Femoral Neck Bone Mass Research Articles

Calcimimetics and Bone Mineral Density in Renal Transplant Patients With Persistent Secondary Hyperparathyroidism

The persistence of secondary hyperparathyroidism plays an important role in posttransplant bone loss. Calcimimetics are efficient to control metabolic alterations associated with this problem, but there are few publications that assess their effects on bone density. This prospective study assessed the effects of a single daily dose of cinacalcet on calcemia, phosphatemia, parathyroid hormone (PTH), and bone densitometry (femur and spine) values of 27 renal transplant patients with stable kidney function, calcium > 10.5 mg/dL, and PTH > 65 pg/mL. A preliminary study after 6 months showed decreased calcemia (11.05 +/- 0.5 to 10.18 +/- 0.6 mg/dL; P < .0001), reduced levels of intact PTH (iPTH; 258 +/- 104 to 209.61 +/- 127 pg/mL; P < .05), and increased phosphatemia (2.38 +/- 0.45 to 2.54 +/- 0.3 mg/dL; P < .05). We also observed an increase in femoral neck bone mass with improved T score (-1.36 +/- 1.19 to -1.05 +/- 0.84 g/cm(2); P < .05). Cinacalcet was effective in the management of posttransplant persistent secondary hyperparathyroidism, resulting in decreased calcemia and iPTH, while also improving femoral neck bone loss. Longer-term studies with control groups are needed to determine the drug's influence on overall bone mineral density.

Sex-Specific Genetic Loci for Femoral Neck Bone Mass and Strength Identified in Inbred COP and DA Rats

Hip fracture is the most devastating osteoporotic fracture type with significant morbidity and mortality. Several studies in humans identified chromosomal regions linked to hip size and bone mass. Animal models, particularly the inbred rat, serve as complementary approaches for studying the genetic influence on hip fragility. The purpose of this study is to identify sex-independent and sex-specific quantitative trait loci (QTLs) for femoral neck density, structure, and strength in inbred Copenhagen 2331 (COP) and Dark Agouti (DA) rats. A total of 828 (405 males and 423 females) F(2) progeny derived from the inbred COP and DA strains of rats were phenotyped for femoral neck volumetric BMD (vBMD), cross-sectional area, polar moment of inertia (Ip), neck width, ultimate force, and energy to break. A whole genome screen was performed using 93 microsatellite markers with an average intermarker distance of 20 cM. Recombination-based marker maps were generated using MAPMAKER/EXP from the COP x DA F(2) data and compared with published Rat Genome Database (RGD) maps. These maps were used for genome-wide linkage analyses to detect sex-independent and sex-specific QTLs. Significant evidence of linkage (p < 0.01) for sex-independent QTLs were detected for (1) femoral neck vBMD on chromosomes (Chrs) 1, 6, 10, and 12, (2) femoral neck structure on Chrs 5, 7, 10, and 18, and (3) biomechanical properties on Chrs 1 and 4. Male-specific QTLs were discovered on Chrs 2, 9, and 18 for total vBMD, on Chr 17 for trabecular vBMD, on Chr 9 for total bone area, and on Chr 15 for ultimate force. A female-specific QTL was discovered on Chr 2 for ultimate force. The effect size of the individual QTL varied between 1% and 4%. We detected evidence that sex-independent and sex-specific QTLs contribute to hip fragility in the inbred rat. Several QTLs regions identified in this study are homologous to human chromosomal regions previously linked to QTLs contributing to femoral neck and related phenotypes.

Does a novel school-based physical activity model benefit femoral neck bone strength in pre- and early pubertal children?

