Bone Loss In Older Women Research Articles

Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: a prospective study.

The purpose of this study was to test whether low serum vitamin B-12 levels are associated with more rapid bone loss in elderly women. We archived sera and measured calcaneal bone mineral density (BMD) in community-dwelling white women, aged 65 yr and over, who participated in the Study of Osteoporotic Fractures. BMD of the hip and subregions was measured 2 yr later. Repeat measurements of calcaneal and hip BMD were obtained after 5.9 and 3.5 yr of follow-up, respectively. Serum vitamin B-12 assays were performed in 83 randomly selected participants with initial and repeat measurements of BMD who were not taking estrogen replacement therapy at baseline. After adjusting for age, weight, and clinic site, women with vitamin B-12 levels at or below 280 pg/ml (207.2 pmol/liter; lowest quintile) experienced an annual change of -1.6% (95% confidence interval, -2.4% to -0.8%) in total hip BMD, compared with -0.2% (-0.5% to 0.2%) in women with levels above 280 pg/ml (P = 0.003). Results were similar when subregions of the hip were analyzed separately. Serum vitamin B-12 levels were not significantly associated with calcaneal bone loss. We conclude that low serum vitamin B-12 levels are associated with increased rates of hip, but not calcaneal, bone loss in older women.

Hysterectomy and oophorectomy are unrelated to bone loss in older women

Objective: The relation of hysterectomy and oophorectomy to change in bone mineral density (BMD) was examined in older women using and not using estrogen replacement therapy (ERT). Methods: Women aged 60–80 years from the Rancho Bernardo Study attended clinic visits in 1988–1991 and 1992–1995 when hysterectomy and oophorectomy were ascertained, ERT use was validated and spine and hip BMD was assessed at both visits with DEXA. Women were either current ERT users or nonusers at both visits. Results: Among these 447 women, average age was 71 (S.D.=9.0); average years postmenopause was 24.7 (S.D.=10.9). Overall, 122 had a hysterectomy with ovarian conservation and 91 had a hysterectomy with bilateral oophorectomy; 41% reported current ERT use for an average duration of 19.1 years (S.D.=10.8). Hysterectomized women were 2.3 times more likely to report ERT use than intact women ( P<0.001). Comparisons adjusted for age, obesity, and age at menopause but not for ERT use showed hysterectomized women had less bone loss per year at the hip than intact women ( P<0.05). However, this difference was explained by ERT; after adjustment for ERT, mean hip bone loss per year was −0.57% for intact women, −0.42% for hysterectomized women with ovarian conservation and −0.32% for bilaterally oophorectomized women ( P's>0.10). There were no differences by hysterectomy or oophorectomy in bone loss at the spine or femoral neck. For all sites, women using ERT had higher BMD at both visits than nonusers ( P's<0.001). Stratification by ERT showed that within users and nonusers, there were no differences in BMD or bone loss at any site by hysterectomy or oophorectomy. Conclusions: There are no long term effects of hysterectomy and bilateral oophorectomy on bone loss. Women who use ERT have better BMD than nonusers.

Preliminary report: Vitamin D receptor and aromatase gene interaction and bone mass in older African-American women

Aromatization of androgens by the CYP19 gene product, aromatase, is the major source of endogenous estrogen in postmenopausal women. We determined whether an Arg264Cys polymorphism in the CYP19 gene is associated with bone mineral density (BMD) and bone loss in older women. Because vitamin D regulates CYP19 gene expression, we also tested for an interaction with a translation start site polymorphism in the vitamin D receptor (VDR) gene. Hip BMD was measured twice, an average of 1.9 years apart, in 100 African-American women aged ≥65 years. Neither polymorphism alone was significantly associated with BMD or bone loss. BMD measurements in women with the less frequent allele at both loci were 0.5 to 1.3 SD lower than in women with neither or only a single rare allele (P <.001 for interaction). These women also experienced more rapid hip bone loss than other women (P <.05 for interaction). We conclude that VDR and CYP19 gene polymorphisms may jointly influence bone mass and the rate of bone loss in older African-American women. © 2003 Elsevier Inc. All rights reserved.

