidences suggest that oxidative stress caused and deteriorated the aging related osteoporosis and pyrroloquinoline quinone (PQQ) is a powerful antioxidant. However, it is unclear whether PQQ can prevent testosterone deficiency-induced osteoporosis. In this study, the orchidectomized (ORX) mice were supplemented in diet with/without PQQ for 48 weeks, and compared with each other and with sham mice. Results showed that bone mineral density, trabecular bone volume, collagen deposition and osteoblast number were decreased significantly in ORX mice compared with shame mice, whereas PQQ supplementation largely prevented these alterations. In contrast, osteoclast surface and ratio of RANKL and OPG mRNA relative expression levels were increased significantly in ORX mice compared with shame mice, but were decreased significantly by PQQ supplementation. Furthermore, we found that CFU-f and ALP positive CFU-f forming efficiency and the proliferation of mesenchymal stem cells were reduced significantly in ORX mice compared with shame mice, but were increased significantly by PQQ supplementation. Reactive oxygen species (ROS) levels in thymus were increased, antioxidant enzymes SOD-1, SOD-2, Prdx I and Prdx IV protein expression levels in bony tissue were down-regulated, whereas the protein expression levels of DNA damage response related molecules including γ-H2AX, p53, Chk2 and NFκB-p65 in bony tissue were up-regulated significantly in ORX mice compared with shame mice, whereas PQQ supplementation largely rescued these alterations observed in ORX mice. Our results indicate that PQQ supplementation can prevent testosterone deficiency-induced osteoporosis by inhibiting oxidative stress and DNA damage, stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption. PMID:28386349

  4. Role of calcium and vitamin D in the prevention and the treatment of postmenopausal osteoporosis: an overview.

    PubMed

    Kaufman, J M

    1995-09-01

    When discussing the use of calcium and vitamin D in the prevention and the treatment of osteoporosis one can make a distinction between the use as dietary supplementation to correct or prevent deficiencies, and the pharmacologic use of higher doses, whether or not in association with other drugs. However, in practical terms it is not always possible to clearly make this distinction. Available evidence suggests that increasing the calcium intake can favourably affect the build-up of bone mass in adolescence. In this population, the daily consumption of calcium in the diet should, optimally, be at least 1200 mg/day. In view of the lack of data pertaining to the effect on the final peak bone mass, there is at present time no basis for the systematic administration of calcium supplements to healthy children and adolescents. Calcium supplementation, aiming at a total calcium intake of at least 1500 mg/day, has a partial protective effect on postmenopausal bone loss, this effect being documented mainly in women more than 5 years after menopause. In the present state of our knowledge, there is no established role for vitamin D supplementation in the prevention of postmenopausal osteoporosis, except in elderly patients presenting with a higher risk for relative vitamin D deficiency and with low calcium intake. The results of a controlled trial suggest that in institutionalised elderly patients, systematic administration of calcium and vitamin D supplements can substantially reduce the risk of hip fracture. In the treatment of established postmenopausal osteoporosis, calcium supplementation has only a role as a general adjuvant therapeutic measure and as a specific complement to the treatment with other active compounds. There are indications that treatment alpha-calcidol or calcitriol has a positive effect on the evolution of bone mass, but awaiting further confirmation of a favourable effect on the incidence of osteoporotic fractures, treatment with these drugs remains

  5. Corticosteroid osteoporosis.

    PubMed

    Sambrook, P; Lane, N E

    2001-07-01

    Corticosteroids are widely used and effective agents for the control of many inflammatory diseases, but corticosteroid osteoporosis is a common problem associated with their long term high dose use. Prevention of corticosteroid osteoporosis is preferable to treatment of established corticosteroid bone loss. Several large double-blind controlled clinical trials in patients with corticosteroid osteoporosis have recently been published that provide new insights into its treatment. Based upon available evidence, the rank order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or an oestrogen type medication. Calcium alone appears to be unable to prevent rapid bone loss in patients starting corticosteroids, especially with prednisolone doses at 10 mg a day or greater. If an active vitamin D metabolite is used, calcium supplementation should be avoided unless dietary calcium intake is low. Hormone replacement therapy should be considered if hypogonadism is present. Since vertebral fracture is a common and important complication of high dose corticosteroid therapy, these findings suggest that rapid bone loss and hence fractures, can be prevented by prophylactic treatment. Although the follow-up data is limited, it is likely that such therapy needs to be continued beyond 12 months whilst patients continue significant doses of corticosteroid therapy.

  6. Interventions to improve inpatient osteoporosis management following first osteoporotic fracture: the PREVENT project.

    PubMed

    Carpintero, Pedro; Gil-Garay, Enrique; Hernández-Vaquero, Daniel; Ferrer, Humbert; Munuera, Luis

    2009-02-01

    To establish a protocol for the treatment of fragility fractures in the hospital setting based on treatment of osteoporosis. An intervention protocol was implemented in patients with fragility fractures based on (1) indicating the diagnosis of osteoporotic fracture in the summary of discharge; (2) "lifestyle recommendations"; and (3) therapy for osteoporosis. Thirty-one hospitals were involved and they were informed of the importance of protocol compliance. In the first phase, a retrospective study was conducted to establish the number of low-energy fractures treated and the percentage of them that had complied with the protocol (n = 887). Then, prospectively, the same data were collected for the patients managed for 1 year (n = 6,826) in three sections of 4-month intervals. The percentage of compliance increased from 8.2 to 57.2% in the first point, from 12.6 to 42.4% in the second, and from 10.3 to 43.2% in the third. The implementation of programs to improve osteoporosis treatment is very useful for ensuring adherence in the management of osteoporosis following admission due to fragility fracture.

  7. Middle school-aged child enjoyment of food tastings predicts interest in nutrition education on osteoporosis prevention

    PubMed Central

    Cheng, Feon W.; Monnat, Shannon M.; Lohse, Barbara

    2015-01-01

    BACKGROUND NEEDs for Bones (NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11-14 year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. METHODS NFB was administered by teachers as part of standard practice and evaluated after the 4th lesson using a 21-item survey. Significant clustering of students within classrooms required use of random-intercept multilevel ordinal regression models in SAS proc GLIMMIX, with students nested within classrooms. Analyses considered tasting experience, eating attitudes, sex, grade, and cohort. RESULTS Students (N = 1619; 50% girls) participated from 85 4th-8th grade classrooms (47% 6th grade; 31% 7th grade) in 16 Pennsylvania SNAP-Ed eligible schools over 2 academic years. For all foods tasted, students who did not enjoy the food tasting were less interested in the lesson than students who did enjoy the food tasting (all p < .001); refried beans (OR 0.30), soy milk (OR = 0.55), cranapple juice (OR = 0.51), sunflower kernels (OR = 0.48), and Swiss cheese (OR = 0.49). CONCLUSIONS Enjoyment of food tasting activities can predict interest in nutrition education on osteoporosis prevention, supporting resource allocation and inclusion of food tasting activities in school-age nutrition education. PMID:26032277

  8. Osteoporosis: from early fracture prevention to better bone health with strontium ranelate.

    PubMed

    Cortet, Bernard

    2009-10-01

    Given its increasing incidence and serious complications, osteoporosis requires safe and effective long-term treatment. Strontium ranelate (SR) is an osteoporosis treatment with a unique mode of action, which was launched in 2004. It has been investigated in the Spinal Osteoporosis Therapeutic Intervention (SOTI) and the TReatment Of Peripheral OSteoporosis (TROPOS) trials, two major 3-year multinational placebo-controlled Phase III randomized clinical trials. In SOTI, SR treatment reduced the risk of vertebral fracture by 41% (20.9 vs 32.8%; P < 0.001); in TROPOS, it reduced the risk of non-vertebral fracture by 16% (11.2 vs 12.9%; P = 0.04) and the risk of hip fracture in patients at high risk by 36% (4.3 vs 6.4%; P = 0.046). Unlike anti-resorptive agents, SR produced steady and significant BMD increases that correlated directly with decreases in vertebral and hip fracture risk. Preplanned analysis of the pooled dataset from SOTI and TROPOS showed that SR was effective whether or not patients had key risk factors for fractures at baseline. SR was also effective in patients with osteopenia and younger postmenopausal patients aged 50-65 years. Finally, SR significantly attenuated height loss and decreased back pain. The safety profile of SR was almost similar to placebo in both trials. Thus, SR demonstrates broad spectrum safety and efficacy in reducing the risks of both vertebral and non-vertebral (including hip) fractures in a wide variety of patients, and should be considered as a first-line option to treat women at risk of osteoporotic fractures, whatever their age, the severity of the disease and their risk factors.

  9. Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

    PubMed Central

    Andersen, Pernille Tanggaard; El Ansari, Walid; Rasmussen, Hanna Barbara; Stock, Christiane

    2010-01-01

    This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP’s stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working. PMID:21139870

  10. Municipalities collaborating in public health: the Danish Smoking Prevention and Cessation Partnership.

    PubMed

    Andersen, Pernille Tanggaard; El Ansari, Walid; Rasmussen, Hanna Barbara; Stock, Christiane

    2010-11-01

    This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP's stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working.

  11. [Clinical efficacy instant goat milk in the complex therapy and prevention of osteoporosis in patients with rheumatoid arthritis].

    PubMed

    Shostak, N A; Muradiants, A A; Kondrashov, A A; Denisova, S N

    2014-01-01

    Osteoporosis (OP) in rheumatoid arthritis (RA) refers to a secondary immune-mediated metabolic osteopathy characterized by periarticular and systemic decreased bone mass, impaired bone strength and increased risk of fractures. According to some studies, adding milk in the diet helps to increase bone mineral density and to reduce the risk of osteoporosis and maintain normal levels of vitamin D. To study the state of mineral and bone metabolism in RA patients zeith osteopenic syndrome and to evaluate the effectiveness of treatment and prevention of OP by adding dry goat milk "Amalteya" in the diet. The study included 42 patients with a documented diagnosis of RA (ACR, 1987) - 23 men (mean age 59 years) and 19 postmenopausal women (mean age 62 years) with the presence of osteoporosis and osteopenia according to the dual-energy X-ray absorptiometry. 21 (50%) RA patients (main group) received standard antiosteoporotichesky (alendronate 70 mg/week + calcium 1000 mg/day + Vitamin D3 800 IU/day) therapy and milk powder Amalteya® (400 ml/day). The control group (21 patients with RA) received only standard antiosteoporotic therapy. Follow-up lasted for 6 months. The concentration of total calcium in the blood of RA patients was on average 2.33 mmol/l, ionized Ca - 1,18 mmol/l and inorganic P - 1,09 mmol/l, which corresponds to normal values. Vitamin D deficiency was found in 17,5% of patients, and failure - in 32,5% of patients with RA. After 6 months of the treatment it was found that b-CrossLaps levels tend to be reducing in both of the groups and with reduction of bone formation marker osteocalcin in the group not receiving goat milk. Also, due to the background of ongoing combinative therapy it was clear that concentrations of 1,25(OH)2D and 25(OH)D in the blood serum are increasing (by 18,5-28,2% at the main group and by 8,0-17,9% at the control group), however, inter-group differences was below the level of the reliable importance. It was strongly marked in the group

  12. Prevention of Bone Loss in a Model of Postmenopausal Osteoporosis through Adrenomedullin Inhibition

    PubMed Central

    Martínez-Herrero, Sonia; Larrayoz, Ignacio M.; Ochoa-Callejero, Laura; Fernández, Luis J.; Allueva, Alexis; Ochoa, Ignacio; Martínez, Alfredo

    2016-01-01

    Despite recent advances in the understanding and treatment options for osteoporosis, this condition remains a serious public health issue. Adrenomedullin (AM) is a regulatory peptide with reported activity on bone remodeling. To better understand this relationship we built an inducible knockout for AM. An outstanding feature of knockout mice is their heavier weight due, in part, to the presence of denser bones. The femur of knockout animals was denser, had more trabeculae, and a thicker growth plate than wild type littermates. The endocrine influence of AM on bone seems to be elicited through an indirect mechanism involving, at least, the regulation of insulin, glucose, ghrelin, and calcitonin gene-related peptide (CGRP). To confirm the data we performed a pharmacological approach using the AM inhibitor 16311 in a mouse model of osteoporosis. Ovariectomized females showed significant bone mass loss, whereas ovariectomized females treated with 16311 had similar bone density to sham operated females. In conclusion, we propose the use of AM inhibitors for the treatment of osteoporosis and other conditions leading to the loss of bone mass. PMID:27445864

  13. Optimal vitamin D status for the prevention and treatment of osteoporosis.

    PubMed

    Holick, Michael F

    2007-01-01

    Vitamin D(3) (cholecalciferol) sufficiency is essential for maximising bone health. Vitamin D enhances intestinal absorption of calcium and phosphorus. The major source of vitamin D for both children and adults is exposure of the skin to sunlight. Season, latitude, skin pigmentation, sunscreen use, clothing and aging can dramatically influence the synthesis of vitamin D in the skin. Very few foods naturally contain vitamin D or are fortified with vitamin D. Serum 25-hydroxyvitamin D [25(OH)D; calcifediol] is the best measure of vitamin D status. Vitamin D deficiency [as defined by a serum 25(OH)D level of <50 nmol/L (<20 ng/mL)] is pandemic. This deficiency is very prevalent in osteoporotic patients. Vitamin D deficiency causes osteopenia, osteoporosis and osteomalacia, increasing the risk of fracture. Unlike osteoporosis, which is a painless disease, osteomalacia causes aching bone pain that is often misdiagnosed as fibromyalgia or chronic pain syndrome or is simply dismissed as depression. Vitamin D deficiency causes muscle weakness, increasing the risk of falls and fractures, and should be aggressively treated with pharmacological doses of vitamin D. Vitamin D sufficiency can be sustained by sensible sun exposure or ingesting at least 800-1000 IU of vitamin D(3) daily. Patients being treated for osteoporosis should be adequately supplemented with calcium and vitamin D to maximise the benefit of treatment.

  14. The Anti-Inflammatory, Phytoestrogenic, and Antioxidative Role of Labisia pumila in Prevention of Postmenopausal Osteoporosis

    PubMed Central

    Nadia, M. E.; Nazrun, A. S.; Norazlina, M.; Isa, N. M.; Norliza, M.; Ima Nirwana, S.

    2012-01-01

    Osteoporosis is characterized by skeletal degeneration with low bone mass and destruction of microarchitecture of bone tissue which is attributed to various factors including inflammation. Women are more likely to develop osteoporosis than men due to reduction in estrogen during menopause which leads to decline in bone-formation and increase in bone-resorption activity. Estrogen is able to suppress production of proinflammatory cytokines such as IL-1, IL-6, IL-7, and TNF-α. This is why these cytokines are elevated in postmenopausal women. Studies have shown that estrogen reduction is able to stimulate focal inflammation in bone. Labisia pumila (LP) which is known to exert phytoestrogenic effect can be used as an alternative to ERT which can produce positive effects on bone without causing side effects. LP contains antioxidant as well as exerting anti-inflammatory effect which can act as free radical scavenger, thus inhibiting TNF-α production and COX-2 expression which leads to decline in RANKL expression, resulting in reduction in osteoclast activity which consequently reduces bone loss. Hence, it is the phytoestrogenic, anti-inflammatory, and antioxidative properties that make LP an effective agent against osteoporosis. PMID:22611381

  15. The latest from the ivd industry: prevention, diagnosis and therapy of osteoporosis.

    PubMed

    2005-01-01

    At first glance the human bone appears to be solid, rigid and unchangeable. But in point of fact this is not so, for a process of change is continuously going on, during which bone mass is resorbed and formed. Up until the age of 30 bone mass continues to be formed, although at an increasingly slower pace. A few years of equilibrium between bone formation and bone resorption follow. Thereafter, from about the age of 40, a continuous slow loss of bone mass sets in. This is considered to be a normal process of aging. But if the speed of resorption exceeds a certain degree and bone resorption increases, osteoporosis can develop after several years. Osteoporosis is therefore an illness in which bone mass has been massively resorbed over the past years and/or is being acutely resorbed. Given the altered demographic structure--an ever larger number of people living to an advanced age--the number of people affected by osteoporosis is increasing. Once the bone loss reaches a certain degree, there is a greater susceptibility to bone fractures. Particularly affected are the vertebrae, the neck of the femur, and the forearm.

  16. POST-MENOPAUSAL OSTEOPOROSIS

    PubMed Central

    Hogg, C. Alison

    1997-01-01

    Millions of women will be prescribed hormone replacement therapy (HRT) and be told that it will prevent osteoporosis occuring, despite the fact that there is doubt about its long term usefulness. Preventive measures outlined in this article are much more preferable, but need to be directed towards the whole population, not just menopausal women. The prevention of osteoporosis is an important public health issue which needs to be addressed now, not in the next century. This article explores the issues that surround the medicalisation of post-menopausal osteoporosis. PMID:17987149

  17. Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials.

    PubMed

    Huang, Z-B; Wan, S-L; Lu, Y-J; Ning, L; Liu, C; Fan, S-W

    2015-03-01

    To identify the role of vitamin K2 for the prevention and treatment of osteoporosis in postmenopausal women, we conducted this meta-analysis of 19 randomized controlled trials. Our results showed that vitamin K2 might play a role in maintaining the bone mineral density and in reducing the incidence of fractures for postmenopausal women with osteoporosis. Vitamin K2 has been revealed to be effective in the prevention and treatment of osteoporosis in Japan, which was not confirmed in western countries. Thus, we conduct this meta-analysis to verify the hypothesis that vitamin K2 plays a role in the prevention and treatment of osteoporosis for postmenopausal women. We searched the Cochrane Library, Pub Med, EMBASE, and ISI web of knowledge (until December 1, 2013) and reference lists of eligible articles. A meta-analysis of all-including randomized controlled trials was then performed. Nineteen randomized controlled trials encompassing 6759 participants have met the inclusion criteria. Subgroup analysis of postmenopausal women with osteoporosis revealed a significant improvement of vertebral BMD for both medium-term and long-term results favoring vitamin K2 group (p < 0.00001 and p = 0.0005). However, no significant difference in BMD changes was revealed for the non-osteoporosis subgroup analysis. As for the incidence of fractures, pooled analysis of the seven related studies demonstrated no significant difference in the incidence of fractures favoring vitamin K2 (RR = 0.63, p = 0.08). However, sensitivity analysis by rejecting the study inducing heterogeneity demonstrated a significant difference in the incidence of fractures favoring vitamin K2 (RR = 0.50, p = 0.0005). Significant differences were found in undercarboxylated osteocalcin reduction and osteocalcin increment. The result of adverse reaction analysis showed that vitamin K2 group seemed to have a higher adverse reaction rate (RR = 1.22, p = 0.06). This meta-analysis seemed to support the hypothesis that

  18. Male osteoporosis.

    PubMed

    Giusti, A; Bianchi, G

    2014-07-28

    As a result of population ageing worldwide, osteoporotic fractures are becoming a serious problem in the western world. Osteoporotic fractures are associated with a significant burden in terms of morbidity, mortality, and economic costs. Although less frequent than in women, male osteoporosis is also a relatively common problem. Since bone loss and fragility fractures in men have been recognized as a serious medical condition, over the last two decades several studies have investigated a number of aspects related to the pathogenesis, diagnosis and assessment, prevention and treatment of male osteoporosis. A better understanding of factors underlying increased bone fragility in men has led to the definition of appropriate screening and diagnostic strategies, and the development of treatments that have shown to improve bone mineral density and, in some cases, reduce fracture risk in men as well as in women. This review will summarize recent findings on male osteoporosis with a particular focus on risk factors and causes of bone loss, and available therapeutic options.

  19. US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50-64 years.

    PubMed

    Bansal, S; Pecina, J L; Merry, S P; Kennel, K A; Maxson, J; Quigg, S; Thacher, T D

    2015-04-01

    The US Preventative Services Task Force (USPSTF) recommends consideration for screening for osteoporosis in women under age 65 who have an estimated 10-year major osteoporotic fracture risk of 9.3 % or higher. We found that this threshold for osteoporosis screening in women ages 50-64 years old has a low sensitivity to detect osteoporosis. The US Preventative Services Task Force (USPSTF) recommends consideration of dual-energy X-ray absorptiometry (DXA) in women under ages 50-64 with a major osteoporotic fracture (MOF) risk of 9.3 % or higher, as estimated by the fracture risk assessment tool (FRAX) tool. We assessed the performance of the 9.3 % MOF risk threshold for detecting osteoporosis and evaluated whether DXA indication appeared appropriate, based on USPSTF criteria and other risk factors, at our institution. We performed a retrospective record review of women ages 50-64.5 years old to determine clinical factors and FRAX scores of women undergoing a DXA at our institution over a 6-month period after the USPSTF recommendations were released and evaluated the sensitivity and specificity of the 9.3 % MOF threshold to detect densitometric osteoporosis. Additionally, using the USPSTF criteria and several additional risk factors, we evaluated the extent of potentially inappropriate DXA use in women ages 50 to 64 years in a large primary care practice in an academic medical center. The analysis included 465 DXA tests. The overall sensitivity and specificity of a FRAX-calculated MOF risk ≥9.3 % was 37 and 74 %, respectively, for the detection of osteoporosis. The receiver operator characteristic curve (ROC) demonstrated an area under the curve of 0.58. Lowering the FRAX risk threshold to 5.5 % would increase the sensitivity of detecting osteoporosis in our population from 37 to 80 % while reducing the specificity from 74 to 27 %. Out of 465 DXAs, 371 (79.8 %) were classified as appropriately ordered per our pre-specified criteria. Of the 120 women with

  20. Dairy products, dietary calcium and bone health: possibility of prevention of osteoporosis in women: the Polish experience.

    PubMed

    Wadolowska, Lidia; Sobas, Kamila; Szczepanska, Justyna W; Slowinska, Malgorzata A; Czlapka-Matyasik, Magdalena; Niedzwiedzka, Ewa

    2013-07-16

    The objective of the study was to analyze the consumption of dairy products and dietary calcium by women in the context of bone mineral density and to assess opportunities to prevent osteoporosis in a dietary manner. The study was carried out with 712 Polish women. In 170 women aged 32 to 59 bone mineral density (BMD) was measured. The data on the consumption of dairy products and dietary calcium and some other osteoporosis risk factors was collected from 712 women. The average calcium intake from a diet was 507 mg/day. Only 2% of the women met Polish calcium intake recommendations. During adulthood, dairy product consumption or dietary calcium intake did not differ significantly between women with low BMD (below -1 SD) and women with regular BMD (≥-1 SD) (47.4 vs. 44.3 servings/week and 459 vs. 510 mg/day, respectively, p > 0.05). The odds ratios adjusted for age, menstruation and BMI in women with upper BMD tercile in comparison to the reference group (bottom tercile) was 2.73 (95% CI: 1.14, 6.55; p < 0.05) for the daily consumption of dairy products during the pre-school period and 2.40 (95% CI: 1.01, 5.70; p < 0.05) for the daily consumption of dairy products during the school period. Two clusters of women were established. In the S1 cluster, low BMD (below -1 SD) was associated with older age (≥ 50 years), lack of menstrual cycle. In the S2 cluster, regular BMD (≥-1 SD) was related to younger aged women (<50 years), presence of menstrual cycle, consumption of higher level of dairy products (≥28 servings/week) during adulthood and daily intake of dairy products during childhood and adolescence. The results indicate that good bone health to the larg e extent depended upon the combined impact of dietary factors and some non-modifiable risk factors of osteoporosis such as age and the presence of menstruation. Consumption of dairy products in childhood and adolescence may improve bone mineral density and reduce the risk of osteoporosis in adult women.

  1. Phosphorylated Peptides from Antarctic Krill (Euphausia superba) Prevent Estrogen Deficiency Induced Osteoporosis by Inhibiting Bone Resorption in Ovariectomized Rats.

    PubMed

    Xia, Guanghua; Zhao, Yanlei; Yu, Zhe; Tian, Yingying; Wang, Yiming; Wang, Shanshan; Wang, Jingfeng; Xue, Changhu

    2015-11-04

    In the current study, we investigated the improvement of phosphorylated peptides from Antarctic krill Euphausia superba (PP-AKP) on osteoporosis in ovariectomized rats. PP-AKP was supplemented to ovariectomized Sprague-Dawley rats for 90 days. The results showed that PP-AKP treatment remarkably prevented the reduction of bone mass and improved cancellous bone structure and biochemical properties. PP-AKP also significantly decreased serum contents of tartrate-resistant acid phosphatase (TRACP), cathepsin K (Cath-k), matrix metalloproteinases-9 (MMP-9), deoxypyridinoline (DPD), C-terminal telopeptide of collagen I (CTX-1), Ca, and P. Mechanism investigation revealed that PP-AKP significantly increased the osteoprotegerin (OPG)/receptor activator of nuclear factor κB ligand (RANKL) ratio in mRNA expression, protein expression, and serum content. Further research suggested that NF-κB signaling pathways were inhibited by suppressing the mRNA and protein expressions of nuclear factor of activated T-cells (NFATc1) and tumor necrosis factor receptor-associated factor 6 (TRAF6), diminishing the mRNA expression and phosphorylation of nuclear factor κB p65 (NF-κB p65), three key transcription factors in NF-κB pathways. These results suggest that PP-AKP can improve osteoporosis by inhibiting bone resorption via suppressing the activation of osteoclastogenesis related NF-κB pathways.

  2. Prevention of bone loss by oil extract of garlic (Allium sativum Linn.) in an ovariectomized rat model of osteoporosis.

    PubMed

    Mukherjee, M; Das, A S; Mitra, S; Mitra, C

    2004-05-01

    The effects of oil extract of garlic (Allium sativum Linn.) on different primary and secondary osteoporotic marker changes were tested in an ovariectomized rat model of osteoporosis. Experiments were performed on three different rat models: sham-operated control, ovariectomized and ovariectomized supplemented with garlic oil. In ovariectomized group, there has been a significant increase in different relative organ weights compared to sham-operated control, while the uterine weight was found to be decreased. Supplementation with oil extract of garlic could effectively reverse these changes. Also low bone densities that developed in the ovariectomized group were significantly recovered in the garlic oil supplemented group. In our study, the development of high rate of bone turnover and osteoporosis in the ovariectomized animals were confirmed by significant alteration of serum alkaline phosphatase activity, serum tartrate resistant acid phosphatase activity, urinary excretion of calcium, phosphate, hydroxyproline and urinary calcium to creatinine ratio, when compared with the sham-operated control group. Garlic oil extract supplementation, apart from its unique influence in lowering blood cholesterol, could also prevent ovariectomy-induced rise in all the above-mentioned marker changes. The results of this study emphasize that oil extract of garlic possibly has a positive role in suppressing ovariectomy-induced bone resorption. Copyright 2004 John Wiley & Sons, Ltd.

  3. Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention.

    PubMed

    Sinaki, Mehrsheed

    2012-11-01

    Maintenance of bone health and quality requires mechanical strain, but the mechanical force needs to be within the bone's biomechanical competence. In osteoporosis, compression of vertebral bodies can be insidious. Therefore, absence of pain does not necessarily indicate absence of vertebral microfracture and deformity. Further, patients with previous vertebral fractures are at risk for further vertebral fractures and their associated morbidity. Exercise is a part of the comprehensive management of patients with osteoporosis and has been associated with improvement of quality of life and lowered risk of future fracture. The exercise prescription needs to match the needs of the patient. If exercise is not prescribed properly, then it may have negative consequences. In general, an exercise program, therapeutic or recreational, needs to address flexibility, muscle strength, core stability, cardiovascular fitness, and gait steadiness. As with pharmacotherapy, therapeutic exercises need to be individualized on the basis of musculoskeletal status and an individual's exercise interest. In osteoporosis, axial strength and stability are of primary importance. In particular, a spinal extensor strengthening program should be performed with progressive measured resistance as tolerated. To address falls and fractures, an exercise program should also include balance and lower extremity strength training. Proper dosing of oral cholecalciferol and calcium supplements can enhance the effect of strengthening exercises. Finally, a coordinated approach, such as the Spinal Proprioception Extension Exercise Dynamic (SPEED) program, can improve back extensor strength, the level of physical activity, and locomotion, and reduce back pain and fear and risk of falls. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  4. Prevention of hand eczema among Danish hairdressing apprentices: an intervention study.

    PubMed

    Bregnhøj, Anne; Menné, Torkil; Johansen, Jeanne Duus; Søsted, Heidi

    2012-05-01

    To investigate whether an evidence-based intervention could reduce the incidence of hand eczema in a cohort of Danish hairdressing apprentices during their training, as hairdressing apprentices are known to have a high risk of developing hand eczema. This study was a clinically controlled, prospective intervention study. Within 2 weeks of starting their training, 502 hairdressing apprentices were enrolled in the study on occupational hand eczema. Approximately half of the apprentices were assigned to an intervention group and received an evidence-based training program developed for this study and delivered by teachers specially trained in the prevention of hand eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding hand eczema, use of gloves and degree of wet work, and were all clinically examined for hand eczema three times during the 18-month study period. The three examinations were scheduled as school visits and consisted of a baseline examination and two follow-up examinations approximately 8 and 18 months later. More apprentices from the intervention group used gloves during wet work procedures and significantly fewer developed hand eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of hand eczema in the cohort irrespective of the intervention. We were able to increase the use of gloves and reduce the incidence of hand eczema in hairdressing apprentices by implementing a training program in hairdressing schools.

  5. [Secondary osteoporosis in gynecology].

    PubMed

    Taguchi, Y; Gorai, I

    1998-06-01

    Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

  6. [The new concept of osteoporosis. Early diagnosis, prevention and therapy are possible today].

    PubMed

    Hesch, R D; Harms, H; Rittinghaus, E F; Brabant, G

    1990-04-15

    A paradigma of osteoporosis pathology is discussed, at the center of which is the hormone-related disturbance of the osteoblast/osteoclast functional unit. A liberal replacement of estrogen-gestagen in post-menopausal women is advocated. Early diagnosis with the aid of quantitative computed tomography makes it possible to establish the indication for timely hormonal treatment in the future, which can result in a measureable increase in bone mass. Late therapy, that is, treatment initiated after the occurrence of fractures, has proven largely ineffective.

  7. Estrogen and Osteoporosis.

    ERIC Educational Resources Information Center

    Lindsay, Robert

    1987-01-01

    This article reviews the use of estrogen in the prevention and treatment of osteoporosis. Dosage levels, interactions with other factors, side effects, and the mechanism of estrogen action are discussed. (Author/MT)

  8. Estrogen and Osteoporosis.

    ERIC Educational Resources Information Center

    Lindsay, Robert

    1987-01-01

    This article reviews the use of estrogen in the prevention and treatment of osteoporosis. Dosage levels, interactions with other factors, side effects, and the mechanism of estrogen action are discussed. (Author/MT)

  9. Management of Age-Related Osteoporosis and Prevention of Associated Fractures

    PubMed Central

    MacLaughlin, Eric J; Sleeper, Rebecca B; McNatty, Danny; Raehl, Cynthia L

    2006-01-01

    Osteoporosis and related fractures are a significant concern for the global community. As the population continues to age, morbidity and mortality from fractures due to low bone mineral density (BMD) will likely continue to increase. Efforts should be made to screen those at risk for osteoporosis, identify and address various risk factors for falls and associated fractures, ensure adequate calcium and vitamin D intake, and institute pharmacological therapy to increase BMD when indicated. Agents which increase BMD and have been shown to decrease fractures, particularly at the hip, should be considered preferentially over those for which only BMD data are available. Drugs which have been shown to decrease the risk of age-related osteoporotic fractures include oral bisphosphonates (alendronate, ibandronate, and risedronate), intranasal calcitonin, estrogen receptor stimulators (eg, estrogen, selective estrogen receptor modulators [raloxifene]), parathyroid hormone (teriparatide), sodium fluoride, and strontium ranelate. Data are beginning to emerge supporting various combination therapies (eg, bisphosphonate plus an estrogen receptor stimulator), though more data are needed to identify combinations which are most effective and confer added fracture protection. In addition, further research is needed to identify ideal regimens in special populations such as nursing home patients and men. PMID:18360603

  10. Differences between the bisphosphonates for the prevention and treatment of osteoporosis

    PubMed Central

    Grey, Andrew; Reid, Ian R

    2006-01-01

    Bisphosphonates, pyrophosphate analogs which potently inhibit osteoclastic bone resorption, are now firmly established as first-line therapy for osteoporosis. Several bisphosphonates of varying antiresorptive potency are either in clinical use or well advanced in clinical trials. Alendronate and risedronate are agents of choice at present because data from randomized controlled trials demonstrate that each of these nitrogen (N)-containing-bisphosphonates reduces the incidence of vertebral and nonvertebral fractures by about 50%, whereas evidence for antifracture efficacy is limited to the vertebral site currently for other bisphosphonates such as etidronate and ibandronate. There have not been direct studies comparing the antifracture efficacy of alendronate with that of risedronate. Intermittent administration of bisphosphonates is now a well established clinical practice, and the potent bisphosphonate zoledronate produces suppression of bone resorption for at least 12 months after a single intravenous dose. Future research will better define how to optimally administer these agents to maximize efficacy and patient compliance. The place in osteoporosis therapeutics of combining bisphosphonate therapy with agents that primarily stimulate bone formation, such as parathyroid hormone, remains to be defined. PMID:18360583

  11. The effectiveness of an osteoporosis prevention education programme for women in Hong Kong: a randomized controlled trial.

    PubMed

    Chan, Moon Fai; Ko, Chung Ying; Day, Mary Christine

    2005-10-01

    The purpose of this study was to evaluate whether a nurse-initiated education programme on four specific osteoporosis-prevention related behaviours leads to their adoption or positive attitude changes compared with women who did not participate in this programme. The design was a randomized controlled design and the setting was a local private beauty clinic. Pre-, post- and follow-up education data compared attitudes and consumption frequency before and after the education programme. The results showed significant increases in the reported follow-up for each behaviour: consumption of soya foods (mean = 4.3, SD = 0.5), milk (mean = 4.2, SD = 0.8), more exercise (mean = 4.3, SD = 0.5) and vitamin D/exposure to sunlight (mean = 4.2, SD = 0.9) for subjects in the case group compared with control group subjects (soya foods: mean = 3.3, SD = 0.9, P < 0.001; milk: mean = 3.0, SD = 0.9, P < 0.001; more exercise: mean = 3.4, SD = 1.0, P = 0.003; vitamin D/sunlight: mean = 2.7, SD = 0.9, P < 0.00). Most of the participants either disagreed (n = 11, 55.0%) or strongly disagreed (n = 9, 45.0%) that there was not enough information provided in the education programme to motivate them to change. On the satisfaction score, they rated the nurse's performance as either satisfactory (n = 11, 55.0%) or very satisfactory (n = 9, 45.0%) on presentation and ability to answer their questions and either satisfactory (n = 12, 60.0%) or very satisfactory (n = 8, 40.0%) on ability to describe each behaviour clearly. A targeted education programme conducted with Hong Kong women resulted in significantly increased consumption of calcium including soya-based foods, milk and vitamin D. According to the reported attitudinal and behavioural intentions, participants' positive feedback suggests that women who participated in this educational programme were motivated to make changes and benefited from the support of this nurse-initiated education programme. Osteoporosis was a serious health concern

  12. Cost-Effectiveness of Zoledronic Acid to Prevent and Treat Postmenopausal Osteoporosis in Comparison with Routine Medical Treatment

    PubMed Central

    Golmohamdi, Fateme Rostami; Abbasi, Mahnaz; Karyani, Ali Kazemi; Sari, Ali Akbari

    2016-01-01

    Introduction Fractures caused by osteoporosis are prevalent among elderly females, which reduce quality of life significantly. This study aimed at comparing cost-effectiveness of Zoledronic acid in preventing and treating post-menopause osteoporosis as compared with routine medical treatment. Methods This cost-effectiveness study was carried out retrospectively from the Ministry of Health and insurance organizations perspective. Costs were evaluated based on the cost estimation of a sample of patients. Outcomes were obtained from a systematic review. The Cost-Effectiveness Ratio (CER) and incremental cost-effectiveness ratio (ICER) for outcome of femoral neck Bone Mineral Density (BMD), hip trochanter BMD, total hip BMD and lumbar spine BMD and cost-benefit of consuming Zoledronic Acid were calculated for fracture outcome obtained from reviewing hospital records. Results The results and the ICER calculated for study outcomes indicated that one percent increase of BMD on femoral neck BMD requires further cost of $386. One percent increase of BMD on hip trochanter BMD requires further cost of $264. One percent increase of BMD on total hip BMD requires further cost of $388, one percent increase of BMD on lumbar spine BMD requires further cost of $347. The Cost Benefit Analysis (CBA) calculated for vertebral and hip fracture, non-vertebral fracture, any clinical fracture, and morphometric fracture for a 36-month period were about 0.82, 0.57, and 1.06, respectively. Vertebral and hip fractures, and non-vertebral fractures or any clinical fracture for a 12-month period were calculated as 1.14 and 0.64, respectively. In other words, Zoledronic acid consumption approach is a cheaper and better approach based on an economic assessment, and it can be considered as a dominant approach. Conclusion According to the cost-effectiveness of zoledronic acid in the prevention and treatment of osteoporosis in women, despite the costs, it is recommended that insurance coverage for the

  13. Screening, prevention and management of osteoporosis and bone loss in adult and pediatric hematopoietic cell transplant recipients.