The effects of physical activity on bone strength acquisition during growth are not well understood. In our cluster randomized trial, we found that participation in a novel school-based physical activity program enhanced bone strength acquisition and bone mass accrual by 2-5% at the femoral neck in girls; however, these benefits depended on teacher compliance with intervention delivery. Our intervention also enhanced bone mass accrual by 2-4% at the lumbar spine and total body in boys. We investigated the effects of a novel school-based physical activity program on femoral neck (FN) bone strength and mass in children aged 9-11 yrs. We used hip structure analysis to compare 16-month changes in FN bone strength, geometry and bone mineral content (BMC) between 293 children who participated in Action Schools! BC (AS! BC) and 117 controls. We assessed proximal femur (PF), lumbar spine (LS) and total body (TB) BMC using DXA. We compared change in bone outcomes between groups using linear regression accounting for the random school effect and select covariates. Change in FN strength (section modulus, Z), cross-sectional area (CSA), subperiosteal width and BMC was similar between control and intervention boys, but intervention boys had greater gains in BMC at the LS (+2.7%, p = 0.05) and TB (+1.7%, p = 0.03) than controls. For girls, change in FN-Z tended to be greater (+3.5%, p = 0.1) for intervention girls than controls. The difference in change increased to 5.4% (p = 0.05) in a per-protocol analysis that included girls whose teachers reported 80% compliance. AS! BC benefits bone strength and mass in school-aged children; however, our findings highlight the importance of accounting for teacher compliance in classroom-based physical activity interventions.

Effects of risedronate on fracture risk in postmenopausal women with osteopenia

SummaryThis posthoc analysis of four trials studied the efficacy of risedronate to reduce fragility fractures in postmenopausal women with osteopenia (i.e., T-scores between −1 and −2.5). Risedronate reduced the fracture risk by 73% ( = 0.023) in this population of women with low femoral neck bone mass and no prevalent vertebral fractures.IntroductionLow bone mass represents an increasing health risk and burden. Half of fragility fractures occur in osteopenic women underscoring the need for treatments reducing fracture risk. This analysis reports the effect of risedronate to reduce fragility fracture risk in osteopenic women without prevalent vertebral fractures.MethodsPostmenopausal women with osteopenia, defined as femoral neck T-score between −1 and −2.5 by DXA and no prevalent vertebral fractures, were identified from four controlled randomized trials (BMD Multinational, BMD North America, VERT Multinational and VERT North America). The risk reduction for fragility fractures in patients receiving 5 mg risedronate daily for 1.5 to 3 years compared to placebo was assessed. An additional sensitivity analysis excluded patients who were osteopenic at the femoral neck but had a BMD lower than −2.5 SD at the lumbar spine.ResultsSix hundred and twenty postmenopausal women with osteopenia were included, receiving either placebo ( = 309) or risedronate 5 mg ( = 311). Risedronate reduced the risk of fragility fractures by 73% over 3 years versus placebo ( = 0.023); cumulative fragility fracture incidence was 6.9% in placebo-treated versus 2.2% in risedronate-treated patients. The magnitude of the effect was similar in the sensitivity analysis subset.ConclusionRisedronate significantly reduced the risk of fragility fractures in postmenopausal women with osteopenia (femoral neck T-score between −1 and −2.5 SD) and no prevalent vertebral fractures.

Growth Hormone Favorably Affects Bone Turnover and Bone Mineral Density in Patients With Short Bowel Syndrome Undergoing Intestinal Rehabilitation

Patients with short bowel syndrome (SBS) have a high prevalence of metabolic bone disease due to nutrient malabsorption and potential effects of parenteral nutrition (PN). Human growth hormone (hGH) has been shown in some studies to have anabolic effects on bone, but hGH effects on bone in patients with SBS are unknown. Adults with PN-dependent SBS underwent a 7-day period of baseline studies while receiving usual oral diet and PN and then began receiving modified diets designed to improve nutrient absorption and daily oral calcium/vitamin D supplements (1500 mg elemental calcium and 600 IU vitamin D, respectively). Subjects were randomized to receive in a double-blind manner either subcutaneous (sc) saline placebo as the control or hGH (0.1 mg/kg/d for 3 weeks, then 0.1 mg/kg 3 days a week for 8 subsequent weeks). Open-label hGH was given from week 13 to week 24 in subjects who required PN after completion of the 12-week double-blind phase. Markers of bone turnover (serum osteocalcin and urinary N-telopeptide [NTX]), vitamin D nutriture (serum calcium, 25-hydroxyvitamin D [25-OH D] and parathyroid hormone [PTH] concentrations), and intestinal calcium absorption were measured at baseline and at weeks 4 and 12. Dual x-ray absorptiometry (DXA) of the hip and spine was performed to determine bone mineral density (BMD) at baseline and weeks 12 and 24. The majority of subjects in each group exhibited evidence of vitamin D deficiency at baseline (25-OH D levels<30 ng/mL; 78% and 79% of control and hGH-treated subjects, respectively). Subjects treated with hGH demonstrated a significant increase from baseline in serum osteocalcin levels at 12 weeks (+62%; p<.05). The levels of NTX were increased over time in the hGH-treated group; however, this did not reach statistical significance. Both NTX and osteocalcin remained unchanged in control subjects. BMD of the spine and total hip was unchanged in subjects treated with placebo or hGH at 24 weeks. However, femoral neck BMD was slightly but significantly decreased in the placebo group at this time point but remained unchanged from baseline in the hGH-treated subjects. hGH therapy significantly increased markers of bone turnover during the initial 3 months of therapy and stabilized femoral neck bone mass over a 6-month period in patients with severe SBS undergoing intestinal rehabilitation.

