Proximal Femur Bone Mineral Density Research Articles

Multicomponent Training Program with Weight-Bearing Exercises Elicits Favorable Bone Density, Muscle Strength, and Balance Adaptations in Older Women

Physical exercise is advised as a preventive and therapeutic strategy against aging-induced bone weakness. In this study we examined the effects of 8-month multicomponent training with weight-bearing exercises on different risk factors of falling, including muscle strength, balance, agility, and bone mineral density (BMD) in older women. Participants were randomly assigned to either an exercise-training group (ET, n=30) or a control group (CON, n=30). Twenty-seven subjects in the ET group and 22 in the CON group completed the study. Training was performed twice a week and was designed to load bones with intermittent and multidirectional compressive forces and to improve physical function. Outcome measures included lumbar spine and proximal femoral BMD (by dual X-ray absorptiometry), muscle strength, balance, handgrip strength, walking performance, fat mass, and anthropometric data. Potential confounding variables included dietary intake, accelerometer-based physical activity, and molecularly defined lactase nonpersistence. After 8months, the ET group decreased percent fat mass and improved handgrip strength, postural sway, strength on knee flexion at 180°/s, and BMD at the femoral neck (+2.8%). Both groups decreased waist circumference and improved dynamic balance, chair stand performance, strength on knee extension for the right leg at 180°/s, and knee flexion for both legs at 60°/s. No associations were found between lactase nonpersistence and BMD changes. Data suggest that 8months of moderate-impact weight-bearing and multicomponent exercises reduces the potential risk factors for falls and related fractures in older women.

Bone mineral density in young males with ankylosing spondylitis

To assess bone mineral density (BMD) abnormalities in young Indian males with ankylosing spondylitis (AS) and factors influencing this. Eighty AS male subjects were compared with 160 age/sex matched controls for BMD of lumbar spine and proximal femur. AS subjects were evaluated and followed up every 3 months for disease activity. BMD was estimated at spine and proximal femur using the dual-energy X-ray absorptiometry (DXA) technique. All subjects were males with mean age of 32.9 ± 8.3 years and mean duration of disease was 8.1 ± 5.8 years. AS subjects had significantly lower BMD at the spine and femur as compared with controls (both P < 0.001). Using WHO standards, osteoporosis (OP) in spine and femur neck was seen in 28.75% (controls: 1.84%, P < 0.001) and 11.54% (controls: 1.23%, P < 0.001), respectively. No statistically significant difference in prevalence of OP was seen with disease duration, C-reactive protein levels and disease activity indices (all P > 0.05). Syndesmophytes were seen in 22.5% (n = 18) of AS subjects. There was no significant difference between BMD values at spine in AS subjects with or without syndesmophytes (0.91 + 0.16 g/cm(2) vs. 0.90 + 0.14 g/cm(2), P = 0.79). OP is a significant complication in AS even in young males with early disease, and more prevalent in the spine compared to femur. In our study, BMD was not influenced by disease activity indices, inflammatory markers or total disease duration. Spinal BMD is the most sensitive site for defining OP in AS.

Comparisons of Bone Mineral Density and Bone Quality in Adult Rock Climbers, Resistance-Trained Men, and Untrained Men