    PubMed

    McClune, B L; Polgreen, L E; Burmeister, L A; Blaes, A H; Mulrooney, D A; Burns, L J; Majhail, N S

    2011-01-01

    Long-term survivors of hematopoietic cell transplantation (HCT) are at risk for loss of bone mineral density (BMD) and subsequent osteoporosis. There is a lack of clear guidelines for the screening, prevention and treatment of bone loss after HCT. We reviewed the prevailing literature and provide guidelines developed by our center for the screening and management of this complication. Bone loss occurs predominantly within the first 6-12 months after autologous and allogeneic HCT. Recovery first occurs in the lumbar spine and is followed by a slower recovery of BMD in the femoral neck. BMD may not return to baseline levels in patients with continuing exposure to corticosteroids and calcineurin inhibitors. All HCT recipients should be advised general interventions to reduce fracture risk including adequate intake of calcium and vitamin D. We recommend screening all adult allogeneic and autologous HCT recipients with dual-energy X-ray absorptiometry 1 year after transplantation. Patients at high risk for bone loss (for example, patients receiving ≥ 5 mg of prednisone equivalent daily for > 3 months) can be screened earlier (for example, 3-6 months after HCT). Where indicated, bisphosphonates or other anti-resorptive agents (for example, calcitonin) can be used for prevention or treatment of osteoporosis in adult HCT recipients. Pediatric HCT recipients should be referred to a pediatric endocrinologist for evaluation and treatment of bone loss. There remain several areas of uncertainty that need further research in adult and pediatric HCT recipients, such as the optimal timing and frequency of screening for loss of bone mineral density, relationship of bone loss with risk of fractures, selection of appropriate patients for pharmacologic therapy, and optimal dosing schedule and duration of therapy with anti-resorptive agents.

  14. Royal jelly prevents osteoporosis in rats: beneficial effects in ovariectomy model and in bone tissue culture model.

    PubMed

    Hidaka, Saburo; Okamoto, Yoshizo; Uchiyama, Satoshi; Nakatsuma, Akira; Hashimoto, Ken; Ohnishi, S Tsuyoshi; Yamaguchi, Masayoshi

    2006-09-01

    Royal jelly (RJ) has been used worldwide for many years as medical products, health foods and cosmetics. Since RJ contains testosterone and has steroid hormone-type activities, we hypothesized that it may have beneficial effects on osteoporosis. We used both an ovariectomized rat model and a tissue culture model. Rats were divided into eight groups as follows: sham-operated (Sham), ovariectomized (OVX), OVX given 0.5% (w/w) raw RJ, OVX given 2.0% (w/w) RJ, OVX given 0.5% (w/w) protease-treated RJ (pRJ), OVX given 2.0% (w/w) pRJ, OVX given 17beta-estradiol and OVX given its vehicle, respectively. The Ovariectomy decreased tibial bone mineral density (BMD) by 24%. Administration of 17beta-estradiol to OVX rats recovered the tibial BMD decrease by 100%. Administration of 2.0% (w/w) RJ and 0.5-2.0% (w/w) pRJ to OVX rats recovered it by 85% or more. These results indicate that both RJ and pRJ are almost as effective as 17beta-estradiol in preventing the development of bone loss induced by ovariectomy in rats. In tissue culture models, both RJ and pRJ increased calcium contents in femoral-diaphyseal and femoral-metaphyseal tissue cultures obtained from normal male rats. However, in a mouse marrow culture model, they neither inhibited the parathyroid hormone (PTH)-induced calcium loss nor affected the formation of osteoclast-like cells induced by PTH in mouse marrow culture system. Therefore, our results suggest that both RJ and pRJ may prevent osteoporosis by enhancing intestinal calcium absorption, but not by directly antagonizing the action of PTH.

  15. [Osteoporosis: a clinical perspective].

    PubMed

    Matikainen, Niina

    2016-01-01

    Osteoporosis is defined by decreased bone density and microarchitectural deterioration that predispose to fragility fractures. The WHO diagnostic criteria of osteoporosis require bone densitometry but treatment is possible on the basis of high clinical fracture risk and can be assessed by the FRAX risk algorithm. All those subject to fracture risk should be advised about proper basic treatment of osteoporosis, including exercise, prevention of falls, smoking cessation, avoidance of alcohol intake, and dietary or supplemental abundance of calcium and vitamin D. Underlying diseases must be studied after diagnosis of osteoporosis even if treatment is initiated without densitometry. When indicated, specific osteoporosis therapy includes bisphosphonates, denosumab, teriparatide, strontium ranelate or SERMs. In hypogonadism, gonadal steroids may be indicated alone or in addition to a specific treatment. Treatment effect and continuation are assessed after 2 to 5 years.

  16. Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database

    PubMed Central

    Trijau, Sophie; de Lamotte, Gaëlle; Pradel, Vincent; Natali, François; Allaria-Lapierre, Véronique; Coudert, Hervé; Pham, Thao; Sciortino, Vincent; Lafforgue, Pierre

    2016-01-01

    Introduction Long-term glucocorticoid therapy is the leading cause of secondary osteoporosis. The management of glucocorticoid-induced osteoporosis (GIOP) seems to be inadequate in many European countries. Objective To evaluate the rate of screening and treatment of GIOP. Design Information was collected from a national public health-insurance database in our geographic area of Provence-Alpes-Côte-d'Azur and in Corsica, from September 2009 through August 2011. Patients We identified participants aged 15 years and over starting glucocorticoid therapy (≥7.5 mg of prednisone equivalent per day during at least 90 days consecutive). This cohort was compared with an age-matched and sex-matched population that did not receive glucocorticoids. Main outcome measures Bone mass, prescription of bone antiresorptive medication and use of calcium and/or vitamin D treatment. Results We identified 32 812 patients who were prescribed glucocorticoid therapy, yielding 1% prevalence. Incidence of glucocorticoid therapy was 2.8/1000 inhabitants/year. Males represented 44%, the mean age was 58 years. The median prednisone-equivalent dose was 11 mg/day (IQR 9–18 mg/day). 8% underwent bone mass measurement. Calcium and/or vitamin D, and bisphosphonates were prescribed in 18% and 12%, respectively. Results were lower for the control population: 3% underwent bone mass measurement and 3% received bisphosphonate therapy. The rates of osteodensitometry and treatments were higher in women over 55 years of age than in men and women 55 years of age and younger, and also when glucocorticoid therapy was initiated by a rheumatologist versus other physician specialty. Conclusions The management of GIOP remains very inadequate, despite the availability of a statutory health insurance system. Targeted interventions are needed to improve the management of GIOP. PMID:27486526

  17. Cost-effectiveness of multifaceted evidence implementation programs for the prevention of glucocorticoid-induced osteoporosis

    PubMed Central

    Saag, K. G.; Curtis, J. R.; Kilgore, M. L.; Pisu, M.

    2013-01-01

    Summary Using a computer simulation model, we determined that an intervention aimed at improving the management of glucocorticoid-induced osteoporosis is likely to be cost-effective to third-party health insurers only if it focuses on individuals with very high fracture risk and the proportion of prescriptions for generic bisphosphonates increases substantially. Introduction The purpose of this study is to determine whether an evidence implementation program (intervention) focused on increasing appropriate management of glucocorticoid-induced osteoporosis (GIOP) might be cost-effective compared with current practice (no intervention) from the perspective of a third-party health insurer. Methods We developed a Markov microsimulation model to determine the cost-effectiveness of the intervention. The hypothetical patient cohort was of current chronic glucocorticoid users 50–65 years old and 70% female. Model parameters were derived from published literature, and sensitivity analyses were performed. Results The intervention resulted in incremental cost-effectiveness ratios (ICERs) of $298,000 per quality adjusted life year (QALY) and $206,000 per hip fracture averted. If the cohort’s baseline risk of fracture was increased by 50% (10-year cumulative incidence of hip fracture of 14%), the ICERs improved significantly: $105,000 per QALY and $137,000 per hip fracture averted. The ICERs improved significantly if the proportion of prescriptions for generic bisphosphonates was increased to 75%, with $113,000 per QALY and $77,900 per hip fracture averted. Conclusions Evidence implementation programs for the management of GIOP are likely to be cost-effective to third-party health insurers only if they are targeted at individuals with a very high risk of fracture and the proportion of prescriptions for less expensive generic bisphosphonates increases substantially. PMID:19937227

  18. Summary of AHRQ's comparative effectiveness review of treatment to prevent fractures in men and women with low bone density or osteoporosis: update of the 2007 report.

    PubMed

    Levis, Silvina; Theodore, George

    2012-05-01

    In 2007, the Agency for Healthcare Research and Quality(AHRQ) published a systematic review on the comparative effectiveness of treatments for osteoporosis. The review included studies on the benefits and risks of medications and therapies used to prevent fractures in postmenopausal women and men with low bone density (osteopenia) or osteoporosis. Factors that may affect adherence to treatment, and monitoring for the identification of those most likely to benefit from treatment were also included in this review. AHRQ published an updated review in March 2012 that summarized the benefits and risks of osteoporosis medications in treatment and prevention of osteoporosis, including bisphosphonates (aledronate, risedronate, ibandronate, zoledronic acid), parathyroid hormone, teriparatide, calcitonin, estrogens (for prevention in postmenopausal women), selective estrogen receptor modulators (raloxifene), and denosumab(approved by the FDA in 2010). In addition, dietary and supplemental calcium and vitamin D, as well as weight-bearing exercise, for the preservation of bone mass and the decrease of fracture risk in patients with osteoporosis, were evaluated. To (a) familiarize health care professionals with the methods and findings from AHRQ's 2012 comparative effectiveness review on treatments to prevent fractures in men and women with low bone density or osteoporosis, (b) encourage consideration and application of the findings of this review in clinical and managed care settings, and (c) identify limitations and gaps in the existing research with respect to the benefits and risks of treatments for osteoporosis. Osteoporosis is a prevalent systemic skeletal disease caused by bone deterioration and loss of mass resulting in fractures, chronic pain and physical disability. It is common in postmenopausal women but men are at risk as well for fractures associated with low bone density. The increasing prevalence and cost of treating osteoporosis make the study of safety and

  19. Positive predictive values of International Classification of Diseases, 10th revision codes for dermatologic events and hypersensitivity leading to hospitalization or emergency room visit among women with postmenopausal osteoporosis in the Danish and Swedish national patient registries

    PubMed Central

    Adelborg, Kasper; Christensen, Lotte Brix; Munch, Troels; Kahlert, Johnny; Trolle Lagerros, Ylva; Tell, Grethe S; Apalset, Ellen M; Xue, Fei; Ehrenstein, Vera

    2017-01-01

    Background Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs) of International Classification of Diseases, 10th revision (ICD-10) codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO). Methods This validation study included women with PMO identified from the Danish and Swedish national patient registries (2005–2014). Medical charts of the potential cases served as the gold standard for the diagnosis confirmation and were reviewed and adjudicated by physicians. Results We obtained and reviewed 189 of 221 sampled medical records (86%). The overall PPV was 92.4% (95% confidence interval [CI], 85.1%–96.3%) for dermatologic events, while the PPVs for bullous events and erythematous dermatologic events were 52.5% (95% CI, 37.5%–67.1%) and 12.5% (95% CI, 2.2%–47.1%), respectively. The PPV was 59.0% (95% CI, 48.3%–69.0%) for hypersensitivity; however, the PPV of hypersensitivity increased to 100.0% (95% CI, 67.6%–100.0%) when restricting to diagnostic codes for anaphylaxis. The overall results did not vary by country. Conclusion Among women with PMO, the PPV for any dermatologic event recorded as the primary diagnosis at hospitalization or at an emergency room visit was high and acceptable for epidemiologic research in the Danish and Swedish national patient registries. The PPV was substantially lower for hypersensitivity leading to hospitalization or emergency room visit.

  20. Positive predictive values of International Classification of Diseases, 10th revision codes for dermatologic events and hypersensitivity leading to hospitalization or emergency room visit among women with postmenopausal osteoporosis in the Danish and Swedish national patient registries.

    PubMed

    Adelborg, Kasper; Christensen, Lotte Brix; Munch, Troels; Kahlert, Johnny; Trolle Lagerros, Ylva; Tell, Grethe S; Apalset, Ellen M; Xue, Fei; Ehrenstein, Vera

    2017-01-01

    Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs) of International Classification of Diseases, 10th revision (ICD-10) codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO). This validation study included women with PMO identified from the Danish and Swedish national patient registries (2005-2014). Medical charts of the potential cases served as the gold standard for the diagnosis confirmation and were reviewed and adjudicated by physicians. We obtained and reviewed 189 of 221 sampled medical records (86%). The overall PPV was 92.4% (95% confidence interval [CI], 85.1%-96.3%) for dermatologic events, while the PPVs for bullous events and erythematous dermatologic events were 52.5% (95% CI, 37.5%-67.1%) and 12.5% (95% CI, 2.2%-47.1%), respectively. The PPV was 59.0% (95% CI, 48.3%-69.0%) for hypersensitivity; however, the PPV of hypersensitivity increased to 100.0% (95% CI, 67.6%-100.0%) when restricting to diagnostic codes for anaphylaxis. The overall results did not vary by country. Among women with PMO, the PPV for any dermatologic event recorded as the primary diagnosis at hospitalization or at an emergency room visit was high and acceptable for epidemiologic research in the Danish and Swedish national patient registries. The PPV was substantially lower for hypersensitivity leading to hospitalization or emergency room visit.

  1. Glucocorticoid osteoporosis.

    PubMed

    Sambrook, Philip N

    2002-01-01

    Postmenopausal women are at greatest risk of rapid bone loss and fracture with glucocorticoids and should be actively considered for prophylactic measures. In men and premenopausal women receiving glucocorticoids, the decision to use anti-osteoporosis prophylaxis is less clear and depends upon baseline bone mineral density [BMD], anticipated dose and duration of glucocorticoids. Based upon evidence the order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or hormone replacement therapy [HRT]. Calcium alone appears unable to prevent rapid bone loss in patients starting glucocorticoids. HRT should clearly be considered if hypogonadism is present. In patients receiving chronic low dose glucocorticoids, treatment with calcium and vitamin D may be sufficient to prevent further bone loss. However since fracture risk is a function of multiple factors including the degree of reduction in BMD as well as the duration of exposure, treatment with therapy to increase BMD will reduce fracture risk even in patients receiving chronic low dose glucocorticoids.

  2. Olive oil in the prevention and treatment of osteoporosis after artificial menopause

    PubMed Central

    Liu, Huilan; Huang, Huijuan; Li, Boheng; Wu, Dong; Wang, Fengmei; Zheng, Xiao hua; Chen, Qingxia; Wu, Bifang; Fan, Xiaojie

    2014-01-01

    Purpose The goal of this study was to investigate the anti-osteoporosis effect of extra virgin olive oil (EVOO) in vivo, and explore its antioxidant, anti-inflammatory properties in Sprague Dawley rats and its anticancer properties in patients. Materials and methods A total of 120 healthy female Sprague Dawley rats aged 6 months were divided into four groups: 1) sham-operated control (Sham group, n=30); 2) ovariectomized (OVX group, n=30); 3) ovariectomized rats supplemented with EVOO (OVX + Olive, n=30); 4) ovariectomized rats supplemented with estrogen (OVX + E2, n=30). EVOO and estrogen were administered by oral gavage at a dose of 1 mL/100 g weight on a daily basis for 12 consecutive weeks. Twelve weeks later blood samples were obtained to detect the levels of calcium, alkaline phosphatase, phosphorus, interleukin-6 (IL-6), malonyldialdehyde (MDA), and nitrate content. Dual energy X-ray absorptiometer measured bone mineral density (BMD) of ovariectomized Sprague Dawley rats that had been fed olive oil for 3 months. Blood samples from patients, who regularly consumed olive oil over a 1 year period were also used to measure carbohydrate antigen 125, carcino-embryonic antigen, α-fetoprotein, and carbohydrate antigen 19-9 levels. BMD of lumbar spine and left femur was also evaluated by dual energy X-ray absorptiometry. Results Animal experiments showed that EVOO significantly increased BMD and decreased phosphatase, alkaline phosphatase, IL-6, MDA, and nitrate levels. However, it had no significant effect on the Ca2+ level. In clinical follow-up, EVOO also improved patient BMD levels on L3, L4, and left femoral neck, and reduced carbohydrate antigen 125, α-fetoprotein, and carcino-embryonic antigen levels. But it had no significant effect on the carbohydrate antigen 19-9 level. Conclusion EVOO illustrated significant anti-osteoporosis, antioxidant, anti-inflammatory, and anticancer properties in vivo. However, further studies are required to determine the active

  3. A survey of steroid-related osteoporosis diagnosis, prevention and treatment practices of pediatric rheumatologists in North America.

    PubMed

    Soybilgic, Arzu; Tesher, Melissa; Wagner-Weiner, Linda; Onel, Karen B

    2014-01-01

    The purpose of our study is to assess practices of North American pediatric rheumatologists regarding monitoring, prevention, and treatment of low bone mineral density (BMD) in children on long-term glucocorticoid treatment. Long-term glucocorticoid therapy is associated with accelerated bone loss. Children with JIA and lupus have low baseline BMD and incident vertebral fractures commonly occur in these groups of patients even after a relatively short period of time being on systemic glucocorticoids. There are no established guidelines for identification, prevention, and treatment of glucocorticoid-induced bone loss in children. A cross-sectional online survey was conducted with 199 physicians who were listed in the ACR database as practicing pediatric rheumatology in North America. 86 physicians (43%) responded; 87% were board-certified in pediatric rheumatology. 95% used dual energy X-ray absorptiometry as their primary modality for assessing BMD. 79% "rarely" or "never" obtained a baseline BMD measurement prior to initiation of glucocorticoid therapy. 42% of respondents followed BMD annually. 93% "frequently" or "always" prescribed calcium for patients on long-term corticosteroid therapy; 81% "frequently" or "always" prescribed vitamin D. In patients diagnosed with osteoporosis, 35%-50 % of the practitioners "sometimes", "frequently" or "always" prescribed bisphosphonates. Bisphosphonates are prescribed at similar rates for male and female patients, and slightly more frequently for pubertal than for pre-pubertal patients. 96% of respondents "rarely" or "never" prescribed calcitonin for patients on long-term glucocorticoid therapy; 92% "rarely" or "never" prescribe this medication for patients with known osteopenia or osteoporosis. Utilization of DXA in children on long-term corticosteroid therapy varies greatly among North American pediatric rheumatologists. Most respondents do not screen for low BMD on a regular basis despite acknowledging the risks of bone

  4. [Preventive and therapeutic effect of strontium ranelate on osteoporosis in rats subjected to simulated weightlessness].

    PubMed

    Yang, Rui; Huang, Zhen; Cai, De-hong; Zhang, Hua; Lai, A-na; Zhang, Zhen; Sun, Ping; Chen, Hong

    2010-04-01

    To study the effects of strontium ranelate on osteoporosis induced by simulated weightlessness in male rats. Twenty-seven male SD rats were randomly divided into 3 groups, namely the normal control group (group A) and two groups of weightlessness simulated by tail suspension (groups B and C). The rats in group C were treated with strontium ranelate, and those in the other two groups were given the same dose of normal saline for 28 consecutive days. The rats in group B showed significantly lower levels of alkaline phosphatase (ALP), bone mineral density (BMD) and bone mineral content (BMC) than those in group A (P<0.05), but serum calcium and phosphonium concentrations underwent no significant changes in the 3 groups (P>0.05). In the rats of group B, the trabeculae of the femur became thinner, fragile, and discontinuous with reduced quantity as compared with those in group A. The rats in group C had greater number of the trabeculae than those in group B with decreased resorption surface and more regular arrangement of the collagen fibers. Strontium ranelate may produce beneficial effect on the bone microstructure, reduce bone loss and stimulate bone formation in male rats subjected to simulated weightlessness.

  5. Osteoporosis (image)

    MedlinePlus

    Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency ...

  6. Osteoporosis (image)

    MedlinePlus

    Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency ...

  7. Management of postmenopausal osteoporosis.

    PubMed

    Murphy, Frederick T; Kivitz, Alan J; Sands, Earl E

    2003-10-01

    Postmenopausal osteoporosis is associated with significant morbidity, mortality, reduction in quality of life, and increasing health care costs. It is estimated that 1.5 million women in the United States have one or more osteoporosis-related fractures annually. Fractures may occur at any site, but vertebral fractures are the most common. Longitudinal studies have demonstrated a decreased life expectancy associated with both vertebral and nonvertebral fractures. Once an initial fracture occurs, there is a fivefold increased risk of a second fracture within 1 year. The management of osteoporosis today incorporates multiple modalities of therapy. In addition to early detection, patient education, exercise, and nutritional supplementation, multiple therapeutic agents should be implemented early in an attempt to prevent initial and subsequent fractures. This article reviews currently approved modalities of therapy for the prevention and treatment of postmenopausal osteoporosis.

  8. [Osteoporosis in children and adolescents].

    PubMed

    Marcelli, Christian

    2007-01-01

    There is currently no consensus definition of osteopenia and osteoporosis in children according to bone mineral density (BMD) values measured by dual energy x-ray absorptiometry (DXA); interpretation of BMD measures must take into account the child's weight and pubertal status. In children, primary forms of osteoporosis--juvenile idiopathic osteoporosis and osteogenesis imperfecta--are rare; on the other hand, the frequency of secondary osteoporosis is increasing. Fractures, especially of the forearm, are frequent in children. During the peak growth period, bone growth and mineralization are dissociated; in consequence temporary bone fragility promotes fractures. Several recent studies show that children with fractures have reduced BMD and that the occurrence of fractures in children may constitute a risk factor for osteoporosis and fracture during adulthood. In cases of secondary osteoporosis, close monitoring of the causal disease is the key element of treatment; there are very few controlled studies of the prevention or treatment of osteoporosis in children.

  9. Pomegranate Peel Extract Prevents Bone Loss in a Preclinical Model of Osteoporosis and Stimulates Osteoblastic Differentiation in Vitro

    PubMed Central

    Spilmont, Mélanie; Léotoing, Laurent; Davicco, Marie-Jeanne; Lebecque, Patrice; Miot-Noirault, Elisabeth; Pilet, Paul; Rios, Laurent; Wittrant, Yohann; Coxam, Véronique

    2015-01-01

    The nutritional benefits of pomegranate have attracted great scientific interest. The pomegranate, including the pomegranate peel, has been used worldwide for many years as a fruit with medicinal activity, mostly antioxidant properties. Among chronic diseases, osteoporosis, which is associated with bone remodelling impairment leading to progressive bone loss, could eventually benefit from antioxidant compounds because of the involvement of oxidative stress in the pathogenesis of osteopenia. In this study, with in vivo and ex vivo experiments, we investigated whether the consumption of pomegranate peel extract (PGPE) could limit the process of osteopenia. We demonstrated that in ovariectomized (OVX) C57BL/6J mice, PGPE consumption was able to significantly prevent the decrease in bone mineral density (−31.9%; p < 0.001 vs. OVX mice) and bone microarchitecture impairment. Moreover, the exposure of RAW264.7 cells to serum harvested from mice that had been given a PGPE-enriched diet elicited reduced osteoclast differentiation and bone resorption, as shown by the inhibition of the major osteoclast markers. In addition, PGPE appeared to substantially stimulate osteoblastic MC3T3-E1 alkaline phosphatase (ALP) activity at day 7, mineralization at day 21 and the transcription level of osteogenic markers. PGPE may be effective in preventing the bone loss associated with ovariectomy in mice, and offers a promising alternative for the nutritional management of this disease. PMID:26569295

  10. Physical activity in the prevention and amelioration of osteoporosis in women : interaction of mechanical, hormonal and dietary factors.

    PubMed

    Borer, Katarina T

    2005-01-01

    Osteoporosis is a serious health problem that diminishes quality of life and levies a financial burden on those who fear and experience bone fractures. Physical activity as a way to prevent osteoporosis is based on evidence that it can regulate bone maintenance and stimulate bone formation including the accumulation of mineral, in addition to strengthening muscles, improving balance, and thus reducing the overall risk of falls and fractures. Currently, our understanding of how to use exercise effectively in the prevention of osteoporosis is incomplete. It is uncertain whether exercise will help accumulate more overall peak bone mass during childhood, adolescence and young adulthood. Also, the consistent effectiveness of exercise to increase bone mass, or at least arrest the loss of bone mass after menopause, is also in question. Within this framework, section 1 introduces mechanical characteristics of bones to assist the reader in understanding their responses to physical activity. Section 2 reviews hormonal, nutritional and mechanical factors necessary for the growth of bones in length, width and mineral content that produce peak bone mass in the course of childhood and adolescence using a large sample of healthy Caucasian girls and female adolescents for reference. Effectiveness of exercise is evaluated throughout using absolute changes in bone with the underlying assumption that useful exercise should produce changes that approximate or exceed the absolute magnitude of bone parameters in a healthy reference population. Physical activity increases growth in width and mineral content of bones in girls and adolescent females, particularly when it is initiated before puberty, carried out in volumes and at intensities seen in athletes, and accompanied by adequate caloric and calcium intakes. Similar increases are seen in young women following the termination of statural growth in response to athletic training, but not to more limited levels of physical activity

  11. Radon balneotherapy and physical activity for osteoporosis prevention: a randomized, placebo-controlled intervention study.

    PubMed

    Winklmayr, Martina; Kluge, Christian; Winklmayr, Wolfgang; Küchenhoff, Helmut; Steiner, Martina; Ritter, Markus; Hartl, Arnulf

    2015-03-01

    Low-dose radon hyperthermia balneo treatment (LDRnHBT) is applied as a traditional measure in the non-pharmacological treatment of rheumatic diseases in Europe. During the last decades, the main approach of LDRnHBT was focused on the treatment of musculoskeletal disorders, but scientific evidence for the biological background of LDRnHBT is weak. Recently, evidence emerged that LDRnHBT influences bone metabolism. We investigated, whether combined LDRnHBT and exercise treatment has an impact on bone metabolism and quality of life in a study population in an age group at risk for developing osteoporosis. This randomized, double-blind, placebo-controlled trial comprised guided hiking tours and hyperthermia treatment in either radon thermal water (LDRnHBT) or radon-free thermal water (PlaceboHBT). Markers of bone metabolism, quality of life and somatic complaints were evaluated. Statistics was performed by linear regression and a linear mixed model analysis. Significant changes over time were observed for most analytes investigated as well as an improvement in self-assessed health in both groups. No significant impact from the LDRnHBT could be observed. After 6 months, the LDRnHBT group showed a slightly stronger reduction of the osteoclast stimulating protein receptor activator of nuclear kB-ligand compared to the PlaceboHBT group, indicating a possible trend. A combined hyperthermia balneo and exercise treatment has significant immediate and long-term effects on regulators of bone metabolism as well as somatic complaints. LDRnHBT and placeboHBT yielded statistically equal outcomes.

  12. Rare causes of osteoporosis

    PubMed Central

    Marcucci, Gemma; Brandi, Maria Luisa

    2015-01-01

    Summary Osteoporosis is a metabolic bone disease characterized by loss of bone mass and strength, resulting in increased risk of fractures. It is classically divided into primary (post-menopausal or senile), secondary and idiopathic forms. There are many rare diseases, that cause directly or indirectly osteoporosis. The identification and classification of most of these rare causes of osteoporosis is crucial for the specialists in endocrinology and not, in order to prevent this bone complication and to provide for an early therapy. Several pathogenic mechanisms are involved, including various aspects of bone metabolism such as: decreased bone formation, increased bone resorption, altered calcium, phosphorus and/or vitamin D homeostasis, and abnormal collagen synthesis. In this review, less common forms of primary and secondary osteoporosis are described, specifying, if applicable: genetic causes, epidemiology, clinical features, and pathogenic mechanisms causing osteoporosis. A greater awareness of all rare causes of osteoporosis could reduce the number of cases classified as idiopathic osteoporosis and allow the introduction of appropriate and timely treatments. PMID:26604941

  13. OSTEOPOROSIS DIAGNOSIS AND TREATMENT

    PubMed Central

    de Souza, Márcio Passini Gonçalves

    2015-01-01

    Articles that update the state of knowledge regarding osteoporosis run the risk of quickly becoming obsolete because research and studies on osteoporosis today are arousing great interest among researchers, the pharmaceutical and medical equipment industries, governments and even WHO. All orthopedists know about osteoporosis because of its most deleterious effect: osteoporotic fracture. Osteoporosis without fractures does not arouse suspicion because this is a pathological condition with a nonspecific clinical profile. Osteoporotic fractures have an economic cost (from treatment), a social cost (from its sequelae) and a medical cost (from deaths). Many fractures could be avoided through diagnosing osteoporosis prior to the first fracture and thus many temporary and permanent disabilities could be avoided and many lives saved. Awareness of the risk factors for osteoporosis raises suspicions and bone densitometry aids in diagnosis. Treatment should be based on the physiopathology of the disease. Hence, for prevention or treatment of osteoporosis, the activity of osteoclasts should be diminished or the activity of osteoblasts should be increased, or both. Treatment that reduces the incidence of fractures by improving the bone geometry and microarchitecture would be ideal. Newly formed bone tissue needs to have good cell and matrix quality, normal mineralization, a good ratio between mineralized (mechanically resistant) and non-mineralized (flexible) bone, and no accumulated damage. The ideal treatment should have a positive remodeling rate and fast and long-lasting therapeutic effects. Such effects need to be easily detectable. They need to be safe. PMID:27022545

  14. OSTEOPOROSIS DIAGNOSIS AND TREATMENT.

    PubMed

    de Souza, Márcio Passini Gonçalves

    2010-01-01

    Articles that update the state of knowledge regarding osteoporosis run the risk of quickly becoming obsolete because research and studies on osteoporosis today are arousing great interest among researchers, the pharmaceutical and medical equipment industries, governments and even WHO. All orthopedists know about osteoporosis because of its most deleterious effect: osteoporotic fracture. Osteoporosis without fractures does not arouse suspicion because this is a pathological condition with a nonspecific clinical profile. Osteoporotic fractures have an economic cost (from treatment), a social cost (from its sequelae) and a medical cost (from deaths). Many fractures could be avoided through diagnosing osteoporosis prior to the first fracture and thus many temporary and permanent disabilities could be avoided and many lives saved. Awareness of the risk factors for osteoporosis raises suspicions and bone densitometry aids in diagnosis. Treatment should be based on the physiopathology of the disease. Hence, for prevention or treatment of osteoporosis, the activity of osteoclasts should be diminished or the activity of osteoblasts should be increased, or both. Treatment that reduces the incidence of fractures by improving the bone geometry and microarchitecture would be ideal. Newly formed bone tissue needs to have good cell and matrix quality, normal mineralization, a good ratio between mineralized (mechanically resistant) and non-mineralized (flexible) bone, and no accumulated damage. The ideal treatment should have a positive remodeling rate and fast and long-lasting therapeutic effects. Such effects need to be easily detectable. They need to be safe.

  15. Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention.

    PubMed

    Duque, Gustavo; Close, Jacqueline J; de Jager, Julien P; Ebeling, Peter R; Inderjeeth, Charles; Lord, Stephen; McLachlan, Andrew J; Reid, Ian R; Troen, Bruce R; Sambrook, Philip N

    2010-08-02

    Older people living in residential aged care facilities (RACFs) are at considerably higher risk of suffering fractures than older people living in the community. When admitted to RACFs, patients should be assessed for fracture risk to ensure early implementation of effective fracture prevention measures. Routine or regular determination of calcium and phosphate serum levels in institutionalised older people is not indicated. Opinion is divided about the value of routine measurements of serum concentrations of 25-hydroxyvitamin D, parathyroid hormone and bone turnover markers. The non-pharmacological approach to fracture prevention includes multifactorial programs of falls prevention and the use of hip protectors. Vitamin D supplementation is recommended for all patients in RACFs. Dietary calcium intake should be optimised (1200-1500 mg per day is recommended) and supplementation offered to those with inadequate intake. The decision to prescribe calcium supplements should be guided by patients' tolerance, whether or not they have a history of kidney stones, and emerging data about its cardiovascular safety. Bisphosphonates are the first-choice pharmacological agents for fracture prevention in older persons at high risk. Intravenous administration is as efficient as oral and has the significant advantage of better adherence. Use of strontium ranelate has not been tested on people in RACFs, but evidence in the "old-old" (those aged 75 years and older) suggests it could be a therapeutic option for fracture prevention in this setting. In general, teriparatide should not be considered as a first-line treatment for fracture prevention, particularly for people in RACFs.

  16. Bazedoxifene and Conjugated Equine Estrogen: A Combination Product for the Management of Vasomotor Symptoms and Osteoporosis Prevention Associated with Menopause.

    PubMed

    Umland, Elena M; Karel, Lauren; Santoro, Nanette

    2016-05-01

    Bazedoxifene (BZA), a third-generation selective estrogen receptor modulator (SERM), has been combined with conjugated equine estrogen (CE) to create a tissue selective estrogen complex (TSEC) for the management of vasomotor symptoms (VMS) and the prevention of osteoporosis (OP) associated with menopause. Both of these outcomes of menopause contribute to significant negative effects on quality of life and increases in utilization of health care resources and dollars. Current treatment modalities for VMS and OP include estrogen therapy that requires the use of progestin in women who have a uterus to reduce the risk of endometrial hyperplasia and resultant cancer. However, progestin use results in nuisance bleeding as well as a further increased risk of breast cancer when combined with estrogen. And while SERMs can be used to prevent OP, their use alone has been shown to increase hot flashes. The combination of BZA and CE does not require progestin treatment with CE as the BZA component acts as an antagonist on endometrial tissue. The U.S. Food and Drug Administration approval of BZA/CE in 2013 was based on a series of five phase 3 studies known as the Selective estrogens, Menopause And Response to Therapy (SMART) trials. These trials, in their entirety, evaluated the impact of BZA/CE on VMS frequency and severity, bone mineral density, bone turnover markers, vaginal symptoms, lipid profiles, sleep, quality of life, breast density, and endometrial safety. The approved dose of BZA/CE is 20 mg BZA and 0.45 mg CE. Although this TSEC manages VMS while opposing breast and endometrial proliferation, preventing bone resorption, and improving lipid profiles, long-term experience with BZA/CE is currently lacking. © 2016 Pharmacotherapy Publications, Inc.

  17. Osteoporosis Prevention by Adlay ( Yì Yǐ: The Seeds of Coix Lachryma-Jobi L. var. ma-yuen Stapf) in a Mouse Model.

    PubMed

    Yang, Rong-Sen; Lu, Yi-Hsiang; Chiang, Wenchang; Liu, Shing-Hwa

    2013-04-01

    Osteoporosis is characterized by reduced bone mass and quality due to an imbalanced bone remodeling. A grass crop, adlay (Coix lachryma-jobi), is a kind of nourishing food, which has also been used in traditional Chinese medicine. In this study, we investigated the effect of adlay (C. lachryma-jobi L. var. ma-yuen Stapf) on osteoporosis using an ovariectomized mouse model. The adlay diet (10% and 30% adlay in mouse diet) or water extract of adlay (0.3 g/kg/day) was given to ovariectomized mice for 4 weeks. In some experiments, the primary rat osteoblast cells were used to test the possible mechanism of adlay on osteoporosis. The body weight was slightly increased and uterus weight was markedly decreased in ovariectomized mice, which were not affected by adlay treatment. Adlay diet (30%) and adlay extract feedings significantly reversed the decreased bone alkaline phosphatase activity and calcium contents and bone mineral density in ovariectomized mice. Moreover, adlay extracts increased the osteoblast cell proliferation in a dose-dependent manner. Adlay extracts also increased the protein expressions of proliferating cell nuclear antigen and phosphorylated extracellular signal-regulated kinase (ERK) 1/2 in osteoblast cells. ERK inhibitor PD98059 significantly reversed the increased osteoblast cell proliferation by adlay extracts. Taken together, these findings indicate that adlay effectively alleviates the osteoporotic status in ovariectomized mice. Adlay is capable of increasing the proliferation of osteoblast cells via an ERK-regulated signaling pathway. Adlay may be a helpful healthy food for osteoporosis prevention.

  18. Efficacy of a workplace osteoporosis prevention intervention: a cluster randomized trial.

    PubMed

    Tan, Ai May; LaMontagne, Anthony D; English, Dallas R; Howard, Peter

    2016-08-24

    Osteoporosis is a debilitating disease. Adequate calcium consumption and physical activity are the two major modifiable risk factors. This paper describes the major outcomes and efficacy of a workplace-based targeted behaviour change intervention to improve the dietary and physical activity behaviours of working women in sedentary occupations in Singapore. A cluster-randomized design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the units of randomization and intervention. Sixteen workplaces were recruited from a pool of 97, and randomly assigned to intervention and control arms (eight workplaces in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organization-wide educational activities. Workplaces in the control/standard care arm received print resources. Outcome measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, 4 weeks and 6 months post intervention. Adjusted cluster-level analyses were conducted comparing changes in intervention versus control groups, following intention-to-treat principles and CONSORT guidelines. Workplaces in the intervention group reported a significantly greater increase in calcium intake and duration of load-bearing moderate to vigorous physical activity (MVPA) compared with the standard care control group. Four weeks after intervention, the difference in adjusted mean calcium intake was 343.2 mg/day (95 % CI = 337.4 to 349.0, p < .0005) and the difference in adjusted mean load-bearing MVPA was 55.6 min/week (95 % CI = 54.5 to 56.6, p < .0005). Six months post intervention, the mean differences attenuated slightly to 290.5 mg/day (95 % CI = 285.3 to 295.7, p < .0005) and 50.9 min/week (95 % CI =49.3 to 52.6, p < .0005) respectively. This workplace-based intervention

  19. RETRACTED: The effect of an educational program based on health belief model and social cognitive theory in prevention of osteoporosis in women.

    PubMed

    Khani Jeihooni, Ali; Hidarnia, Alireza; Kaveh, Mohammad Hossein; Hajizadeh, Ebrahim; Askari, Alireza

    2017-04-01

    At the request of the Journal Editor and the Publisher, the following article has been retracted: Khani Jeihooni A, Hidarnia A, Hossein Kaveh M, Hajizadeh E and Askari A (2015) The effect of an education program based on health belief model and social cognitive theory in prevention of osteoporosis in women. Journal of Health Psychology. Epub ahead of print 8 September. DOI: 10.1177/1359105315603696.