Correlation between Clinical Radiologic Manifes­tation and Changes of Femoral Neck Bone Mass and Stabilometric Data in Coxarthrosis

Correlation between clinical radiologic manifestations and changes of stabilometric data and mineral density of bone tissue in proximal femur was studied. It was detected that displacement of median position of gravity center in frontal plane took place in healthy side and depended on the stage of coxarthrosis. DEXA showed that decrease of mineral density of bone tissue in femoral neck was more significant at the injured side.

Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period

Generalized low bone mass has been well documented in patients with adolescent idiopathic scoliosis (AIS). However, studies linking calcium-intake (CA), weight-bearing physical-activity (PA) and bone mass of AIS are lacking. We aimed to study the relationship between CA, PA and bone mass in AIS girls and compared to those of healthy non-AIS controls during the peripubertal period. Newly diagnosed AIS girls (n=596) aged 11-16 years with Cobb angle >/=10 degrees were recruited to compare with age-matched healthy girls (n=302) in a cross-sectional study. Anthropometric parameters, pubertal status, CA and PA were assessed. Areal bone mass of lumbar spine and femoral neck, and volumetric bone mass of distal radius and tibia were determined by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. The results showed that weight and body mass index (BMI) of AIS were lower than the controls (P<0.05). Corrected height and arm span of AIS were longer than those of controls from 13 years onwards (P<0.02). Median CA of AIS was <410 mg/day across the ages and did not differ from the controls (P=0.063). Median PA of AIS (1.6 h/day) was lower than the controls (1.8 h/day) (P=0.025). Bone mass of AIS was on average 6.5% lower than controls across the ages (P<0.05). CA and PA were significantly correlated with bone mass of AIS (P<0.04). Multivariate analysis showed that AIS in girls was associated with lower bone mass, and that both CA and PA were independent predictors of bone mass in AIS. In conclusion, AIS girls were found to have lower body weight and BMI, longer segmental lengths and generalized low bone mass. Inadequate calcium intake and weight-bearing physical activity were significantly associated with low bone mass in AIS girls during the peripubertal period. The importance of preventing generalized osteopenia in the control of AIS progression during the peripubertal period warrants further study.

Peak spine and femoral neck bone mass in young women

Achievement of higher peak bone mass early in life may play a critical role against postmenopausal bone loss. Bone mineral density (BMD) of the spine, femoral neck, greater trochanter, Ward’s triangle, and spine bone mineral content (BMC) and bone surface area (BSA) were assessed by dual energy x-ray absorptiometry in 300 healthy females (age 6–32 years). Bone measurements were described by using nonlinear models with age, weight, height, or dietary calcium intake as the explanatory variables. At the spine, femoral neck, greater trochanter, and Ward’s triangle, the highest BMD level was observed at 23.0 ± 1.4, 18.5 ± 1.6, 14.2 ± 2.0, and 15.8 ± 2.1 years, respectively. The age of attaining peak spine BMC and BSA cannot be estimated, as significant increases in these two measures were observed through this age group. Age, weight, and height were all significant predictors of all these bone measurements. Weight was a stronger predictor than age for all sites. Dietary calcium intake was not a significant predictor for any of these bone measurements. We conclude that age of attaining peak bone mass at the hip is younger than at the spine, and BMC and BSA at the spine continue to increase through the early thirties in females.