The nature of muscular contractions and episodes of impact loading during technical rock climbing are often varied and complex, and the resulting effects on bone health are unclear. The purpose of this study was to compare total body, lumbar spine, proximal femur, and forearm areal bone mineral density (aBMD) and tibia and forearm bone quality in male rock climbers (RC) (n = 15), resistance trained men (RT) (n = 16), and untrained male controls (CTR) (n = 16). Total body, anteroposterior (AP) lumbar spine, proximal femur, and forearm aBMD and body composition were measured using dual-energy X-ray absorptiometry (DXA) (Lunar Prodigy, v. 10.50.086; GE Healthcare, Waukesha, Wisconsin, U.S.A.). Volumetric BMD (vBMD), bone content, bone area, and muscle cross-sectional area (MCSA) of the tibia and forearm were measured using pQCT (peripheral quantitative computed tomography; Stratec XCT 3000, Pforzheim, Germany). No significant group differences were seen in bone-free lean body mass. CTR had significantly (p < 0.05) greater body fat % than RC and RT and significantly (p < 0.05) greater fat mass than RC. Lumbar spine and femoral neck aBMD were significantly (p < 0.05) greater in RT compared to both RC and CTR. RC had significantly (p < 0.05) lower aBMD at the 33% radius site than CTR. Forearm MCSA was significantly (p < 0.05) lower in CTR than in the other groups. No significant differences were seen between groups for vBMD or bone area of the tibia and forearm. In conclusion, resistance-trained men had higher bone density at the central skeletal sites than rock climbers; however, bone quality variables of the peripheral limbs were similar in rock climber and resistance-trained groups.

International variation in proximal femur bone mineral density

We observed higher proximal femur bone mineral density (BMD) in European women compared to average values derived from US Caucasian women in the National Health and Nutrition Examination Survey (NHANES) study. Across European centres, Parisian women had lower proximal femur BMD compared to women from Kiel or Sheffield. Proximal femur BMD of US adults (NHANES III) may not accurately reflect that of European women. We examined the heterogeneity of BMD across European and US Caucasian women and across different European populations. Proximal femur BMD was measured in women ages 20-39 years (n=258) and 55-79 years (n=1,426) from three European centres. Cross-calibrated BMD for total hip, femoral neck, trochanter and intertrochanter were examined. International variation in BMD was assessed by comparing means and SDs in the European data with those from the US NHANES III study. European populations were stratified into 5-year age bands to establish individual centre reference intervals. Between-centre differences were assessed using ANOVA and post hoc Fisher's least significant difference tests. European women had higher BMD than US women: The differences were 7.1% to 14.2% (p<0.001) and 0% to 3.9% (p<0.05) in the older and younger women, respectively. Standard deviations for BMD at the different sites were comparable to those for US women. Among older, but not younger European women, proximal femur BMD was significantly lower in French women (Paris) than in women from Germany (Kiel) or the UK (Sheffield) (difference=5.0% to 9.6%, p<0.05). International variation in hip BMD does exist, with international and between-centre differences being less evident at the femoral neck.

Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women

Six hundred sixty-one participants who had at least one cardiac risk factor but were without known coronary heart disease underwent low-dose multidetector computed tomography coronary angiography (MDCT-CA) and dual-energy X-ray absorptiometry. The association between presence of subclinical coronary calcified plaque and low bone mineral density for the middle-aged individual was not significant after multivariate adjustment. Results of previous clinical studies assessing the relationship between osteoporosis and coronary calcification are inconsistent. This study aimed to evaluate the association between subclinical coronary calcification and osteoporosis in middle-aged men, premenopausal women, and postmenopausal women by using low-dose MDCT-CA and bone mineral density (BMD). This study enrolled 661 participants with at least one cardiac risk factor but without known coronary artery disease (CAD). All subjects underwent low-dose MDCT-CA and dual-energy X-ray absorptiometry on the same day. The mean age was 52.2 years for men, 44.8 years for premenopausal women, and 59.1 years for postmenopausal women. The prevalence of calcified plaques between men with normal BMD and low BMD at lumbar spine were significantly different (P=0.042). The prevalence of mixed plaque and calcified plaque between pre- and postmenopausal women with normal BMD and low BMD at lumbar spine and femoral neck were not significantly different (P>0.05). Possible association between lumbar spine, femoral neck, and total proximal femur BMD and the presence of CAP was evaluated for men, premenopausal women, and postmenopausal women using multivariate logistic regression analysis: results were not significant (P>0.05). Our study demonstrates that the association between the presence of subclinical coronary calcification and low BMD among middle-aged men and women was not significant after controlling for age and other risk factors for CAD and osteoporosis.