  20. A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered

    PubMed Central

    Ansari, Hourieh; Farajzadegan, Ziba; Hajigholami, Ali; Paknahad, Zamzam

    2014-01-01

    Background: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. Aims: To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. Materials and Methods: It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls’ high schools. Subjects in the intervention groups participated in three educational sessions. Students’ osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. Results: After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. Conclusion: Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers. PMID:25422660

  1. Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review

    PubMed Central

    Swe, Myint; Benjamin, Biju; Tun, Aye Aye; Sugathan, Sandheep

    2016-01-01

    A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men. PMID:27904420

  2. Combination treatment with whole body vibration and a kidney-tonifying herbal Fufang prevent osteoporosis in ovariectomized rats.

    PubMed

    Wei, Qiu-shi; Wang, Hai-bin; Wang, Jun-ling; Fang, Bin; Zhou, Guang-quan; Tan, Xin; He, Wei; Deng, Wei-min

    2015-02-01

    To assess the ability of whole body vibration (WBV) with the kidney-tonifying herbal Fufang (Bushen Zhuanggu Granules, BZG) to prevent osteoporosis in ovariectomized rats. Fifty 6-month-old female Sprague Dawley rats were divided into five groups: sham-operated (SHAM), ovariectomized (OVX), OVX with WBV (OVX + WBV), OVX with BZG (OVX + BZG), OVX with both WBV and BZG (OVX + WBV + BZG). The SHAM group received normal saline. After 12 weeks of treatment, the rats were killed, their serum concentrations of osteopontin (OPN), receptor activator of nuclear factor kappa-B ligand RANKL and bone turnover markers assayed and bone mineral density (BMD), histomorphometry and bone strength evaluated. Concentrations of OPN were significantly lower in the SHAM, OVX + WBV and OVX + WBV + BZG groups at 12 weeks, whereas concentrations of RANKL had decreased significantly in the SHAM, OVX + WBV, OVX + BZG and OVX + WBV + BZG groups. In the OVX + WBV, OVX + BZG and OVX + WBV + BZG groups the amount of bone turnover had been significantly antagonized. Compared with OVX group, BMD, % trabecular area (Tb.Ar), number of trabeculae (Tb.N) and assessed biomechanical variables were higher in OVX+WBV group, whereas and BMD, %Tb.Ar, Tb.N, maximal load and yield load were higher in the OVX + BZG group. All tested indices were significantly lower in the OVX + WBV and OVX + BZG groups than in the OVX + WBV + BZG group. Either WBV or BZG alone prevents OVX-induced bone loss. However, BZG enhances the effect of WBV by further enhancing BMD, bone architecture and strength. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  3. Instructing students to measure their own bone density and prepare a simulated health class during pharmacy school improves their awareness and understanding of osteoporosis prevention.

    PubMed

    Tomishige-Mukai, Erisa; Kawachi, Akio; Kiyohara, Erika; Esaki, Fuminori; Sonoda, Junichiro; Shinya, Tomohiro; Narumi, Keiko; Sato, Keizo; Motoya, Toshiro

    2016-01-01

    Osteoporosis is estimated to afflict over 200 million people worldwide and healthcare professionals are needed to successfully intervene. The aim of this study was to assess cognitive changes in students pertaining to the primary prevention of osteoporosis after measuring their bone density and having them participate in a simulated health class during pharmacy school. Third year pharmacy students participated in the training program, which consisted of measuring their bone density using quantitative ultrasound and preparing educational materials and conducting a simulated health class. The students' knowledge concerning the prevention and education on osteoporosis was surveyed using questionnaires before and after the training. The bone area ratio (BAR) in 24 % of the students was evaluated as category 4 (slightly low) or 5 (low or caution). Regression analysis indicated a significant relationship between the BAR and amount of exercise reported in both males (p = 0.005) and females (p = 0.004). The student-made educational materials were prepared in line with the requirements of the Japanese 2011 guidelines. The student response rates for the importance of food, exercise, and the bone density measurement in youth were significantly increased after the training (p < 0.001 in all). More than 95 % of students reported that the program was useful, improved their understanding, and important, with 94 % satisfied with the experience. This experience-based educational program combining measuring the bone density and the preparation and presentation of a simulated health class appeared to improve the awareness and understanding of osteoporosis prevention in pharmacy students.

  4. Anti-osteopontin monoclonal antibody prevents ovariectomy-induced osteoporosis in mice by promotion of osteoclast apoptosis

    SciTech Connect

    Zhang, Bo; Dai, Jianxin; Wang, Huaqing; Wei, Huafeng; Zhao, Jian; Guo, Yajun; and others

    2014-09-26

    Highlight: • We first report that anti-osteopontin mAb could protect osteoporosis in mice. • Anti-osteopontin mAb could promote the osteoclast apoptosis. • Targeting osteopontin might have therapeutic potentials for osteoporosis. - Abstract: Osteopontin (OPN) is abundant in mineralized tissues and has long been implicated in bone remodeling. However, the therapeutic effect of targeting OPN in bone loss diseases and the underlying molecular mechanism remain largely unknown. Here, we reported that anti-OPN mAb (23C3) could protect against ovariectomy-induced osteoporosis in mice, demonstrated by microcomputed tomography analysis and histopathology evaluation. In vitro assay showed that 23C3 mAb reduced osteoclasts (OCs)-mediated bone resorption through promotion of mature OC apoptosis. Thus, the study has important implications for understanding the role of OPN in OC bone resorption and survival, and OPN antagonists may have therapeutic potential for osteoporosis and other osteopenic diseases.

  5. Blueberry prevents bone loss in ovariectomized rat model of postmenopausal osteoporosis.

    PubMed

    Devareddy, Latha; Hooshmand, Shirin; Collins, Julie K; Lucas, Edralin A; Chai, Sheau C; Arjmandi, Bahram H

    2008-10-01

    The objective of the present study was to explore the bone protective role of blueberry in an ovariectomized rat model. Thirty 6-month-old female Sprague-Dawley rats were either sham-operated (Sham) or ovariectomized (Ovx) and divided into three groups: Sham, Ovx (control), Ovx+blueberry (5% blueberry w/w). After 100 days of treatment, rats were euthanized, and blood and tissues were collected. Bone mineral density (BMD) and content of whole body, right tibia, right femur and fourth lumbar vertebra were assessed via dual-energy X-ray absorptiometry. As expected, Ovx resulted in loss of whole-body, tibial, femoral, and 4th lumbar BMD by approximately 6%. Blueberry treatment was able to prevent the loss of whole-body BMD and had an intermediary effect on prevention of tibial and femoral BMD when compared to either Sham or Ovx controls. The bone-protective effects of blueberry may be due to suppression of Ovx-induced increase in bone turnover, as evident by lowered femoral mRNA levels of alkaline phosphatase, collagen type I and tartrate-resistant acid phosphatase to the Sham levels. Similarly, serum osteocalcein levels were also lower in the blueberry group when compared to the Ovx control group, albeit not significantly. In summary, our findings indicate that blueberry can prevent bone loss as seen by the increases in BMD and favorable changes in biomarkers of bone metabolism.

  6. Two Different Isomers of Vitamin E Prevent Bone Loss in Postmenopausal Osteoporosis Rat Model

    PubMed Central

    Muhammad, Norliza; Luke, Douglas Alwyn; Shuid, Ahmad Nazrun; Mohamed, Norazlina; Soelaiman, Ima-Nirwana

    2012-01-01

    Postmenopausal osteoporotic bone loss occurs mainly due to cessation of ovarian function, a condition associated with increased free radicals. Vitamin E, a lipid-soluble vitamin, is a potent antioxidant which can scavenge free radicals in the body. In this study, we investigated the effects of alpha-tocopherol and pure tocotrienol on bone microarchitecture and cellular parameters in ovariectomized rats. Three-month-old female Wistar rats were randomly divided into ovariectomized control, sham-operated, and ovariectomized rats treated with either alpha-tocopherol or tocotrienol. Their femurs were taken at the end of the four-week study period for bone histomorphometric analysis. Ovariectomy causes bone loss in the control group as shown by reduction in both trabecular volume (BV/TV) and trabecular number (Tb.N) and an increase in trabecular separation (Tb.S). The increase in osteoclast surface (Oc.S) and osteoblast surface (Ob.S) in ovariectomy indicates an increase in bone turnover rate. Treatment with either alpha-tocopherol or tocotrienol prevents the reduction in BV/TV and Tb.N as well as the increase in Tb.S, while reducing the Oc.S and increasing the Ob.S. In conclusion, the two forms of vitamin E were able to prevent bone loss due to ovariectomy. Both tocotrienol and alpha-tocopherol exert similar effects in preserving bone microarchitecture in estrogen-deficient rat model. PMID:23118785

  7. [Osteoporosis and Colles' fracture].

    PubMed

    Hindsø, K; Lauritzen, J B

    2001-10-01

    We describe the connection between osteoporosis and Colles' fractures of the distal radius from an epidemiological and aetiological point of view. In addition, the value of these fractures as markers of osteoporosis and future risk of fracture is assessed. Several studies have clearly shown an epidemiological association between osteoporosis and fractures of the distal radius, with the association strongest for women up to 65 years of age and for osteoporosis located in the forearm. The association weakens for other locations and for older women. Osteoporosis may have some aetiologic significance for the development of Colles' fractures, but several extraskeletal factors are of equal or further importance. The occurrence of a Colles' fracture in the first 10-15 years after the postmenopause indicates an increased relative risk of sustaining another fracture in the future. However the relative risk approaches one after a few years and, because of the comparatively low absolute risk in this age-group, Colles' fracture as a risk factor contributes little to an assessment of the lifetime fracture risk. In a few longitudinal studies, Colles' fractures could not predict the long-term risk of osteoporosis. The presence of a Colles' fracture should lead to considerations concerning the skeletal and extraskeletal causes of the fracture for the purpose of initiating preventive and therapeutic measures.

  8. [Hip Fracture--Epidemiology, Management and Liaison Service. Practice of the secondary fracture prevention of the proximal femoral fracture by the Osteoporosis Liaison Service].

    PubMed

    Ikeda, Satoshi

    2015-04-01

    The proximal femoral fracture number of patients increases with age, and it is predicted that patients over 90 years old will increase in future. It causes a decline of ADL and the QOL, mortality aggravation, a remarkable rise of medical care, the nursing-care cost when they present with a fracture. Primary prevention is important to prevent osteoporotic fracture, but the secondary prevention for the prior or new fracture patient is particularly important. For the practice of the secondary prevention, cooperation of a doctor and the medical staff who included not only the hospital but also the cooperation with the medical institution in the area is indispensable. This report introduces osteoporosis liaison service working on in our hospital and is happy if it is with consideration of the practice of the secondary prevention of the proximal femoral fracture.

  9. United States adults meeting 2010 American College of Rheumatology criteria for treatment and prevention of glucocorticoid-induced osteoporosis.

    PubMed

    Overman, Robert A; Toliver, Joshua C; Yeh, Jun-Yen; Gourlay, Margaret L; Deal, Chad L

    2014-11-01

    The American College of Rheumatology (ACR) updated its guidelines on the prevention and treatment of glucocorticoid-induced osteoporosis (GIO) in 2010. An unknown proportion of US adults at risk of fracture due to glucocorticoid use would be recommended antiosteoporosis pharmaceutical (AOP) therapies based on the ACR guidelines. Using the 2005-2010 National Health and Nutrition Examination Survey (NHANES) data for postmenopausal women (PMW), and men age ≥50 years reporting current glucocorticoid use, we categorized individuals according to ACR criteria for low, medium, and high fracture risk (<10%, ≥10%, and ≥20%, respectively) and provided percentages of treatment recommendations for chronic (≥90 days) medium and all high-risk patients. Glucocorticoids were used by 1.66% of PMW and 1.65% of men age ≥50 years. Of these patients, 0.80% of PMW and 0.45% of men age ≥50 years were at high risk of fracture. A majority of PMW (81.2%) and men age ≥50 years (75.8%) were chronic glucocorticoid users. In patients for whom treatment recommendations could be made, 64.9% of PMW and 51.9% of men age ≥50 years would be recommended therapy, but only 28.4% of PMW and 9.7% of men age ≥50 years reported AOP use. Based on the NHANES (2005-2010) data, we estimate glucocorticoid use in >1.5 million US PMW and men age ≥50 years. Treatment would be recommended in at least 50% of this population based on the 2010 ACR guidelines. Self-reported AOP use was documented in <30%, suggesting a treatment gap in the management of GIO in the US before the guideline release. Copyright © 2014 by the American College of Rheumatology.

  10. Patterns of attendance to health checks in a municipality setting: the Danish 'Check Your Health Preventive Program'.

    PubMed

    Bjerregaard, Anne-Louise; Maindal, Helle T; Bruun, Niels Henrik; Sandbæk, Annelli

    2017-03-01

    We aimed to investigate the determinants of attendance to a preventive health check program and to explore the homogeneity of the attenders.4853 eligible persons living in the municipality of Randers, Denmark, from 2012 to 2013, aged 30–49 years, received an invitation to attend the ‘Check Your Health Preventive Program’. Data was obtained from the Danish National Registers. Socio-demographic factors, use of preventive services, morbidity were examined as determinants of attendance by Poisson regression analyses. A chi-squared automatic interaction detection decision tree analysis was used to identify mutually exclusive groups.In total, 55% of the invited population attended (49% men). Attenders were more likely to be: of higher age; immigrants; cohabiting; have: higher socio-economic status; higher use of preventive services and lower morbidity. Decision tree analysis revealed six groups, with the most important variable being income: 1) low income, low education (A = attendance rate: 38%; P = population size: 11%); 2) low income, education higher than 10 years, living alone (A: 41%; P: 5%); 3) low income, education higher than 10 years, cohabiting (A: 56%; P: 16%); 4) middle income (A: 60%; P: 34%); 5) high income, living alone (A: 56%; P: 4%); 6) high income, cohabiting (A: 69%; P: 30%).More than half of a general population voluntarily attended a general health check, despite a resource intensive offer. People with low resources had lower attendance rates. This study adds a detailed description of mutually exclusive groups of attenders, for use in future planning and implementation of preventive actions.

  11. Osteoporosis in chronic liver disease.

    PubMed

    Yadav, Anitha; Carey, Elizabeth J

    2013-02-01

    Osteoporosis is a common skeletal complication seen in patients with chronic liver disease. Osteoporosis is usually asymptomatic and, if untreated, can result in fractures and impaired quality of life. For this review, we performed a systematic search of the PubMed database, and all recent peer-reviewed articles regarding the prevalence, pathophysiology, diagnosis, and management of osteoporosis in chronic liver disease were included. The prevalence of osteoporosis varies between 11% and 58% in patients with chronic liver disease and in transplant recipients. The etiology of osteoporosis is multifactorial and only partially understood. Various factors linked to the pathogenesis of bone loss are vitamin D, calcium, insulin growth factor-1, receptor activation of nuclear factor-κB ligand (RANKL), bilirubin, fibronectin, leptin, proinflammatory cytokines, and genetic polymorphisms. Management of osteoporosis involves early diagnosis, identifying and minimizing risk factors, general supportive care, nutrition therapy, and pharmacotherapy. Osteoporosis is diagnosed based on the bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry scan. Measurement of BMD should be considered in all patients with advanced liver disease and in transplant recipients. Vitamin D and calcium supplementation is recommended for all patients with osteoporosis. Specific agents used for treatment of osteoporosis include bisphosphonates, calcitonin, hormonal therapy, and raloxifene. Bisphosphonates have become the mainstay of therapy for osteoporosis prevention and treatment. Prolonged suppression of bone remodeling resulting in atypical fractures has emerged as a significant complication with long-term use of bisphosphonates. Newer treatment agents and better fracture prevention strategies are necessary to prevent and treat osteoporosis.

  12. Association of protein intake with the change of lean mass among elderly women: The Osteoporosis Risk Factor and Prevention - Fracture Prevention Study (OSTPRE-FPS).

    PubMed

    Isanejad, Masoud; Mursu, Jaakko; Sirola, Joonas; Kröger, Heikki; Rikkonen, Toni; Tuppurainen, Marjo; Erkkilä, Arja T

    2015-01-01

    Low protein intake can lead to declined lean mass (LM) in elderly. We examined the associations of total protein (TP), animal protein (AP) and plant protein (PP) intakes with LM. The association of TP intake with LM change was further evaluated according to weight change status. This cross-sectional and prospective cohort study included 554 women aged 68 (sd 1·9) years from the Osteoporosis Risk Factor and Prevention - Fracture Prevention Study (OSTPRE-FPS). The intervention group (n 270) received daily cholecalciferol (800 IU; 20 μg) and Ca (1000 mg) for 3 years while the control group received neither supplementation nor placebo (n 282). Participants filled out a questionnaire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years. Multiple linear regressions evaluated the association between protein intake and LM, adjusting for relevant covariates. At the baseline TP and AP intakes were positively associated with LM and trunk LM, TP was associated also with appendicular LM (aLM). Follow-up results showed that in the total population and the intervention group, higher TP and AP were associated with increased LM and aLM (P ≤ 0·050). No such associations were observed in the control group. PP intake was also associated with aLM change in the total population. Overall, the associations were independent of fat mass. Further, among weight maintainers, TP intake was positively associated with LM, aLM and trunk LM changes (P ≤ 0·020). In conclusion, dietary TP, especially AP, intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly.

  13. Postmenopausal osteoporosis.

    PubMed

    Diab, Dima L; Watts, Nelson B

    2013-12-01

    The aim of this study is to provide a thorough updated review of the diagnosis and treatment of postmenopausal osteoporosis. There have been several important findings in the field of postmenopausal osteoporosis over the past 1-2 years. Fewer morphometric vertebral fractures were found in women treated for 6 years with zoledronic acid compared with those who stopped treatment after 3 years. Longer duration of bisphosphonate therapy is associated with a higher risk of atypical femur fractures. Combination therapy with teriparatide and denosumab appears to increase bone mineral density to a greater extent than either therapy alone in postmenopausal women at high risk for fracture. There are several novel therapies under investigation for the treatment of osteoporosis, which are in various stages of development. Nonadherence to osteoporosis therapies continues to be a major problem in clinical practice. There are numerous effective pharmacologic treatment options for postmenopausal osteoporosis. Bisphosphonate drug holidays continue to be an area of significant debate.

  14. Secondary osteoporosis

    PubMed Central

    Sheu, Angela; Diamond, Terry

    2016-01-01

    SUMMARY Secondary osteoporosis is less common than primary osteoporosis. It may be suspected in patients who present with a fragility fracture despite having no risk factors for osteoporosis. In addition, secondary osteoporosis should be considered if the bone density Z-score is –2.5 or less. Consider the fracture site and presence of other clinical clues to guide investigations for an underlying cause. The tests to use are those that are indicated for the suspected cause. Baseline investigations include tests for bone and mineral metabolism (calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone), liver and kidney function, full blood count and thyroid-stimulating hormone. More detailed testing may be required in patients with severe osteoporosis. PMID:27346916

  15. Osteoporosis Prevention by Adlay (薏苡 Yì Yǐ: The Seeds of Coix Lachryma-Jobi L. var. ma-yuen Stapf) in a Mouse Model

    PubMed Central

    Yang, Rong-Sen; Lu, Yi-Hsiang; Chiang, Wenchang; Liu, Shing-Hwa

    2013-01-01

    Osteoporosis is characterized by reduced bone mass and quality due to an imbalanced bone remodeling. A grass crop, adlay (Coix lachryma-jobi), is a kind of nourishing food, which has also been used in traditional Chinese medicine. In this study, we investigated the effect of adlay (C. lachryma-jobi L. var. ma-yuen Stapf) on osteoporosis using an ovariectomized mouse model. The adlay diet (10% and 30% adlay in mouse diet) or water extract of adlay (0.3 g/kg/day) was given to ovariectomized mice for 4 weeks. In some experiments, the primary rat osteoblast cells were used to test the possible mechanism of adlay on osteoporosis. The body weight was slightly increased and uterus weight was markedly decreased in ovariectomized mice, which were not affected by adlay treatment. Adlay diet (30%) and adlay extract feedings significantly reversed the decreased bone alkaline phosphatase activity and calcium contents and bone mineral density in ovariectomized mice. Moreover, adlay extracts increased the osteoblast cell proliferation in a dose-dependent manner. Adlay extracts also increased the protein expressions of proliferating cell nuclear antigen and phosphorylated extracellular signal-regulated kinase (ERK) 1/2 in osteoblast cells. ERK inhibitor PD98059 significantly reversed the increased osteoblast cell proliferation by adlay extracts. Taken together, these findings indicate that adlay effectively alleviates the osteoporotic status in ovariectomized mice. Adlay is capable of increasing the proliferation of osteoblast cells via an ERK-regulated signaling pathway. Adlay may be a helpful healthy food for osteoporosis prevention. PMID:24716168

  16. Progressive load training for the quadriceps muscle associated with proprioception exercises for the prevention of falls in postmenopausal women with osteoporosis: a randomized controlled trial.

    PubMed

    Teixeira, L E P P; Silva, K N G; Imoto, A M; Teixeira, T J P; Kayo, A H; Montenegro-Rodrigues, R; Peccin, M S; Trevisani, V F M

    2010-04-01

    This study aims to evaluate the effect of 18-week progressive muscular strength and proprioception training program on the muscle strength of the quadriceps, in prevention of falls in postmenopausal women with osteoporosis. The incidence of falls in the intervention group was significantly lower than in the control group (incidence rate ratio (IRR) = 0.263, 95% CI 0.10-0.68). This study aims to evaluate the effect of a progressive muscular strength and proprioception training program on the muscle strength of the quadriceps, balance, quality of life, and reduction in the risk of falls in postmenopausal women with osteoporosis. One hundred sedentary postmenopausal women with osteoporosis, ages ranging from 55 to 75, were selected and randomized into two groups: the intervention group comprised of 50 patients who underwent a 18-week of progressive load training for the quadriceps muscle (50% up to 80% of 1-RM-one maximum repetition) and proprioception training associated to a drug treatment of osteoporosis and the control group that included 50 patients who only underwent a drug treatment of osteoporosis. The muscular strength, balance, functional mobility, and quality of life were evaluated in the beginning and end of the research. The number of falls was evaluated 24 weeks post-treatment. Eighty-five patients concluded the research. The program promoted a significant difference among the groups for SF-36 in the eight sub-scales (p prevention of falls, increasing the muscle power, the static and dynamic balance and increasing the speed of the motor responses, therefore improving the performance of daily activities.

  17. Mechanical restraint in psychiatry: preventive factors in theory and practice. A Danish-Norwegian association study.

    PubMed

    Bak, Jesper; Zoffmann, Vibeke; Sestoft, Dorte Maria; Almvik, Roger; Brandt-Christensen, Mette

    2014-07-01

    To examine how potential mechanical restraint preventive factors in hospitals are associated with the frequency of mechanical restraint episodes. This study employed a retrospective association design, and linear regression was used to assess the associations. Three mechanical restraint preventive factors were significantly associated with low rates of mechanical restraint use: mandatory review (exp[B] = .36, p < .01), patient involvement (exp[B] = .42, p < .01), and no crowding (exp[B] = .54, p < .01). None of the three mechanical restraint preventive factors presented any adverse effects; therefore, units should seriously consider implementing these measures. © 2013 Wiley Periodicals, Inc.

  18. Design of a pragmatic approach to evaluate the effectiveness of concurrent treatment for the prevention of osteoporotic fractures: rationale, aims and organization of a Japanese Osteoporosis Intervention Trial (JOINT) initiated by the Research Group of Adequate Treatment of Osteoporosis (A-TOP).

    PubMed

    Shiraki, Masataka; Kuroda, Tatsuhiko; Miyakawa, Nobuaki; Fujinawa, Naohito; Tanzawa, Kazumasa; Ishizuka, Akiko; Tanaka, Shiro; Tanaka, Yukari; Hosoi, Takayuki; Itoi, Eiji; Morimoto, Shigeto; Itabashi, Akira; Sugimoto, Toshitsugu; Yamashita, Toshihiko; Gorai, Itsuo; Mori, Satoshi; Kishimoto, Hideaki; Mizunuma, Hideki; Endo, Naoto; Nishizawa, Yoshiki; Takaoka, Kunio; Ohashi, Yasuo; Ohta, Hiroaki; Fukunaga, Masao; Nakamura, Toshitaka; Orimo, Hajime

    2011-01-01

    The aim of osteoporosis treatment is to prevent future fractures. Although concurrent treatment has been used very frequently for osteoporosis in clinical practice, there are no data on accurate and verified effectiveness of concurrent treatment for fracture prevention in patients with osteoporosis. To clarify the clinical usefulness of concurrent treatment, the Japan Osteoporosis Society has authorized the establishment of the A-TOP (Adequate Treatment of Osteoporosis) research group. The objective of this research is to establish a design for a clinical trial to prove whether concurrent treatment using both alfacalcidol (1-alpha-hydroxycholecalciferol) and alendronate is more effective as compared to treatment using alendronate alone in terms of fracture prevention. The present study was named JOINT (Japanese Osteoporosis Intervention Trial) and is based on a method using national, prospective, randomized, open-labeled, blinded endpoints focusing on postmenopausal osteoporosis with a high risk for fracture. The patients were mainly selected by practitioners and allocated randomly by a central registration system into two groups, of which one received 5 mg/day of alendronate alone, and the other received 1 μg/day of 1-alpha-hydroxycholecalciferol (alfacalcidol) in addition to the alendronate. The endpoints focused primarily on fracture prevention, and the patients' quality of life (QOL) and change in body height, as well as adherence and the adverse events of the treatments were evaluated secondarily. To obtain sufficient statistical power in the events during a 2-year observation period, the patients who are expected to have higher risk were selected to participate in this study, and it was decided that the final plan would involve 890 patients per group (two-sided alpha = 0.05, power = 0.8). Data collection began in November 2003. Correspondence regarding the registration of the investigator and the progress of the study was conducted through a web system

  19. Osteoporosis: an update.

    PubMed

    el-Hajj Fuleihan, G

    1998-01-01

    Prevention is the therapy of choice for optimizing skeletal health and preventing osteoporosis. Attempts directed at increasing peak bone mass (e.g., good calcium intake during preadolescence, adolescence, and adulthood), reducing risk factors for bone loss such as menstrual abnormalities, thin body habitus, decreased physical activity or excessive alcohol intake, and slowing down bone loss and reversing any causes of secondary bone loss should be pursued vigorously. In practice, all patients should be encouraged to get regular exercise, as well as adequate vitamin D and calcium intake. In the absence of contraindications, estrogen is the mainstay therapy for the prevention and treatment of osteoporosis. Other antiresorptive agents are available as alternative therapies to estrogen. Of equal importance to elderly women with established osteoporosis is counseling on how to prevent falls. Therapies that increase bone formation (aside from fluoride), including growth factors, are not currently available. However, such interventions used in conjunction with an antiresorptive therapy, offer the potential to greatly enhance and therefore normalize bone mass and may hold a promise for the treatment of osteoporosis in the future.

  20. Effect of educational intervention using the Internet on quantitative ultrasound parameters in prevention of osteoporosis: a randomized controlled trial in young Japanese women

    PubMed Central

    Asakawa, Kazumi; Koyama, Katsuhiro; Yamagata, Zentaro

    2011-01-01

    Background The objective of this study was to determine whether or not educational intervention using the Internet, to prevent osteoporosis, is able to increase bone strength in young women. Methods Subjects were 253 healthy female university and junior college students aged 18–25 years. After initial measurements of bone stiffness index, a bone formation marker, and a bone absorption marker, the minimization method was used to allocate the subjects to an intervention group (n = 126) or a control group (n = 127) according to whether the measurements were above or below average. Subjects in the intervention group were instructed to perform osteoporosis prevention activities, ie, jump on the spot as high as possible ten times per day and increase calcium intake by 300 mg per day to a total of 800 mg or more per day on average. In addition, they were instructed to report the implementation status of the recommended measures via email. The researcher sent out information on osteoporosis and preventive behaviors to the subjects five times via email. Results A total of 182 subjects, comprising 87 (69.0%) in the intervention group and 95 (74.8%) in the control group, underwent remeasurement 6 months later. Of the subjects in the intervention group, 54 (42.9%) reported their daily additional calcium intake amount and number of jumps via email. The mean amount of additional calcium taken was 216.3 ± 85.9 mg per day, and mean number of jumps performed was 6.4 ± 4.2 per day. Subjects in the intervention group were further divided into an implementation group (n = 54), consisting of subjects who sent in reports and a nonimplementation group (n = 72) who did not. No significant difference was found among the groups for rate of change in bone stiffness index and speed of sound, but there was a significant difference for broadband ultrasound attenuation (BUA) (P = 0.017). Sheffe’s multiple comparison test was performed using baseline body weight and BUA values as covariates

  1. [Osteoporosis treatment by gynecologist].

    PubMed

    Mizunuma, Hideki

    2003-02-01

    Postmenopausal bone loss is accelerated since women experience menstrual irregularity. Postmenopausal women lose their bone mineral density by 20 to 25% during 10 years after menopause, therefore early detection of risks for postmenopausal osteoporosis is mandatory for prevention of the disease. Because estrogen deficiency is the primary cause of postmenopausal bone loss, hormone replacement therapy can be a reasonable choice for the first treatment of osteoporosis. However, to those who have contraindications against estrogen or who complain severe estrogen-related symptoms, other medication using SERM and bisphosphonate should be considered.

  2. Suppression of EZH2 Prevents the Shift of Osteoporotic MSC Fate to Adipocyte and Enhances Bone Formation During Osteoporosis.

    PubMed

    Jing, Huan; Liao, Li; An, Yulin; Su, Xiaoxia; Liu, Shiyu; Shuai, Yi; Zhang, Xinjing; Jin, Yan

    2016-02-01

    During osteoporosis, the shift of mesenchymal stem cell (MSC) lineage commitment to adipocyte leads to the imbalance between bone mass and fat, which increases the risk of fracture. The Enhancer of Zeste homology 2 (EZH2), which methylates histone H3 on lysine 27 (H3K27me3), controls MSC cell lineage commitment. However, whether EZH2 is related to osteoporosis remains elusive. In our study, we found EZH2 expression was significantly increased in osteoporotic MSCs. EZH2 directly increased H3K27me3 levels on promoters of Wnt1, Wnt6, and Wnt10a to silence Wnt gene transcription. The inhibition of Wnt/β-catenin signaling shifted MSC cell lineage commitment to adipocyte. Knockdown of EZH2 by lentivirus-expressing shRNA rescued the abnormal fate of osteoporotic MSC. By employing the H3K27me3 inhibitor DZNep, we effectively derepressed Wnt signaling and improved osteogenic differentiation of osteoporotic MSCs in vitro. Furthermore, in vivo administration of DZNep successfully increased bone formation and repressed excessive bone marrow fat formation in osteoporotic mice. Noteworthy, DZNep treatment persistently enhanced osteogenic differentiation of endogenous MSCs. In conclusion, our study demonstrated that redundant EZH2 shifted MSC cell lineage commitment to adipocyte, which contributed to the development of osteoporosis. We also provided EZH2 as a novel therapeutic target for improving bone formation during osteoporosis.

  3. [Steroid-induced osteoporosis].

    PubMed

    Perrot, Serge; Le Jeunne, Claire

    2012-04-01

    Bone-related steroid involvement is one of the most frequent complications of steroid treatment. Epidemiological data demonstrate that osteoporosis starts early during the treatment, predominantly involves trabecular bone and is correlated to dosage and treatment duration. Mechanisms and consequences of steroid bone involvement are related to osseous and extra-osseous mechanisms. In clinical practice, steroid-induced osteoporosis remains underdiagnosed and undertreated both in preventive and curative approaches. Recently, new molecules as teriparatide and zoledronic acid got indication for the treatment of steroid-induced osteoporosis. To guide treatment strategies, several recommendations are available: French, not updated recommendations since 2003 (Afssaps, 2003), European elaborated by the EULAR in 2007 and those of the ACR updated in 2010. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. [Treatment of postmenopausal osteoporosis].

    PubMed

    Chapurlat, Roland; Delmas, Pierre D

    2004-12-15

    The treatment of postmenopausal osteoporosis relies on management of some risk factors for fracture, e.g., risk factors for falls, improvement of calcium and vitamin D intake, and on various medications. All elderly women with calcium and vitamin D deficiency should receive calcium and vitamin D supplements. Estrogen replacement therapy should not longer be used to prevent or treat postmenopausal osteoporosis, owing to its poor long-term risk/benefit ratio. Raloxifene, biphosphonates (alendronate, risedronate) are well tolerated compounds with proven anti-fracture efficacy. Teriparatide is a new bone forming agent to treat severe osteoporosis. Strontium ranelate is a new drug also reducing the risk of fractures that should be available soon.

  5. Restrictions in Means for Suicide: An Effective Tool in Preventing Suicide: The Danish Experience

    ERIC Educational Resources Information Center

    Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin

    2007-01-01

    Restriction of means for suicide is an important part of suicide preventive strategies in different countries. The effect on method-specific suicide rate and overall suicide rate of restrictions on availability of carbon monoxide, barbiturates, and dextropropoxyphene was examined. From 1970 to 2000, overall suicide mortality and method-specific…

  6. Restrictions in Means for Suicide: An Effective Tool in Preventing Suicide: The Danish Experience

    ERIC Educational Resources Information Center

    Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin

    2007-01-01

    Restriction of means for suicide is an important part of suicide preventive strategies in different countries. The effect on method-specific suicide rate and overall suicide rate of restrictions on availability of carbon monoxide, barbiturates, and dextropropoxyphene was examined. From 1970 to 2000, overall suicide mortality and method-specific…

  7. Transient osteoporosis.

    PubMed

    Korompilias, Anastasios V; Karantanas, Apostolos H; Lykissas, Marios G; Beris, Alexandros E

    2008-08-01

    Transient osteoporosis is characterized primarily by bone marrow edema. The disease most commonly affects the hip, knee, and ankle in middle-aged men. Its cause remains unknown. The hallmark that separates transient osteoporosis from other conditions presenting with a bone marrow edema pattern is its self-limited nature. Laboratory tests usually do not contribute to the diagnosis. Plain radiographs may reveal regional osseous demineralization. Magnetic resonance imaging is used primarily for early diagnosis and monitoring disease progression. Early differentiation from more aggressive conditions with long-term sequelae is essential to avoid unnecessary treatment. Clinical entities such as transient osteoporosis of the hip and regional migratory osteoporosis are spontaneously resolving conditions. However, early differential diagnosis and surgical treatment are crucial for the patient with osteonecrosis of the hip or knee.

  8. The Developmental Origins of Osteoporosis

    PubMed Central

    Wood, Claire L; Stenson, Charlotte; Embleton, Nicholas

    2015-01-01

    Osteoporosis is one of the most prevalent skeletal disorders and has enormous public health consequences due to the morbidity and mortality of the resulting fractures. This article discusses the developmental origins of osteoporosis and outlines some of the modifiable and non-modifiable risk factors in both intrauterine and postnatal life that contribute to the later onset of osteoporosis. Evidence for the effects of birth size and early growth in both preterm and term born infants are discussed and the role of epigenetics within the programming hypothesis is highlighted. This review provides compelling evidence for the developmental origins of osteoporosis and highlights the importance of osteoporosis prevention at all stages of the life course. PMID:27018386

  9. A cluster-randomised, controlled trial to assess the impact of a workplace osteoporosis prevention intervention on the dietary and physical activity behaviours of working women: study protocol

    PubMed Central

    2013-01-01

    Background Osteoporosis is a debilitating disease and its risk can be reduced through adequate calcium consumption and physical activity. This protocol paper describes a workplace-based intervention targeting behaviour change in premenopausal women working in sedentary occupations. Method/Design A cluster-randomised design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the clusters and units of randomisation and intervention. Sample size calculations incorporated the cluster design. Final number of clusters was determined to be 16, based on a cluster size of 20 and calcium intake parameters (effect size 250 mg, ICC 0.5 and standard deviation 290 mg) as it required the highest number of clusters. Sixteen workplaces were recruited from a pool of 97 workplaces and randomly assigned to intervention and control arms (eight in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organisation wide educational activities. Workplaces in the control/standard care arm received print resources. Intervention workshops were guided by self-efficacy theory and included participatory activities such as goal setting, problem solving, local food sampling, exercise trials, group discussion and behaviour feedback. Outcomes measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, four weeks and six months post intervention. Discussion This study addresses the current lack of evidence for behaviour change interventions focussing on osteoporosis prevention. It addresses missed opportunities of using workplaces as a platform to target high-risk individuals with sedentary occupations. The intervention was designed to modify behaviour levels to bring about risk reduction. It is the first to address dietary and physical activity components each with unique intervention

  10. "Osteoporosis and orthopods" incidences of osteoporosis in distal radius fracture from low energy trauma.

    PubMed

    Bahari, Syah; Morris, Seamus; Lenehan, Brian; McElwain, John P

    2007-07-01

    Fracture of the distal radius from low energy trauma is a common presentation to orthopaedic trauma services. This fragility type fracture is associated with underlying osteoporosis. Osteoporosis is a 'silent disease' where fragility fracture is a common presentation. Orthopaedic surgeons may be the only physician that these patients encounter. We found a high percentage of female patients who sustained a fragility fracture of the distal radius have an underlying osteoporosis. Further management of osteoporosis is important to prevent future fragility fractures.

  11. Application of the health belief model and social cognitive theory for osteoporosis preventive nutritional behaviors in a sample of Iranian women.