Effects of estriol on cell viability and 1,25-dihydroxyvitamin D3receptor mRNA expression in cultured human osteoblast-like cells

It is clinically evident that administration of estriol (E3) increases the bone mass density of the lumbar vertebrae in postmenopausal women, and that combined treatment with estrogen and 1,25-dihydroxyvitamin D3(VD3) increases femoral neck bone mass density compared with treatment with estrogen alone in postmenopausal osteoporotic women. However, the molecular mechanism whereby treatment with E3affects osteoblast cell function is still unknown. This study was conducted first to examine the comparative effects of E3and VD3on the cell viability of cultured human osteoblast-like cells (HOS) and second to determine whether E3affects VD3receptor mRNA expression in HOS. The cell viability and VD3receptor mRNA expression of cultured HOS were assessed by MTT assay and semiquantitative reverse transcriptase—polymerase chain reaction with Southern blot analysis, respectively. The treatment with E3increased the cell viability of cultured HOS compared with untreated control cultures. The increase in cell viability caused by the treatment with E3was further augmented by the combined treatment with VD3. The addition of either E3(3.52 × 10−8 mol/l) or E3(3.52 × 10−7 mol/l) to cultured HOS for 24 h resulted in a fourfold and eightfold increase, respectively, in VD3receptor mRNA expression in HOS, compared with that in untreated control cultures. These results suggest that E3may up-regulate the cell viability of osteoblast cells, and that the concomitant treatment with E3and VD3further augments the cell viability being associated with an E3-induced increase in VD3receptor mRNA expression in those cells.

Alta prevalencia de osteoporosis en mujeres mapuches postmenopáusicas asintomáticas

Genetic and environmental factors are responsible for variations in the frequency of osteoporosis. Prevalence of osteoporosis in Mapuche women (native Chileans) is unknown. To assess the prevalence and risk factors for osteoporosis in Mapuche women. A random sample of 95 asymptomatic postmenopausal Mapuche females, stratified by age, was studied. Women with diseases or medications that could interfere with calcium metabolism were excluded. Spine and femoral neck bone mass density was determined using a Lunar DPX Alpha densitometer. Seventeen percent of women had normal bone mineral density in both spine and femoral neck. In the spine, 25.3% had a normal bone mineral density, 17.9% had osteopenia and 56.8% had osteoporosis. In the femoral neck, 34.7% had a normal bone mineral density, 57.9% had osteopenia, and 7.4% had osteoporosis. There was a positive correlation between bone mineral density and body mass index. Women with more than one hour per day of physical activity, had a significantly lower proportion of osteopenia or osteoporosis. No association between bone mineral density and parity or calcium intake, was observed. There is a high prevalence of osteopenia and osteoporosis among Mapuche women. Osteoporosis was associated with low body mass index.

Predictors of bone mass in healthy older men in the community.

To determine the predictors of bone mass (in lumbar spine and femoral neck) in healthy older men living in the community. Cross-sectional study. Bone mineral density (BMD) was measured and known predictors of bone mass and bone turnover were assessed. 113 independent, healthy men (70 years and over), not taking glucocorticoid therapy and without medical conditions known to affect bone mass and bone turnover, were recruited from recreational and sports clubs in southern Sydney in April/May 1997. BMD (measured by dual-energy x-ray absorptiometry); known predictors of bone mass (height; weight; body mass index; calcium level; serum 25-hydroxyvitamin D and free testosterone levels); and markers of bone turnover (serum bone Gla protein and procollagen-1 concentrations, and urinary deoxypyridinoline excretion rates). The mean age of the men was 76.6 years (range, 70-92 years). Mean (SE) BMD of the lumbar spine was 1.143 (0.019) g/cm2 and that of the femoral neck was 0.897 (0.013) g/cm2. BMD values indicating osteoporosis were found in the lumbar spine in 13 men (11.5%) and in the femoral neck in 35 men (31%). The best predictor of lumbar spine BMD was weight (R = 0.37; P = 0.001), and weight- and age-predicted femoral-neck BMD (R = 0.49; P < 0.001). The study group was analysed in two groups with BMD higher or lower than median bone mass corrected for age. Men with lower femoral-neck BMD for age had significantly lower weight, lower lean mass and higher bone Gla protein concentrations. In addition, men with lower lumbar spine BMD for age also had significantly lower fat mass. These data indicate that measures of body composition, such as weight and lean mass, are the main predictors of bone mass in healthy, community-dwelling older men.