Risedronate improves proximal femur bone density and geometry in patients with osteoporosis or osteopenia and clinical risk factors of fractures: a practice-based observational study

The purpose of this practice-based observational study was to clarify the acute effect of risedronate on proximal femur bone mineral density (BMD) and structural geometry in patients with an increased risk of fractures. One hundred sixty-four patients (7 men and 157 postmenopausal women; mean age, 69.2 years) with osteoporosis or osteopenia and clinical risk factors of fractures were analyzed. All these patients were treated with risedronate for 1 year. Urinary levels of cross-linked N-terminal telopeptide of type I collagen (NTX) were measured at baseline and 4 months after the start of treatment. BMD of the lumbar spine and proximal femur and structural geometric parameters of the proximal femur were evaluated by dual-energy X-ray absorptiometry with advanced hip assessment (AHA) software at baseline and every 4 months. Urinary NTX levels significantly decreased after 4 months of treatment. BMD of the femoral neck and total hip significantly increased after 4, 8, and 12 months of treatment. Cross-sectional moment of inertia (CSMI) and cross-sectional area significantly increased after 4, 8, and 12 months of treatment. An increase in CSMI was apparently greater than those of proximal femur BMD after 4 months of treatment. These results suggest the acute (4 months) and sustained (12 months) effect of risedronate on proximal femur structural geometry as well as BMD as a result of suppression of bone resorption in patients with an increased risk of fractures.

Zinc supplementation can protect from enhanced risk of femoral neck fracture in male rats chronically exposed to cadmium

The aim of this study was to evaluate whether zinc (Zn) supplementation can protect from an enhanced risk of femoral neck fracture due to chronic exposure to cadmium (Cd). For this purpose, biomechanical properties of the neck and bone mineral density (BMD) at the proximal femur of rats receiving Cd (5 or 50 mg/l) or/and Zn (30 or 60 mg/l) in drinking water for 6 and 12 months were evaluated. The exposure to 5 and 50 mg Cd/l decreased the proximal femur BMD and affected biomechanical properties of the femoral neck. In the rats treated with 5 mg Cd/l, weakening of the femoral neck strength was observed after 12 months, whereas at higher exposure – already after 6 months. The supplementation with 30 and 60 mg Zn/l, enhancing its daily intake by 68% and 138%, respectively, compared to the standard diet, had beneficial influence on the femoral neck biomechanical properties during the exposure to Cd, but it had no impact on the proximal femur BMD. Zn administration during the 12-month exposure to 5 mg Cd/l totally prevented the weakening of the neck. Zn supplementation during the 6-month treatment with 50 mg Cd/l entirely prevented the Cd-induced decrease in the neck fracture strength; however, at the longer exposure to Cd the protective effect of Zn was only partial. The beneficial Zn influence was independent on its dose. The results allow the conclusion that an increase in the daily intake of Zn during moderate and relatively high exposures to Cd can reduce femoral neck susceptibility to fracture. Based on the findings, it seems that enhanced Zn consumption in subjects chronically exposed to Cd may, at least partly, protect from the enhanced risk of femoral neck fracture.

Dose–response effect of 40 weeks of resistance training on bone mineral density in older adults

Resistance training is becoming popular for maintaining bone health. Previous studies examined high intensity exercise; we compared high and low intensity resistance training performed 2 or 3days per week in older adults. We found positive bone density responses for the hip and spine for all types of resistance training. This study determined the dose-response effect of resistance training on lumbar spine, proximal femur, and total body bone mineral density (BMD) in older men and women (55-74years). Subjects included 45 men and 79 women who were assigned to one of the following training groups: 1-high intensity (80% 1RM), 2days/week (2HI); 2-low intensity (40% 1RM), 2days/week (2LI); 3-high intensity (80% 1RM), 3days/week (3HI); and 4-low intensity (40% 1RM), 3days/week (3LI). Bone scans (dual energy X-ray absorptiometry) were performed at baseline and after 40weeks of training. Muscular strength (1-repetition maximum) was assessed every 5weeks. There were significant trial (p < 0.05) effects but no significant trial × training group interactions for the BMD sites. Spine, trochanter, and total hip BMD increased from baseline to 40weeks; however, the total body BMD site decreased in the 3LI group. Men and women exhibited similar improvements for the trochanter and total hip sites but the percent change in the spine tended (p = 0.054) to be higher for men (1.8%) than women (0.4%). The resistance training programs, regardless of intensity and frequency, were effective in improving BMD of the proximal femur and lumbar spine but not the total body. Both men and women responded similarly for the hip sites but men show a greater response at the lumbar spine than women.