    PubMed

    Jeihooni, Ali Khani; Hidarnia, Alireza; Kaveh, Mohammad Hossein; Hajizadeh, Ebrahim; Askari, Alireza

    2016-01-01

    Osteoporosis is the most common metabolic bone disease. The purpose of this study is to investigate the health belief model (HBM) and social cognitive theory (SCT) for osteoporosis preventive nutritional behaviors in women. In this quasi-experimental study, 120 patients who were women and registered under the health centers in Fasa City, Fars Province, Iran were selected. A questionnaire consisting of HBM constructs and the constructs of self-regulation and social support from SCT was used to measure nutrition performance. Bone mineral density was recorded at the lumbar spine and femur. The intervention for the experimental group included 10 educational sessions of 55-60 min of speech, group discussion, questions and answers, as well as posters and educational pamphlets, film screenings, and PowerPoint displays. Data were analyzed using SPSS 19 via Chi-square test, independent t-test, and repeated measures analysis of variance (ANOVA) at a significance level of 0.05. After intervention, the experimental group showed a significant increase in the HBM constructs, self-regulation, social support, and nutrition performance, compared to the control group. Six months after the intervention, the value of lumbar spine bone mineral density (BMD) T-score increased to 0.127 in the experimental group, while it reduced to -0.043 in the control group. The value of the hip BMD T-score increased to 0.125 in the intervention group, but it decreased to -0.028 in the control group. This study showed the effectiveness of HBM and constructs of self-regulation and social support on adoption of nutrition behaviors and increase in the bone density to prevent osteoporosis.

  12. Application of the health belief model and social cognitive theory for osteoporosis preventive nutritional behaviors in a sample of Iranian women

    PubMed Central

    Jeihooni, Ali Khani; Hidarnia, Alireza; Kaveh, Mohammad Hossein; Hajizadeh, Ebrahim; Askari, Alireza

    2016-01-01

    Background: Osteoporosis is the most common metabolic bone disease. The purpose of this study is to investigate the health belief model (HBM) and social cognitive theory (SCT) for osteoporosis preventive nutritional behaviors in women. Materials and Methods: In this quasi-experimental study, 120 patients who were women and registered under the health centers in Fasa City, Fars Province, Iran were selected. A questionnaire consisting of HBM constructs and the constructs of self-regulation and social support from SCT was used to measure nutrition performance. Bone mineral density was recorded at the lumbar spine and femur. The intervention for the experimental group included 10 educational sessions of 55-60 min of speech, group discussion, questions and answers, as well as posters and educational pamphlets, film screenings, and PowerPoint displays. Data were analyzed using SPSS 19 via Chi-square test, independent t-test, and repeated measures analysis of variance (ANOVA) at a significance level of 0.05. Results: After intervention, the experimental group showed a significant increase in the HBM constructs, self-regulation, social support, and nutrition performance, compared to the control group. Six months after the intervention, the value of lumbar spine bone mineral density (BMD) T-score increased to 0.127 in the experimental group, while it reduced to −0.043 in the control group. The value of the hip BMD T-score increased to 0.125 in the intervention group, but it decreased to −0.028 in the control group. Conclusions: This study showed the effectiveness of HBM and constructs of self-regulation and social support on adoption of nutrition behaviors and increase in the bone density to prevent osteoporosis. PMID:27095985

  13. MALE OSTEOPOROSIS

    PubMed Central

    Oliveira, Lindomar Guimarães; Guimarães, Mara Lucia Rassi

    2015-01-01

    ABSTRACT Population aging is a reality that is being faced worldwide, and Brazil is no different. Osteoporosis was considered to be a postmenopausal women's disease for many years. Men have many development and hormonal factors that differentiate their skeletal maturation, which affects the incidence of osteoporosis and fractures. An up-to-date review of the specific literature within the Medline system is presented. PMID:27022584

  14. What Is Osteoporosis?

    MedlinePlus

    ... your browser. Home Osteoporosis Osteoporosis Basics What Is Osteoporosis? Fast Facts: An Easy-to-Read Series of ... in the hip, spine, and wrist. Who Gets Osteoporosis? In the United States, millions of people either ...

  15. Osteoporosis screening in postmenopausal women 50 to 64 years old: comparison of US Preventive Services Task Force strategy and two traditional strategies in the Women's Health Initiative.

    PubMed

    Crandall, Carolyn J; Larson, Joseph; Gourlay, Margaret L; Donaldson, Meghan G; LaCroix, Andrea; Cauley, Jane A; Wactawski-Wende, Jean; Gass, Margery L; Robbins, John A; Watts, Nelson B; Ensrud, Kristine E

    2014-07-01

    The US Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women younger than 65 years whose 10-year predicted risk of major osteoporotic fracture is ≥ 9.3%. For identifying screening candidates among women aged 50 to 64 years, it is uncertain how the USPSTF strategy compares with the Osteoporosis Self-Assessment Tool (OST) and the Simple Calculated Osteoporosis Risk Estimate (SCORE). We examined data (1994 to 2012) from 5165 Women's Health Initiative participants aged 50 to 64 years. For the USPSTF (Fracture Risk Assessment Tool [FRAX] major fracture risk ≥ 9.3% calculated without bone mineral density [BMD]), OST (score <2), and SCORE (score >7) strategies, we assessed sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) to discriminate between those with and without femoral neck (FN) T-score ≤-2.5. Sensitivity, specificity, and AUC for identifying FN T-score ≤-2.5 were 34.1%, 85.8%, and 0.60 for USPSTF (FRAX); 74.0%, 70.8%, and 0.72 for SCORE; and 79.8%, 66.3%, and 0.73 for OST. The USPSTF strategy identified about one-third of women aged 50 to 64 years with FN T-scores ≤-2.5. Among women aged 50 to 64 years, the USPSTF strategy was modestly better than chance alone and inferior to conventional SCORE and OST strategies in discriminating between women with and without FN T-score ≤-2.5.

  16. [Osteoporosis and intake of vitamins].

    PubMed

    Hirota, Takako; Hirota, Kenji

    2005-05-01

    Subclinical vitamins deficiency is common in the elderly, especially in osteoporotic patients. However, most physicians in this area are just focused on drugs for the treatment of osteoporosis. It is already established that several vitamins influence bone turnover, bone mineral density, or even the risk of hip fractures. Improving these vitamins status may help to treat and prevent osteoporosis in elderly people. Recently higher vitamin D intake is recognized to be needed to keep not only bone health but also muscle strength. More sun exposure might be needed for improved bone health in the elderly. Deficiency of Vitamin K, C, or B(12) may be also important modifiable risk factors for osteoporosis and bone fracture. Excessive retinal supplementation may become associated with higher bone loss. Thus such diet rich in fruit and vegetables together with fish and meat could fulfill a balance among these vitamins and should be recommended for prevention or treatment of osteoporosis.

  17. Implementation of an occupational skin disease prevention programme in Danish cheese dairies.

    PubMed

    Sell, Lea; Flyvholm, Mari-Ann; Lindhard, Gitte; Mygind, Karen

    2005-09-01

    The purpose of this study was to implement an evidence-based prevention programme to reduce occupational skin diseases in a wet work occupation by educational activities and elements from an occupational health-management system. The effects were studied by telephone interviews using a standardized questionnaire (NOSQ-2002) with trade-modified questions on work and exposure. The study population consisted of all employees at 5 cheese dairies. At baseline, October 2002, a total of 557 answered (83.8%). At follow up 1 year later, a total of 650 current and former employees answered (81.8%). At 4 of the 5 dairies, the eczema frequency at baseline was relatively low (11.8% and 5.9% at intervention dairies; 7.0%, 10.4% and 33.3% at comparison dairies). On all the studied dairies, about one-third of the workers reported having 2 or more skin symptoms at baseline. At follow up, skin symptoms were reduced significantly on all dairies. Effects restricted to the intervention dairies included significant increases in the use of gloves and moisturizers. The comparison dairy with high eczema frequency at baseline introduced skin-care products, changed hand soap and mowed employees with skin problems, away from adverse working areas during the intervention period, and the frequency of eczema was significantly reduced at follow up.

  18. Premenopausal Osteoporosis.

    PubMed

    Cohen, Adi

    2017-03-01

    Most premenopausal women with low trauma fracture(s) or low bone mineral density have a secondary cause of osteoporosis or bone loss. Where possible, treatment of the underlying cause should be the focus of management. Premenopausal women with an ongoing cause of bone loss and those who have had, or continue to have, low trauma fractures may require pharmacologic intervention. Clinical trials provide evidence of benefits of bisphosphonates and teriparatide for bone mineral density in several types of premenopausal osteoporosis, but studies are small and do not provide evidence regarding fracture risk reduction.

  19. Electroacupuncture stimulation at CV4 prevents ovariectomy-induced osteoporosis in rats via Wnt-β-catenin signaling

    PubMed Central

    FAN, HUAILING; JI, FENG; LIN, YING; ZHANG, MULAN; QIN, WEI; ZHOU, QI; WU, QIANG

    2016-01-01

    The present study aimed to investigate the effect of electroacupuncture stimulation at CV4 (also termed Guanyuan) on femoral osteocalcin also termed bone gla protein (BGP), alkaline phosphatase (ALP), bone mineral density (BMD) and biomechanics, as well as the Wnt-β-catenin signaling pathway in rats with postmenopausal osteoporosis. Female Sprague-Dawley rats (4.5-months old) were randomly divided into sham, Ovx, CV4 and mock groups (n=10/group). With the exception of those in the sham group, the rats were ovariectomized to induce postmenopausal osteoporosis. The rats in the CV4 and mock groups were given electroacupuncture at CV4 and non-acupoint, respectively. The rats in the Ovx model and sham groups underwent identical fixing procedures, but did not undergo electroacupuncture. Following treatment, hematoxylin and eosin staining was used to observe morphological changes in the left femoral trabecular bone, and a three-point-bending test was used to analyze femur biomechanics and determine the BMD. In addition, an enzyme-linked immunosorbent assay was used to measure the serum levels of ALP/BGP and reverse transcription-quantitative polymerase chain reaction was used detect the expression levels of Wnt3a, β-catenin and Runx2. In the present study, it was demonstrated that electroacupuncture at CV4 significantly improved the osteoporotic morphological changes that occurred in the ovariectomized rats, increased serum ALP and BGP levels, enhanced the maximum and fracture loads, increased BMD (P<0.01), and activated the Wnt-β-catenin signaling pathway. These findings demonstrated that electroacupuncture stimulation at CV4 affected bone formation and promoted bone metabolism in rats with postmenopausal osteoporosis, possibly by activating the Wnt-β-catenin signaling pathway. PMID:26846191

  20. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

    PubMed Central

    Watanabe, Reiko; Inoue, Daisuke

    2016-01-01

    Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients. PMID:27622174

  1. Management of postmenopausal osteoporosis.

    PubMed

    Andreopoulou, Panagiota; Bockman, Richard S

    2015-01-01

    A hallmark of menopause, which follows the decline in the ovarian production of estrogen, is the aggressive and persistent loss of bone mineral and structural elements leading to loss of bone strength and increased fracture risk. This review focuses on newer methods of diagnosing osteoporosis and assessing fracture risk, as well as on novel management strategies for prevention and treatment. Fracture-risk prediction has been significantly enhanced by the development of methods such as the trabecular bone score, which helps assess bone microarchitecture and adds value to standard bone densitometry, and the Fracture Risk Assessment Tool (FRAX) algorithm techniques. The treatment of osteoporosis, which has the goals of fracture prevention and risk reduction, is moving beyond traditional monotherapies with antiresorptives and anabolic agents into new combination regimens.

  2. Osteoporosis in childhood.

    PubMed

    Vierucci, Francesco; Saggese, Giuseppe; Cimaz, Rolando

    2017-09-01

    The aim of this review is to highlight recent findings in prevention, diagnosis, and treatment of pediatric osteoporosis. Several genes are involved in bone mass acquisition, and various monogenic bone disorders characterized by reduced bone mineral density and increased bone fragility have been recently described. Moreover, many chronic diseases and/or their treatment have been associated with impaired bone mass acquisition. Pediatric osteoporosis should be adequately suspected and properly diagnosed in children at risk of fractures. Particularly, detection of vertebral fracture allows the diagnosis regardless of densitometric evaluation. Dual X-ray absorptiometry remains the most widely used densitometric technique in childhood, but interpretation of results should be made with caution because of different confounding factors. Bisphosphonates represent one of the main medical treatments of pediatric osteoporosis, and many different protocols have been proposed. Bisphosphonates administration should be characterized by a first phase, followed by a period of maintenance. Optimal route of administration, duration of therapy, and long-term safety of bisphosphonates treatment require further investigation. Careful monitoring of children at risk of fractures is essential to pose early diagnosis of osteoporosis. In children with persistent risk factors and reduced probability of spontaneous recovery, medical treatment with bisphosphonates should be considered.

  3. Animal models for osteoporosis

    NASA Technical Reports Server (NTRS)

    Turner, R. T.; Maran, A.; Lotinun, S.; Hefferan, T.; Evans, G. L.; Zhang, M.; Sibonga, J. D.

    2001-01-01

    Animal models will continue to be important tools in the quest to understand the contribution of specific genes to establishment of peak bone mass and optimal bone architecture, as well as the genetic basis for a predisposition toward accelerated bone loss in the presence of co-morbidity factors such as estrogen deficiency. Existing animal models will continue to be useful for modeling changes in bone metabolism and architecture induced by well-defined local and systemic factors. However, there is a critical unfulfilled need to develop and validate better animal models to allow fruitful investigation of the interaction of the multitude of factors which precipitate senile osteoporosis. Well characterized and validated animal models that can be recommended for investigation of the etiology, prevention and treatment of several forms of osteoporosis have been listed in Table 1. Also listed are models which are provisionally recommended. These latter models have potential but are inadequately characterized, deviate significantly from the human response, require careful choice of strain or age, or are not practical for most investigators to adopt. It cannot be stressed strongly enough that the enormous potential of laboratory animals as models for osteoporosis can only be realized if great care is taken in the choice of an appropriate species, age, experimental design, and measurements. Poor choices will results in misinterpretation of results which ultimately can bring harm to patients who suffer from osteoporosis by delaying advancement of knowledge.

  4. Animal models for osteoporosis

    NASA Technical Reports Server (NTRS)

    Turner, R. T.; Maran, A.; Lotinun, S.; Hefferan, T.; Evans, G. L.; Zhang, M.; Sibonga, J. D.

    2001-01-01

    Animal models will continue to be important tools in the quest to understand the contribution of specific genes to establishment of peak bone mass and optimal bone architecture, as well as the genetic basis for a predisposition toward accelerated bone loss in the presence of co-morbidity factors such as estrogen deficiency. Existing animal models will continue to be useful for modeling changes in bone metabolism and architecture induced by well-defined local and systemic factors. However, there is a critical unfulfilled need to develop and validate better animal models to allow fruitful investigation of the interaction of the multitude of factors which precipitate senile osteoporosis. Well characterized and validated animal models that can be recommended for investigation of the etiology, prevention and treatment of several forms of osteoporosis have been listed in Table 1. Also listed are models which are provisionally recommended. These latter models have potential but are inadequately characterized, deviate significantly from the human response, require careful choice of strain or age, or are not practical for most investigators to adopt. It cannot be stressed strongly enough that the enormous potential of laboratory animals as models for osteoporosis can only be realized if great care is taken in the choice of an appropriate species, age, experimental design, and measurements. Poor choices will results in misinterpretation of results which ultimately can bring harm to patients who suffer from osteoporosis by delaying advancement of knowledge.

  5. Pharmacogenomics in osteoporosis: Steps toward personalized medicine.

    PubMed

    Greene, Robert; Mousa, Shaymaa S; Ardawi, Mohamed; Qari, Mohamed; Mousa, Shaker A

    2009-01-01

    Osteoporosis is a complicated and preventable disease with major morbidity complications that affects millions of people. In the last 15 years, there have been numerous studies and research in the new fields of pharmacogenetics and pharmacogenomics related to osteoporosis. Numerous "candidate genes" have been identified and have been found to be associated with osteoporosis as well as the treatment of osteoporosis. Many studies have found conflicting results on different polymorphisms and whether or not they are related to bone mineral density and osteoporosis. There is a need for larger and better designed pharmacogenomic studies related to osteoporosis incorporating a greater variety of candidate genes. The evaluation of osteoporosis and fracture risk is moving from a risk stratification approach to a more individualized approach, in which an individual's absolute risk of fracture is evaluable as a constellation of the individual's environmental exposure and genetic makeup. Therefore, the identification of gene variants associated with osteoporosis phenotypes or response to therapy might help individualize the prognosis, treatment, and prevention of fracture. This review focuses on major candidate genes and what needs to be done to take the genetics of osteoporosis and incorporate them into the pharmacogenomics of the management of osteoporosis.

  6. Pharmacogenomics in osteoporosis: Steps toward personalized medicine

    PubMed Central

    Greene, Robert; Mousa, Shaymaa S; Ardawi, Mohamed; Qari, Mohamed; Mousa, Shaker A

    2009-01-01

    Osteoporosis is a complicated and preventable disease with major morbidity complications that affects millions of people. In the last 15 years, there have been numerous studies and research in the new fields of pharmacogenetics and pharmacogenomics related to osteoporosis. Numerous “candidate genes” have been identified and have been found to be associated with osteoporosis as well as the treatment of osteoporosis. Many studies have found conflicting results on different polymorphisms and whether or not they are related to bone mineral density and osteoporosis. There is a need for larger and better designed pharmacogenomic studies related to osteoporosis incorporating a greater variety of candidate genes. The evaluation of osteoporosis and fracture risk is moving from a risk stratification approach to a more individualized approach, in which an individual’s absolute risk of fracture is evaluable as a constellation of the individual’s environmental exposure and genetic makeup. Therefore, the identification of gene variants associated with osteoporosis phenotypes or response to therapy might help individualize the prognosis, treatment, and prevention of fracture. This review focuses on major candidate genes and what needs to be done to take the genetics of osteoporosis and incorporate them into the pharmacogenomics of the management of osteoporosis. PMID:23226036

  7. Recognizing and treating secondary osteoporosis.

    PubMed

    Walker-Bone, Karen

    2012-08-01

    Osteoporosis, through its association with fragility fracture, is a major public health problem, costing an estimated $34.8 billion worldwide per annum. With projected demographic changes, the burden looks set to grow. Therefore, the prevention of osteoporosis, as well as its identification and treatment once established, are becoming increasingly important. Osteoporosis is secondary when a drug, disease or deficiency is the underlying cause. Glucocorticoids, hypogonadism, alcohol abuse and malnutrition are among the most frequently recognized causes of secondary osteoporosis but the list of implicated diseases and drugs is growing and some of the more recently recognized associations, such as those with haematological conditions and acid-suppressing medications, are less well publicized. In some cases, advancement in treatment of the primary disease has led to people living long enough to develop secondary osteoporosis; for example, successful treatment for breast and prostate malignancies by hormonal manipulation, improved survival in HIV with the advent of anti-retroviral therapies, and improved treatment for cystic fibrosis. This Review emphasizes the importance of secondary osteoporosis, discusses familiar and less well-known causes and what is known of their mechanisms, provides guidance as to the pragmatic identification of secondary osteoporosis and summarizes treatment options, where available.

  8. Osteoporosis and jawbones in women.

    PubMed

    Gulsahi, Ayse

    2015-01-01

    Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.

  9. [Osteoporosis associated with spinal cord lesion].

    PubMed

    Miladinović, Ksenija; Vavra-Hadziahmetović, Narcisa; Muftić, Mirsad; Sakota, Slavica

    2007-01-01

    One of the complications caused by spinal lesion is osteoporosis which development is induced by lesion itself, and its mechanism is not explained enough. Risk factor of this kind of osteoporosis is fracture which management is difficult and is cause of further complications which aggravate already damaged quality of life of patients with spinal cord injury, and demand additional health insurance expenses. Importance of prevention and treatment of spinal cord injury induced osteoporosis is enlightened by case report.

  10. Sustained efficacy and safety of bazedoxifene in preventing fractures in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled study.

    PubMed

    Silverman, S L; Chines, A A; Kendler, D L; Kung, A W C; Teglbjærg, C S; Felsenberg, D; Mairon, N; Constantine, G D; Adachi, J D

    2012-01-01

    In this 2-year extension of a 3-year study, bazedoxifene showed sustained efficacy in preventing new vertebral fractures in postmenopausal women with osteoporosis and in preventing non-vertebral fractures in higher-risk women. Bazedoxifene significantly increased bone mineral density and reduced bone turnover versus placebo and was generally safe and well tolerated. This study evaluated the efficacy and safety of bazedoxifene for the treatment of postmenopausal osteoporosis over 5 years. A total of 4,216 postmenopausal women with osteoporosis were enrolled in this 2-year extension of a 3-year, randomized, double-blind, placebo-controlled, phase 3 trial. In the core study (N = 7,492), subjects received bazedoxifene 20 or 40 mg/day, raloxifene 60 mg/day, or placebo. The raloxifene arm was discontinued after 3 years; subjects receiving bazedoxifene 40 mg were transitioned to bazedoxifene 20 mg after 4 years. Five-year findings are reported for bazedoxifene 20 and 40/20 mg and placebo. Endpoints included incidence of new vertebral fractures (primary) and non-vertebral fractures, and changes in bone mineral density (BMD) and bone turnover markers. At 5 years, the incidence of new vertebral fractures in the intent-to-treat population was significantly lower with bazedoxifene 20 mg (4.5%) and 40/20 mg (3.9%) versus placebo (6.8%; P < 0.05), with relative risk reductions of 35% and 40%, respectively. Non-vertebral fracture incidence was similar among groups. In a subgroup of higher-risk women (n = 1,324; femoral neck T-score ≤-3.0 and/or ≥ 1 moderate or severe or ≥ 2 mild vertebral fracture[s]), bazedoxifene 20 mg reduced non-vertebral fracture risk versus placebo (37%; P = 0.06); combined data for bazedoxifene 20 and 40/20 mg reached statistical significance (34% reduction; P < 0.05). Bazedoxifene significantly increased BMD and reduced bone turnover versus placebo (P < 0.05) and was generally safe and well tolerated. The findings support a sustained anti

  11. Effect of distributing an evidence-based guideline for prevention of osteoporosis on health education programs in municipal health centers: a randomized controlled trial.

    PubMed

    Nakatani, Yoshimi; Tamaki, Junko; Komatsu, Misa; Iki, Masayuki; Kajita, Etsuko

    2012-01-01

    Current health education programs for osteoporosis prevention are not strictly evidence-based. We assessed whether distribution of an evidence-based guideline improved such programs at municipal health centers. This randomized controlled trial evaluated 100 municipal health centers throughout Japan that were randomly selected from those that planned to revise osteoporosis prevention programs. The implementation status of educational items recommended by the guideline was assessed before and after the intervention by evaluators blinded to the allocation. After the pre-intervention assessment, centers were randomly allocated in a 1:1 ratio to intervention and control groups by a minimization method defining region and city/town as stratification factors. Centers in the intervention group were given copies of the guideline; centers in the control group were instructed to use any information except the guideline. Analyses were performed on an intention-to-treat basis. The guideline was used by 50% of the intervention group. Before the intervention, there was no significant difference in the evidence-based status of health education between the groups. The post-intervention assessment showed that the implementation rates of health education on dietary calcium intake for postmenopausal women and exercise for elderly persons were higher in the intervention group. Specific advice on intakes of calcium and vitamin D and exercise became more evidence-based in the intervention group. The findings suggest that the guideline helped healthcare professionals to improve health education programs by making them more evidence-based. However, the improvements seemed to be limited to items that the professionals felt prepared to improve.

  12. [A guide for osteoporosis management].

    PubMed

    Zárate, Arturo; Saucedo, Renata; Basurto, Lourdes

    2004-01-01

    Osteoporosis has to be considered only as a risk factor for bone fractures and its measurement by the bone mass index has some limitations. The aim of treatment of osteoporosis is to reduce the frequency of fractures (especially at the vertebral and the hip) which are responsible for morbidity and mortality with the osteoporosis. It has been demonstrated that antiresorptive drugs (bisphosphonates, estrogens, raloxifen) as well as anabolic agents (synthetic parathormone) are useful for preventing fractures. Calcium and vitamin D supplementation is not sufficient to treat persons with osteoporosis. Choice of treatment depends of age, the presence or absence of prevalent fractures, and the degree of bone mineral density measured at the spine and hip. The main inconvenient for the adherence of treatment is the high cost of the medicaments and agents as well as the poor information given to the patients.

  13. Osteopenia and osteoporosis in children.

    PubMed

    Cassidy, J T

    1999-01-01

    The purpose of this paper is to review the normal physiologic processes of skeletal accretion, abnormalities that may occur in children with chronic illnesses, and therapeutic maneuvers that the clinician may be able to employ to prevent or partially correct abnormalities of skeletal growth. Skeletal maturation in children is dependent upon bone formation exceeding resorption, whereas in adults these two fundamental processes of homeostasis are closely balanced. Skeletal growth is effectively completed at the end of the period of adolescent growth acceleration with closure of the epiphyses. An important determinant of future fracture risk and osteoporosis is the peak bone mass achieved during this second decade of life. If the hereditarily determined peak bone mass is not established during that time, the patient will enter young adulthood with osteopenia, an increased fracture risk, and accelerated postmenopausal osteoporosis or involutional osteoporosis. Thus osteopenia and osteoporosis have their origins in childhood and adolescence.

  14. Management of osteoporosis.

    PubMed

    Lewiecki, E Michael

    2004-07-14

    Osteoporosis or osteopenia occurs in about 44 million Americans, resulting in 1.5 million fragility fractures per year. The consequences of these fractures include pain, disability, depression, loss of independence, and increased mortality. The burden to the healthcare system, in terms of cost and resources, is tremendous, with an estimated direct annual USA healthcare expenditure of about $17 billion. With longer life expectancy and the aging of the baby-boomer generation, the number of men and women with osteoporosis or low bone density is expected to rise to over 61 million by 2020. Osteoporosis is a silent disease that causes no symptoms until a fracture occurs. Any fragility fracture greatly increases the risk of future fractures. Most patients with osteoporosis are not being diagnosed or treated. Even those with previous fractures, who are at extremely high risk of future fractures, are often not being treated. It is preferable to diagnose osteoporosis by bone density testing of high risk individuals before the first fracture occurs. If osteoporosis or low bone density is identified, evaluation for contributing factors should be considered. Patients on long-term glucocorticoid therapy are at especially high risk for developing osteoporosis, and may sustain fractures at a lower bone density than those not taking glucocorticoids. All patients should be counseled on the importance of regular weight-bearing exercise and adequate daily intake of calcium and vitamin D. Exposure to medications that cause drowsiness or hypotension should be minimized. Non-pharmacologic therapy to reduce the non-skeletal risk factors for fracture should be considered. These include fall prevention through balance training and muscle strengthening, removal of fall hazards at home, and wearing hip protectors if the risk of falling remains high. Pharmacologic therapy can stabilize or increase bone density in most patients, and reduce fracture risk by about 50%. By selecting high risk

  15. Overview of osteoporosis.

    PubMed Central

    Riggs, B. L.

    1991-01-01

    Osteoporosis is a common age-related disorder manifested clinically by skeletal fractures, especially fractures of the vertebrae, hip, and distal forearm. The major cause of these fractures is low bone mass, although an increase in trauma due to falls in the elderly also contributes. There are multiple causes for the low bone mass which, in any given individual, may contribute differently to the development of the osteopenia. The most important groups of causes are failure to achieve adequate peak bone mass, slow bone loss due to processes relating to aging, the menopause in women, and a variety of sporadic behavioral, nutritional, and environmental factors that affect bone mass in some but not in other individuals. The most important approach is prevention. Drugs and behavioral factors known to cause bone loss should be eliminated and perimenopausal women should be evaluated for possible preventive administration of estrogen. For patients with fractures due to established osteoporosis, the only drugs approved by the Food and Drug Administration are the antiresorptive agents calcium, estrogen, and calcitonin. Formation-stimulating regimens, however, are being developed and may be available for clinical use in the foreseeable future. These regimens may be capable of increasing bone mass to above the fracture threshold, thereby resulting in a clinical cure of the osteoporosis. Images PMID:2024511

  16. Osteoporosis and Hispanic Women

    MedlinePlus

    ... not supported by your browser. Home Osteoporosis Women Osteoporosis and Hispanic Women Publication available in: PDF (54 KB) Related Resources Women Fitness: Overtraining Risks Pregnancy, Nursing and Bone Health Osteoporosis and African American ...

  17. Breastfeeding and postmenopausal osteoporosis.

    PubMed

    Grimes, Julia P; Wimalawansa, Sunil J

    2003-06-01

    Bone loss associated with osteoporosis occurs with high frequency among the elderly and often results in debilitating fractures. A combination of lifestyle behaviors, genetic predisposition, and disease processes contributes to bone metabolism. Therefore, any discussion regarding bone health must address these factors. The impact of menopause on bone turnover has been generally well studied and characterized. Breastfeeding places significant stress on calcium metabolism and, as a consequence, directly influences bone metabolism. The most significant factors affecting bone mineral density (BMD) and bone metabolism are the duration and frequency of lactation, the return of menses, and pre-pregnancy weight. Although transient, lactation is associated with bone loss. As clinical guidelines and public health policies are being formulated, there is a compelling need for further investigation into the relationship of lactation, BMD, and subsequent risk of osteoporosis. Better understanding of this relationship will provide new opportunities for early intervention and ultimately help in the prevention of bone loss in postmenopausal women.

  18. Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.

    PubMed

    Mayoux-Benhamou, M A; Roux, C; Perraud, A; Fermanian, J; Rahali-Kachlouf, H; Revel, M

    2005-03-01

    This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score < or =-2.5, predicted compliance (OR=0.34; 95% CI, 0.10 to 1.16). Despite the addition of an educational session to usual medical care to inform participants about the benefits of exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.

  19. Compliance to The Joint Commission proposed Core Measure set on osteoporosis-associated fracture: review of different secondary fracture prevention programs in an open medical system from 2010 to 2015.

    PubMed

    Fojas, Ma Conchitina; Southerland, Lauren T; Phieffer, Laura S; Stephens, Julie A; Srivastava, Tanya; Ing, Steven W

    2017-12-01

    There are care gaps in the evaluation and treatment of osteoporosis after a fragility fracture. The Joint Commission is considering adoption of core measures. We compared compliance between two secondary fracture prevention programs in our institution. Incorporating strengths of both may provide the best outcomes for secondary fracture prevention. There are significant care gaps in the evaluation and treatment of osteoporosis after occurrence of fragility fracture. The Joint Commission is considering adoption of a core measure set on osteoporosis-associated fractures, including laboratory assessment, bone density testing, and osteoporosis pharmacologic therapy. We compared compliance to these proposed measures between two secondary fracture prevention programs in patients hospitalized for acute fracture in an open medical system. We conducted a retrospective, single center medical records review of a nurse practitioner-led Fracture Liaison Service (FLS), a physician-led Fracture Prevention Program (FPP), and a historical time without any secondary fracture prevention program (Usual Care) for baseline care. Primary outcomes were the completion of five laboratory tests (calcium, 25-hydroxy vitamin D, renal function, liver function, and complete blood count), order placement and completion of dual x-ray absorptiometry (DXA) scan within 3 months, prescription of osteoporosis medication within 3 months, and medication adherence at 6 months after hospital discharge. Completion of all five laboratory tests was higher in FPP versus FLS (84.7 vs. 36.9%, p < 0.001). DXA scan completion was higher in FPP than FLS but not statistically significant (66.7 vs. 54.9%, p = 0.11). Medication prescription at 3 months and adherence at 6 months were significantly higher in FPP versus FLS (65.3 vs. 24.0%, p < 0.001 and 70.8 vs. 27.7%, p < 0.001, respectively). Incorporating strengths of both FLS (care coordination) and FPP (physician direction) may provide the best outcomes

  20. Balance control in elderly people with osteoporosis.

    PubMed

    Hsu, Wei-Li; Chen, Chao-Yin; Tsauo, Jau-Yih; Yang, Rong-Sen

    2014-06-01

    Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population. Copyright © 2014. Published by Elsevier B.V.

  1. Osteoporosis in Parkinson's disease.

    PubMed

    Invernizzi, Marco; Carda, Stefano; Viscontini, Giovanni Sguazzini; Cisari, Carlo

    2009-06-01

    Patients affected by Parkinson's disease are at a high risk for fractures, mainly of the hip. These fractures are caused by falls due to postural imbalance, neurological impairment and reduced bone mass. The purpose of this study was (1) to investigate the correlations and the pathophysiological mechanisms underlying bone loss in Parkinson's disease and appraise bone loss or fracture risk reduction interventions; (2) to develop a research agenda that informs the design and development of risk reduction strategies. Osteoporosis and osteopenia are very common findings in patients with Parkinson's disease, affecting up to 91% of women and 61% of men. Reduced bone mass in Parkinsonian patients seems to be caused mainly by reduced mobility through a mechanism similar to that observed in other neurological diseases. Endocrine (such as vitamin D deficiency), nutritional and iatrogenic factors also play an important role in bone mass depletion. Female gender, disease duration and severity (Hoehn and Yahr stages III and IV), old age and low body mass index are related to more severe osteoporosis. Vitamin D supplementation and bisphosphonates seem to be effective in reducing the risk of nonvertebral fractures in patients affected by Parkinson's disease. Prevention and evaluation of osteoporosis through bone mass density assessment should be considered in all patients with Parkinson's disease.

  2. Oxygen ultra-fine bubbles water administration prevents bone loss of glucocorticoid-induced osteoporosis in mice by suppressing osteoclast differentiation.

    PubMed

    Noguchi, T; Ebina, K; Hirao, M; Morimoto, T; Koizumi, K; Kitaguchi, K; Matsuoka, H; Iwahashi, T; Yoshikawa, H

    2017-03-01

    Oxygen ultra-fine bubbles (OUB) saline injection prevents bone loss of glucocorti\\coid-induced osteoporosis in mice, and OUB inhibit osteoclastogenesis via RANK-TRAF6-c-Fos-NFATc1 signaling and RANK-p38 MAPK signaling in vitro. Ultra-fine bubbles (<200 nm in diameter) have several unique properties, and they are tested in various medical fields. The purpose of this study was to investigate the effects of oxygen ultra-fine bubbles (OUB) on glucocorticoid-induced osteoporosis (GIO) model mice. Prednisolone (PSL, 5 mg) was subcutaneously inserted in 6-month-old male C57BL/6J mice, and 200 μl of saline, OUB-diluted saline, or nitrogen ultra-fine bubbles (NUB)-diluted saline was intraperitoneally injected three times per week for 8 weeks the day after operations. Mice were divided into four groups; (1) control, sham-operation + saline; (2) GIO, PSL + saline; (3) GIO + OUB, PSL + OUB saline; (4) GIO + NUB, PSL + NUB saline. The effects of OUB on osteoblasts and osteoclasts were examined by serially diluted OUB medium in vitro. Bone mass was significantly decreased in GIO [bone volume/total volume (%): control vs. GIO 12.6 vs. 7.9; p < 0.01] while significantly preserved in GIO + OUB (GIO vs. GIO + OUB 7.9 vs. 12.9; p < 0.05). In addition, tartrate-resistant acid phosphatase (TRAP)-positive cells in the distal femur [mean osteoclasts number/bone surface (mm(-1))] was significantly increased in GIO (control vs. GIO 6.8 vs. 11.6; p < 0.01) while suppressed in GIO + OUB (GIO vs. GIO + OUB 11.6 vs. 7.5; p < 0.01). NUB did not affect these parameters. In vitro experiments revealed that OUB significantly inhibited osteoclastogenesis by inhibiting RANK-TRAF6-c-Fos-NFATc1 signaling, RANK-p38 MAPK signaling, and TRAP/Cathepsin K/DC-STAMP mRNA expression in a concentration-dependent manner. OUB did not affect osteoblastogenesis in vitro. OUB prevent bone loss in GIO mice by inhibiting osteoclastogenesis.

