Journal ArticleDOI
Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study.
P. Garnero,E. Hausherr,Marie-Claire Chapuy,Christian Marcelli,Hélène Grandjean,C. Muller,C. Cormier,Gérard Bréart,P. J. Meunier,Pierre D. Delmas +9 more
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TLDR
Elderly women are characterized by increased bone turnover, and some markers of bone resorption predict the subsequent risk of hip fracture independently of hip BMD, which may be useful to improve the assessment of the risk of Hip fracture in elderly women.Abstract:
Increased bone turnover has been suggested as a potential risk factor for osteoporotic fractures. We investigated this hypothesis in a prospective cohort study performed on 7598 healthy women more than 75 years of age. One hundred and twenty-six women (mean years 82.5) who sustained a hip fracture during a mean 22-month follow-up were age-matched with three controls who did not fracture. Baseline samples were collected prior to fracture for the measurement of two markers of bone formation and three urinary markers of bone resorption: type I collagen cross-linked N- (NTX) or C-telopeptide (CTX) and free deoxypyridinoline (free D-Pyr). Elderly women had increased bone formation and resorption compared with healthy premenopausal women. Urinary excretion of CTX and free D-Pyr, but not other markers, was higher in patients with hip fracture than in age-matched controls (p = 0.02 and 0.005, respectively). CTX and free D-Pyr excretion above the upper limit of the premenopausal range was associated with an increased hip fracture risk with an odds ratio (95% confidence interval) of 2.2 (1.3-3.6) and 1.9 (1.1-3.2), respectively, while markers of formation were not. Increased bone resorption predicted hip fracture independently of bone mass, i.e., after adjustment for femoral neck bone mineral density (BMD) and independently of mobility status assessed by the gait speed. Women with both a femoral BMD value of 2.5 SD or more below the mean of young adults and either high CTX or high free D-Pyr levels were at greater risk of hip fracture, with an odds ratio of 4.8 and 4.1, respectively, than those with only low BMD or high bone resorption. Elderly women are characterized by increased bone turnover, and some markers of bone resorption predict the subsequent risk of hip fracture independently of hip BMD. Combining the measurement of BMD and bone resorption may be useful to improve the assessment of the risk of hip fracture in elderly women.read more
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Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial
Bruce Ettinger,Dennis M. Black,Bruce H. Mitlak,Ronald Keith Knickerbocker,Thomas Nickelsen,Harry K. Genant,Claus Christiansen,Pierre D. Delmas,Jose R. Zanchetta,J. A. Stakkestad,Claus C. Glüer,Kathryn A. Krueger,Fredric J. Cohen,Stephen Eckert,Kristine E. Ensrud,Louis V. Avioli,Paul Lips,Steven R. Cummings +17 more
TL;DR: The Multiple Outcomes of Raloxifene Evaluation (MORE) study as mentioned in this paper evaluated the effect of raloxion hydrochloride therapy on risk of vertebral and non-vertebral fractures.
Journal ArticleDOI
Birth and death of bone cells: basic regulatory mechanisms and implications for the pathogenesis and treatment of osteoporosis.
TL;DR: The role and the molecular mechanism of action of regulatory molecules, such as cytokines and hormones, in osteoclast and osteoblast birth and apoptosis are reviewed to review the evidence for the contribution of changes in bone cell birth or death to the pathogenesis of the most common forms of osteoporosis.
Journal ArticleDOI
Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial.
Steven R. Cummings,Dennis M. Black,Desmond E. Thompson,William B. Applegate,Elizabeth Barrett-Connor,Thomas Musliner,Lisa Palermo,Ronald J. Prineas,Susan M. Rubin,Jean Scott,Thomas M. Vogt,Robert B. Wallace,A. John Yates,Andrea Z. LaCroix +13 more
TL;DR: In women with low BMD but without vertebral fractures, 4 years of alendronate safely increased BMD and decreased the risk of first vertebral deformity.
Journal ArticleDOI
Diagnosis of osteoporosis and assessment of fracture risk
TL;DR: Although hip fracture prediction with BMD alone is at least as good as blood pressure readings to predict stroke, the predictive value of BMD can be enhanced by use of other factors, such as biochemical indices of bone resorption and clinical risk factors.
Journal ArticleDOI
2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary
Alexandra Papaioannou,Suzanne N Morin,Angela M. Cheung,Stephanie A. Atkinson,Jacques P. Brown,Sidney Feldman,David A. Hanley,Anthony B. Hodsman,Sophie A. Jamal,Stephanie M. Kaiser,Brent Kvern,Kerry Siminoski,William D. Leslie +12 more
TL;DR: There has been a paradigm shift in the prevention and treatment of osteoporosis and fractures, and the focus now is on preventing fragility fractures and their negative effects.
References
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Journal ArticleDOI
Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group.
Steven R. Cummings,Michael C. Nevitt,Warren S. Browner,Katie L. Stone,Kathleen M. Fox,Kristine E. Ensrud,Jane A. Cauley,Dennis Black,Thomas M. Vogt +8 more
TL;DR: Women with multiple risk factors and low bone density have an especially high risk of hip fracture and maintaining body weight, walking for exercise, avoiding long-acting benzodiazepines, minimizing caffeine intake, and treating impaired visual function are among the steps that may decrease the risk.
Journal ArticleDOI
Vitamin D3 and calcium to prevent hip fractures in elderly women
Marie Claire Chapuy,Monique E. Arlot,François Duboeuf,Jacqueline Brun,Bridgette Crouzet,Simone Arnaud,Pierre D. Delmas,Pierre J. Meunier +7 more
TL;DR: The effects of supplementation with vitamin D3 (cholecalciferol) and calcium on the frequency of hip fractures and other nonvertebral fractures, identified radiologically, in 3270 healthy ambulatory women are studied.
Journal ArticleDOI
Bone density at various sites for prediction of hip fractures
Steven R. Cummings,Dennis M. Black,Michael C. Nevitt,Warren S. Browner,Jane A. Cauley,Kristine E. Ensrud,Harry K. Genant,L. Palermo,J. Scott,Thomas M. Vogt +9 more
TL;DR: In this article, the femoral neck bone density was measured by dual X-ray absorptiometry is a better predictor of hip fracture than measurements of other bones, including the radius or calcaneus.
Journal ArticleDOI
Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss.
TL;DR: The data indicate that age-related bone loss occurs principally by a process that removes entire structural elements of bone; those that remain are more widely separated and some may undergo compensatory thickening, but most slowly become reduced in thickness.
Journal ArticleDOI
Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis
TL;DR: Assessing bone marker levels may be useful in the evaluation of osteoporosis risk in elderly women, as secondary hyperparathyroidism caused in part by reduced serum 25‐hydroxyvitamin D appears to be a marginal determinant of an increased bone turnover rate.