Bone Status among Postmenopausal Women with Different Habitual Caffeine Intakes: A Longitudinal Investigation

Objective: Caffeine consumption has been proposed as a risk factor for bone loss in postmenopausal women. Past epidemiologic studies on caffeine and bone have been confounded by covariates including cigarette and alcohol use, differing levels of physical activity and hormone replacement therapy. The purpose of the study was to use a longitudinal design to determine the relationship between habitual dietary caffeine intake and postmenopausal bone status.Methods: Data were collected at two time points separated by two years; 138 women with little or no exposure to tobacco or to drugs known to affect bone status were seen at Visit 1, and 112 returned for Visit 2. Ninety-two of these subjects had received no drugs known to affect bone status over the two-year interval and were kept in the sample. Nutrient and caffeine intake were assessed from three-day diet records. Bone measurements were made by dual energy x-ray absorptiometry (DXA).Results: Correlation analyses indicated no association between dietary caffeine intake and total body or femoral neck bone density or bone mass. Similarly, no associations were found between caffeine consumption and longitudinal changes in total body or femoral neck bone measurements. These results held true both with and without statistical adjustment for calcium intake.Conclusions: This study does not support the idea that caffeine is a risk factor for bone loss in healthy postmenopausal women.

A randomized study of tibolone on bone mineral density in osteoporotic postmenopausal women with previous fractures

Objective: To investigate the effects of tibolone on trabecular and cortical bone mineral density and on indices of calcium metabolism in postmenopausal women with previous fractures. Methods: In a 2-year, randomized, double-blind, placebo-controlled, bicenter study, 45 women were treated with tibolone and 43 with placebo. All subjects received 800 mg of calcium daily. Trabecular bone mineral density of lumbar spine (L1 to L4) and cortical bone mass at the femoral neck were assessed by dual energy x-ray absorptiometry at baseline and at 6-month intervals. Serum and urinary bone biochemistry variables were also assessed. Results: After 2 years, subjects in the tibolone group gained 6.9% bone mass at lumbar spine and 4.5% at femoral neck, and respective increases from baseline in the placebo group were 2.7% and 1.4%. Tibolone-treated patients gained statistically significantly more bone mass than placebo-treated patients in the spine and femur. Urinary calcium:creatinine and hydroxyproline:creatinine ratios, as well as serum alkaline phosphatase and phosphate levels, were significantly reduced with tibolone compared with placebo. Conclusion: Tibolone induced a significant increase in trabecular (lumbar spine) and cortical (femoral neck) bone mass in postmenopausal osteoporotic women compared to placebo, suggesting its potential to treat postmeno- pausal osteoporosis.

A Randomized Study of Tibolone on Bone Mineral Density in Osteoporotic Postmenopausal Women With Previous Fractures

In Brief Objective To investigate the effects of tibolone on trabecular and cortical bone mineral density and on indices of calcium metabolism in postmenopausal women with previous fractures. Methods In a 2-year, randomized, double-blind, placebo-controlled, bicenter study, 45 women were treated with tibolone and 43 with placebo. All subjects received 800 mg of calcium daily. Trabecular bone mineral density of lumbar spine (LI to L4) and cortical bone mass at the femoral neck were assessed by dual energy x-ray absorptiometry at baseline and at 6-month intervals. Serum and urinary bone biochemistry variables were also assessed. Results After 2 years, subjects in the tibolone group gained 6.9% bone mass at lumbar spine and 4.5% at femoral neck, and respective increases from baseline in the placebo group were 2.7% and 1.4%. Tibolone-treated patients gained statistically significantly more bone mass than placebo-treated patients in the spine and femur. Urinary calcium: creatinine and hydroxyproline:creatinine ratios, as well as serum alkaline phosphatase and phosphate levels, were significantly reduced with tibolone compared with placebo. Conclusion Tibolone induced a significant increase in trabecular (lumbar spine) and cortical (femoral neck) bone mass in postmenopausal osteoporotic women compared to placebo, suggesting its potential to treat postmenopausal osteoporosis. Tibolone increases trabecular and cortical bone mineral density in women with postmenopausal osteoporosis.

WEIGHTED VEST JUMP TRAINING IMPROVES HIP BONE MASS IN NON-ESTROGEN REPLACED POSTMENOPAUSAL WOMEN.