  3. Effect of Low-Magnitude Whole-Body Vibration Combined with Alendronate in Ovariectomized Rats: A Random Controlled Osteoporosis Prevention Study

    PubMed Central

    Zhong, Zhao-Ming; Wu, Xiu-Hua; Huang, Zhi-Ping; Li, Wei; Ding, Ruo-Ting; Yu, Hui; Chen, Jian-Ting

    2014-01-01

    Background Alendronate (ALE) is a conventional drug used to treat osteoporosis. Low-magnitude whole-body vibration (WBV) exercise has been developed as a potential treatment for osteoporosis. The aim of this study was to investigate whether low-magnitude WBV could enhance the protective effect of ALE on bone properties in ovariectomized rats. Methods A total of 128 Sprague-Dawley rats were randomly divided into five groups (SHAM, OVX+VEH, OVX+WBV, OVX + ALE, OVX+WBV+ALE). The level of WBV applied was 0.3 g at 45–55 Hz for 20 min/day, 5 day/week and for 3 months. ALE was administered in dose of 1 mg/Kg once a week. Every four weeks eight rats from each group were sacrificed and their blood and both tibiae were harvested. The expression of osteocalcin and CTX in serum was measured by enzyme-linked immunosorbent assay (ELISA) and the tibiae were subjected to metaphyseal three-point bending and μCT analysis. Results Osteocalcin rose after ovariectomy and was not appreciably changed by either alendronate or WBV alone or in combination. Alendronate treatment significantly prevented an increase in CTX. WBV alone treatment did not alter this effect. Compared with the OVX+WBV group, nearly all tested indices such as the BV/TV, TV apparent, Tb.N, Tb.Th, and Conn.D were higher in the OVX+ALE group at week 12.Compared with the OVX+WBV group, certain tested indices such as BV/TV, TV apparent, Tb.N, and Con.D, were higher in the OVX+WBV+ALE group at week 12. At week 12, tibiae treated with WBV+ALE exhibited a significantly higher Fmax compared to the OVX+VEH group, and a significant difference was also found in energy absorption between the OVX+WBV+ALE and OVX+VEH groups. Conclusions Compared with the WBV, ALE was more effective at preventing bone loss and improved the trabecular architecture. However, WBV enhanced the effect of alendronate in ovariectomized rats by inducing further improvements in trabecular architecture. PMID:24796785

  4. Denosumab for the management of postmenopausal osteoporosis.

    PubMed

    Singer, Andrea; Grauer, Andreas

    2010-11-01

    View the National Osteoporosis Foundation Clinician's Guide Postmenopausal osteoporosis is a major concern to public health. Fractures are the major clinical consequence of osteoporosis and are associated with substantial morbidity, mortality, and health care costs. Despite the availability of screening and treatment guidelines, osteoporosis diagnosis and treatment remain low. Health care providers may consult guidelines in the clinical management of their patients with osteoporosis, including those from the National Osteoporosis Foundation, and the new fracture risk assessment tool from the World Health Organization. Bisphosphonates are the most commonly used treatment for postmenopausal osteoporosis. Although these agents are effective in preventing fractures and bone loss, the benefits of treatment may be limited by suboptimal adherence and compliance. Denosumab is a human monoclonal antibody that targets and inhibits RANK ligand, an essential mediator of bone resorption. In clinical trials in postmenopausal women with osteoporosis, denosumab 60 mg given subcutaneously every 6 months was well tolerated and statistically significantly reduced the risk of vertebral, nonvertebral, and hip fractures. The introduction of denosumab into clinical practice provides physicians with another option for the treatment of postmenopausal osteoporosis, and the twice-yearly dosing regimen has the potential to improve adherence.

  5. The use of guideline recommended beta-blocker therapy in primary prevention implantable cardioverter defibrillator patients: insight from Danish nationwide registers.

    PubMed

    Ruwald, Anne-Christine; Gislason, Gunnar Hilmar; Vinther, Michael; Johansen, Jens Brock; Nielsen, Jens Cosedis; Petersen, Helen Høgh; Torp-Pedersen, Christian; Riahi, Sam; Jøns, Christian

    2017-02-20

    We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. From the Danish Pacemaker and ICD Registry we identified all 1st-time primary prevention ICD and cardiac resynchronization therapy defibrillator (CRT-D) implantations in Denmark from 2007-12 (n = 2935). Use of beta-blocker, type and dose was acquired through the Danish Prescription Registry. According to guideline recommendations, we defined target daily doses as ≥50 mg carvedilol and ≥200 mg metoprolol. Prior to implantation 2427 of 2935 (83%) patients received beta-blocker therapy, with 2166 patients (89%) having initiated treatment 3 months or more prior to implantation. The majority of patients was prescribed carvedilol (52%) or metoprolol (41%). Patients on carvedilol reached target dosages more frequently than patients on metoprolol, with 39% of patients on carvedilol and 26% of patients on metoprolol at the time of implantation (P < 0.001 for all time-points). Increase in proportion of patients reaching target daily doses was observed for both carvedilol and metoprolol after ICD implantation. Carvedilol treatment was a strong predictor for being on target dose of BB at time of implant, as was treatment with angiotensin-converting enzyme inhibitors and/or spironolactone, no history of myocardial infarction, younger age and less pronounced heart failure symptoms. In a real-life setting of primary prevention ICD patients, 39% and 26% of patients were titrated to optimal target dose of carvedilol or metoprolol prior to implantation. A higher proportion of patients on carvedilol reached target dose, as compared with metoprolol.

  6. Research Advances: Onions Battle Osteoporosis

    ERIC Educational Resources Information Center

    King, Angela G.

    2005-01-01

    Researchers at the University of Bern in Switzerland have identified a compound in the popular vegetable that appears to decrease bone loss in laboratory studies using rat bone cells. It is suggested that eating onions might help prevent bone loss and osteoporosis, a disease, which predominantly affects older women.

  7. Research Advances: Onions Battle Osteoporosis

    ERIC Educational Resources Information Center

    King, Angela G.

    2005-01-01

    Researchers at the University of Bern in Switzerland have identified a compound in the popular vegetable that appears to decrease bone loss in laboratory studies using rat bone cells. It is suggested that eating onions might help prevent bone loss and osteoporosis, a disease, which predominantly affects older women.

  8. Gender Disparities in Osteoporosis

    PubMed Central

    Alswat, Khaled A.

    2017-01-01

    Osteoporosis is a growing health concern worldwide and its complications are as prevalent as other common chronic disease complications such as hypertension and diabetes. In this review, we will discuss the role of gender in osteoporosis, especially related to peak bone mass and maturation, rate of annual bone loss, screening, prevalence of osteoporosis and its related fractures, mortality after osteoporosis-related fracture, fracture risk predication using different technologies and the impact of gender on osteoporosis management. PMID:28392857

  9. DHEA prevents bone loss by suppressing the expansion of CD4(+) T cells and TNFa production in the OVX-mouse model for postmenopausal osteoporosis.

    PubMed

    Zhang, Na; Gui, Yuyan; Qiu, Xuemin; Tang, Wei; Li, Lisha; Gober, Hans-Jürgen; Li, Dajin; Wang, Ling

    2016-09-05

    Recent studies have suggested that dehydroepiandrosterone (DHEA) might serve as a form of immunomodulatory therapy for postmenopausal osteoporosis (PMO). The current study investigated the effects of DHEA administration on ovariectomy (OVX)-induced bone loss and its corresponding immunological changes. Adult OVX mice were treated with DHEA or 17-β-estradiol (E2) for 12 weeks, with or without the aromatase inhibitor letrozole. DHEA improved bone mass after OVX and displayed action like that of E2 with regard to decreasing osteoclast-related parameters. DHEA also suppressed an OVX-induced increase in CD4(+) T cell subsets and TNF-α production. However, DHEA elevated serum E2 levels to a lesser extent than E2. Although letrozole decreased serum E2 levels in OVX mice treated with DHEA, it did not alter DHEA's effects on corresponding immunological changes due to OVX. In conclusion, DHEA may prevent bone loss by suppressing the OVX-induced expansion of CD4(+) T cells and TNF-α production in mice, independent of E2.

  10. Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a Randomized Clinical Trial

    PubMed Central

    KAVEH, MOHAMMAD HOSSIEN; GOLIJ, MONIRE; NAZARI, MAHIN; MAZLOOM, ZOHREH; REZAEIAN ZADEH, ABBAS

    2014-01-01

    Introduction: Osteoporosis is a major problem in today's world, being characterized by decreased bone mass and bone change. Due to deficiency of theory-based studies in young population, especially in students, there are significant knowledge gaps of effective planning. Thepresent study was performed in response to this need. The present study investigated the effect of an empowerment program on physical activity related stages of change and self-efficacyin preventing osteoporosis among university students. Methods:In this randomized controlled trial (IRCT: IRCT201212016261N2), 152 female students of Shiraz University of Medical Sciences were selected through multi-stages cluster sampling and were randomly assigned to an experimental (n=76) and a control (n=76) group.The pre-and post-intervention data were collected using the Stages of Exercise Change Questionnaire (SECQ) of Marcos with Cronbach's alpha reliability of 0.89 and also the self-efficacy scale with a Cronbach's alpha reliability of 0.88 and Test-Retest Correlation Coefficient of 0.80. The educational intervention for the experimental group took place through problem-based learning method, small group discussion, and training manuals. In addition, training CDs and brochures were given to the subjects and short SMSs were sent to them. The data were analyzed throughSPSS, version 14, usingMann-Whitney test, Chi-square test, Wilcoxon and regression tests. Results:Pre-intervention findings showed that participants had behavioral constructs below the expected levels. The results showed that the experimental group received significant statisticalincrease after the intervention in stage of change. Before the intervention, the mean scores of stages of changes in the experimental groups was 2.28±0.86 but this rose to 3±0.84 in the first post-test and 3.22±0.84 in the second post-test. The control group showed a significant increase in stage of change without intervention (pre-test 2.04±0.82, first post

  11. Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a Randomized Clinical Trial.

    PubMed

    Kaveh, Mohammad Hossien; Golij, Monire; Nazari, Mahin; Mazloom, Zohreh; Rezaeian Zadeh, Abbas

    2014-10-01

    Osteoporosis is a major problem in today's world, being characterized by decreased bone mass and bone change. Due to deficiency of theory-based studies in young population, especially in students, there are significant knowledge gaps of effective planning. Thepresent study was performed in response to this need. The present study investigated the effect of an empowerment program on physical activity related stages of change and self-efficacyin preventing osteoporosis among university students. In this randomized controlled trial (IRCT: IRCT201212016261N2), 152 female students of Shiraz University of Medical Sciences were selected through multi-stages cluster sampling and were randomly assigned to an experimental (n=76) and a control (n=76) group.The pre-and post-intervention data were collected using the Stages of Exercise Change Questionnaire (SECQ) of Marcos with Cronbach's alpha reliability of 0.89 and also the self-efficacy scale with a Cronbach's alpha reliability of 0.88 and Test-Retest Correlation Coefficient of 0.80. The educational intervention for the experimental group took place through problem-based learning method, small group discussion, and training manuals. In addition, training CDs and brochures were given to the subjects and short SMSs were sent to them. The data were analyzed throughSPSS, version 14, usingMann-Whitney test, Chi-square test, Wilcoxon and regression tests. Pre-intervention findings showed that participants had behavioral constructs below the expected levels. The results showed that the experimental group received significant statisticalincrease after the intervention in stage of change. Before the intervention, the mean scores of stages of changes in the experimental groups was 2.28±0.86 but this rose to 3±0.84 in the first post-test and 3.22±0.84 in the second post-test. The control group showed a significant increase in stage of change without intervention (pre-test 2.04±0.82, first post-test 2.18±0.87 and second post

  12. Understanding osteoporosis.

    PubMed Central

    Marcus, R.

    1991-01-01

    Considerable progress has been achieved recently in our understanding of the normal process by which bone mass is regulated. Age-related trabecular bone loss is characterized not simply by a global loss of bone but also by cortical porosity and loss of trabecular connections. Because bone strength depends on architectural as well as material properties, bone quantity alone cannot define fracture risk with precision. Traditional therapies for osteoporosis increase bone mass, and estrogen therapy, in particular, profoundly decreases fracture risk. The pharmacologic restoration of bone quantity and quality, however, remains elusive. Modern biotechnology offers the hope that progress may come about through the development of growth factors and other osteotropic compounds for clinical use. Images PMID:1877231

  13. Causes of secondary pediatric osteoporosis.

    PubMed

    Bianchi, Maria Luisa

    2013-06-01

    Secondary osteoporosis is increasingly observed in both adult and pediatric patients affected by many heterogeneous diseases. Most forms of secondary osteoporosis derive from one or more of the following causes: malnutrition, malabsorption, immobilization and/or reduced mechanical load, vitamin D deficiency, chronic inflammation, hormonal derangements, and chronic use of glucocorticoids and other drugs. Considering the lack of symptoms in the early phases, both the risk and the presence of secondary osteoporosis tend to be underestimated, and as a consequence, appropriate prevention/treatment measures are often delayed or not taken at all. Failure to accumulate an appropriate bone mass for gender and age or to build an architecturally "strong" bone must always be suspected when a child or adolescent presents with frequent and/or low-trauma fractures, chronic bone pain, or an incidental finding of "osteopenia" on plain X-rays. Known risk factors must always be considered.

  14. Health technology assessment in osteoporosis.

    PubMed

    Hiligsmann, Mickael; Kanis, John A; Compston, Juliet; Cooper, Cyrus; Flamion, Bruno; Bergmann, Pierre; Body, Jean-Jacques; Boonen, Steven; Bruyere, Olivier; Devogelaer, Jean-Pierre; Goemaere, Stefan; Kaufman, Jean-Marc; Rozenberg, Serge; Reginster, Jean-Yves

    2013-07-01

    We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.

  15. Clomipramine causes osteoporosis by promoting osteoclastogenesis via E3 ligase Itch, which is prevented by Zoledronic acid

    PubMed Central

    Li, Xing; Sun, Wen; Li, Jinbo; Wang, Mengmeng; Zhang, Hengwei; Pei, Lingpeng; Boyce, Brendan F.; Wang, Zhiyu; Xing, Lianping

    2017-01-01

    Patients taking antidepressants, including Clomipramine (CLP), have an increased risk of osteoporotic fracture. However, the effects of CLP on bone metabolism are unknown. Here, we demonstrate that WT mice treated with CLP for 2 weeks had significantly reduced trabecular bone volume and cortical bone thickness, associated with increased osteoclast (OC) numbers, but had no change in osteoblast numbers or bone formation rate. Bone marrow cells from CLP-treated mice had normal OC precursor frequency, but formed significantly more OCs when they were cultured with RANKL and M-CSF. CLP promoted OC formation and bone resorption and expression of OC-associated genes. CLP-induced bone loss was prevented by Zoledronic acid. At the molecular level, CLP inhibited the activity of the ubiquitin E3 ligase Itch. CLP did not promote OC formation from bone marrow cells of Itch−/− mice in vitro nor induce bone loss in Itch−/− mice. Our findings indicate that CLP causes bone loss by enhancing Itch-mediated osteoclastogenesis, which was prevented by Zoledronic acid. Thus, anti-resorptive therapy could be used to prevent bone loss in patients taking antidepressants, such as CLP. PMID:28145497

  16. Osteoporosis and Asian American Women

    MedlinePlus

    ... not supported by your browser. Home Osteoporosis Women Osteoporosis and Asian American Women Publication available in: PDF ( ... Are Available? Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  17. Studies on action of menaquinone-7 in regulation of bone metabolism and its preventive role of osteoporosis.

    PubMed

    Tsukamoto, Yoshinori

    2004-01-01

    The effect of menaquinone-7 (MK-7) on bone components and bone resorbing factors induced-bone resorption using the femoral-diaphyseal and - metaphyseal tissues obtained from elderly female rats in vitro were examined. Calcium content, alkaline phosphatase activity and deoxyribonucleic acid (DNA) in the diaphyseal and metaphyseal tissues in elderly females rats were significantly decreased as compared with that of young rats, indicating that aging causes a deterioration of bone formation. The presence of MK-7 (10(-6)-10(-5) M) caused a significant prevention of reduction of biochemical components. On the other hand, the bone-resorbing factor, parathyroid hormone (1-34) (PTH; 10(-7) M) and prostaglandin E(2) (PGE(2); 10(-5) M) caused a significant decrease in calcium content in the diaphyseal and metaphyseal tissues. This decreases was completely inhibited in the presence of MK-7 (10(-7)-10(-5) M). In addition, MK-7 (10(-7)-10(-5) M) completely prevented the PTH (10(-7) M) or PGE(2) (10(-5) M) induced increases in medium glucose consumption and lactic acid production by bone tissues, Furthermore, the effect of the prolonged intake of dietary MK-7 on bone loss in ovariectomized rats was investigated. As a result, it was found that the intake of experimental diets containing the fermented soybean (natto) with supplemental MK-7 caused significant elevations of MK-7 and gamma-carboxylated osteocalcin concentration, a bio marker of bone formation, in the serum of both ovariectomized rats and normal subjects, suggesting that MK-7 may play an important role in the prevention of age-related bone loss.

  18. [Phosphorus intake and osteoporosis].

    PubMed

    Omi, N; Ezawa, I

    2001-10-01

    Phosphorus (P) is one of the most important nutrients for bone metabolism, such as calcium. In general, P intake is usually adequate in our daily diet, and there is a risk of over-consumption from processed food. On the other hand, Ca intake is not always adequate from the Japanese daily diet. When Ca/P is taken from the daily diet at a level of 0.5 - 2.0, the P intake level dose not affect intestinal Ca absorption. Therefore, it is important not only to pay attention to preventing the over-consumption of P, but also to obtain a sufficient intake of Ca. For the prevention of osteoporosis, it is important to consume sufficient Ca and to maintain and appropriate Ca/P balance from diet.

  19. Studies on the pathophysiology and therapy of osteoporosis.

    PubMed

    Ambrus, J L; Ambrus, J L; Robin, J C; Ambrus, C M; Kahn, E A

    1984-01-01

    Etiologic and pathologic factors in clinical osteoporosis are reviewed. Techniques were developed to determine total skeletal calcium content with in vivo neutron activation analysis and to induce osteoporosis (in about three months) with low calcium diet, corticosteroid or heparin treatment in experimental animals. Genetic influence was demonstrated: C3H/St (Ha) mice were more susceptible to osteoporosis by all three modalities than C57B1/6 (J) mice. Fluoride was ineffective in preventing osteoporosis induced by either of these three modalities. Heparin induced osteoporosis was prevented by conjugated estrogens, progestins or their combinations. Progestins were shown in other studies to inhibit estrogen induced metaplasia and neoplasia. Combining estrogens with progestin may result in an increased therapeutic index for the prevention of postmenopausal osteoporosis. Human and salmon calcitonin, Deca - Durabolin, an anabolic steroid, Mopidamole, a pyrimidopyrimidine derivative, Trental, a methylxanthine derivative, certain 2-thiophene carboxylic acid derivatives and imidazoquinazolines exhibited anti-osteoporotic effects.

  20. An overview and management of osteoporosis

    PubMed Central

    Sözen, Tümay; Özışık, Lale; Başaran, Nursel Çalık

    2017-01-01

    Osteoporosis -related to various factors including menopause and aging- is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and women. With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Currently, it has been estimated that more than 200 million people are suffering from osteoporosis. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. Every fracture is a sign of another impending one. Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality. Moreover, osteoporosis results in a decreased quality of life, increased disability-adjusted life span, and big financial burden to health insurance systems of countries that are responsible for the care of such patients. With an early diagnosis of this disease before fractures occur and by assessing the bone mineral density and with early treatment, osteoporosis can be prevented. Therefore, increasing awareness among doctors, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic. PMID:28293453

  1. An overview and management of osteoporosis.

    PubMed

    Sözen, Tümay; Özışık, Lale; Başaran, Nursel Çalık

    2017-03-01

    Osteoporosis -related to various factors including menopause and aging- is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and women. With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Currently, it has been estimated that more than 200 million people are suffering from osteoporosis. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. Every fracture is a sign of another impending one. Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality. Moreover, osteoporosis results in a decreased quality of life, increased disability-adjusted life span, and big financial burden to health insurance systems of countries that are responsible for the care of such patients. With an early diagnosis of this disease before fractures occur and by assessing the bone mineral density and with early treatment, osteoporosis can be prevented. Therefore, increasing awareness among doctors, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic.

  2. Strontium ranelate for the management of osteoporosis.

    PubMed

    Lam, Sum; Zouzias, Katerina

    2008-07-01

    To evaluate the role of strontium ranelate in the management of osteoporosis. A MEDLINE (January 1966 to May 2007) search using the terms osteoporosis, strontium ranelate, bonemineral density, and fractures. All English-language articles identified from the data sources were evaluated. Strontium ranelate stimulates bone formation and inhibits bone resorption. Its safety and efficacy for osteoporosis were evaluated in four prospective, randomized, double-blind, placebo-controlled trials. The PREVOS (Prevention of Early Postmenopausal Bone Loss by Strontium Ranelate) trial suggested that 1 g daily is the optimal dose for preventing postmenopausal bone loss and was associated with a 1.41% increase in lumbar bone-mineral density (BMD). However, the STRATOS (Strontium Administration for Treatment of Osteoporosis) study found that a 1 g daily regimen was associated with a higher incidence of new vertebral deformities, and a 2 g daily regimen reduced lumbar BMD by 3% in postmenopausal, osteoporotic women. The SOTI (Spinal Osteoporosis Therapeutic Intervention) and TROPOS (Treatment of Peripheral Osteoporosis) studies suggested that a 2 g daily regimen reduced vertebral fractures by 39% to 41%, nonvertebral fractures by 16%, in postmenopausal, osteoporotic women. Most common adverse events reported were nausea and diarrhea. Four clinical trials demonstrated the efficacy and safety of strontium ranelate for the management of postmenopausal osteoporosis; however, the Food and Drug Administration has not approved it for this indication.

  3. Causes, mechanisms and management of paediatric osteoporosis.

    PubMed

    Mäkitie, Outi

    2013-08-01

    Osteoporosis, a skeletal disorder characterized by compromised bone strength and an increased risk of fractures, is an important paediatric disorder that involves almost all paediatric subspecialties. Osteogenesis imperfecta is the most common form of childhood-onset primary osteoporosis, but several other forms are also known. Secondary osteoporosis is caused by an underlying chronic illness or its treatment. The most common causes of secondary osteoporosis include chronic systemic inflammation, glucocorticoid use and neuromuscular disabilities. The skeletal sequelae can present in childhood as low-energy peripheral and vertebral fractures, or become evident in adulthood as low bone mass and an increased propensity to develop osteoporosis. Management should aim at prevention, as interventions to treat symptomatic osteoporosis in the paediatric age group are scarce. Bisphosphonates are the principal pharmacological agents that can be used in this setting, but data on their efficacy and safety in paediatric populations remain inadequate, especially in patients with secondary osteoporosis. Consequently, it is important to understand the potential skeletal effects of paediatric illnesses and their therapies in order to institute effective and timely prevention of skeletal complications.

  4. Opportunistic Osteoporosis Screening

    PubMed Central

    Ziemlewicz, Timothy J.; Binkley, Neil; Lubner, Meghan G.; Pickhardt, Perry J.

    2017-01-01

    Purpose For patients undergoing CT colonography, an opportunity exists for concurrent osteoporosis screening without additional radiation exposure or patient time using proximal femur quantitative CT (QCT) “CTXA”. Materials and Methods This cohort included 129 female and 112 male adults (mean age, 60.1±8.2 years; range, 50–95 years) who underwent CT colonography between March 2013 and September 2014. Areal BMD in g/cm2 and resultant left femoral neck T-score was prospectively measured on the supine CT series using QCT Pro Version 5.1 (Mindways Software, Austin, TX). QCT results were reported with the CT colonography. Chart review evaluated if the patients were eligible for BMD screening according to the United States Preventative Service Task Force (USPSTF) and National Osteoporosis Foundation (NOF) guidelines, had undergone prior BMD testing, and to assess if QCT results changed patient management. Results Overall, 68.0% (164/241) of patients from this cohort had not previously undergone BMD screening. According to the NOF guidelines, 44.0% (106/241) of patients were eligible for screening. T-scores within the osteopenic and osteoporotic range were detected in 32.3% (78/241) and 5.0% (12/241) of patients respectively. Of these patients with low bone mineral density, 66.7% (60/90) had not previously undergone screening or were eligible for BMD testing. Reporting of CTXA T-scores altered management in 9 patients (3.7%) with low bone mineral density. Conclusion Maximizing the pre-existing value from imaging studies is crucial in the current era of healthcare reform. We demonstrate the ability to combine colorectal and osteoporosis screening at CT, adding clinical and likely economic value. PMID:26435117

  5. The effects of an educational self-efficacy intervention on osteoporosis prevention and diabetes self-management among adults with type 2 diabetes mellitus.

    PubMed

    Ha, Mei; Hu, Jie; Petrini, Marcia A; McCoy, Thomas P

    2014-10-01

    Prevalence of osteoporosis (OP) is high among Chinese adults with diabetes. Assessment of OP and fracture risk as well as patient education should be included as part of the management of diabetes. The purpose of this pilot study was to test the effectiveness of an educational self-efficacy intervention on knowledge about OP, dietary calcium intake, the importance of physical activity (PA), and glycemic control among Chinese adults with type 2 diabetes residing in Wuhan, China. A quasi-experimental design with repeated measures was employed. Participants were assigned to either the intervention (n = 23) or the control group (n = 23). Intervention participants attended 6 weekly 1-hr educational sessions comprising presentations, demonstration, and discussions. Control participants received standard care. Data were collected via questionnaires at pre- and postintervention and at 3-month follow-up, and blood was drawn at preintervention and 3-month follow-up. Participants in the intervention group had significant improvement in OP knowledge, F(2, 43) = 11.504, p < .001; OP self-efficacy, F(2, 43) = 6.915, p = .003; dietary calcium intake, F(2, 43) = 7.856, p = .002; level of PA, F(2, 43) = 4.787, p = .011; diabetes self-care activities, F(2, 43) = 14.009, p < .001; diabetes self-efficacy, F(2, 43) = 19.722, p < .001; and glycemic control (A1C level; t = 2.809, p = .010) compared to the control group at the 3-month follow-up. The results demonstrate the effectiveness of OP prevention education based on self-efficacy theory among Chinese adults with type 2 diabetes. © The Author(s) 2014.

  6. Osteoporosis: identifying high-risk persons.

    PubMed

    McMahon, M A; Peterson, C; Schilke, J

    1992-10-01

    Osteoporosis is the most common systemic bone disorder causing thousands of injuries and deaths each year. The pathogenesis of osteoporosis is a complex puzzle that contains many interlocking pieces involving both genetic and environmental factors. The prevention of age-related bone loss, which could be gained through health teaching by the nurse, should be optimized. Nurses and other caregivers can make significant contributions toward the initial identification of those persons at risk or who may already have the debilitating disease by using the Osteoporosis Risk Questionnaire.

  7. [Evidence of dietary therapy for osteoporosis].

    PubMed

    Uenishi, Kazuhiro

    2008-10-01

    A significant point of dietary therapy for osteoporosis is that calcium, vitamin D and vitamin K are recommended to be actively administered on top of sufficient intake of energy and the other nutrients including protein. In Japanese guidelines for the prevention and treatment of osteoporosis 2006 edition, daily intake of calcium and vitamin D is encouraged at least 800mg and 400 to 800IU (10 to 20microg) , respectively. Calcium and vitamin D are also important for maximizing the effect of drug for osteoporosis. Calcium and vitamin D supplementation could be a supportive measure, when their necessary requirement is difficult to be consumed.

  8. Osteoporosis: An Overview.

    ERIC Educational Resources Information Center

    Johnston, C. Conrad; Slemenda, Charles

    1987-01-01

    An overview of osteoporosis, its types, causes, diagnosis, and treatment is presented. Risk factors and bone mass measurement are also discussed. This article serves as an introduction to a symposium on osteoporosis containing five other articles in this issue. (MT)

  9. Osteoporosis and Your Spine

    MedlinePlus

    ... Movement › Osteoporosis and Your Spine Osteoporosis and Your Spine Your spine is made up of small bones ... called kyphosis. Kyphosis and Bone Breaks in the Spine The bones in the spine are called vertebrae. ...

  10. Osteoporosis: An Overview.

    ERIC Educational Resources Information Center

    Johnston, C. Conrad; Slemenda, Charles

    1987-01-01

    An overview of osteoporosis, its types, causes, diagnosis, and treatment is presented. Risk factors and bone mass measurement are also discussed. This article serves as an introduction to a symposium on osteoporosis containing five other articles in this issue. (MT)

  11. [Osteoporosis--current diagnostics and therapy].

    PubMed

    Pfeilschifter, Johannes

    2009-08-01

    Osteoporotic fractures are a frequent cause of disability and a loss of quality of life in old age. Maintenance of muscle function and balance, a daily calcium intake of 1,000 mg, sufficient vitamin D, and a prudent use of fall- and osteoporosis-associated drugs are key components of fracture prevention. The German guideline recommends to initiate a specific long-term osteoporosis medication in individuals with a 30% 10-year risk for hip fractures and vertebral fractures.

  12. Osteoporosis in Men

    MedlinePlus

    Osteoporosis in Men A Patient’s Guide In osteoporosis, bones become weak and are more likely to fracture (break). It is a “ ... osteoporosis or osteopenia (mildly low bone mass) are men. The lifetime risk of having a fracture due ...

  13. Osteoporosis and Lifestyle.

    PubMed

    Ishimi, Yoshiko

    2015-01-01

    Skeletal tissue is formed during the first two decades of life; then a constant bone mass is maintained until 40 y of age. In the case of women, the bone mass is rapidly reduced at menopause at around 50 y of age. After that, bone mass slowly decreases in both men and women who have passed the 70-y-old mark. The National Institute of Health Consensus Conference adopted the definition of osteoporosis as a skeletal disorder that is characterized by compromised bone strength leading to a predisposition for and an increased risk of fracture. Since osteoporotic fractures are the third-highest cause for becoming bedridden, the maintenance of healthy bones is an important factor in extending a person's healthy lifespan. Bone mass is influenced by many factors, such as nutrition, physical activity, smoking and alcohol intake, as well as by genetic factors. Thus, a healthy diet providing balanced nutrients including calcium, vitamin D, vitamin K and protein, regular physical activity, and not smoking help maintain bone health and delay or prevent osteoporosis. Some functional foods containing soy isoflavones, milk basic protein and n-3 fatty acid may help promote bone health.

  14. Economic evaluation of a 100% whey-based partially hydrolyzed infant formula in the prevention of atopic dermatitis among Danish children.

    PubMed

    Iskedjian, Michael; Haschke, Ferdinand; Farah, Bechara; van Odijk, Jenny; Berbari, Jade; Spieldenner, Jörg

    2012-01-01

    A pharmacoeconomic analysis was undertaken to determine costs, consequences, and cost-effectiveness of a brand of partially hydrolyzed 100%-whey formula manufactured by Nestlé (PHF-W), in the prevention of atopic dermatitis (AD) in 'at risk' Danish children compared to extensively hydrolyzed formula (EHF-Whey or Casein). Given the non-significant differences between PHF-W and EHF, the base case analytic approach amounted to a cost-minimization analysis (CMA) reporting the difference in formula acquisition costs over the period of formula consumption for the population of interest. However, sensitivity analyses (SAs) were undertaken to explore applying the nominal efficacy of PHF-W and EHF, thus leading to a cost-effectiveness analysis (CEA). Hence, an economic model based on a 12-month time horizon was developed synthesizing treatment pathways, resource utilization, and costs associated with the treatment of AD in the population of interest. The final economic outcome of the SAs was the incremental cost per avoided case (ICER) defined as the expected cost per avoided case of AD for PHF-W vs EHF, determined from three perspectives: the Ministry of Health (MOH), the family of the subject, and society (SOC). In the base case CMA, savings of DKK 9 M, DKK 20 M, and DKK 29 M were generated for PHF-W vs EHF from the MOH, family, and SOC perspectives. In the sensitivity CEA, PHF-W was dominant over EHF-Whey from all perspectives, while EHF-Casein displayed against PHF-W unattractive ICERs of DKK 315,930, DKK 408,407, and DKK 724,337 from the MOH, family, and SOC perspectives. Probabilistic SAs indicated that PHF-W was 86% likely to be dominant over EHF-Whey, whereas EHF-Casein had no likelihood of dominating PHF-W. Under a range of assumptions, this analysis demonstrated the attractiveness of PHF-W vs both types of EHF in the prevention of AD among 'at risk' Danish infants who are not or cannot be exclusively breastfed.

  15. [Osteoporosis in premenopausal women].

    PubMed

    Mitringer, Antje; Pietschmann, P

    2002-01-01

    Osteoporosis is a systemic disease of bone, which is characterized by decreased bone mass and changes in the microarchitecture of bone tissue followed by brittleness of bones and increased risk of fractures. Osteoporosis frequently is a disease of postmenopausal women, nevertheless, in rare cases, osteoporosis can also occur in young adults. There are only few studies on the pathophysiology of "premenopausal osteoporosis"; in addition to idiopathic forms, osteoporosis in young women can be caused by glucocorticoid treatment, by eating disorders or can be associated with pregnancy.

  16. Osteoporosis and Gastrointestinal Disease

    PubMed Central

    Weinerman, Stuart

    2010-01-01

    Gastrointestinal disease is often overlooked or simply forgotten as a cause of osteoporosis. Yet, the consequences of osteoporotic fractures can be devastating. Although the bulk of the published experience regarding osteoporosis is derived from the postmenopausal population, this review will focus on gastrointestinal disorders implicated in osteoporosis, with an emphasis on inflammatory bowel disease and celiac disease. The unique aspects of gastrointestinal diseases associated with osteoporosis include early onset of disease (and, therefore, prolonged exposure to risk factors for developing osteoporosis, particularly with inflammatory bowel disease and celiac disease), malabsorption, and maldigestion of nutrients necessary for bone health and maintenance (eg, calcium, vitamin D), as well as the impact of glucocorticoids. These factors, when added to smoking, a sedentary lifestyle, hypogonadism, and a family history of osteoporosis, accumulate into an imposing package of predictors for osteoporotic fracture. This paper will review the identification and treatment strategies for patients with gastrointestinal disorders and osteoporosis. PMID:20978554

  17. Modern Rehabilitation in Osteoporosis, Falls, and Fractures

    PubMed Central

    Dionyssiotis, Yannis; Skarantavos, Grigorios; Papagelopoulos, Panayiotis

    2014-01-01

    In prevention and management of osteoporosis, modern rehabilitation should focus on how to increase muscular and bone strength. Resistance exercises are beneficial for muscle and bone strength, and weight-bearing exercises help maintain fitness and bone mass. In subjects at higher risk for osteoporotic fractures, particular attention should be paid to improving balance – the most important element in falls prevention. Given the close interaction between osteoporosis and falls, prevention of fractures should be based on factors related to bone strength and risk factors for falls. Fractures are the most serious complication of osteoporosis and may be prevented. The use of modern spinal orthosis helps to reduce pain and improve posture. Vibration platforms are used in rehabilitation of osteoporosis, based on the concept that noninvasive, short-duration, mechanical stimulation could have an impact on osteoporosis risk. Pharmacologic therapy should be added for those at high risk of fracture, and vitamin D/calcium supplementation is essential in all prevention strategies. Success of rehabilitation in osteoporotic and fractured subjects through an individualized educational approach optimizes function to the highest level of independence while improving the overall quality of life. PMID:24963273

  18. Type 1 diabetes and osteoporosis: A review of literature

    PubMed Central

    Dhaon, Pooja; Shah, Viral N.

    2014-01-01

    With better care and intensive insulin therapy, microvascular complications have reduced and longevity has increased in patients with type 1 diabetes (T1DM). Therefore, there is a need to change the focus from microvascular complications to cardiovascular disease and osteoporosis. Though number of studies from other parts of the world show that patients with T1DM are at increased risk of osteoporosis and fractures, there is a paucity of data from India. A number of factors and mechanisms affecting bone health in patients with T1DM have been proposed. The main defect in genesis of osteoporosis is osteoblastic function, rather than osteoclastic overfunction. Assessment of bone mineral density by dual X-ray absorptiometry and other risk factors for osteoporosis, as a part of diagnostic procedure can help to design tailored treatment plans. A physically active healthy lifestyle, prevention of diabetic complications and adequate calcium and vitamin D supplementation are the mainstay for prevention of osteoporosis. Treatment of osteoporosis is not evidence based but it is proposed to be similar to osteoporosis associated with other conditions. Bisphosphonates are the mainstay for treatment of osteoporosis in patients with T1DM. However, more studies are needed to make definitive guidelines on prevention and treatment of osteoporosis in patients with T1DM. PMID:24741510

  19. Nutrition and osteoporosis.

    PubMed

    Lau, E M; Woo, J

    1998-07-01

    Nutritional factors have a significant influence on the cause of osteoporosis. Calcium supplementation may be particularly effective in populations with a low calcium diet. Supplementations of 500 mg/d may produce about 4% gain in skeletal calcium in adolescents. Supplementations of 800 mg/d may prevent bone loss in postmenopausal women. The results of clinical trials also suggested that such supplementation may prevent hip and vertebral fractures in the elderly. The largest effect of calcium supplementation occurs in the first year of treatment, whereas sustained effects are not proven. Vitamin D supplementation may be particularly useful in vitamin D-deficient elderly. In this group, hip fractures may be prevented by vitamin D administration. Urinary sodium excretion is correlated with urinary calcium excretion in humans, and a direct effect of high sodium intake on loss at the hip has been demonstrated. Observational epidemiologic studies suggested a negative effect of a high protein intake on bone density, although there are no results from clinical trials to support this view. Dietary fiber, phytate, oxalate, and caffeine intake may have a small negative effect on calcium absorption.

  20. Similarities in Acquired Factors Related to Postmenopausal Osteoporosis and Sarcopenia

    PubMed Central

    Sirola, Joonas; Kröger, Heikki

    2011-01-01

    Postmenopausal population is at increased risk of musculoskeletal impairments. Sarcopenia and osteoporosis are associated with significant morbidity and social and health-care costs. These two conditions are uniquely linked with similarities in pathophysiology and diagnostic methods. Uniform diagnostic criteria for sarcopenia are still evolving. Postmenopausal sarcopenia and osteoporosis share many environmental risk- and preventive factors. Moreover, geriatric frailty syndrome may result from interaction of osteoporosis and sarcopenia and may lead to increased mortality. The present paper reviews the factors in evolution of postmenopausal sarcopenia and osteoporosis. PMID:21904688

  1. Primary osteoporosis in children.

    PubMed

    Tan, Lay Ong; Lim, Soo Yen; Vasanwala, Rashida Farhad

    2017-09-01

    Osteoporosis in childhood is uncommon, and it may be secondary to a spectrum of diverse conditions. Idiopathic juvenile osteoporosis is a primary osteoporosis of unknown aetiology present in previously well children and is a diagnosis of exclusion. We describe a 10-year-old prepubertal boy who presented with back pain of 1-week duration. His spinal X-ray showed generalised loss of vertebral body heights in keeping with osteoporosis. Endocrine and haematological work-up were normal. He was treated with vitamin D supplement and intravenous pamidronate. This case illustrates the general work-up and causes for paediatric osteoporosis, and the management for idiopathic juvenile osteoporosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. A Multidisciplinary Osteoporosis Service-Based Action Research Study

    ERIC Educational Resources Information Center

    Whitehead, Dean; Keast, John; Montgomery, Val; Hayman, Sue

    2004-01-01

    Objective: To investigate an existing Trust-based osteoporosis service's preventative activity, determine any issues and problems and use this data to reorganise the service, as part of a National Health Service Executive/Regional Office-commissioned and funded study. Setting: A UK Hospital Trust's Osteoporosis Service. Design & Method: A…

  3. A Multidisciplinary Osteoporosis Service-Based Action Research Study

    ERIC Educational Resources Information Center

    Whitehead, Dean; Keast, John; Montgomery, Val; Hayman, Sue

    2004-01-01

    Objective: To investigate an existing Trust-based osteoporosis service's preventative activity, determine any issues and problems and use this data to reorganise the service, as part of a National Health Service Executive/Regional Office-commissioned and funded study. Setting: A UK Hospital Trust's Osteoporosis Service. Design & Method: A…

  4. Comparing Osteoporosis Drugs: The Bisphosphonates

    MedlinePlus

    Drugs to Treat Low Bone Density Comparing Osteoporosis Drugs: The Bisphosphonates What is osteoporosis (low bone density)? Osteoporosis is a condition in which the body does not build enough new bone. ...