The Soy Isoflavones for Reducing Bone Loss (SIRBL) Study: a 3-y randomized controlled trial in postmenopausal women

Our previous study indicated that soy protein with isoflavones lessened lumbar spine bone loss in midlife women. We examined the efficacy of isoflavones (extracted from soy protein) on bone mineral density (BMD) in nonosteoporotic postmenopausal women. We hypothesized that isoflavone tablets would spare BMD, with biological (age, body weight, serum 25-hydroxyvitamin D) and lifestyle (physical activity, dietary intake) factors modulating BMD loss. Our double-blind, randomized controlled trial (36 mo) included healthy postmenopausal women (aged 45.8-65.0 y) with intent-to-treat (n = 224) and compliant (n = 208) analyses. Treatment groups consisted of a placebo control group and 2 soy isoflavone groups (80 compared with 120 mg/d); women received 500 mg calcium and 600 IU vitamin D(3). Outcomes included lumbar spine, total proximal femur, femoral neck, and whole-body BMD. Analysis of variance for intent-to-treat and compliant (> or =80%) models, respectively, showed no treatment effect for spine (P = 0.46, P = 0.21), femur (P = 0.86, P = 0.46), neck (P = 0.17, P = 0.14), or whole-body (P = 0.86, P = 0.78) BMD. From baseline to 36 mo, BMD declined regardless of treatment. In intent-to-treat and compliant models, respectively, BMD decreases were as follows: spine (-2.08%, -1.99%), femur (-1.43%, -1.38%), neck (-2.56%, -2.51%), and whole body (-1.66%, -1.62%). Regression analysis (compliant model) indicated that age, whole-body fat mass, and bone resorption were common predictors of BMD change. After adjustment for these factors, 120 mg (compared with placebo) was protective (P = 0.024) for neck BMD. We observed no treatment effect on adverse events, endometrial thickness, or bone markers. Our results do not show a bone-sparing effect of extracted soy isoflavones, except for a modest effect at the femoral neck. This trial was registered at clinicaltrials.gov as NCT00043745.

Does A One-minute Unipedal-standing Balance Exercise with Eyes Open Three Times Daily Increase Bone Mineral Density? A Randomized Controlled Trial

A randomized controlled trial was conducted to ascertain whether bone mineral density (BMD) in the proximal femur and L2-4 could be increased by instructing elderly persons to stand on one leg for 1 min 3 times / day to apply mechanical stress, i.e., body weight applied to the femoral head. Subjects were 47 outpatients 60 years old (3 men, 44 women) . Data were analyzed for 18 women who performed the exercise and 13 women who did not. Dual-energy X-ray absorptiometry was performed to measure BMD. No signicant differences were seen in the percent change in BMD in L2-4 or proximal femur between groups. Comparing the number of subjects with increased BMD from L2-4 to Wards triangle at month 6 of the study revealed the only signicant difference to be in the neck BMD (7 of 11 women in the exercise group vs. 2 of 10 women in the control group ; P = 0.0436) . One- minute unipedal standing with eyes open seemed effective for improving femoral neck BMD in patients with osteoporosis and preventing hip fractures, particularly in elderly individuals.