1293 We studied the effects of weighted vest jump training on femoral neck (FN) and lumbar spine (LS) bone mass in women currently participating in lower body resistance training. Thirty-two women had originally begun participation in a 9-month lower body resistance training program. During the last five months women were introduced to jump training, beginning with 4 jumps per session and progressing to 36 jumps per session by month 9. Eleven (mean age 65 ± 6 y; height 162.3 ± 6.4 cm; weight 68.2 ± 8.6 kg) of the original 32 participants continued to engage in lower body resistance and jump training for an additional 2 years. None of the eleven women had taken hormone replacement therapy or anti-resorptive agents at any time during the study period. During the first year of additional jump training, the number of jumps completed per session increased from 36 to 60 jumps per session. During the second year, jumping volume remained at 60 jumps/session, but women now performed jumps with weighted vests gradually increasing vest weight to 7% of body mass. Bone mass (DXA) was assessed at baseline, 12 and 24 months during the additional jump training. Percent change for LS bone mass was +0.77%(± 3.0%) over the first year and +0.56% (± 2.8%) over the second. Neither value was significantly different from the other (p>0.05). Percent change for FN bone mass was -1.7% (±2.8%) over the first year and +2.1% (±4.2%) over the second. The percent change over the second year was significantly different (p=0.045) from the percent change over the first year. We conclude that the addition of mass to impact exercise appeared to provide sufficient force magnitude to increase hip bone mass in non-estrogen replaced postmenopausal women.

Calcium and vitamin D for corticosteroid-induced osteoporosis.

To assess the effects of calcium and vitamin D compared to calcium alone or placebo in the prevention of bone loss in patients taking systemic corticosteroids. We searched the Cochrane Musculoskeletal trials register, Cochrane Controlled Trials Register, EMBASE and Medline up to 1996. We also conducted a hand search of abstracts from various scientific meetings and reference lists of selected trials. All randomized trials comparing calcium and vitamin D to calcium alone or placebo in patients taking systemic corticosteroids. Data was abstracted from trials by two investigators. Methodological quality was assessed in a similar manner. Analysis was performed using fixed effects models. Five trials were included, with 274 patients. The analysis was performed at two years after starting calcium and vitamin D. There was a significant weighted mean difference (WMD) between treatment and control groups in lumbar (WMD 2.6 (95% CI 0.7, 4.5), and radial bone mineral density (WMD 2.5 (95% CI 0.6, 4.4). The other outcome measures (femoral neck bone mass, fracture incidence, biochemical markers of bone resorption) were not significantly different. This meta-analysis demonstrated a clinically and statistically significant prevention of bone loss at the lumbar spine and forearm with vitamin D and calcium in corticosteroid treated patients. Because of low toxicity and cost all patients being started on corticosteroids should receive prophylactic therapy with calcium and vitamin D.

Weighted vest exercise improves indices of fall risk in older women.

Bone mass and fall propensity are two major risk factors for hip fracture. Our intent was to determine if weight-bearing exercises with added resistance from weighted vests would improve dynamic balance, muscle strength and power, and bone mass in postmenopausal women, thereby reducing risk for falls and hip fracture. Forty-four nonsmoking, community-dwelling, Caucasian women aged 50-75 years participated in the study. All participants were at least 5 years past menopause and most were estrogen-deplete (n = 36). Bone mass and body composition were assessed by dual-energy x-ray absorptiometry, muscular strength by isokinetic dynamometry, muscular power by modified Wingate Anaerobic Power Test, and indices of postural stability by dynamic posturography. Half of the subjects participated in a 9-month regimen of weight-bearing exercises performed three times a week that emphasized lower-body muscle strength and power development. Resistance was added progressively and individually by the use of a weighted vest. Controls maintained customary diet and activity patterns. Significant improvements were observed for indices of lateral stability, lower-body muscular strength (16-33% increase), muscular power (13% increase), and leg lean mass (3.5% increase) in exercisers vs controls (p < .05). No significant changes (p > .05) were detected for femoral neck bone mass in exercisers or controls at the conclusion of the trial. Lower body exercise, using a weighted vest for resistance, provides an effective means of improving key indices of falls in postmenopausal women.

Calcium nutrition: strategies for maximal bone mass.