  5. Osteoporosis: a disease management opportunity.

    PubMed

    Taft, L B; Looker, P A; Cella, D

    2000-01-01

    Advances in the ability to detect and effectively treat osteoporosis lead to questions about when testing and treatment should be initiated. Disease management provides answers with the promise of both cost-effective use of resources and improved health outcomes. Applying the characteristics and principles of disease management to osteoporosis provides a powerful rationale for a population-based approach to this disease. Disease management makes it possible to systematically identify persons at risk, intervene with prevention and treatment programs, and measure clinical, quality of life, and economic outcomes. Clinical guidelines are a critical element in disease management. This article presents clinical guidelines developed recently by national medical and public health experts based on a review of available research and clinical evidence.

  6. Review of postmenopausal osteoporosis pharmacotherapy.

    PubMed

    Mayes, Stacey L

    2007-06-01

    The degradation of bone tissue leading to osteoporosis is often silent and unrecognized until a postmenopausal woman develops a bone fracture. The costs of medical treatment and subsequent changes in the quality of life of a patient are significant, and avoidance via proper nutrition, exercise, and pharmacologic therapy may be the key to decreasing healthcare costs associated with this disease state. A periodic review of current literature is necessary to update the reader of current therapeutic options for the treatment and prevention of osteoporosis. A number of medications exist, and new options are ongoing. Clinicians now have access to antiresorptive and anabolic therapy in addition to lifestyle modification as options for patients. This article consists of a review of established guidelines for screening, diagnosis, and pharmacologic modalities and will provide a comprehensive assessment of therapeutic options.

  7. Intravenous bisphosphonates for postmenopausal osteoporosis

    PubMed Central

    Mottaghi, Peyman

    2010-01-01

    Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for managment of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density. This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis. PMID:21526078

  8. Gender specificity and osteoporosis.

    PubMed

    Bilezikian, J P

    2000-10-01

    To a certain extent, the emphasis placed on women in light of the predominance of osteoporosis in this sex is well-justified. As researchers are appreciating the potential size of the male population at risk for osteoporosis, increasing interest is becoming apparent on the part of investigators and the pharmaceutical companies that are developing therapies. As more is learned about osteoporosis in men, experts will then be in a position to better understand the similarities and differences between genders.

  9. Pharmacological management of severe postmenopausal osteoporosis.

    PubMed

    Gaudio, Agostino; Morabito, Nancy

    2005-01-01

    The most devastating consequence of osteoporosis is bone fracture, particularly at the vertebral or femoral level. As defined by the WHO, patients with osteoporosis who have had one or more fragility fractures have severe osteoporosis. Those who sustain a vertebral fracture represent a particularly vulnerable group whose risk of another vertebral fracture within the following year is increased by a factor of 3-5. In addition, the presence of a vertebral fracture is associated with an increased risk of hip fracture. In light of these data, treatment of established osteoporosis is extremely important to prevent other fragility fractures. This review examines the therapies approved by the US FDA for the treatment of osteoporosis that have been shown to reduce the incidence of new fractures in patients with established osteoporosis. We evaluated the mechanisms of action, available formulations, efficacy in preventing fractures and increasing bone mineral density (BMD), duration of treatment, adverse effects and contraindications to use of alendronic acid (alendronate), risedronic acid (risedronate), calcitonin, raloxifene and teriparatide. All these drugs are able to prevent new vertebral fractures in patients with established osteoporosis. Only alendronic acid and risedronic acid have also been shown to reduce the risk of fracture at the femoral level, but they are contraindicated in patients with upper gastrointestinal diseases. Calcitonin is a good option in subjects with back pain because of its analgesic effect. Raloxifene is useful when patients have high plasma lipid levels or a family history of breast cancer. Teriparatide is indicated in subjects with very low BMD and multiple vertebral fractures. Patient characteristics should determine selection of therapy but the decision is always difficult and fraught with uncertainty.

  10. Perspectives on osteoporosis.

    PubMed

    Kaltenborn, K C

    1992-12-01

    The goal of this chapter was to provide enough information so that the following questions could be answered in a clinical context: 1. Does the patient have osteoporosis or a risk for it? Is densitometry needed? 2. Why does the patient have osteoporosis? Is the diagnosis "the tip of the iceberg" because of an occult secondary cause? 3. Is the patient receiving adequate calcium? Can the patient benefit from estrogen? 4. What clinical information or tests are required to follow a patient with osteoporosis? 5. What drugs are indicated for osteoporosis? Which are promising and which require further research?

  11. Osteoporosis in paediatric patients with spina bifida

    PubMed Central

    Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Methods Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB. PMID:22330186

  12. Managing elderly people's osteoporosis. Why? Who? How?

    PubMed Central

    Juby, A.

    1999-01-01

    OBJECTIVE: To guide family physicians through assessment of why treating elderly people's osteoporosis is necessary, who to treat, and how to treat in a practical way. QUALITY OF EVIDENCE: Evidence of the efficacy of treatment for osteoporosis is shown by a reduced probability of fracture. This can be ascertained by direct evaluation for bisphosphonates, calcium, and calcitonin, or indirectly by ascertaining benefit to bone mineral density for hormone replacement therapy (HRT) and exercise. MAIN MESSAGE: Unless medically contraindicated, all elderly people should take supplementary vitamin D (800 IU/d) and calcium (1500 mg/d). Those with risk factors for osteoporosis (e.g., smoking, thinness, previous fracture when older than 50 years, fracture in first-degree relatives older than 50 years, and steroid use) should have a bone density measurement. Those meeting World Health Organization criteria for osteoporosis should also be treated with HRT or bisphosphonates or possibly with selective estrogen receptor modulators. CONCLUSIONS: Good evidence indicates that adequate treatment of osteoporosis can prevent fractures and thus reduce associated morbidity and mortality among vulnerable elderly people. Because of the prevalence of osteoporosis, the onus falls on family physicians to be the front-line managers. PMID:10386218

  13. Non-response to osteoporosis treatment.

    PubMed

    Francis, Roger M

    2004-06-01

    There are now a number of effective treatments for osteoporosis, which increase bone mineral density (BMD) and decrease the risk of fractures. There is no clear consensus on the optimal method for assessing response to treatment in the individual patient. The goal of osteoporosis treatment is to prevent fractures after minimal trauma, but these are relatively uncommon events and cannot be totally avoided by the use of currently available therapies. Alternative methods of assessing response to treatment include serial measurement of BMD or the biochemical markers of bone turnover, but the observed changes may be misleading if they do not exceed the least significant change. The proportion of patients who fail to respond to osteoporosis treatments is difficult to quantify. Clinical trials show continuing bone loss in up to 15% of participants on hormone replacement therapy or bisphosphonates. Non-response to treatment is probably more common in clinical practice, but may be due to poor adherence to treatment recommendations. Other potential causes of an apparent failure to respond to treatment include the use of a weak antiresorptive agent, differences in bioavailability, low dietary calcium intake, vitamin D insufficiency and underlying causes of secondary osteoporosis. The management of patients who fail to respond to treatment includes confirmation that they are adhering to treatment and have an adequate dietary calcium intake and vitamin D status and excluding causes of secondary osteoporosis. Consideration should also be given to the addition of calcium and vitamin D supplementation and the use of alternative treatments for osteoporosis.

  14. Osteoporosis Screening in Postmenopausal Women 50-64 years-old: Comparison of U.S. Preventive Services Task Force Strategy and Two Traditional Strategies in the Women's Health Initiative

    PubMed Central

    Crandall, Carolyn J.; Larson, Joseph; Gourlay, Margaret L.; Donaldson, Meghan G.; LaCroix, Andrea; Cauley, Jane A.; Wactawski-Wende, Jean; Gass, Margery L.; Robbins, John A.; Watts, Nelson B.; Ensrud, Kristine E.

    2014-01-01

    The U.S. Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women younger than 65 years whose 10-year predicted risk of major osteoporotic fracture is ≥ 9.3%. For identifying screening candidates among women aged 50-64 years, it is uncertain how the USPSTF strategy compares with the Osteoporosis Self-Assessment Tool (OST) and the Simple Calculated Osteoporosis Risk Estimate (SCORE). We examined data (1994-2012) from 5165 Women's Health Initiative participants aged 50-64. For the USPSTF (FRAX major fracture risk ≥ 9.3% calculated without BMD), OST (score <2), and SCORE (score >7) strategies, we assessed sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) to discriminate between those with and without femoral neck (FN) T-score ≤ −2.5. Sensitivity, specificity, and AUC for identifying FN T-score ≤ −2.5 were 34.1%, 85.8%, and 0.60 for USPSTF (FRAX), 74.0%, 70.8%, and 0.72 for SCORE, and 79.8%, 66.3%, and 0.73 for OST. The USPSTF strategy identified about 1/3rd of women aged 50-64 with FN T-scores ≤ −2.5. Among women aged 50-64 years, the USPSTF strategy was modestly better than chance alone and inferior to conventional SCORE and OST strategies in discriminating between women with and without FN T-score ≤ −2.5. PMID:24431262

  15. Emerging Therapies for Osteoporosis.

    PubMed

    McClung, Michael R

    2015-12-01

    Although several effective therapies are available for the treatment of osteoporosis in postmenopausal women and older men, there remains a need for the development of even more effective and acceptable drugs. Several new drugs that are in late-stage clinical development will be discussed. Abaloparatide (recombinant parathyroid hormone related peptide [PTHrP] analogue) has anabolic activity like teriparatide. Recent data from the phase 3 fracture prevention trial demonstrate that this agent is effective in reducing fracture risk. Inhibiting cathepsin K reduces bone resorption without decreasing the numbers or activity of osteoclasts, thereby preserving or promoting osteoblast function. Progressive increases in bone mineral density (BMD) have been observed over 5 years. Early data suggest that odanacatib effectively reduces fracture risk. Lastly, inhibiting sclerostin with humanized antibodies promotes rapid, substantial but transient increases in bone formation while inhibiting bone resorption. Marked increases in BMD have been observed in phase 2 studies. Fracture prevention studies are underway. The new therapies with novel and unique mechanisms of action may, alone or in combination, provide more effective treatment options for our patients.

  16. [Pathophysiology of immobilization osteoporosis.

    PubMed

    Menuki, Kunitaka; Sakai, Akinori

    Enhancement of bone resorption and suppression of bone formation in response to reduced mechanical stress cause rapid bone loss. pharmacotherapy for immobilization osteoporosis in motor paralysis and long-term bedrest is effective therapy. Early intervention for rapid bone loss is important for immobilization osteoporosis.

  17. Pituitary Disorders and Osteoporosis

    PubMed Central

    Jawiarczyk-Przybyłowska, Aleksandra

    2015-01-01

    Various hormonal disorders can influence bone metabolism and cause secondary osteoporosis. The consequence of this is a significant increase of fracture risk. Among pituitary disorders such effects are observed in patients with Cushing's disease, hyperprolactinemia, acromegaly, and hypopituitarism. Severe osteoporosis is the result of the coexistence of some of these disorders and hypogonadism at the same time, which is quite often. PMID:25873948

  18. [Risk of osteoporosis in women in 4 different occupational groups].

    PubMed

    Rásky, E; Stronegger, W J; Freidl, W

    1996-01-01

    Primary osteoporosis is common, with significant sociomedical consequences. This paper studies the prevalence of risk factors and risk behavior for osteoporosis in women of four different occupational groups: housewives, blue collar workers, white collar workers/civil servants and farmers. We analyzed risk factors and risk behavior associated with osteoporosis in the scientific literature. The sample comprises 9,939 women. The data set is based on a health survey conducted in 79 selected rural communities of Styria (Austria) between 1989 and 1993. Sociodemographic data, lifestyle, health complaints, chronic conditions and utilization of preventive and treatment services were surveyed by means of standardized personal interviews. The results show that the women of the four occupational groups were subjected to very different stresses. White collar workers/civil servants had the lowest risk with regard to osteoporosis. Our results suggest that efficient intervention programs to prevent osteoporosis need to specifically focus on the different social life styles of women.

  19. Animal models for osteoporosis.

    PubMed

    Komori, Toshihisa

    2015-07-15

    The major types of osteoporosis in humans are postmenopausal osteoporosis, disuse osteoporosis, and glucocorticoid-induced osteoporosis. Animal models for postmenopausal osteoporosis are generated by ovariectomy. Bone loss occurs in estrogen deficiency due to enhanced bone resorption and impaired osteoblast function. Estrogen receptor α induces osteoclast apoptosis, but the mechanism for impaired osteoblast function remains to be clarified. Animal models for unloading are generated by tail suspension or hind limb immobilization by sciatic neurectomy, tenotomy, or using plaster cast. Unloading inhibits bone formation and enhances bone resorption, and the involvement of the sympathetic nervous system in it needs to be further investigated. The osteocyte network regulates bone mass by responding to mechanical stress. Osteoblast-specific BCL2 transgenic mice, in which the osteocyte network is completely disrupted, can be a mouse model for the evaluation of osteocyte functions. Glucocorticoid treatment inhibits bone formation and enhances bone resorption, and markedly reduces cancellous bone in humans and large animals, but not consistently in rodents.

  20. [Osteoporosis in collagen diseases].

    PubMed

    Momohara, S; Aritomi, H

    1994-09-01

    The pathogenesis of osteoporosis in patients with rheumatic diseases, especially rheumatoid arthritis (RA), is poorly understood. The duration of the disease, the severity of the inflammatory process, gender, age, steroid therapy and menopause have been suggested as risk factors for osteoporosis in patients with RA. Although these factors may contribute to the development of osteoporosis, the influence of one specific factor is difficult to evaluate. It is said that the treatment with steroids has a deleterious effect on bone turnover, but this effect has been controversial. The dose margin of prednisone that will lead to osteoporosis is not known but has been estimated to be 10 mg per day. Fractures and stress fractures in patients with RA are probably much more common. Further study concerning osteoporosis in rheumatic diseases is necessary.

  1. Management of severe osteoporosis.

    PubMed

    Miller, Paul D

    2016-01-01

    Severe osteoporosis represents a disease of high mortality and morbidity. Recognition of what constitutes and causes severe osteoporosis and aggressive intervention with pharmacological agents with evidence to reduce fracture risk are outlined in this review. This review is a blend of evidence obtained from literature searches from PubMed and The National Library of Medicine (USA), clinical experience and the author's opinions. The review covers the recognition of what constitutes severe osteoporosis, and provides up-to-date references on this sub-set of high risk patients. Severe osteoporosis can be classified by using measurements of bone densitometry, identification of prevalent fractures, and, knowledge of what additional risk factors contribute to high fracture risk. Once recognized, the potential consequences of severe osteoporosis can be mitigated by appropriate selection of pharmacological therapies and modalities to reduce the risk for falling.

  2. A non-invasive prevention program model for the assessment of osteoporosis in the early postmenopausal period: a pilot study on FRAX(®) and QUS tools advantages.

    PubMed

    Villa, P; Lassandro, A P; Moruzzi, M C; Amar, I D; Vacca, L; Di Nardo, F; De Waure, C; Pontecorvi, A; Scambia, G

    2016-02-01

    The study analyses the performances of FRAX algorithm and quantitative ultrasound (QUS) tool in relationship to the dual-energy X-ray absorptiometry (DXA) categorization to identify patients at risk of osteoporosis during menopause and to reach new thresholds for recommending the first DXA examination. Retrospective cohort study. Two hundred eighty-two postmenopausal patients filled out a questionnaire which determined their FRAX index and performed a bone evaluation by QUS of the calcaneus to determine their stiffness index (SI). Thereafter, they underwent assessments by the gold-standard DXA bone examination. Statistically significant correlations were observed between FRAX (calculated without BMD) and both QUS and DXA diagnosis. FRAX mean indices of risk corresponding to the diagnosis of osteoporosis by QUS and DXA were similar. Receiver operating characteristic (ROC) curve analysis showed that both FRAX and QUS tests were sufficiently accurate in predicting the alteration of bone mineral composition. The ROC curves of QUS allowed us to identify, in our population, SI cutoff for normal patients (SI > 90.5) and for patients having osteoporosis (SI < 78.5). We selected a cutoff screening value from FRAX ROC curve for major clinical fracture (2.94). The following diagnostic algorithm demonstrated that the use of FRAX test alone has a sensitivity of 85.3 % and a specificity of 33.8 % while the use of QUS exam alone showed a sensitivity of 81.3 % and a specificity of 45.1 %. When considering the capacity of QUS exam in combination with FRAX test, the final algorithm showed a sensitivity of 69.4 % and a specificity of 57.7 %. The use of QUS test with adjusted cutoffs offers a similar performance to the FRAX test alone in terms of sensitivity. The combined use of the tests reduces the sensibility but increases the specificity and adds clinical information related to the bone status of the patient.

  3. The position of strontium ranelate in today's management of osteoporosis.

    PubMed

    Reginster, J-Y; Brandi, M-L; Cannata-Andía, J; Cooper, C; Cortet, B; Feron, J-M; Genant, H; Palacios, S; Ringe, J D; Rizzoli, R

    2015-06-01

    Osteoporosis accounts for about 3 % of total European health-care spending. The low proportion of costs for the pharmacological prevention of osteoporotic fracture means that it is highly cost saving, especially in patient with severe osteoporosis or patients who cannot take certain osteoporosis medications due to issues of contraindications or tolerability. Following recent regulatory changes, strontium ranelate is now indicated in patients with severe osteoporosis for whom treatment with other osteoporosis treatments is not possible, and without contraindications including uncontrolled hypertension, established, current or past history of ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease. We review here today's evidence for the safety and efficacy of strontium ranelate. The efficacy of strontium ranelate in patients complying with the new prescribing information (i.e. severe osteoporosis without contraindications) has been explored in a multivariate analysis of clinical trial data, which concluded that the antifracture efficacy of strontium ranelate is maintained in patients with severe osteoporosis without contraindications and also demonstrated how the new target population mitigates risk. Strontium ranelate is therefore an important alternative in today's management of osteoporosis, with a positive benefit-risk balance, provided that the revised indication and contraindications are followed and cardiovascular risk is monitored. The bone community should be reassured that there remain viable alternatives in patients in whom treatment with other agents is not possible and protection against the debilitating effects of fracture is still feasible in patients with severe osteoporosis.

  4. Osteoporosis: the need for comprehensive treatment guidelines.

    PubMed

    Abbott, T A; Lawrence, B J; Wallach, S

    1996-01-01

    Osteoporosis is a debilitating disease that results in nearly 1.3 million fractures per year in the United States. The cost of treating these fractures has been estimated to be as high as $10 billion per year. These costs are expected to more than double during the next 50 years unless comprehensive programs of prevention and treatment are initiated. Both pharmacologic and nonpharmacologic interventions (eg, diet and exercise) have been shown to have a significant impact on the incidence of osteoporosis, depending on the time of their application. Unfortunately, osteoporosis is often not diagnosed until after fractures have occurred, when it may be too late for treatment to have a major impact. To be most effective, therapy should be started early, before serious bone loss has occurred. Because of its efficacy and relatively low acquisition cost, long-term hormone replacement therapy (HRT) is considered first-line pharmacologic therapy for the prevention of osteoporosis. However, for various reasons, less than 25% of US women who might benefit from HRT are receiving it. Aside from HRT, the only other products approved by the US Food and Drug Administration for the treatment of osteoporosis are salmon calcitonin and alendronate. Several other agents are under development, including sustained-release fluoride and other products in the bisphosphonate class. The development and adoption of early detection programs and treatment guidelines are crucial to help ease the economic burden of osteoporosis. These guidelines should incorporate preventive measures such as diet and exercise, risk assessment through proper screening programs, and the appropriate use of pharmaceutical products. The purpose of this paper is to discuss relevant economic issues associated with osteoporosis and discuss the need for a management algorithm that could be used to more efficiently prevent and treat this disease. We conclude that further modeling is needed to determine which programs and

  5. Exercising with Osteoporosis: Stay Active the Safe Way

    MedlinePlus

    ... stretching exercises are best for you. Stability and balance exercises Fall prevention is especially important for people with osteoporosis. Stability and balance exercises help your muscles work together in a ...

  6. Osteoporosis: What is the Role of Exercise?

    ERIC Educational Resources Information Center

    Munnings, Frances

    1992-01-01

    Research has not yet identified the best combination of estrogen replacement, calcium, and exercise for fighting osteoporosis, but clinical experience indicates all are needed to prevent the rapid bone loss that occurs in postmenopausal women. Physicians must encourage women to reduce their risk using all available options. (SM)

  7. Osteoporosis: What is the Role of Exercise?

    ERIC Educational Resources Information Center

    Munnings, Frances

    1992-01-01

    Research has not yet identified the best combination of estrogen replacement, calcium, and exercise for fighting osteoporosis, but clinical experience indicates all are needed to prevent the rapid bone loss that occurs in postmenopausal women. Physicians must encourage women to reduce their risk using all available options. (SM)

  8. Interleukin-32 Gamma Stimulates Bone Formation by Increasing miR-29a in Osteoblastic Cells and Prevents the Development of Osteoporosis

    PubMed Central

    Lee, Eun-Jin; Kim, Sang-Min; Choi, Bongkun; Kim, Eun-Young; Chung, Yeon-Ho; Lee, Eun-Ju; Yoo, Bin; Lee, Chang-Keun; Hong, Seokchan; Kim, Beom-Jun; Koh, Jung-Min; Kim, Soo-Hyun; Kim, Yong-Gil; Chang, Eun-Ju

    2017-01-01

    Interleukin-32 gamma (IL-32γ) is a recently discovered cytokine that is elevated in inflamed tissues and contributes to pathogenic features of bone in human inflammatory rheumatic diseases. Nevertheless, the role of IL-32γ and its direct involvement in bone metabolism is unclear. We investigated the molecular mechanism of IL-32γ in bone remodeling and the hypothetical correlation between IL-32γ and disease activity in osteoporosis patients. Transgenic (TG) mice overexpressing human IL-32γ showed reduced bone loss with advancing age, increased bone formation, and high osteogenic capacity of osteoblast compared to wild-type (WT) mice through the upregulation of miR-29a, which caused a reduction of Dickkopf-1 (DKK1) expression. IL-32γ TG mice were protected against ovariectomy (OVX)induced osteoporosis compared with WT mice. Decreased plasma IL-32γ levels were associated with bone mineral density (BMD) in human patients linked to increased DKK1 levels. These results indicate that IL-32γ plays a protective role for bone loss, providing clinical evidence of a negative correlation between IL-32γ and DKK1 as bone metabolic markers. PMID:28079119

  9. Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature

    PubMed Central

    Hanson, H. M.

    2016-01-01

    Purpose. Much of the research on osteoporosis has been generated quantitatively. However, the qualitative osteoporosis literature provides valuable information on patient and clinician experiences and perspectives, informing the design and implementation of health research and healthcare services. To identify knowledge gaps and inform the design of future qualitative research, a narrative review was conducted to consolidate and synthesize the existing insights available within the qualitative osteoporosis research. Methods. Search terms reflecting the domains of osteoporosis and qualitative research were entered into the Scopus database to generate a comprehensive survey of qualitative research in the area of osteoporosis. Articles were thematically analysed and the results are presented in the form of a narrative review. Results. Forty-four articles were included in the narrative review. Qualitative research in the field of osteoporosis research can be summarized by 3 thematic areas: the meaning of osteoporosis for patients and the public, the lived experience of an osteoporosis diagnosis, and the programmatic approach to osteoporosis prevention and treatment. Conclusions. Qualitative studies provide clinically valuable insights in how osteoporosis is conceptualized and managed and programmatic aspects of osteoporosis treatment. The findings of this narrative review suggest the need for balance between presenting osteoporosis as a serious health condition and producing unwarranted anxiety and inactivity so as to ensure the best possible outcomes for individuals with osteoporosis. PMID:27994908

  10. [Genetics of osteoporosis].

    PubMed

    Cohen-Solal, M; de Vernejoul, M C

    2004-12-01

    Osteoporosis is a multifactorial disease involving genetic component and several environmental factors. Some rare diseases that are associated with osteoporosis such as Lobstein disease or the "pseudoglial osteoporosis" syndrom are monogenetic. Nevertheless common osteoporosis is a polygenic affection resulting from the interaction between the polymorphism of different genes and the environmental factors. The genetic component of osteoporosis encompasses roughly 60 to 70% of bone mineral density, whereas the effect on fracture risk seems lower because of the importance of other environmental factors as falls. Many polymorphisms of candidate genes involved in the regulation of bone mass have been correlated to bone density. It is likely that many genes participate to the regulation of bone density although the existence of a major gene is highly suspected. Moreover linkage analysis after genome-wide search in populations with severe osteoporosis has focused on some regions of interest (QTL) on the chromosomes. This will allow to localize one or more specific genes. The current genetic studies on different populations affected by osteoporosis or not will be useful in order to better predict the fracture risk in association with bone density and biochemical markers of bone turnover. Moreover, this will lead to the development of new treatments of osfeoporosis and will help to adapt the therapy for individual patients.

  11. Osteoporosis in ankylosing spondylitis.

    PubMed

    Magrey, Marina; Khan, Muhammad Asim

    2010-10-01

    Osteoporosis (OP) is a frequent complication of ankylosing spondylitis (AS), even in early stages of the disease, and is associated with elevated levels of biochemical markers of bone turnover, proinflammatory cytokines, and acute-phase reactants. This suggests that systemic inflammatory mediators, such as interleukin-6 and tumor necrosis factor-alpha, may be involved. Various factors that conceivably work in conjunction with one another also cause bone loss in AS (eg, genetic polymorphisms of vitamin D, low levels of osteoprotegerin and sex steroid hormones, and impaired calcium and vitamin D absorption). Dual x-ray absorptiometry for assessing bone mineral density (BMD) has limitations in patients with AS because of unreliability of spinal measurements, particularly in advanced disease with new bone formation. Femoral neck BMD is reduced and correlates with increased risk of vertebral fractures. Hence, measurement of BMD at the femoral neck may provide the most accurate means of detecting osteopenia and OP and could assess fracture risk in AS patients. No guidelines are available for detection and treatment of OP in AS, and most patients are young men, who are less likely to be screened. The only evidence-based recommendation is that optimal control of disease activity in AS prevents bone loss. A recent study showed a beneficial effect of infliximab therapy on bone turnover markers and BMD in AS. Also, bisphosphonates may be useful in managing OP in AS.

  12. District nurses' perceptions of osteoporosis management: a qualitative study.

    PubMed

    Claesson, A; Toth-Pal, E; Piispanen, P; Salminen, H

    2015-07-01

    Underdiagnosis of osteoporosis is common. This study investigated Swedish district nurses' perceptions of osteoporosis management. They perceived the condition as having low priority, and the consequences of this perception were insufficient awareness of the condition and perceptions of bone-specific medication as unsafe. They perceived, though, competency when working with fall prevention. Undertreatment of patients with osteoporosis is common. Sweden's medical care strategy dictates prioritisation of various conditions; while guidelines exist, osteoporosis is not prioritised. The aim of this study was to investigate district nurses' perceptions of osteoporosis management within Sweden's primary health care system. Four semi-structured focus group interviews were conducted with 13 female district nurses. The interviews were analysed using thematic analysis. The overall theme was perceiving osteoporosis management as ambiguous. The themes were perceiving barriers and perceiving opportunities. These subthemes were linked to perceiving barriers: (i) insufficient procedures, lack of time and not aware of the condition; (ii) insufficient knowledge about diagnosis and about fracture risk assessment tools; (iii) low priority condition and unclear responsibility for osteoporosis management; and (iv) bone-specific medication was sometimes perceived to be unsafe. These subthemes were linked to perceiving opportunities: (i) professional competency when discussing fall prevention in home visit programs, (ii) willingness to learn more about osteoporosis management, (iii) collaboration with other professionals and (iv) willingness to identify individuals at high risk of fracture. Osteoporosis was reported, by the district nurses, to be a low-priority condition with consequences being unawareness of the condition, insufficient knowledge about bone-specific medications, fracture risk assessment tools and procedures. These may be some of the explanations for the undertreatment of

  13. Osteoporosis in children and adolescents: etiology and management.

    PubMed

    Baroncelli, Giampiero Igli; Bertelloni, Silvano; Sodini, Federica; Saggese, Giuseppe

    2005-01-01

    Bone mass increases progressively during childhood, but mainly during adolescence when approximately 40% of total bone mass is accumulated. Peak bone mass is reached in late adolescence, and is a well recognised risk factor for osteoporosis later in life. Thus, increasing peak bone mass can prevent osteoporosis. The critical interpretation of bone mass measurements is a crucial factor for the diagnosis of osteopenia/osteoporosis in children and adolescents. To date, there are insufficient data to formally define osteopenia/osteoporosis in this patient group, and the guidelines used for adult patients are not applicable. In males and females aged <20 years the terminology 'low bone density for chronologic age' may be used if the Z-score is less than -2. For children and adolescents, this terminology is more appropriate than osteopenia/osteoporosis. Moreover, the T-score should not be used in children and adolescents. Many disorders, by various mechanisms, may affect the acquisition of bone mass during childhood and adolescence. Indeed, the number of disorders that have been identified as affecting bone mass in this age group is increasing as a consequence of the wide use of bone mass measurements. The increased survival of children and adolescents with chronic diseases or malignancies, as well as the use of some treatment regimens has resulted in an increase in the incidence of reduced bone mass in this age group. Experience in treating the various disorders associated with osteoporosis in childhood is limited at present. The first approach to osteoporosis management in children and adolescents should be aimed at treating the underlying disease. The use of bisphosphonates in children and adolescents with osteoporosis is increasing and their positive effect in improving bone mineral density is encouraging. Osteoporosis prevention is a key factor and it should begin in childhood. Pediatricians should have a fundamental role in the prevention of osteoporosis

  14. [Management of osteoporosis: room for improvment].

    PubMed

    Roux, Christian

    2010-11-01

    The objective of anti-osteoporotic treatments is the prevention of the first or recurrent fractures. Screening of at risk patients is the basis of improvement of osteoporosis management. Prevalent fractures are strong determinants of incident fractures. In patients without fractures screening of risk factors, and quantification of risk using FRAX tool, allows detection of patients who should receive highest priority for treatment. Several drugs have shown that they are able to decrease the risk of fracture, providing persistence and compliance. Non pharmacological approach (including nutrition and physical activity) is part of optimal management of osteoporosis.

  15. Osteoporosis, osteopenia, and atherosclerotic vascular disease

    PubMed Central

    Aronow, Wilbert S.

    2011-01-01

    Older women with low bone mineral density (BMD) have a higher prevalence of atherosclerotic vascular disease (coronary artery disease, ischemic stroke, or peripheral arterial disease) than older women with normal BMD. Three coronary angiographic studies have shown that low BMD is associated with obstructive coronary artery disease. Low BMD has been shown to be associated with stress test-induced myocardial ischemia, reduced exercise capacity, and with aortic valve calcification. Women with osteoporosis have an increased risk for cardiovascular events. Treatment of osteoporosis or osteopenia should include therapeutic measures to prevent cardiovascular events. PMID:22291728

  16. Subcutaneous administration of insulin-like growth factor (IGF)-II/IGF binding protein-2 complex stimulates bone formation and prevents loss of bone mineral density in a rat model of disuse osteoporosis

    NASA Technical Reports Server (NTRS)

    Conover, Cheryl A.; Johnstone, Edward W.; Turner, Russell T.; Evans, Glenda L.; John Ballard, F. John; Doran, Patrick M.; Khosla, Sundeep

    2002-01-01

    Elevated serum levels of insulin-like growth factor binding protein-2 (IGFBP-2) and a precursor form of IGF-II are associated with marked increases in bone formation and skeletal mass in patients with hepatitis C-associated osteosclerosis. In vitro studies indicate that IGF-II in complex with IGFBP-2 has high affinity for bone matrix and is able to stimulate osteoblast proliferation. The purpose of this study was to determine the ability of the IGF-II/IGFBP-2 complex to increase bone mass in vivo. Osteopenia of the femur was induced by unilateral sciatic neurectomy in rats. At the time of surgery, 14-day osmotic minipumps containing vehicle or 2 microg IGF-II+9 microg IGFBP-2/100g body weight/day were implanted subcutaneously in the neck. Bone mineral density (BMD) measurements were taken the day of surgery and 14 days later using a PIXImus small animal densitometer. Neurectomy of the right hindlimb resulted in a 9% decrease in right femur BMD (P<0.05 vs. baseline). This loss in BMD was completely prevented by treatment with IGF-II/IGFBP-2. On the control limb, there was no loss of BMD over the 14 days and IGF-II/IGFBP-2 treatment resulted in a 9% increase in left femur BMD (P<0.05). Bone histomorphometry indicated increases in endocortical and cancellous bone formation rates and in trabecular thickness. These results demonstrate that short-term administration of the IGF-II/IGFBP-2 complex can prevent loss of BMD associated with disuse osteoporosis and stimulate bone formation in adult rats. Furthermore, they provide proof of concept for a novel anabolic approach to increasing bone mass in humans with osteoporosis.

  17. Beneficial effects of traditional Chinese medicine on the treatment of osteoporosis on ovariectomised rat models.

    PubMed

    Rufus, Pamela; Mohamed, Norazlina; Shuid, Ahmad Nazrun

    2013-12-01

    Osteoporosis is a metabolic bone disorder that affects both men and women worldwide. It causes low bone mass and therefore increases bone susceptibility to fracture when bone undergoes a minor trauma. Lack of estrogen is the principal cause of osteoporosis. Estrogen, calcium, calcitonin, vitamin D and several antioxidants help in the prevention of osteoporosis. In order to effectively treat osteoporosis, there has been an extended research on the biological activities of traditional medicines since synthetic medicines possess several side effects that reduce their efficacy. Therefore, there is a need to develop new treatment alternatives for osteoporosis. This review centres on the scientific researches carried out on the evaluation of Chinese traditional medicines in the treatment of osteoporosis. Various plants like Achyranthes bidentata, Davallia formosana, polygonatum sibiricum, Cibotium barometz, Er-Zhi-Wan, Curculigo orchioides and a combined treatment of Hachimi-jio-gan (Ba-Wei-Di-Huang-Wan) with alendronate proved active in preventing post-menopausal osteoporosis.

  18. New Antiresorptive Therapies for Postmenopausal Osteoporosis

    PubMed Central

    2015-01-01

    Osteoporosis is a systemic skeletal disease whose risk increases with age and it is common among postmenopausal women. Currently, almost all pharmacological agents for osteoporosis target the bone resorption component of bone remodeling activity. Current antiresorptive agents are effective, but the effectiveness of some agents is limited by real or perceived intolerance, longterm adverse events (AEs), coexisting comorbidities, and inadequate long-term adherence. New antiresorptive therapies that may expand options for the prevention and treatment of osteoporosis include denosumab, combination of conjugated estrogen/bazedoxifene and cathepsin K inhibitors. However, the long-term efficacy and AEs of these antiresorptive therapies need to be confirmed in studies with a longer follow-up period. PMID:26046031

  19. Vitamin K₂ therapy for postmenopausal osteoporosis.

    PubMed

    Iwamoto, Jun

    2014-05-16

    Vitamin K may play an important role in the prevention of fractures in postmenopausal women with osteoporosis. Menatetrenone is the brand name of a synthetic vitamin K2 that is chemically identical to menaquinone-4. The present review study aimed to clarify the effect of menatetrenone on the skeleton in postmenopausal women with osteoporosis, by reviewing the results of randomized controlled trials (RCTs) in the literature. RCTs that investigated the effect of menatetrenone on bone mineral density (BMD), measured by dual-energy X-ray absorptiometry and fracture incidence in postmenopausal women with osteoporosis, were identified by a PubMed search for literature published in English. Eight studies met the criteria for RCTs. Small RCTs showed that menatetrenone monotherapy decreased serum undercarboxylated osteocalcin (ucOC) concentrations, modestly increased lumbar spine BMD, and reduced the incidence of fractures (mainly vertebral fracture), and that combined alendronate and menatetrenone therapy enhanced the decrease in serum ucOC concentrations and further increased femoral neck BMD. This review of the literature revealed positive evidence for the effects of menatetrenone monotherapy on fracture incidence in postmenopausal women with osteoporosis. Further studies are required to clarify the efficacy of menatetrenone in combination with bisphosphonates against fractures in postmenopausal women with osteoporosis.