Lactose malabsorption and rate of bone loss in older women.

to study the prevalence of lactose malabsorption with increasing age and to determine whether lactose malabsorbers consume less dietary calcium, have lower bone mineral density or display faster bone loss than lactose absorbers. 80 healthy Caucasian women aged 40-79 years (20 per decade) were studied for 1 year. breath hydrogen exhalation was measured for 3 after a 50 g oral lactose challenge. Bone density was assessed in the radius, femoral neck, lumbar spine and total body by dual energy x-ray absorptiometry and dietary calcium intake was estimated by 4-day diet records and food-frequency questionnaires. lactose malabsorption rose with age (15% in those aged 40-59 years versus 50% in those aged 60-79; P < 0.01). Malabsorbers aged 70-79 years consumed significantly less calcium than lactose absorbers of this age (P < 0.05). Baseline total body calcium values were lower in lactose malabsorbers (n=26) than in lactose absorbers (n=54) but age-adjustment eliminated this difference. Bone change (% per year) was correlated with dietary calcium intake at the femoral neck and trochanter (P < 0.05) but was not statistically greater in malabsorbers than in absorbers. the ability to absorb lactose declines in the 7th decade. This may contribute to decreased dietary intakes of milk products and calcium in elderly women. However, lactose malabsorption without reduction in calcium intake has little effect on bone mineral density or the rate of bone loss.

Low thyrotropin levels are not associated with bone loss in older women: a prospective study.

The relationship between excess thyroid hormone and bone loss is controversial. To determine whether low TSH levels, indicating excessive thyroid hormone, are associated with low bone mass or accelerated bone loss in older women, we performed a prospective cohort study of 458 women over age 65 yr participating in the multicenter Study of Osteoporotic Fractures. Three hundred and twenty-three women were randomly selected from the entire cohort of 9704; an additional 135 randomly selected thyroid hormone users were studied. Medical history, medication use, and calcaneal bone mineral density (BMD) were assessed at the baseline visit. Serum was collected and stored at -190 C. Hip and spine BMD were measured approximately 2 yr later, and follow-up calcaneal and hip BMD measurements were obtained after mean follow-up periods of 5.7 and 3.5 yr, respectively. TSH levels were determined in baseline serum samples using a third generation chemiluminescent assay. After adjustment for age, weight, previous hyperthyroidism, and use of estrogen, bone loss over 4-6 yr was similar in women with low, normal, or high TSH. For example, femoral neck bone loss was -0.3%/yr (95% confidence interval, -0.8%, 0.3%) among women with low TSH (< or = 0.1 mU/L) and -0.5%/yr (95% confidence interval, -0.7%, -0.3%) in those with normal TSH (0.1-5.5 mU/L). There were no statistically significant differences in baseline bone mass of the calcaneus, spine, or femoral neck or trochanteric hip subregions. Baseline total hip BMD was 6% lower (P = 0.01) in women with low TSH. Similar results were obtained in analyses confined to women not taking estrogens. We found no consistent evidence that low TSH, a sensitive biochemical marker of excess thyroid hormone, was associated with low BMD or accelerated bone loss in older ambulatory women.

Low Thyrotropin Levels Are Not Associated with Bone Loss in Older Women: A Prospective Study

Low Thyrotropin Levels Are Not Associated with Bone Loss in Older Women: A Prospective Study

Effects of physical exercise on some parameters of bone metabolism in postmenopausal women.

This study was performed on 19 postmenopausal female volunteers in a period of five months of moderate physical exercise in order to examine beneficial changes in muscle strength and flexibility as well as changes in sex hormone binding globulin (SHBG) and other parameters related to bone metabolism. While SHBG decreased significantly (from 56.0 +/- 20.0 to 43.9 +/- 16.1 nM, P = 0.009) phosphorus and urea increased (from 2.8 +/- 0.4 to 4.0 +/- 0.5 mg/dl, P = 0.00006 and from 32.1 +/- 9.4 to 42.3 +/- 11.0 mg/dl, P = 0.03, respectively). These changes were accompanied by significant increases in muscle strength and flexibility. Other parameters such as alkaline phosphatase and calcium did not change significantly during the study. Plasma levels of SHBG were negatively correlated with phosphorus. As higher SHBG has been related to increased bone loss in older women, we conclude that moderate physical activity is an effective means to preserve bone loss in postmenopausal women.