Journal of Women's HealthVol. 6, No. 6 Calcium Nutrition: Strategies for Maximal Bone MassCONNIE M. WEAVERCONNIE M. WEAVERSearch for more papers by this authorPublished Online:25 Apr 2009https://doi.org/10.1089/jwh.1997.6.661AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byRelationship Between Nutrient Intake and Bone Mineral Density in 20∼30 Year-old Korean WomenJournal of Food Science and Nutrition, Vol. 14, No. 3Bone mass and soy isoflavones in socially housed, premenopausal macaquesThe American Journal of Clinical Nutrition, Vol. 86, No. 1Peak spine and femoral neck bone mass in young womenBone, Vol. 32, No. 5Lifetime Physical Activity and Calcium Intake Related to Bone Density in Young Women7 July 2004 | Journal of Women's Health & Gender-Based Medicine, Vol. 11, No. 4The role of calcium in health and diseaseAmerican Journal of Obstetrics and Gynecology, Vol. 181, No. 6 Volume 6Issue 6Dec 1997 To cite this article:CONNIE M. WEAVER.Calcium Nutrition: Strategies for Maximal Bone Mass.Journal of Women's Health.Dec 1997.661-664.http://doi.org/10.1089/jwh.1997.6.661Published in Volume: 6 Issue 6: April 25, 2009PDF download

The relationship between childhood growth, bone mass, and muscle strength in male and female adolescents.

In this population-based study, the relationship between childhood weight and height, and adolescent bone mass and muscle strength have been studied in 39 girls and 48 boys. Total body and femoral neck bone mass measurements (bone mineral content, BMC and bone mineral density, BMD) were made by dual X-ray absorptiometry. Quadriceps muscle strength was measured. Mean age at the time of measurement was 15.1 years for girls and boys. Results were individually linked to data on childhood (birth to 6 years of age) weight and height, taken from community health records. Childhood weight was found to be predictive of adolescent total body BMC (TBMC). However, this was not the case when correlating childhood weight and total body BMD (TBMD), suggesting that growth determines the size of the skeleton, whereas the density within that bone envelope is to a greater extent governed by other factors. Further, in a multiple regression model we found that the combined effect of childhood weight and height was significantly correlated with adolescent quadriceps muscle strength.

Weight Change and Fractures in Older Women

Background: The effect of change in weight in later years on risk of osteoporotic fractures is uncertain. Prior studies have assessed the relationship between weight change and risk of hip fracture only and have not examined whether the association between weight loss and increased risk of hip fracture is because of voluntary or involuntary weight loss. Objectives: To determine the association between weight change in later years and the risk of fractures in elderly women and to assess the effect of weight loss intention on this relationship. Methods: The association between weight change and fracture risk was assessed in 6754 ambulatory, non-black women aged 65 years or older enrolled in the Study of Osteoporotic Fractures who had measurements of weight performed at both the baseline and fourth examinations (mean, 5.7 years between examinations). These 6754 women were followed up for all incident nonspine fractures and frailty fractures (defined as fractures of the proximal femur, pelvis, and proximal humerus) occurring after the fourth examination (average follow-up, 19.5 months). All incident fractures were confirmed by radiographic report. Results: During an average of 19.5 months after the fourth examination, 264 women (4%) had at least 1 nonspine fracture, including 83 women who suffered frailty fractures. After adjustment for age, women who lost weight between the baseline and fourth examinations had an increased risk of subsequent nonspine fracture (relative risk [RR] per 10% decrease in weight, 1.32; 95% confidence interval [CI],1.11-1.55). This observed increase in the risk of nonspine fracture was entirely caused by an increase in the risk of frailty fracture (age-adjusted RR per 10% decrease in weight, 1.86; 95% CI, 1.42- 2.43). Weight change was not significantly related to other types of nonspine fractures (age-adjusted RR per 10% decrease in weight, 1.09; 95% CI, 0.90-1.33). Further adjustment for cigarette smoking, physical activity, estrogen use, medical conditions, health status, body weight, femoral neck bone mass, and rate of change in calcaneal bone mass did not substantially alter the association between weight change and frailty fracture (multivariate RR per 10% decrease in weight, 1.68; 95% CI, 1.17-2.41). Weight change was an even stronger predictor of risk of frailty fracture in those women who were not trying to lose weight (multivariate RR per 10% decrease in weight, 1.81; 95% CI, 1.26-2.61). Conclusions: Involuntary weight loss in later years substantially increases the risk of frailty fracture including hip fracture in elderly women. Weight change is not related to risk of other nonspine fractures in older women. Arch Intern Med. 1997;157:857-863