  20. Management of glucocorticoid-induced osteoporosis.

    PubMed

    Rizzoli, R; Adachi, J D; Cooper, C; Dere, W; Devogelaer, J P; Diez-Perez, A; Kanis, J A; Laslop, A; Mitlak, B; Papapoulos, S; Ralston, S; Reiter, S; Werhya, G; Reginster, J Y

    2012-10-01

    This review summarizes the available evidence-based data that form the basis for therapeutic intervention and covers the current status of glucocorticoid-induced osteoporosis (GIOP) management, regulatory requirements, and risk-assessment options. Glucocorticoids are known to cause bone loss and fractures, yet many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated. An European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis workshop was convened to discuss GIOP management and to provide a report by a panel of experts. An expert panel reviewed the available studies that discussed approved therapeutic agents, focusing on randomized and controlled clinical trials reporting on bone mineral density and/or fracture risk of at least 48 weeks' duration. There is no evidence that GIOP and postmenopausal osteoporosis respond differently to treatments. The FRAX algorithm can be adjusted according to glucocorticoid dose. Available antiosteoporotic therapies such as bisphosphonates and teriparatide are efficacious in GIOP management. Several other agents approved for the treatment of postmenopausal osteoporosis may become available for GIOP. It is advised to stop antiosteoporotic treatment after glucocorticoid cessation, unless the patient remains at increased risk of fracture. Calcium and vitamin D supplementation as an osteoporosis-prevention measure is less effective than specific antiosteoporotic treatment. Fracture end-point studies and additional studies investigating specific subpopulations (pediatric, premenopausal, or elderly patients) would strengthen the evidence base and facilitate the development of intervention thresholds and treatment guidelines.

  1. Efficacy of Osteoporosis Therapies in Diabetic Patients.

    PubMed

    Schwartz, Ann V

    2017-02-01

    Diabetes is characterized by increased fracture risk and by reduced bone strength for a given density. Contributing factors may include lower bone turnover and accumulation of advanced glycation endproducts. There are concerns that the pharmacological therapies for osteoporosis, particularly anti-resorptive therapies that suppress bone turnover, may not be as effective in the setting of diabetes. This review considers clinical trials and observational studies that have assessed the efficacy of anti-resorptive and anabolic therapies in diabetic patients. Post hoc analyses of randomized trials indicate that raloxifene has similar efficacy for prevention of vertebral fractures in diabetic compared with non-diabetic patients. Evidence from randomized clinical trials is lacking for anti-fracture efficacy of other osteoporosis therapies in diabetes. However, observational studies suggest that bisphosphonates are effective in preventing fractures in diabetic patients. The great majority of diabetic patients in studies to date have been type 2, and efficacy of osteoporosis therapies in type 1 diabetic patients remains to be addressed. Further evaluation of the efficacy of osteoporosis therapies in the setting of diabetes is needed to provide optimal fracture prevention for this population.

  2. Glucocorticoid-induced osteoporosis: 2013 update.

    PubMed

    Mazzantini, M; Di Munno, O

    2014-07-28

    Glucocorticoids are the most common cause of secondary osteoporosis leading to the so-called glucocorticoid-induced osteoporosis (GIO). A treatment with 10 mg/d of prednisone or equivalent for more than 3 months leads to a 7-fold increase in hip fractures and a 17-fold increase in vertebral fractures. The difference between bone quantity and quality in GIO makes bone mineral density measurements inadequate to detect patients at risk of fracture. The adverse effects of glucocorticoids on the skeleton derive from a direct impact on bone cells with a severe impairment of mechanical competence. Crucial to prevention of GIO is early timing of intervention. The World Health Organization has adopted a fracture prevention algorithm (FRAX) intended to estimate fracture risk in GIO. The American College of Rhematology modified its prevention and treatment guidelines taking into account the individual risk of fracture calculated in GIO on the basis of the FRAX algorithm. Recently, also a joint Guideline Working Group of the International Osteoporosis Foundation (IOF) and the European Calcified Tissue Society (ECTS) published a framework for the development of national guidelines for the management of GIO. Bisphosphonates are the first-line drugs to treat GIO; teriparatide counteracts several fundamental pathophysiologic aspects of GIO; denosumab is useful in patients with renal failure and in potentially pregnant young women. Vertebroplasty and kyphoplasty may be less beneficial in GIO than in primary involutional osteoporosis.

  3. Diagnosis of Osteoporosis.

    ERIC Educational Resources Information Center

    Wahner, H. W.

    1987-01-01

    Early recognition of osteoporosis is difficult because symptoms are lacking and there are no distinct, readily accessible diagnostic features. This article reviews the standard approach, radiographic and laboratory diagnosis, bone mass measurement techniques, and interpretation of bone mineral data. (MT)

  4. Medicines for osteoporosis

    MedlinePlus

    ... Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... Your doctor may prescribe certain medicines to help lower your ... make the bones in your hips, spine, and other areas less likely ...

  5. Diagnosis of Osteoporosis.

    ERIC Educational Resources Information Center

    Wahner, H. W.

    1987-01-01

    Early recognition of osteoporosis is difficult because symptoms are lacking and there are no distinct, readily accessible diagnostic features. This article reviews the standard approach, radiographic and laboratory diagnosis, bone mass measurement techniques, and interpretation of bone mineral data. (MT)

  6. [Hypertension and osteoporosis].

    PubMed

    Nakagami, Hironori; Morishita, Ryuichi

    2013-04-01

    The number of patients with high blood pressure and osteoporosis are increased year by year in our society. In hypertension patients, excess urinary calcium secretion induces secondary parathyroidism to increase serum calcium level by calcium release from bone, which may accelerate osteoporosis. In this aspect, there are several reports that anti-hypertensive drugs, especially thiazides, increase bone mineral density and decrease the incidence of bone fracture. In addition, we demonstrated that renin-angiotensin system can be involved in the process of osteoporosis. Angiotensin II significantly induced the expression of RANKL (receptor activator of NF-κB ligand) in osteoblasts, leading to the activation of osteoclasts, while these effects were completely blocked by an Ang II type 1 receptor blockade. Recently, it has been reported that angiotensin receptor blockade clinically decreased the incidence of bone fracture. Renin-angiotensin system might be common molecule to regulate both hypertension and osteoporosis.

  7. Periodontitis and osteoporosis.

    PubMed

    Straka, Michal; Straka-Trapezanlidis, Michaela; Deglovic, Juraj; Varga, Ivan

    2015-01-01

    Today's knowledge and studies show a firm correlation between osteoporosis and periodontitis, particularly in postmenopausal women. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and an osteoporosis. A special emphasis is put on explanation of possible relations between a premature tooth loss and decrease of length and density of jaw bones, particularly their alveolar prolongations. The second part of the paper deals with principles of treatment in patients suffering of osteoporosis. Osteoporosis reduces density of jaw bones and decreases a number of teeth in jaws, but it does not affect other clinical signs and markers of periodontitis such as inflammation, bleeding and the depth of periodontal pockets and microbial plaque.

  8. The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada

    PubMed Central

    Hawker, G.; Cameron, C.; Canavan, J.; Beaton, D.; Bogoch, E.; Jain, R.; Papaioannou, A.

    2016-01-01

    In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives. PMID:20309525

  9. Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms.

    PubMed

    Wongdee, Kannikar; Charoenphandhu, Narattaphol

    2011-03-15

    Osteoporosis, a global age-related health problem in both male and female elderly, insidiously deteriorates the microstructure of bone, particularly at trabecular sites, such as vertebrae, ribs and hips, culminating in fragility fractures, pain and disability. Although osteoporosis is normally associated with senescence and estrogen deficiency, diabetes mellitus (DM), especially type 1 DM, also contributes to and/or aggravates bone loss in osteoporotic patients. This topic highlight article focuses on DM-induced osteoporosis and DM/osteoporosis comorbidity, covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including, insulin, insulin-like growth factor-1 and angiogenesis. Cellular and molecular mechanisms of DM-related bone loss are also discussed. This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.

  10. Safety of pharmacotherapy of osteoporosis in cardiology patients.

    PubMed

    Zapolski, Tomasz; Wysokiński, Andrzej

    2010-01-01

    The commonest medical conditions following menopause are osteoporosis and atherosclerotic disease. This review considers the safety of pharmacotherapy of osteoporosis in cardiology patients. Drugs used for osteoporosis treatment may have adverse effects on the cardiovascular system. This article has detailed analysed of current drug classes, such as the bisphosphonates and strontium ranelate, as well as reviewed of the controversy surrounding hormone replacement therapy (HRT) and the selective estrogen receptor modulators (SERMs). Additionally, we discuss the adverse effects on the heart of calcium and drugs influencing calcium metabolism such as vitamin D, parathormone and calcitonin. We look at the interference between osteoporosis treatment and the drugs used for atherosclerosis. Moreover, the side effects on bones of cardiology drugs are analysed. Lastly, the possible advantages of selected drugs used for cardiovascular diseases in terms of osteoporosis prevention are evaluated.

  11. Wnt signaling and osteoporosis

    PubMed Central

    Manolagas, Stavros C.

    2014-01-01

    Major advances in understanding basic bone biology and the cellular and molecular mechanisms responsible for the development of osteoporosis, over the last 20 years, have dramatically altered the management of this disease. The purpose of this mini-review is to highlight the seminal role of Wnt signaling in bone homeostasis and disease and the emergence of novel osteoporosis therapies by targeting Wnt signaling with drugs. PMID:24815296

  12. Osteoporosis: the role of micronutrients.

    PubMed

    Nieves, Jeri W

    2005-05-01

    Osteoporosis and low bone mass are currently estimated to be a major public health threat. Adequate nutrition plays a major role in the prevention and treatment of osteoporosis; the micronutrients of greatest importance are calcium and vitamin D. Calcium has been shown to have beneficial effects on bone mass at all ages, although the results are not always consistent. Higher doses than the current US recommendation (600 IU) of vitamin D in the elderly (age > or = 65 y) may actually be required for optimal bone health (800-1000 IU/d). The elderly can clearly benefit from increased vitamin D intakes; however, the potential importance of vitamin D in peak bone mass is just being investigated. Vitamin D has been related to falls, with supplementation reducing the number of falls. There are clear fracture benefits demonstrated in randomized clinical trials of calcium and vitamin D supplementation. The other micronutrient needs for optimizing bone health can be easily met by a healthy diet that is high in fruits and vegetables to ensure adequate intakes for magnesium, potassium, vitamin C, vitamin K, and other potentially important nutrients. Healthcare professionals need to be aware of the importance of adequate calcium and vitamin D intakes (easily monitored by serum 25(OH)D) for optimal bone health, as well as the prevention of falls and fractures. In addition, a healthy diet that includes 5 servings a day of fruits and vegetables should optimize the intake of micronutrients required for bone health.

  13. Bisphosphonates for Osteoporosis: Benefits and Risks

    MedlinePlus

    ... o es sis : Benefits and Risks What is osteoporosis? Osteoporosis is a condition in which your bones become ... through menopause are especially at risk of developing osteoporosis. Osteoporosis is more common in women than in ...

  14. Therapeutic potential and outlook of alternative medicine for osteoporosis.

    PubMed

    Wang, Tao; Liu, Qian; Tjhioe, William; Zhao, Jinmin; Lu, Aiping; Zhang, Ge; Tan, Renxiang; Zhou, Mengyu; Xu, Jiake; Feng, Haotian

    2017-03-21

    Osteoporosis, a bone disease resulting in loss of bone density and microstructure quality, is often associated with fragility fractures, and the latter imposes a great burden on the patient and society. Although there are several different treatments available for osteoporosis such as hormone replacement therapy, bisphosphonates, Denosumab, and parathyroid hormone some concern has been raised regarding the inherent side effects of their long term use. It would be of great relevance to search for alternative natural compounds, which could complementarily overcome the limitations of the currently available therapy. Herein, we review current literature on natural compounds that might have therapeutic values for osteoporosis. Search terms included bone resorption, bone density, osteoporosis, postmenopausal, osteoporosis or bone density conservation agents, and any of the terms related to traditional, herbal, natural therapy, natural health, diet, or phytoestrogens. All the compounds and herbs included in the review are naturally bioactive or are used in folk herbal medicine and have been reported to be capable of attenuating osteopenia or osteoporosis in vivo or in vitro, through various mechanisms - estrogen-like activity, antioxidant and anti-inflammatory properties, or by modulating the key signaling pathways in the pathogenesis of osteoporosis. Through our assessment of the therapeutic potential and outlook of alternative medicine, we aim to provide an appealing perspective for the consideration of the application of a complementary anti-osteoporotic treatment option and prevention strategy for osteoporosis or osteolytic bone disorders.

  15. Factors associated with the treatment of osteoporosis in Korean postmenopausal women.

    PubMed

    Jeon, Young-Jee; Kim, Ji Wan; Park, Joo-Sung

    2014-01-01

    This retrospective study was designed to investigate the treatment rate of osteopenia and osteoporosis after diagnosis and determine factors related to osteoporosis treatment in Korea. This analysis included postmenopausal women who had visited the health promotion center from March 2010 to May 2011 (n = 375) and been diagnosed with osteoporosis (19.5%) or osteopenia (45.9%). Telephone surveys were performed one year after diagnosis. We employed multiple logistic regression to determine factors associated with treatment using clinical risk factors as covariates in a FRAX model. Receipt of osteoporosis treatment (nutrition, exercise, and medications) to prevent osteoporotic fracture was reported by 108 of 172 (63.4%) women with osteopenia and 66 of 73 (90.4%) with osteoporosis. Only consultation with a doctor for osteopenia or osteoporosis was significantly related to receiving osteoporosis treatment for osteopenia (odds ratio [OR], 5.01; 95% confidence interval [CI], 2.01-12.00) and osteoporosis (OR, 4.91; 95% CI, 1.16-20.75). In the osteopenic group, increased age, being a current smoker, having a history of parental fracture or previous fracture, and secondary osteoporosis were related to consultation with a doctor. Of women with osteopenia 36.6% and 64.4% with osteoporosis received consultation with a doctor. Consultation with a doctor for osteopenia or osteoporosis after being diagnosed could be an effective strategy to increase osteoporosis treatment.

  16. Osteoporosis: therapeutic guidelines. Guidelines for practice management of osteoporosis.

    PubMed

    Khan, Sana N; Craig, Latasha; Wild, Robert

    2013-12-01

    Therapeutic guidelines of osteoporosis are reviewed from North American Menopause Society, American Association of Clinical Endocrinologists, American College of Obstetrics and Gynecology, and the National Osteoporosis Foundation. The various guidelines are compared and discussed.

  17. Estrogen therapy for postmenopausal osteoporosis.

    PubMed

    Fitzpatrick, Lorraine A

    2006-08-01

    Osteoporosis is a worldwide problem that results in fractures that lead to disability and high costs to society. Estrogen therapy is frequently utilized for postmenopausal symptoms, but also has proven protective effects on the skeleton. The main action of estrogen at the cellular level is to inhibit the osteoclast by increasing levels of osteoprotegerin (OPG). OPG binds to the receptor activator of NFkB and prevents osteoclast differentiation, activity and survival. Numerous trials have demonstrated the positive effect estrogen has on the improvement of bone mineral density, and lower doses have also proven efficacious with fewer side effects. Both observational and randomized clinical trials have demonstrated the ability of estrogen treatment to prevent fractures. Topics that remain controversial include the appropriate length of estrogen treatment for postmenopausal women and the appropriate follow-up after treatment discontinuation.

  18. Osteoporosis in men: its pathophysiology and the role of teriparatide in its treatment.

    PubMed

    Gagnon, Claudia; Li, Vivien; Ebeling, Peter R

    2008-01-01

    As the population ages, the burden of osteoporosis in men is expected to rise. Implementation of preventive measures such as falls prevention strategies, exercise and adequate calcium and vitamin D intake is recommended. However, when the diagnosis of osteoporosis is made, effective treatments need to be initiated to prevent fractures. As opposed to postmenopausal women, reduced bone formation is the predominant mechanism of age-related bone loss in men, making anabolic agents a logical treatment option for men with osteoporosis. Teriparatide is the only anabolic agent currently approved for treatment of osteoporosis in men. This paper summarizes the mechanism of action of teriparatide, as well as its tolerability and safety. Furthermore, the evidence supporting the efficacy of teriparatide treatment in men with osteoporosis is reviewed and its current role in the management of osteoporosis in men is discussed.

  19. Osteoporosis knowledge among female school students in Jordan.

    PubMed

    Abushaikha, L; Omran, S; Barrouq, L

    2009-01-01

    Although osteoporosis is a preventable disease affecting millions of people, public awareness remains low. This study used a pretest-posttest quasi-experimental design to explore osteoporosis knowledge among adolescent female students in Jordan. A questionnaire was administered to 148 students recruited from a secondary school in the city of Irbid before and after a series of health education sessions based on the health belief model. A significant increase in overall scores for osteoporosis knowledge was seen (mean score pretest = 24.1 and posttest = 29.8, P < 0.001). Further research geared toward the follow-up of attained knowledge and behavioural change over time is greatly needed.

  20. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs.

    PubMed

    Hellstein, John W; Adler, Robert A; Edwards, Beatrice; Jacobsen, Peter L; Kalmar, John R; Koka, Sreenivas; Migliorati, Cesar A; Ristic, Helen

    2011-11-01

    This narrative review of osteonecrosis of the jaw in patients with low bone mass receiving treatment with antiresorptive agents is based on an appraisal of the literature by an advisory committee of the American Dental Association Council on Scientific Affairs. It updates the committee's 2008 advisory statement. The authors searched MEDLINE for literature published between May 2008 (the end date of the last search) and February 2011. This report contains recommendations based on the findings of the literature search and on expert opinion that relate to general dentistry; periodontal disease management; implant placement and maintenance; oral and maxillofacial surgery; endodontics; restorative dentistry and prosthodontics; orthodontics; and C-terminal telopeptide testing and drug holidays. The highest reliable estimate of antiresorptive agent-induced osteonecrosis of the jaw (ARONJ) prevalence is approximately 0.10 percent. Osteoporosis is responsible for considerable morbidity and mortality. Therefore, the benefit provided by antiresorptive therapy outweighs the low risk of developing osteonecrosis of the jaw. An oral health program consisting of sound hygiene practices and regular dental care may be the optimal approach for lowering ARONJ risk. No validated diagnostic technique exists to determine which patients are at increased risk of developing ARONJ. Discontinuing bisphosphonate therapy may not lower the risk but may have a negative effect on low-bone-mass-treatment outcomes.

  1. The potential benefits and inherent risks of vibration as a non-drug therapy for the prevention and treatment of osteoporosis.

    PubMed

    Chan, M Ete; Uzer, Gunes; Rubin, Clinton T

    2013-03-01

    The delivery of mechanical signals to the skeleton using vibration is being considered as a non-drug treatment of osteoporosis. Delivered over a range of magnitudes and frequencies, vibration has been shown to be both anabolic and anti-catabolic to the musculoskeletal tissues, yet caution must be emphasized as these mechanical signals, particularly chronic exposure to higher intensities, is a known pathogen to many physiological systems. In contrast, accumulating preclinical and clinical evidence indicates that low intensity vibration (LIV) improves bone quality through regulating the activity of cells responsible for bone remodeling, as well as biasing the differentiation fate of their mesenchymal and hematopoietic stem cell progenitors. In vitro studies provide insights into the biologic mechanisms of LIV, and indicate that cells respond to these low magnitude signals through a distinct mechanism driven not by matrix strain but acceleration. These cell, animal, and human studies may represent the foundation of a safe, non-drug means to protect and improve the musculoskeletal system of the elderly, injured, and infirmed.

  2. The Potential Benefits and Inherent Risks of Vibration as a Non-Drug Therapy for the Prevention and Treatment of Osteoporosis

    PubMed Central

    Chan, M. Ete; Uzer, Gunes; Rubin, Clinton T.

    2013-01-01

    The delivery of mechanical signals to the skeleton using vibration is being considered as a non-drug treatment of osteoporosis. Delivered over a range of magnitudes and frequencies, vibration has been shown to be both anabolic and anti-catabolic to the musculoskeletal tissues, yet caution must be emphasized as these mechanical signals, particularly chronic exposure to higher intensities, is a known pathogen to many physiological systems. In contrast, accumulating preclinical and clinical evidence indicates that low intensity vibration (LIV) improves bone quality through regulating the activity of cells responsible for bone remodeling, as well as biasing the differentiation fate of their mesenchymal and hematopoietic stem cell progenitors. In vitro studies provide insights into the biologic mechanisms of LIV, and indicate that cells respond to these low magnitude signals through a distinct mechanism driven not by matrix strain but acceleration. These cell, animal and human studies may represent the foundation of a safe, non-drug means to protect and improve the musculoskeletal system of the elderly, injured and infirm. PMID:23371467

  3. Osteoporosis and Arthritis: Two Common but Different Conditions

    MedlinePlus

    ... your browser. Home Osteoporosis Osteoporosis and Other Conditions Osteoporosis and Arthritis: Two Common but Different Conditions Publication ... between these conditions. Osteoporosis Arthritis For Your Information Osteoporosis Osteoporosis is a condition in which the bones ...

  4. Bones and nutrition: common sense supplementation for osteoporosis.

    PubMed

    Advani, Sonoo; Wimalawansa, Sunil J

    2003-06-01

    Osteoporosis is a serious public health concern. Skeletal fragility, leading to spine and hip fractures, is a major source of morbidity and mortality. Adequate calcium intake from childhood to the end of life is critical for the formation and retention of a healthy skeleton. It is important to prevent bone loss from occurring, to identify potential risk factors, and to correct them. Many genetic and lifestyle factors influence the risk for osteoporosis. Among these, diet is believed to be one of the most important, especially the roles of calcium and vitamin D. Deficiency in other dietary factors--eg, protein, vitamin K, vitamin A, phytoestrogens, and other nutrients--might also contribute to the risk for osteoporosis. In this article, the roles of diet and nutritional supplementation in preventing and treating osteoporosis are reviewed.

  5. [Treatment of osteoporosis with Denosumab].

    PubMed

    Ferrari, Serge

    2012-03-01

    Denosumab is the first human monoclonal antibody for the treatment of osteoporosis. By inhibiting RANK Ligand, Denosumab prevents the development, activation and survival of osteoclasts. The FREEDOM study reported a 68 % reduction of vertebral fractures, 20 % of non-vertebral fractures and 40 % of hip fractures after 3 years in post-menopausal women with osteoporosis receiving denosumab 60 mg sc every six months vs. placebo. Five years extension of the denosumab group showed a further decrease in the rate of both vertebral and non-vertebral fractures, whereas BMD at spine and hip increased continuously. There was no increase in the rate of adverse events year after year, including of infections, cancer, atypical fractures, delayed fracture healing or ONJ. Clinical hypocalcemia was rare in the context of calcium and vitamin D supplementation. Pre-planned and post-hoc subgroup analyses have further shown the anti-fracture efficacy of denosumab in high-risk subgroups, such as older women and those with low T-scores and/or prevalent vertebral fractures. Denosumab withdrawal is accompanied by a transient rebound of bone turnover markers and a proportional BMD loss. Smaller randomized controlled studies have shown that denosumab further improves BMD after one year compared to alendronate.

  6. Male osteoporosis: A review

    PubMed Central

    Herrera, Antonio; Lobo-Escolar, Antonio; Mateo, Jesús; Gil, Jorge; Ibarz, Elena; Gracia, Luis

    2012-01-01

    Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism. Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis. PMID:23362466

  7. Pathophysiology of immobilization osteoporosis

    NASA Technical Reports Server (NTRS)

    Doty, S. B.; DiCarlo, E. F.

    1995-01-01

    The reduction of gravity-related forces on the skeleton creates a type of osteoporosis that is unique because its severity is dependent on the mechanical stress bearing function of the skeleton as well as the length of time that the forces are absent or reduced. Bones that bear weight under normal conditions are more affected than bones that normally do not bear weight. The cytokine environment and the cells in the affected bones are altered in time so that stem cells produce fewer new cells and the differentiated cells tend to be less active. These alterations in the local environment of the affected parts appear to resemble those of age- and disease-associated systemic forms of osteoporosis. The osteoporosis produced as a result of the loss of normal activity however, appears to be at least partially reversible through remobilization, strenuous exercise, and--possibly in the future--cytokine therapy.

  8. New Horizons in Osteoporosis

    PubMed Central

    Rachner, Tilman D.; Khosla, Sundeep; Hofbauer, Lorenz C.

    2013-01-01

    Summary Osteoporosis is a common disease characterised by a systemic impairment of bone mass and microarchitecture that results in fragility fractures. With an ageing population, the medical and socioeconomic impact of osteoporosis in general and postmenopausal osteoporosis in particular, will increase further. A detailed knowledge of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signalling network has led to the identification of novel therapeutic targets. Based on this, therapeutic strategies have been developed aimed at (I) inhibiting excessive bone resorption and by (II) increasing bone formation. The most promising novel treatments include denosumab, a monoclonal antibody against receptor activator of NF-κB ligand, a key osteoclast cytokine, odanacatib, a specific inhibitor of the osteoclast protease cathepsin K, and antibodies against the proteins sclerostin and dickkopf-1, two endogenous inhibitors of bone formation. This review provides an overview on these novel therapies and explains their underlying physiology. PMID:21450337

  9. Emerging therapies for osteoporosis.

    PubMed

    Minisola, G; Iuliano, A; Prevete, I

    2014-07-28

    Currently available drugs for the treatment of osteoporosis can still be improved in terms of pharmacokinetics, pharmacodynamics and management. New approaches for the development of innovative drugs are possible thanks to our increasing understanding of the bone tissue biology and the cellular and molecular processes that regulate it. One of the new anti-bone resorption agents, odanacatib, a selective cathepsin-K inhibitor, is in late phase III clinical research. Among new bone anabolic drugs, those that have an action on the Wnt signaling pathway appear to be particularly promising. The development of new compounds for the treatment of osteoporosis represents an excellent example of translational medicine efforts aimed to extend the range of treatment options for osteoporosis, a very common disease with a high social and economic impact, particularly when causing fractures.

  10. Genetics of osteoporosis.

    PubMed

    Jin, Huilin; Ralston, Stuart H

    2005-03-01

    Genetic factors play an important role in regulating bone mineral density and other phenotypes relevant to the pathogenesis of osteoporosis such as ultrasound properties of bone, skeletal geometry, and bone turnover. Progress has been made in identifying quantitative traits for regulation of bone mineral density by linkage studies in man and mouse, but relatively few causal genes have been identified. Dramatic progress has been made in identifying the genes responsible for monogenic bone diseases and it appears that polymorphisms in many of these genes also play a role in regulating bone mineral density in the general population. Advances in knowledge about the genetic basis of osteoporosis and other bone diseases offer the prospect of developing new markers for assessment of fracture risk and the identification of novel molecular targets for the design of new drug treatments for osteoporosis.

  11. Pathophysiology of immobilization osteoporosis

    NASA Technical Reports Server (NTRS)

    Doty, S. B.; DiCarlo, E. F.

    1995-01-01

    The reduction of gravity-related forces on the skeleton creates a type of osteoporosis that is unique because its severity is dependent on the mechanical stress bearing function of the skeleton as well as the length of time that the forces are absent or reduced. Bones that bear weight under normal conditions are more affected than bones that normally do not bear weight. The cytokine environment and the cells in the affected bones are altered in time so that stem cells produce fewer new cells and the differentiated cells tend to be less active. These alterations in the local environment of the affected parts appear to resemble those of age- and disease-associated systemic forms of osteoporosis. The osteoporosis produced as a result of the loss of normal activity however, appears to be at least partially reversible through remobilization, strenuous exercise, and--possibly in the future--cytokine therapy.

  12. [Therapy of postmenopausal osteoporosis].

    PubMed

    Keck, E

    2003-12-01

    The therapy of postmenopausal osteoporosis is based on a few comprehensible assumptions. High bone resorption should be reduced by treatment with bisphosphonates, raloxifene or seldom with calcitonins. After reduction of high bone turnover and in low bone turnover situations, an osteoinductive combination therapy should be started, inducing collagen type I with parathyroid hormone or fluorides. This collagen can then be mineralized by calcium, vitamin D, and vitamin D metabolites. In addition, bone resorption should be reduced during menopause with estrogens and gestagens, in the case of a receptor-positive breast cancer with tamoxifen, and after menopause with raloxifene or a bisphosphonate. In elderly patients a depletion of vitamin D often induces an osteoporomalacia instead of an osteoporosis. In this situation, mineralization of the osteoid by calcium and vitamin D is sufficient for therapy. A daily osteoporosis gymnastic program is required and physical activity should be enhanced to increase muscle mass because bone adapts to the individual situation.

  13. Osteoporosis: the emperor has no clothes

    PubMed Central

    Järvinen, T L N; Michaëlsson, K; Aspenberg, P; Sievänen, H

    2015-01-01

    Current prevention strategies for low-trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone-targeted pharmacotherapy (treatment). However, all these three notions can be disputed. Pathophysiology Most fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty. Screening Currently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture. Treatment The evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65–80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20–25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment. PMID:25809279

  14. Pharmacoeconomic analysis of osteoporosis treatment with risedronate.

    PubMed

    Brecht, J G; Kruse, H P; Felsenberg, D; Möhrke, W; Oestreich, A; Huppertz, E

    2003-01-01

    Hip fracture is an important and costly problem. Therapy with the bisphosphonate risedronate effectively prevents hip and other fractures among women with established osteoporosis. Risedronate is a first-choice therapy option in the German Guidelines of the Dachverband Osteologie for Osteoporosis according to evidence-based medicine criteria for the treatment of postmenopausal osteoporosis, osteoporosis of the elderly (women aged > 75 years) and glucocorticoid-induced osteoporosis. There are few published economic evaluations of bisphosphonates in Germany. Therefore, an assessment of the cost-effectiveness of risedronate utilizing a state transition Markov model of established postmenopausal osteoporosis based on randomized clinical trial data was developed. Uncertainty underlying model parameters and outcomes was dealt with using traditional sensitivity analysis and stochastic sensitivity analysis to produce quasi-95% Cls. We focused on patients aged 70 years, since this population most closely matches the randomized controlled trial and is typical of osteoporosis patients in Germany. The baseline model was a cohort of 1,000 70-year-old women, who received risedronate for 3 years and were followed up for an overall observation period of 10 years, modelling transitions through estimated health states and evaluating outcomes. Over the 3-year treatment period and 10-year observation period, risedronate dominated the current average basic treatment in Germany. In the risedronate group 33 hip fractures were averted and 32 quality-adjusted life years (QALYs) were gained (discounted values). Risedronate treatment saves costs for German social insurance: the present net value of the associated costs from the perspective of German social insurance is [symbol: see text]10.66 million if risedronate treatment is used versus [symbol: see text]11 million if basic treatment is used. Thus, net savings of [symbol: see text]340,000 for the treatment group per 1,000 treated women

  15. [Osteoporosis: Optimizing treatment strategy].

    PubMed

    Thomas, Thierry

    2006-10-01

    Selection of patients for treatment is based on the assessment of their absolute fracture risk over 10 years. Assessment of fracture risk includes not only DXA measurement and age, the two principal risk factors, but also other clinical risk factors. The main goal of postmenopausal osteoporosis treatment is to reduce the risk of fragility fractures. Choice of treatment is based on drug properties, demonstrated in clinical trials, and patients' specific fracture risks. The minimum duration of treatment is 4-5 years, after which individual fracture risk must be reevaluated. Combinations of available drugs are not recommended for treatment of postmenopausal osteoporosis.

  16. [Radiological diagnosis of osteoporosis].

    PubMed

    Issever, A S; Link, T M

    2011-02-01

    Having at their disposal a wide range of imaging techniques, radiologists play a crucial role in the diagnostic evaluation of patients with osteoporosis. The radiological tests range from dual energy X-ray absorptiometry (DXA), which is the only reference method accepted by the WHO, to conventional radiographs for fracture characterization, to more recent techniques for analyzing trabecular structure, and the findings are decisive in initiating correct management of osteoporosis patients. This review provides an overview of established radiological techniques and an outline of new diagnostic approaches.

  17. Bone Health and Osteoporosis.

    PubMed

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  18. Studies on osteoporosis IV. Effect of benzo[b]thiophene-2- and dibenzothiophene-4-carboxylic acid on heparin accelerated osteoporosis.

    PubMed

    Robin, J C; Sharma, S D; Francis, K; Rosenstein, M; Moore, R; Vida, J A; Thomas, C C; Ambrus, J L

    1980-01-01

    Total skeletal calcium was determined in female mice with the aid of whole body neutron activation analysis. Three months treatment with heaprin produced significant osteoporosis in C3-H/St(Ha) mice but not in C57/BL6(J) mice. This was more pronounced in the younger (5-8 months) than in the older (15-18 months) animals. Two 2-thiophene carboxylic acid derivatives showed significant osteoporosis preventive activity.

  19. Postmenopausal Osteoporosis Management: A Review of the Evidence to Inform the Development of Quality Indicators.

    PubMed

    Conklin, Annalijn; Yaqub, Ohid; Celia, Claire; Nolte, Ellen

    2012-01-01

    This article aims to inform the development of quality indicators for postmenopausal osteoporosis management through (a) assessing the evidence for screening and diagnosis of osteoporosis and related risk factors, and for prevention and treatment of osteoporosis and osteoporosis-related fractures; (b) describing current practice for managing postmenopausal osteoporosis in Europe; and (c) highlighting existing gaps in the evidence base and management practices in Europe. Analyses involved a comprehensive review of reviews regarding the screening and diagnosis of osteoporosis and related risk factors and the prevention and treatment of osteoporosis and osteoporosis-related fractures. While this identified a well-developed evidence base on the effects of selected treatments on clinical outcomes of postmenopausal osteoporosis and associated fractures, and on the usefulness of selected simple risk factor assessment tools to identify postmenopausal women who would benefit from further diagnostic assessment, uncertainties remain regarding for example the optimal use of pharmacological interventions for preventive purposes and the effectiveness of population-based screening. We also carried out case study reviews of current practices for managing postmenopausal osteoporosis in England, France, Germany and Spain. We identify a need for the establishment of routine monitoring systems to enable better understanding of contemporary patterns and trends and identify care gaps in the management of postmenopausal osteoporosis and associated fractures. Such analyses are crucial to inform targeted strategies and policies to effectively address the burden of osteoporosis and associated fractures, which is sizable and set to increase across Europe. We set out considerations as a starting point for the further development of quality measures for postmenopausal osteoporosis in Europe.

  20. [Diagnosis and treatment of postmenopausal osteoporosis and osteoporosis in men. German Guidelines Update 2006].

    PubMed

    Kurth, A A; Pfeilschifter, J

    2007-07-01

    The treatment of osteoporosis and prevention of osteoporotic fractures consists of both non-drug and drug therapy. Components of non-drug therapy include the improvement of muscle strength and coordination, treatment of modifiable causes of falls, a diet rich in calcium and sufficient in calories, an adequate supply of Vitamin D and an individual assessment of drugs known to increase falls or osteoporosis. The updated DVO diagnostic and treatment guidelines for osteoporosis recommends a 30% 10-year probability for vertebral and hip fractures as an intervention threshold for drug treatment. Using epidemiological fracture data from central Europe, the guidelines provides an assessment of absolute 10-year fracture risk based on a combination of age, gender, prevalent fragility fractures, spine and total hip dual-energy x-ray absorptiometry (DXA) measurements and several other clinical risk factors.

  1. SECONDARY OSTEOPOROSIS: PATHOPHYSIOLOGY AND MANAGEMENT

    PubMed Central

    Mirza, Faryal; Canalis, Ernesto

    2015-01-01

    Osteoporosis is a skeletal disorder characterized by decreased bone mineral density and compromised bone strength predisposing to an increased risk of fractures. Although idiopathic osteoporosis is the most common form of osteoporosis, secondary factors may contribute to the bone loss and increased fracture risk in patients presenting with fragility fractures or osteoporosis. Several medical conditions and medications significantly increase the risk for bone loss and skeletal fragility. This review focuses on some of the common causes of osteoporosis, addressing the underlying mechanisms, diagnostic approach and treatment of low bone mass in the presence of these conditions. PMID:25971649

  2. Correlation between osteoporosis and cardiovascular disease.

    PubMed

    Sprini, Delia; Rini, Giovam Battista; Di Stefano, Laura; Cianferotti, Luisella; Napoli, Nicola

    2014-05-01

    Several evidences have shown in the last years a possible correlation between cardiovascular diseases and osteoporosis. Patients affected with osteoporosis, for example, have a higher risk of cardiovascular diseases than subjects with normal bone mass. However, the heterogeneous approaches and the different populations that have been studied so far have limited the strength of the findings. Studies conducted in animal models show that vascular calcification is a very complex mechanism that involves similar pathways described in the normal bone calcification. Proteins like BMP, osteopontin, osteoprotegerin play an important role at the bone level but are also highly expressed in the calcified vascular tissue. In particular, it seems that the OPG protect from vascular calcification and elevated levels have been found in patients with CVD. Other factors like oxidative stress, inflammation, free radicals, lipids metabolism are involved in this complex scenario. It is not a case that medications used for treating osteoporosis also inhibit the atherosclerotic process, acting on blood pressure and ventricular hypertrophy. Given the limited amount of available data, further studies are needed to elucidate the underlying mechanisms between osteoporosis and cardiovascular disease which may be important in the future also for preventive and therapeutic approaches of both conditions.