Relationship between 3-month changes in biochemical markers of bone remodelling and changes in bone mineral density and fracture incidence in patients treated with strontium ranelate for 3 years

From two randomised controlled trials, it is shown that 3-month changes in biochemical markers of bone formation (bone-specific alkaline phosphatase and C-terminal propeptide of type I procollagen) were associated with 3-year bone mineral density (BMD) changes, but not fracture incidence in patients treated with strontium ranelate. The purpose of this study was to assess if short-term change in biochemical markers of bone remodelling is associated with long-term BMD change and fracture incidence observed during treatment with strontium ranelate. From the SOTI and TROPOS trials, bone-specific alkaline phosphatase (BALP), C-terminal propeptide of type I procollagen (PICP), serum C-terminal telopeptides (S-CTX) and urine N-terminal telopeptides of type I collagen (U-NTX) were assessed at baseline and after 3 months. Two thousand three hundred seventy-three women were included in this study. Multiple regression analysis showed that 3-month changes in PICP and BALP but not s-CTX I nor s-NTX I were significantly (p < 0.001) associated with 3-year BMD changes at the lumbar spine and the femoral neck. Changes in s-CTX I, PICP and BALP were significantly associated with change in total proximal femur BMD. Changes in biochemical markers explain less than 8% of the BMD changes. The 3-month changes in BALP, PICP s-CTX I and s-NTX I were not significantly associated with fracture incidence. Short-term changes in biochemical markers of bone formation are associated with future BMD changes in patients treated with strontium ranelate, suggesting a bone-forming activity of this treatment, but are not appropriate to monitor the efficacy of strontium ranelate at the individual level.

Abnormal expression and significance of Runx2 in osteoblasts of adolescent idiopathic scoliosis patients.

To investigate the possible relationship between Runx2 and the low bone mass of adolescent idiopathic scoliosis(AIS) patients at the osteoblast level. Twenty eight AIS patients (mean age 14.9 years, mean Cobb angle 57.3 degrees ) in experimental group, including 2 male and 26 female, underwent posterior instrumentation between March and December 2008. They were divided into two groups. Patients in group A maintained normal bone mineral density (BMD). Patients in group B sustained osteopenia. Normal group, including 8 patients (2 males and 6 females) with a mean age of 15.3 years, were age-matched non-scoliosis adolescents who underwent spinal surgery. BMD of the lumbar spine and proximal femur was measured by using dual energy X-ray absorptiometry in three groups. Small cancellous bone samples were harvested from the iliac crest during the operation. The chipped explants were cultured to obtained the osteoblasts. P2 generation osteoblasts were analyzed to confirm the cell phenotype. Expression of mRNA and protein of Runx2 were detected by using RT-PCR and Western blot in P2 generation osteoblasts from three groups. The expression of Runx2 of osteoblasts had decreased obviously in group B compared with group A and group C (P < 0.05). However, there was no significant difference between group A and group C (P > 0.05). The abnormal expression of Runx2 of osteoblasts may be responsible for the low bone mass in adolescent idiopathic scoliosis patients.

Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study.

Subclinical vitamin D deficiency is considered to be a risk factor for osteoporosis. Therefore, we studied vitamin D status and bone mineral density (BMD) in an age- and sex-stratified population based sample (209 males and 206 females aged between 50 and 80 years). In addition, urinary excretion of pyridinium crosslinks of collagen was determined in order to monitor bone resorption. We found a seasonal variation of serum 25-hydroxyvitamin D (25(OH)D) levels with higher values detected in the summer (27 +/ - 10 ng/ml) and lower values measured in the winter (17 +/- 9 ng/ml). Further analyses were performed separately for winter and summer, respectively. We also excluded subjects taking osteotropic medication. In men, we found no significant relationship between vitamin D status and bone density or pyridinium crosslinks. In women, we found significant positive correlations between 25(OH)D and proximal femur BMD in winter (r = 0.21, p < 0.05) and in summer (r = 0.36, p < 0.01). The association between 25(OH)D and proximal femur BMD persisted after correction for age and body mass index. Serum 25(OH)D and urinary pyridinium crosslinks were inversely correlated in females in winter (r = -0.24, p < 0.02) and in summer (r = -0.32, p < 0.02). Our data support the hypothesis that already moderately low serum levels of 25(OH)D within the "normal" range lead to osteopenia via increased bone resorption.

