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
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Journal ArticleDOI
Effects of recombinant insulin-like growth factor-I and growth hormone on bone turnover in elderly women
Laura J. Ghiron,Janice L. Thompson,Leah Holloway,Raymond L. Hintz,Gail E. Butterfield,Andrew R. Hoffman,Andrew R. Hoffman,Robert Marcus,Robert Marcus +8 more
TL;DR: High‐dose IGF‐I may directly increase osteoblastic function with only a minimal increase in bone resorption and may therefore provide a useful means to increase bone mass and the results suggest some of the GH action on renal phosphorus handling represents a direct action of GH on the nephron which does not involve the intermediacy of IGF‐i.
Journal ArticleDOI
Drug therapy for vertebral fractures in osteoporosis: Evidence that decreases in bone turnover and increases in bone mass both determine antifracture efficacy
TL;DR: It is hypothesized that the increased bone turnover in osteoporosis also is a major cause of vertebral fractures because of its adverse effects on the microarchitecture of the vertebrae and that normalization of bone turnover by antiresorptive drug therapy will decrease VFR substantially.
Journal ArticleDOI
Raloxifene Preserves Bone Strength and Bone Mass in Ovariectomized Rats
TL;DR: In rats, raloxifene has beneficial effects on bone biomechanics that are equivalent to those of EE treatment without substantial effects on the uterus.
Journal ArticleDOI
Bone Strength: The Whole Is Greater Than the Sum of Its Parts
K. Shawn Davison,Kerry Siminoski,Jonathan D. Adachi,David A. Hanley,David Goltzman,Anthony B. Hodsman,Robert G. Josse,Stephanie M. Kaiser,Wojciech P. Olszynski,Alexandra Papaioannou,Louis-George Ste-Marie,David L. Kendler,Alan Tenenhouse,Jacques P. Brown +13 more
TL;DR: Bone strength is dependent on numerous, interrelated factors and requires further investigation as to its impact on these factors in isolation and in unison.
Journal ArticleDOI
A Half-century of Community Water Fluoridation in the United States: Review and Commentary
TL;DR: The majority of studies have evaluated the effectiveness of water fluoridation on the permanent teeth of children, while there are fewer studies on deciduous teeth and in adults; the relationship between fluoride ingestion and bone health needs further clarification; the sociopolitical issues of fluoridation need to be better understood.
References
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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.
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Estimation of the probability of an event as a function of several independent variables
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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.