  3. Management of beta-thalassemia-associated osteoporosis.

    PubMed

    Giusti, Andrea; Pinto, Valeria; Forni, Gian Luca; Pilotto, Alberto

    2016-03-01

    Beta-Thalassemia-associated osteoporosis is a multifactorial and complex condition. Different acquired and genetic factors are involved in its pathogenesis. These factors produce an imbalance in bone remodeling by inhibiting osteoblast activity and increasing osteoclast function, leading to bone loss and increased fracture risk. The management of patients presenting with thalassemia-associated osteoporosis should consist of the implementation of general measures and the prescription of a specific pharmacological agent, with the aim of reducing fracture risk and preventing disability and deterioration of quality of life. General measures include control of anemia, adequate chelation therapy, healthy nutrition and lifestyle, regular exercise, adequate management of comorbid conditions, hormone replacement therapy in patients with hypogonadism, and vitamin D supplementation/therapy. Among the pharmacological agents currently available for the management of osteoporosis in postmenopausal women and men, bisphosphonates have been shown to improve bone mineral density, to reduce bone turnover, and to decrease bone/back pain in patients with thalassemia-associated osteoporosis, with a good profile of safety and tolerability. On the other hand, there are limited experiences with other pharmacological agents (e.g., denosumab or teriparatide). The complexity of this condition presents diagnostic and therapeutic challenges and underscores the importance of a comprehensive and multidisciplinary approach.

  4. [New strategies for exercise training in osteoporosis].

    PubMed

    Winkelmann, A; Schilling, S; Neuerburg, C; Mutschler, W; Böcker, W; Felsenberg, D; Stumpf, U

    2015-11-01

    In the prevention and treatment of osteoporosis, movement with muscle strengthening and proprioceptive training plays a major role. This was taken into consideration in the guidelines by the governing body on osteoporosis (Dachverband Osteoporose, DVO) from 2014 on prophylaxis, diagnosis and treatment of osteoporosis and in the DVO guidelines from 2008 on physiotherapy and exercise therapy for osteoporosis. Increases in lumbar bone density of between 0.5 % and 2.5 % can be achieved in women by strengthening exercises with high resistance. With this combination and strengthening of the quadriceps muscle a reduction of falls and hence the fracture risk could also be achieved. In traumatology, training for muscle strengthening is not always possible, especially for elderly patients. Practically relevant alternatives are regular walking and aquatraining, which may also lead to a significant increase in bone mineral density. Furthermore, large effects can be achieved with alternating side whole-body vibration (WBV) training with whole body vibration plates with only 3 days of training per week and with short training periods (15-20 min). Rates of increase in leg strength between 20 % and almost 40 % and in bone density between 0.5 % and 4 % in 6 months have been described. Whether and with what intensity whole body vibration therapy could be used for e.g. more rapid healing of fractures, is currently unclear. Initial positive results have been described in animal models.

  5. Diagnosis and treatment of pediatric osteoporosis.

    PubMed

    Bachrach, Laura K

    2014-12-01

    Progress toward identifying and treating disorders of bone fragility in pediatric patients has been considerable in recent years. This article will summarize several key advances in the management of osteoporosis in children and adolescents. Recommendations from the 2013 pediatric Position Development Conference provide expert guidance for evaluating bone health in younger patients. The diagnosis of pediatric osteoporosis can be made in a child with low-trauma vertebral fractures or a combination of low bone mass and long bone fractures. Management of bone fragility includes optimizing nutrition, activity, and treatment of the underlying disease. Pharmacologic agents can be considered if these measures fail to prevent further bone loss or fractures. Although the efficacy and safety of several intravenous and oral bisphosphonates have been examined, there is still no consensus on the optimal drug, dose, or duration of treatment. Observational studies of children with secondary osteoporosis provide insight into risk factors for fracture or the potential for recovery. Despite advances in the diagnosis and treatment of pediatric osteoporosis, more research is needed. Randomized controlled trials of pharmacologic agents should be defined to target those identified at the highest risk by observational studies. http://links.lww.com/COE/A9

  6. COPD and osteoporosis: links, risks, and treatment challenges

    PubMed Central

    Inoue, Daisuke; Watanabe, Reiko; Okazaki, Ryo

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis and its related fractures are common and have significant impacts on quality of life and even respiratory function in patients with COPD. COPD-associated osteoporosis is however extremely undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Various clinical risk factors of osteoporosis in COPD patients, including older age, emaciation, physical inactivity, and vitamin D deficiency, have also been described. It is critically important for pulmonologists to be aware of the high prevalence of osteoporosis in COPD patients and evaluate them for such fracture risks. Routine screening for osteoporosis will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage and give them appropriate treatment to prevent fracture, which may lead to improved quality of life as well as better long-term prognosis. PMID:27099481

  7. Whole-body vibration exercise in postmenopausal osteoporosis.

    PubMed

    Weber-Rajek, Magdalena; Mieszkowski, Jan; Niespodziński, Bartłomiej; Ciechanowska, Katarzyna

    2015-03-01

    The report of the World Health Organization (WHO) of 2008 defines osteoporosis as a disease characterized by low bone mass and an increased risk of fracture. Postmenopausal osteoporosis is connected to the decrease in estrogens concentration as a result of malfunction of endocrine ovarian function. Low estrogens concentration causes increase in bone demineralization and results in osteoporosis. Physical activity, as a component of therapy of patients with osteoporosis, has been used for a long time now. One of the forms of safe physical activity is the vibration training. Training is to maintain a static position or execution of specific exercises involving the appropriate muscles on a vibrating platform, the mechanical vibrations are transmitted to the body of the patient. According to the piezoelectric theory, pressure induces bone formation in the electrical potential difference, which acts as a stimulant of the process of bone formation. Whole body vibration increases the level of growth hormone and testosterone in serum, preventing sarcopenia and osteoporosis. The aim of this study was to review the literature on vibration exercise in patients with postmenopausal osteoporosis based on the PubMed and Medline database. While searching the database, the following key words were used 'postmenopausal osteoporosis' and 'whole-body vibration exercise'.

  8. Epidemiology and treatment of osteoporosis in women: an Indian perspective

    PubMed Central

    Khadilkar, Anuradha V; Mandlik, Rubina M

    2015-01-01

    The number of women with osteoporosis, ie, with reduced bone mass and the disruption of bone architecture, is increasing in India. While data on prevalence of osteoporosis among women in India come from studies conducted in small groups spread across the country, estimates suggest that of the 230 million Indians expected to be over the age of 50 years in 2015, 20%, ie, ~46 million, are women with osteoporosis. Thus, osteoporosis is a major public health problem in Indian women. Low calcium intakes with extensive prevalence of vitamin D deficiency, increasing longevity, sex inequality, early menopause, genetic predisposition, lack of diagnostic facilities, and poor knowledge of bone health have contributed toward the high prevalence of osteoporosis. Bone health may be optimized by creating an environment to achieve peak bone mass during adolescence, maintenance of healthy bone throughout the life cycle, and prevention of bone loss postmenopausal. In Indian women, calcium, vitamin D, and bisphosphonates are the commonest first-line therapies used. The use of other drugs such as hormone replacement therapy, estrogen agonists, calcitonin, parathyroid hormone, and denosumab is decided as per the affordability and availability of treatment options. Major gaps still remain in the diagnosis and management of osteoporosis, thus highlighting the need for more structured research in this area. This review focuses on the epidemiology of osteoporosis in Indian women and available treatments. PMID:26527900

  9. [Treatment of osteoporosis: current data and prospects].

    PubMed

    Reginster, J Y; Deroisy, R; Franchimont, P

    1994-12-15

    Postmenopausal osteoporosis is characterized not only by a reduction in bone mass but also by bone microarchitecture alterations, which result in greater bone frailty and in an increased fracture risk. Many drugs have been studied to determine whether they prevent bone loss or reduce the incidence of additional fractures in patients with established osteoporosis. Primary prevention of osteoporosis rests on regular exercising and adequate intake of dietary calcium. For secondary prevention in women undergoing menopause, replacement estrogen therapy given for at least ten years is associated with substantial reductions in fractures of the radius, hip, and spine. Other drugs capable of arresting postmenopausal bone loss include parenteral, nasal or rectal calcitonin and diphosphonates. However, the long-term safety of the latter requires further evaluation. Current studies are evaluating new molecules with potential preventive efficacy, such as ipriflavone. There is no general consensus about the efficacy of treatments for established osteoporosis with fractures. To date, no controlled studies have demonstrated a reduction in the incidence of further fractures in patients given calcium alone. Studies of hydroxylated vitamin D derivatives have been disappointing, although daily administration of vitamin D3 in combination with calcium significantly reduced the incidence of nonvertebral fractures in a population of elderly institutionalized subjects. Plausible explanations for this effect include increased vitamin D levels and reduced parathyroid levels in the bloodstream. Parenteral or nasal calcitonin stabilizes or increases bone mineral content in both cancellous and cortical bone. This effect is especially marked in high-turn-over patients. Several lines of evidence suggest that calcitonin therapy has a protective effect against vertebral and hip fractures. In patients with osteoporosis, oral or intravenous diphosphonates are associated with a significant increase in

  10. Senile osteoporosis. The effects of exercise.

    PubMed

    Yeater, R A; Martin, R B

    1984-02-01

    The available literature indicates that a high level of physical activity throughout life can result in increased skeletal mass during the fourth decade. Such a large reservoir of bone mass at midlife may delay the clinical manifestations of osteoporosis in later life. Furthermore, the published studies of animal models and humans strongly suggest that physical activity retards or prevents involutional bone loss in both recently postmenopausal and very elderly women.

  11. Strontium fructose 1,6-diphosphate prevents bone loss in a rat model of postmenopausal osteoporosis via the OPG/RANKL/RANK pathway

    PubMed Central

    Ma, Bo; Zhang, Qi; Wu, Di; Wang, Yong-lu; Hu, Ying-ying; Cheng, Yan-ping; Yang, Zhen-dong; Zheng, Ya-ya; Ying, Han-Jie

    2012-01-01

    Aim: To evaluate the protective effects of strontium fructose 1,6-diphosphate (FDP-Sr), a novel strontium salt that combined fructose 1,6-diphosphate (FDP) with strontium, on bone in an ovariectomy-induced model of bone loss. Methods: Eighty female Sprague-Dawley rats were ovariectomized (OVX) or sham-operated. Three months later, the rats were assigned to six groups (10 for each): sham-operated, OVX control, OVX+FDP-Sr (110, 220, or 440 mg/kg), or OVX+strontium ranelate (SR, 180 mg/kg). Drugs were administered orally for 3 months. When the treatment was terminated, the following parameters were assessed: bone mineral density (BMD), the biomechanical properties of the femur and lumbar vertebrae, trabecular histomorphology, serum phosphorus, calcium, bone-specific alkaline phosphatase (B-ALP), tartrate-resistant acid phosphatase 5b (TRACP5b), N-telopeptide of type I collagen (NTx) and a series of markers for oxidative stress. Receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) levels in serum were measured using ELISA and their gene expression levels in the bone were measured using R-T PCR. Results: Treatment with FDP-Sr (220 or 440 mg/kg) or SR (180 mg/kg) significantly increased the BMD and improved the bone microarchitecture and bone strength in OVX rats. The treatments also decreased in the levels of H2O2 and MDA, restored the CAT level in serum and bone marrow, increased the serum B-ALP and decreased NTx and TRACP 5b in OVX rats. Treatment with FDP-Sr decreased the RANKL level, and increased the OPG level in serum in a dose-dependent manner. It also significantly down-regulated the RANKL expression and up-regulated OPG expression in bone marrow. Conclusion: FDP-Sr may be an effectve treatment for postmenopausal osteoporosis that acts, in part, via a decrease in osteoclastogenesis through the OPG\\RANKL\\RANK pathway. PMID:22426695

  12. Genetics of osteoporosis

    SciTech Connect

    Urano, Tomohiko; Inoue, Satoshi

    2014-09-19

    Highlights: • Single-nucleotide polymorphisms (SNPs) associated with osteoporosis were identified. • SNPs mapped close to or within VDR and ESR1 are associated with bone mineral density. • WNT signaling pathway plays a pivotal role in regulating bone mineral density. • Genetic studies will be useful for identification of new therapeutic targets. - Abstract: Osteoporosis is a skeletal disease characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue, which increases susceptibility to fractures. BMD is a complex quantitative trait with normal distribution and seems to be genetically controlled (in 50–90% of the cases), according to studies on twins and families. Over the last 20 years, candidate gene approach and genome-wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNPs) that are associated with low BMD, osteoporosis, and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding nuclear receptors and WNT-β-catenin signaling proteins. Understanding the genetics of osteoporosis will help identify novel candidates for diagnostic and therapeutic targets.

  13. Clinical Practice. Postmenopausal Osteoporosis.

    PubMed

    Black, Dennis M; Rosen, Clifford J

    2016-01-21

    Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.

  14. Determining the cut-off point of osteoporosis based on the osteoporosis self-assessment tool, body mass index and weight in Taiwanese young adult women.

    PubMed

    Chang, Shu Fang; Yang, Rong Sen

    2014-09-01

    To examine the cut-off point of the osteoporosis self-assessment tool, age, weight and body mass index for osteoporosis among young adult Taiwanese women, using a large-scale health examination database containing bone mineral density tests. The cut-off points of osteoporosis risk factors identified earlier focus on menopausal or senior Caucasian and Asian women. However, young adult Asian women have seldom been identified. A retrospective historical cohort study. Using the 2009-2011 health examination database of a large-scale medical centre in northern Taiwan, this study investigated young adult Asian women (i.e. range in age from 30-49 years) in Taiwan who had received dual-energy X-ray absorptiometry test. This study also explored the cut-off point, sensitivity, specificity and diagnostic accuracy of receiver operating characteristics of osteoporosis among young adult females in Taiwan. This study collected 2454 young adult Asian women in Taiwan. Cochran-Armitage analysis results indicated that the prevalence of osteoporosis increased with decreasing weight, body mass index and osteoporosis self-assessment method quartiles. According to the results of receiver operating characteristics, weight, body mass index and osteoporosis self-assessment tool approaches can generally be used as indicators to predict osteoporosis among young adult Asian women. Results of this study demonstrate that Taiwanese women contracting osteoporosis tend to be young and underweight, as well as having a low body mass index and osteoporosis self-assessment scores. Those results further suggest that the assessment indicators for cut-off points are appropriately suitable for young adult women in Taiwan. Early detection is the only available means of preventing osteoporosis. Professional nurses should apply convenient and accurate assessment procedures to help young adult women to adopt preventive strategies against osteoporosis early, thus eliminating the probability of osteoporotic

  15. Assessment of osteoporosis in family medicine obtained by ultrasound densitometry.

    PubMed

    Alibasic, Esad; Ramic, Enisa; Batic Mujanovic, Olivera; Avdibasic, Enes; Husic, Damir; Alic, Alma

    2013-12-01

    Osteoporosis is a disease characterized by a decrease in bone mineral density, making bones become less rigid, and therefore susceptible to fractures, either spontaneously or with force, which is lower than otherwise needed for healthy bones fractured. Nearly 10% of the world population and 30% of women after menopause, suffer from osteoporosis. Clinical assessment of osteoporosis in family medicine is key to prevention, early detection and treatment of osteoporosis. To investigate the possibility of early detection and diagnosis of osteoporosis by analyzing the risk factors for osteoporosis and to compare the results with the parameters obtained by ultrasound densitometry of calcaneus, and determine the relationship of calcaneus densitometry with DXA findings, as the gold standard for the diagnosis of osteoporosis. The study included all patients of Family Medicine Kalesija Team 1, aged 50 years and over, a total of 711 patients, of whom 425 were women and 286 men. In all patients we assessed the existence of the following risk factors for osteoporosis: Constitutional: gender, age, weight, constitution, menarche and menopause, loss of height and stooped posture; Living habits: smoking, alcohol consumption, coffee, physical activity, and medications: long-term use corticosteroids, anticonvulsants, antacids, thyroid hormones. Comorbidity: history of fractures, hyperthyroidism, COPD, Chussing's disease, diabetes. In the group of high-risk patients determined by the clinical assessment, quantitative ultrasound densitometry screening was carried out. Monitoring parameters derived with densitometry: the value of T-score, BUA (Broadband Ultrasound Attenuation), SOS (Speed of Sound), QUI (Quantitative Ultrasound Index). To confirm the diagnosis of osteoporosis, in all patients with positive findings using ultrasound densitometry (T score lower than 2.5), another densitometry was performed by standard DXA method. The incidence of osteoporosis was 96% in women and 4% in men

  16. Assessment of Osteoporosis in Family Medicine Obtained by Ultrasound Densitometry

    PubMed Central

    Alibasic, Esad; Ramic, Enisa; Batic Mujanovic, Olivera; Avdibasic, Enes; Husic, Damir; Alic, Alma

    2013-01-01

    Introduction: Osteoporosis is a disease characterized by a decrease in bone mineral density, making bones become less rigid, and therefore susceptible to fractures, either spontaneously or with force, which is lower than otherwise needed for healthy bones fractured. Nearly 10% of the world population and 30% of women after menopause, suffer from osteoporosis. Clinical assessment of osteoporosis in family medicine is key to prevention, early detection and treatment of osteoporosis. Objective: To investigate the possibility of early detection and diagnosis of osteoporosis by analyzing the risk factors for osteoporosis and to compare the results with the parameters obtained by ultrasound densitometry of calcaneus, and determine the relationship of calcaneus densitometry with DXA findings, as the gold standard for the diagnosis of osteoporosis. Patients and methods: The study included all patients of Family Medicine Kalesija Team 1, aged 50 years and over, a total of 711 patients, of whom 425 were women and 286 men. In all patients we assessed the existence of the following risk factors for osteoporosis: Constitutional: gender, age, weight, constitution, menarche and menopause, loss of height and stooped posture; Living habits: smoking, alcohol consumption, coffee, physical activity, and medications: long-term use corticosteroids, anticonvulsants, antacids, thyroid hormones. Comorbidity: history of fractures, hyperthyroidism, COPD, Chussing’s disease, diabetes. In the group of high-risk patients determined by the clinical assessment, quantitative ultrasound densitometry screening was carried out. Monitoring parameters derived with densitometry: the value of T-score, BUA (Broadband Ultrasound Attenuation), SOS (Speed of Sound), QUI (Quantitative Ultrasound Index). To confirm the diagnosis of osteoporosis, in all patients with positive findings using ultrasound densitometry (T score lower than 2.5), another densitometry was performed by standard DXA method. Results

  17. Osteoporosis screening for men: are family physicians following the guidelines?

    PubMed

    Cheng, Natalie; Green, Michael E

    2008-08-01

    To determine rates of screening for osteoporosis among men older than 65 years and to find out whether family physicians are following the recommendations of the Osteoporosis Society of Canada's 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada. Chart audit. The Family Medicine Centre at Hotel Dieu Hospital in Kingston, Ont. All male patients at the Family Medicine Centre older than 65 years for a total of 565 patients associated with 20 different physicians' practices. Rates of screening with bone mineral density (BMD) scans for osteoporosis, results of BMD testing, and associations between results of BMD testing and age. Of the 565 patients reviewed, 108 (19.1% of the study population) had received BMD testing. Rates of screening ranged from 0% to 38% in the 20 practices. Among 105 patients tested (reports for 3 patients were not retrievable), 15 (14.3%) were found to have osteoporosis, 43 (41.0%) to have osteopenia, and 47 (44.8%) to have normal BMD results. No significant association was found between BMD results and age. Screening rates were higher among men older than 75 years than among men aged 65 to 75 and peaked among those 85 to 89 years old. On average, only about 20% of male patients older than 65 years had been screened for osteoporosis, so most of these men were not being screened by BMD testing as recommended in the guidelines. Considering the relatively high rates of osteoporosis and osteopenia found in this study and the known morbidity and mortality associated with osteoporotic fractures in this population, higher rates of BMD screening and more widespread treatment of osteoporosis could prevent many fractures among these patients. Family physicians need to become more aware of the risk factors indicating screening, and barriers to screening and treatment of osteoporosis in men need to be identified and addressed.

  18. Men’s knowledge about osteoporosis and its risk factors

    PubMed Central

    Żołnierczuk-Kieliszek, Dorota; Kulik, Teresa; Dziedzic, Małgorzata A.; Barańska, Agnieszka; Kryk, Aneta

    2016-01-01

    Introduction Until recently osteoporosis was seen mainly as a woman’s problem. However, in the last ten years there has been rising awareness in society that osteoporosis constitutes an inseparable element of getting old for men as well. The aim of the research was to evaluate men’s knowledge about osteoporosis and its risk factors contributing to the development of the disease. Material and methods The study included 205 men aged 20-60. The examined men were patients of selected healthcare centres in Lublin Voivodeship. The study was conducted between September 2014 and April 2015. The research was performed by means of the survey method, using a poll technique. Purposive sampling and an original questionnaire were used. Gathered material was subjected to descriptive and statistical analysis. The Mann-Whitney U test and Kruskal-Wallis test were applied. The statistical significance level was set at α = 0.05. IBM SPSS Statistics software was used to perform the statistical analysis. Results The respondents’ level of knowledge about osteoporosis and its risk factors can be estimated as average. The polled men showed better knowledge on osteoporosis risk factors (M = 59.78) than general osteoporosis knowledge (M = 53.71). Significant differences were found between the respondents’ education and their general osteoporosis knowledge as well as between the respondents’ living conditions and their knowledge about osteoporosis risk factors. Conclusions Because of the insufficient level of knowledge about osteoporosis and its risk factors in the male population it is advisable to launch prevention programmes aimed at men focusing on this issue. PMID:27980526

  19. [Variability in the recommendations for the clinical management of osteoporosis].

    PubMed

    Sanfélix-Genovés, José; Catalá-López, Ferrán; Sanfélix-Gimeno, Gabriel; Hurtado, Isabel; Baixauli, Cristóbal; Peiró, Salvador

    2014-01-07

    Analysis of the variability in the recommendations of the main guidelines and clinical documents for the management of osteoporosis. Searches were carried out in PubMed, Google, web pages of national and international scientific societies related to the management of osteoporosis, and agencies that develop guidelines. We analyzed guidelines and clinical documents that included recommendations for the indication of bone densitometry and/or pharmacological treatment, which could influence the management of osteoporosis in the Spanish National Health System, which have been published between 2006 and 2012. We included 12 documents. Eleven recommend performing bone densitometry upon assessing women risk factors, but the number and type of risk factors vary between documents: 6 recommend its implementation to all women over 65 years, 4 in men aged 65-70 years, and 3 when there is radiological suspicion of osteoporosis. There is agreement on the recommendations on the indication for densitometry to monitor drug response. In primary prevention, all national documents combined risk factors and densitometric osteoporosis and 3 of them recommend individual assessment according to risk factors. Most of the international guidelines require the calculation of risk with the FRAX(®) tool. In secondary prevention, all documents recommend treatment in cases of hip or clinical vertebral fracture; in men, and for the rest of fractures, the recommendations are heterogeneous. Overall there is a high variability in the recommendations of guidelines and other documents for the management of osteoporosis. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Understanding the Female Athlete Triad: Eating Disorders, Amenorrhea, and Osteoporosis.

    ERIC Educational Resources Information Center

    Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.

    1999-01-01

    Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…

  1. Understanding the Female Athlete Triad: Eating Disorders, Amenorrhea, and Osteoporosis.

    ERIC Educational Resources Information Center

    Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.

    1999-01-01

    Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…

  2. [Physiotherapy and exercise in osteoporosis and its complications].

    PubMed

    Preisinger, E

    2009-09-01

    Osteoporosis is defined by decreased bone strength and increased susceptibility to fracture. Fractures and their consequences are the clinical manifestation of osteoporosis. Acute and chronic pain, functional limitations including permanent impairment and the need for long-term care may be caused by osteoporotic fractures. The aim of osteoporosis treatment is to prevent fractures by bone strengthening. The aims of rehabilitation in patients with osteoporosis are to reduce pain, maximize the level of musculoskeletal function, particularly following fractures, decrease risk of falls and optimize quality of life and independence. Certain sports and exercises greatly promote skeletal development in children and adolescents and augment bone strength in adults. Physiotherapy and therapeutic exercise may relieve pain, increase musculoskeletal function and form an important part of fall management.

  3. Osteoporosis in Children with Chronic Illnesses: Diagnosis, Monitoring, and Treatment.

    PubMed

    Grover, Monica; Bachrach, Laura K

    2017-08-01

    Osteoporosis is an under-recognized complication of chronic illness in childhood. This review will summarize recent literature addressing the risk factors, evaluation, and treatment for early bone fragility. Criteria for the diagnosis of pediatric osteoporosis include the presence of low trauma vertebral fractures alone or the combination of low bone mineral density and several long bone fractures. Monitoring for bone health may include screening for vertebral fractures that are common but often asymptomatic. Pharmacologic agents should be offered to those with fragility fractures especially when spontaneous recovery is unlikely. Controversies persist about the optimal bisphosphonate agent, dose, and duration. Newer osteoporosis drugs have not yet been adequately tested in pediatrics, though clinical trials are underway. The prevalence of osteoporosis is increased in children with chronic illness. To reduce the frequency of fragility fractures requires increased attention to risk factors, early intervention, and additional research to optimize therapy and potentially prevent their occurrence.

  4. Hybrid data mining ensemble for predicting osteoporosis risk.

    PubMed

    Wang, Wenjia; Richards, Graeme; Rea, Sarah

    2005-01-01

    This paper presents the research in developing data mining ensembles for predicting the risk of osteoporosis prevalence in women. Osteoporosis is a bone disease that commonly occurs among postmenopausal women and no effective treatments are available at the moment, except prevention, which requires early diagnosis. However, early detection of the disease is very difficult. This research aims to devise an intelligent diagnosis support system by using data mining ensemble technology to assist General Practitioners assessing patient's risk at developing osteoporosis. The paper describes the methods for constructing effective ensembles through measuring diversity between individual predictors. Hybrid ensembles are implemented by neural networks and decision tress. The ensembles built for predicting osteoporosis are evaluated by the real-world data and the results indicate that the hybrid ensembles have relatively high-level of diversity and thus are able to improve prediction accuracy.

  5. Osteoporosis in chronic inflammatory disease: the role of malnutrition.

    PubMed

    Montalcini, Tiziana; Romeo, Stefano; Ferro, Yvelise; Migliaccio, Valeria; Gazzaruso, Carmine; Pujia, Arturo

    2013-02-01

    Osteoporosis is a metabolic bone disorder affecting million of people worldwide. Increased understanding of bone disease has led to a greater recognition of factors affecting bones, and consequently many secondary causes of osteoporosis were demonstrated. In this study, we aim to explore possible causes of bone loss and fractures in subjects affected by chronic inflammatory disease and to suggest new targets for intervention. In fact several studies, evaluated to perform this study, suggest that the patients with chronic inflammatory disease could be at high risk for fractures due to bone loss as consequence of malnutrition, caused by inflammation and hormonal change. Consequently, some actions could derive from the considerations of these mechanisms: a change in actual approach of chronic patients, that may include the investigation on the possible presence of osteoporosis, as well as further research on this topic to find a better therapy to prevent osteoporosis considering all the mechanisms described.

  6. Awareness of osteoporosis in postmenopausal Indian women: An evaluation of Osteoporosis Health Belief Scale

    PubMed Central

    Gopinathan, Nirmal Raj; Sen, Ramesh Kumar; Behera, Prateek; Aggarwal, Sameer; Khandelwal, Niranjan; Sen, Mitali

    2016-01-01

    Context: The level of awareness about osteoporosis in postmenopausal women who are the common sufferers. Aims: This study aims to evaluate the level of awareness in postmenopausal women using the Osteoporosis Health Belief Scale (OHBS). Settings and Design: Osteoporosis has emerged as a common health problem in geriatric population. A proactive role needs to be played for preventing its consequences. Before initiating any preventive measures, an evaluation of awareness level of the target population is necessary. The questionnaire-based study design was used for this study. Subjects and Methods: A questionnaire (OHBS)-based study in 100 postmenopausal women in Chandigarh was conducted. The bone mineral density (BMD) was measured in each case by dual energy X-ray absorptiometry. Height, weight, and body mass index (BMI) of the participants were noted. Statistical Analysis Used: Statistical analysis was conducted to evaluate any correlation between the various components of the OHBS and the BMD. Results: No statistically significant difference was noted in the seven component parameters of OHBS among the normal, osteopenic, and osteoporotic women suggesting that the health belief regarding susceptibility is not much different between the three groups of the study population. A statistically significant difference between the mean BMI of normal and osteoporotic population was noted. Conclusions: The results show that there is a great deficit in the awareness level of postmenopausal Indian women regarding osteoporosis. Most of the women were unaware of the condition and the means to prevent it. The study emphasizes that health care professionals have lot of ground to cover to decrease the incidence of osteoporosis and its associated health problem. PMID:28096642

  7. Osteoporosis in Rett syndrome: a case study presenting a novel management intervention for severe osteoporosis.

    PubMed

    Lotan, M; Reves-Siesel, R; Eliav-Shalev, R S; Merrick, J

    2013-12-01

    The present article describes a successful novel therapeutic intervention with Aredia with one child with Rett syndrome, after suffering from six pathological fractures within less than 3 years due to severe osteoporosis. Since the initiation of the treatment (3 years ago), the child has not suffered any fractures. Patients with chronic diseases and those with disabilities or on anticonvulsant medications are at risk for low bone density and possibly for the resultant pathologic fractures that define osteoporosis in children. Individuals with Rett syndrome (RS) have been shown to have low bone mineral density (or osteopenia) at a young age. If osteoporosis occurs in a girl with RS, it can inflict pain and seriously impair the child's mobility and quality of life. The present article describes a case study of a child with RS (showing an average of 1.75 fractures annually for the 4 years preceding the treatment) before and after a treatment with Aredia. Patient received 30 mg/day for 3 days on a once every 3-month cycle. There was a 45 % improvement in bone mass density (BMD) values from pre-post-intervention. The child had no fractures in the 3 years posttreatment. This finding is significant (p < 0.03). The BMD Z-scores of the child showed severe osteoporosis (Z-score of -3.8) at pre-intervention and are elevated to osteopenia levels (Z-score of -1.3) at post-intervention measurements. All measurements suggest that the treatment successfully reversed the osteoporotic process and prevented further fractures. This change caused great relief to the child and her family and an improvement in their quality of life. The findings support the ability (in one case) to reverse the progression of osteoporosis in individuals with Rett syndrome showing severe osteoporosis with multiple fractures.

  8. Osteoporosis--comparative study between quantitative ultrasound of calcaneus and DXA.

    PubMed

    Muftic, Mirsad; Selimovic, Elma Kucukalic; Miladinovic, Ksenija

    2013-01-01

    Osteoporosis is bone disease characterized by reduced bone mass and reduction of bone tissue. Main complications of osteoporosis and major cause of morbidity and mortality in elderly population are fractures. Early diagnosis and detection of osteoporosis can prevent complications of osteoporosis in terms of fractures. Diagnostic assessment of osteoporosis is mostly being done threw two commonly used methods: ultrasound of calcaneus and osteodensitometry (DXA). The results were compared through a prospective study involving two groups of patients with osteoporosis. The study included 100 female patients with average age 54. In I phase every patient had some protocol. That protocol included: age, body, mass index (BMI), employment, marrital status, risk factors (smoking, coffee, physical activity), endocrine causes of osteoporosis and osteoporotic fractures. ln II phase for every patient we were using two methods in diagnostics of osteoporosis: ultrasound of calcaneus and DXA. In both methods, we analyzed T score and Z score. 21% patients had 21,12 BMI (low BMI), 58% patients were in menopauses, triad of risk factors (smoking, consumption of coffee, low physical activity) had 32%, 28% of patients had osteoporotic fractures. Quality of life patients with osteoporosis was weak. T score is main score for diagnostics. Results of T score with UZ and DXA had statisticly significant differents. T score (UZ) and maximum T score (DXA) (lumbal spine and hip) has statisticly similar value with potential possibility to predict osteoporosis fractures.

  9. Epidemiology, treatment and costs of osteoporosis in Germany--the BoneEVA Study.

    PubMed

    Häussler, B; Gothe, H; Göl, D; Glaeske, G; Pientka, L; Felsenberg, D

    2007-01-01

    In Germany, accurate data on the prevalence and treatment of osteoporosis, as well as the cost of this illness, are not available. The aim of this study is to give a valid estimation of these items for the year 2003. Routine data from a German sickness fund covering 1.5 million beneficiaries and billing data for outpatient visits were used to obtain estimates of prevalence for osteoporosis. Claims data for patients with osteoporosis (M80, M81) or an osteoporosis-related fracture diagnosis (S22, S32, S42, S52, S72, S82) or treatment with anti-osteoporosis drugs were examined. Costs were calculated from the perspective of the German health insurance system and the German nursing care insurance system, respectively. Only direct costs of osteoporosis were considered. In 2003, 7.8 million Germans (6.5 million women) were affected by osteoporosis. Of them, 4.3% experienced at least one clinical fracture. Only 21.7% were treated with an anti-osteoporosis drug. The total direct costs attributable to osteoporosis amounted to euros 5.4 billion. This study confirms that osteoporosis is underdiagnosed, undertreated and imposes a considerable economic burden on the health system in Germany. Effective strategies for the prevention and management of this disease are needed.

  10. Canadian Consensus Conference on Osteoporosis, 2006 Update

    PubMed Central

    Brown, Jacques P.; Fortier, Michel

    2016-01-01

    Objective To provide guidelines for the health care provider on the diagnosis and clinical management of postmenopausal osteoporosis. Outcomes Strategies for identifying and evaluating high-risk individuals, the use of bone mineral density (BMD) and bone turnover markers in assessing diagnosis and response to management, and recommendations regarding nutrition, physical activity, and the selection of pharmacologic therapy to prevent and manage osteoporosis. Evidence MEDLINE and the Cochrane database were searched for articles in English on subjects related to osteoporosis diagnosis, prevention, and management from March 2001 to April 2005. The authors critically reviewed the evidence and developed the recommendations according to the Journal of Obstetrics and Gynaecology Canada’s methodology and consensus development process. Values The quality of evidence is rated using the criteria described in the report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this report. Sponsors The development of this consensus guideline was supported by unrestricted educational grants from Berlex Canada Inc., Lilly Canada, Merck Frosst, Novartis, Novogen, Novo Nordisk, Proctor and Gamble, Schering Canada, and Wyeth Canada. PMID:16626523

  11. Genetics of Osteoporosis in Children.

    PubMed

    van Dijk, Fleur S

    2015-01-01

    In the pathogenesis of paediatric osteoporosis, genetic causes may play an important role. The most prevalent monogenic cause of paediatric osteoporosis is osteogenesis imperfecta, a disorder characterised primarily by liability to fractures. With regard to diagnosis or exclusion of a monogenic cause of paediatric osteoporosis, clinical practice has changed rapidly in recent years. This is largely due to the discovery of many new genetic causes in patients with a clear clinical diagnosis of osteogenesis imperfecta but also due to the identification of genetic causes in patients with isolated or non-syndromal osteoporosis with fractures. In this chapter, known monogenic causes of syndromal and non-syndromal osteoporosis in children will be described. Furthermore, we will discuss when to refer for clinical genetic evaluation as well as the current and future merits of genetic evaluation of children with osteoporosis. © 2015 S. Karger AG, Basel.

  12. Severe low turnover osteoporosis.

    PubMed

    Pietrogrande, Luca

    2007-08-01

    Severe osteoporosis, a situation with fractures, can worsen in the case of poor response to usual therapies, such as bisphosphonates associated with calcium and vitamin D, especially if bone turnover is strongly suppressed. One way of inverting the poor evolution of non-responders is to use Teriparatide. The case of a non-responder is reported, with considerations about the possibility of detecting these patients before a new fracture takes place.

  13. [Osteoporosis in phlebology].

    PubMed

    van der Molen, H R; Overvelde, S

    1993-01-01

    Patient often think that the pains of their extremities (especially during the night) are caused by a plebo or an angiopathy whereas they are in fact due to a vertebral or lumbar discal affection. 84 patients with osteoporosis were treated by an intramuscular injection of deca-durabolin (25 mg/month) and calcium phosphate (tertiare). Results were satisfactory: six months later, 62 patients no longer suffered, 13 had felt improvement and 2 remained unchanged.

  14. Osteoporosis and psoriatic arthritis.

    PubMed

    Del Puente, Antonio; Esposito, Antonella; Parisi, Anna; Atteno, Mariangela; Montalbano, Simona; Vitiello, Maria; Esposito, Carmela; Bertolini, Nicoletta; Foglia, Francesca; Costa, Luisa; Scarpa, Raffaele

    2012-07-01

    Osteoporosis (OP) is a skeletal disorder characterized by compromised bone strength that predisposes to an increased risk of fracture. The prevalence of OP in the general population is very high as established in several studies, and OP represents one of the possible aspects of bone involvement in arthritis. In psoriatic arthritis this involvement is particularly complex because it affects not only mechanisms of bone loss but also of bone formation. We will discuss these aspects and the available epidemiological data.

  15. Canadian Academy of Sport and Exercise Medicine position statement: osteoporosis and exercise.

    PubMed

    Fletcher, Jennifer A

    2013-09-01

    The purpose of this paper is to look at the effects of exercise in the treatment and prevention of osteoporosis in athletes of all age groups. Recommendations for exercise programs will be discussed as a tool to improve bone health. Medical management of osteoporosis will be reviewed mainly as it pertains to postmenopausal women.

  16. The potential impact of new National Osteoporosis Foundation guidance on treatment patterns

    USDA-ARS?s Scientific Manuscript database

    Little information is available on prevalence of osteoporosis risk factors or proportions of U.S. men and women who are potential candidates for treatment. The prevalence of risk factors used in the new National Osteoporosis Foundation (NOF) FRAX (trademark) based Guide to the Prevention and Treatm...

  17. Genetics Home Reference: juvenile primary osteoporosis

    MedlinePlus

    ... Home Health Conditions juvenile primary osteoporosis juvenile primary osteoporosis Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Juvenile primary osteoporosis is a skeletal disorder characterized by thinning of ...

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