Copper supplementation and the maintenance of bone mineral density in middle-aged women

Osteoporosis is a common disease of older women in developed countries. Hormone replacement therapy (HRT) is currently the most effective way of reducing the rate of bone loss in older women. This study investigated the effects of copper supplementation over 2 years on vertebral trabecular bone mineral density (VTBMD) of a group of 73 apparently healthy women, aged 45-56 years, recruited from a general practice in north Belfast. Women were given, at random and double blind, either a supplement of 3 mg copper as amino acid chelate or a placebo to take daily. At the beginning and end of the study, VTBMD of the lumbar vertebrae (L2-4) was measured by computed tomography-scan (CT-scan) and random blood samples were taken for putative measures of copper status (erythrocyte Cu and superoxide dismutase activity). The women were seen every 3 months to monitor compliance with supplementation. There was no difference in initial and final VTBMD for the 24 women who took the copper supplement (initial VTBMD 124.6 (32.1) mg/cm(3) and final VTBMD 123.8 (36.3) mg/cm(3)) while the 32 women who took the placebo had significantly lower VTBMD at the end of the study period (initial VTBMD 120.7 (29.2) mg/cm(3) and final VTBMD 113.2 (26.6) mg/cm(3), paired t-test P = 0.01). Seventeen women (14 allocated the copper supplement and three the placebo) stopped taking the supplement during the study. Although copper supplementation had no effect on the putative biochemical measurements of copper status, it appeared to have reduced the loss of VTBMD in these middle-aged women over a 2 year period. (C) 1997 Wiley-Liss, Inc.

Physiologic, Health and Lifestyle Factors Associated With Femoral Neck Bone Density in Older Women

Three hundred eleven women aged between 60 and 91 years (mean age 72.2) who were randomly recruited from the community underwent bone density assessments of the femoral neck. Two complementary multivariate techniques were used to assess the relationships between femoral neck bone density and a range of anthropometric, health, and lifestyle measures. Stepwise multiple linear regression analysis revealed age, weight, height, quadriceps strength, and lifelong smoking to be variables that independently and significantly explained part of the variance in femoral neck bone density within the group. Multiple logistic regression revealed that after adjusting for established predictors of bone mineral density, age, height, and weight, reduced quadriceps strength, lifelong smoking, and little childhood activity were significantly associated with low bone density (< 0.70 g/cm2), whereas superior quadriceps strength, nonsmoking, and high levels of current physical activity were significantly associated with high bone density (> 0.84 g/cm2). In contrast, current calcium intake was not significantly associated with bone density. The study findings highlight possible public health initiatives for minimizing age-related femoral neck bone loss in older women.

Physiologic, health and lifestyle factors associated with femoral neck bone density in older women

Three hundred eleven women aged between 60 and 91 years (mean age 72.2) who were randomly recruited from the community underwent bone density assessments of the femoral neck. Two complementary multivariate techniques were used to assess the relationships between femoral neck bone density and a range of anthropometric, health, and lifestyle measures. Stepwise multiple linear regression analysis revealed age, weight, height, quadriceps strength, and lifelong smoking to be variables that independently and significantly explained part of the variance in femoral neck bone density within the group. Multiple logistic regression revealed that after adjusting for established predictors of bone mineral density, age, height, and weight, reduced quadriceps strength, lifelong smoking, and little childhood activity were significantly associated with low bone density (< 0.70 g/cm2), whereas superior quadriceps strength, nonsmoking, and high levels of current physical activity were significantly associated with high bone density (> 0.84 g/cm2). In contrast, current calcium intake was not significantly associated with bone density. The study findings highlight possible public health initiatives for minimizing age-related femoral neck bone loss in older women.