Journal ArticleDOI
Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.
B. Lawrence Riggs,Stephen F. Hodgson,W. Michael O'Fallon,Edmund Y. S. Chao,Heinz W. Wahner,Joan M. Muhs,Sandra L. Cedel,L. Joseph Melon +7 more
TLDR
It is concluded that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility, and the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.Abstract:
Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day). Sixty-six women in the fluoride group and 69 women in the placebo group completed the trial. As compared with the placebo group, the treatment group had increases in median bone mineral density of 35 percent (P less than 0.0001) in the lumbar spine (predominantly cancellous bone), 12 percent (P less than 0.0001) in the femoral neck, and 10 percent (P less than 0.0001) in the femoral trochanter (sites of mixed cortical and cancellous bone), but the bone mineral density decreased by 4 percent (P less than 0.02) in the shaft of the radius (predominantly cortical bone). The number of new vertebral fractures was similar in the treatment and placebo groups (163 and 136, respectively; P not significant), but the number of nonvertebral fractures was higher in the treatment group (72 vs. 24; P less than 0.01). Fifty-four women in the fluoride group and 24 in the placebo group had side effects sufficiently severe to warrant dose reduction; the major side effects were gastrointestinal symptoms and lower-extremity pain. We conclude that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility. Thus, under the conditions of this study, the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.read more
Citations
More filters
Journal ArticleDOI
The effect of low-dose continuous estrogen and progesterone therapy with calcium and vitamin D on bone in elderly women. A randomized, controlled trial.
TL;DR: The primary hypothesis was that continuous administration of conjugated equine estrogen, 0.3 mg/d, combined with medroxyprogesterone, 2.5 mg/D, in elderly postmenopausal women would prevent bone loss in the spine over 3.5 years compared with placebo in the context of adequate calcium and vitamin D nutrition.
Journal ArticleDOI
Biologically meaningful determinants of the in vitro strength of lumbar vertebrae.
A. Vesterby,Li. Mosekilde,Hans Jørgen G. Gundersen,F. Melsen,Le. Mosekilde,K. Holme,S. Sørensen +6 more
TL;DR: It was shown by standard multiple regression analysis that the in vitro tested compressive strength could be predicted from mean cortical thickness, mean cross sectional area, and marrow space star volume or ash density with a multiple, squared coefficient of regression (r2) of 0.95 when the height and sex of the individual were known.
Journal Article
Pathogenesis of osteoporosis
Lawrence G. Raisz,K. C. Shoukri +1 more
TL;DR: Animal models developed largely in rodents can suggest specific factors that can be further studied in primate models and in osteoporotic patients to lead to new approaches to the diagnosis and management of this disorder.
Journal ArticleDOI
Implications of architecture for the pathogenesis and prevention of vertebral fracture.
TL;DR: The overall concept of cancellous bone after menopause, first developed about ten years ago, has now been confirmed by a variety of different methods including node-strut analysis, star volume and the change in curvature with profile dilation.
References
More filters
Journal ArticleDOI
Applied regression analysis 2nd ed.
Norman R. Draper,Smith H +1 more
TL;DR: This book brings together a number of procedures developed for regression problems in current use and includes material that either has not previously appeared in a textbook or if it has appeared is not generally available.
Journal ArticleDOI
Estimation of the probability of an event as a function of several independent variables
TL;DR: A recursive approach based on Kalman's work in linear dynamic filtering and prediction is applied, derivable also from the work of Swerling (1959), which provides an example of many other possible uses of recursive techniques in nonlinear estimation and in related areas.
Journal ArticleDOI
Changes in Bone Mineral Density of the Proximal Femur and Spine with Aging: DIFFERENCES BETWEEN THE POSTMENOPAUSAL AND SENILE OSTEOPOROSIS SYNDROMES
B. L. Riggs,Heinz W. Wahner,Ego Seeman,Kenneth P. Offord,William L. Dunn,R. B. Mazess,K. A. Johnson,L. J. Melton +7 more
TL;DR: The data suggest the existence of two distinct syndromes: one form, "postmenopausal osteoporosis," is characterized by excessive and disproportionate trabecular bone loss, involves a small subset of women in the early postmenopausal period, and is associated with hip fractures or vertebral fractures or both.
Journal ArticleDOI
Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis: comparison with conventional therapy
TL;DR: The combination of calcium fluoride, and estrogen was more effective than any other combination and grounds for optimism about the efficacy of combinations of available agents with sodium fluoride for fracture in postmenopausal osteoporosis.
Journal ArticleDOI
Concurrent assays of circulating bone Gla-protein and bone alkaline phosphatase: effects of sex, age, and metabolic bone disease.
TL;DR: The serum concentrations of 2 biochemical markers of bone formation, bone Gla-protein (BGP) and bone alkaline phosphatase (BAP), in 164 normal subjects and 164 patients with metabolic bone disorders gave concordant results, however, in patients with glucocorticoid excess.