Reduced bone perfusion in proximal femur of subjects with decreased bone mineral density preferentially affects the femoral neck

Using dynamic contrast enhanced MR imaging, this study investigated perfusion of the proximal femur in subjects with normal BMD, low bone mass and osteoporosis. Study cohort comprised healthy elderly Hong Kong Chinese volunteers consisting of 107 males (74.4 ± 4.2 years, mean ± SD) and 135 females (73.9 ± 4.3 years). Right proximal femur BMD measurement by DXA and MR perfusion imaging (maximum enhancement, E max and enhancement slope, E slope) of the femoral head, neck, and proximal shaft were carried out within a one month interval. Normal BMD, low bone mass and osteoporotic subjects accounted for 46.7%, 44.9%, and 8.4% of males; and 32.6%, 43.7%, and 23.7% of females. Perfusion indices showed that femoral head perfusion was less perfused compared to the femoral shaft ( E max and E slope indices of head region = 28% of shaft region). Compared with normal BMD subjects, E max of femoral head, neck, and proximal femur shaft were reduced by 15 ± 5% (mean ± standard error); 40 ± 4%; 15 ± 5% respectively for low bone mass subjects, and 36 ± 4%; 50 ± 6%; 47 ± 6% respectively for osteoporotic subjects. E slope of femoral head, neck, and proximal femur shaft were reduced by 17 ± 7%; 41 ± 5%; 4 ± 7% for low bone mass subjects and 50 ± 5%, 62 ± 5%, 34 ± 8% for osteoporotic subjects. In low bone mass and osteoporotic subjects there was a tendency for perfusion in the femoral neck to reduce to a greater degree relative to that in the femoral head and shaft.

Vitamin K Treatment Reduces Undercarboxylated Osteocalcin but Does Not Alter Bone Turnover, Density, or Geometry in Healthy Postmenopausal North American Women

Low vitamin K status is associated with low BMD and increased fracture risk. Additionally, a specific menaquinone, menatetrenone (MK4), may reduce fracture risk. However, whether vitamin K plays a role in the skeletal health of North American women remains unclear. Moreover, various K vitamers (e.g., phylloquinone and MK4) may have differing skeletal effects. The objective of this study was to evaluate the impact of phylloquinone or MK4 treatment on markers of skeletal turnover and BMD in nonosteoporotic, postmenopausal, North American women. In this double-blind, placebo-controlled study, 381 postmenopausal women received phylloquinone (1 mg daily), MK4 (45 mg daily), or placebo for 12 mo. All participants received daily calcium and vitamin D(3) supplementation. Serum bone-specific alkaline phosphatase (BSALP) and n-telopeptide of type 1 collagen (NTX) were measured at baseline and 1, 3, 6, and 12 mo. Lumbar spine and proximal femur BMD and proximal femur geometry were measured by DXA at baseline and 6 and 12 mo. At baseline, the three treatment groups did not differ in demographics or study endpoints. Compliance with calcium, phylloquinone, and MK4 treatment was 93%, 93%, and 87%, respectively. Phylloquinone and MK4 treatment reduced serum undercarboxylated osteocalcin but did not alter BSALP or NTX. No effect of phylloquinone or MK4 on lumbar spine or proximal femur BMD or proximal femur geometric parameters was observed. This study does not support a role for vitamin K supplementation in osteoporosis prevention among healthy, postmenopausal, North American women receiving calcium and vitamin D supplementation.

Association between circulating osteoprogenitor cell numbers and bone mineral density in postmenopausal osteoporosis

The role of circulating osteoprogenitor cells in postmenopausal osteoporosis is unknown. We found that alkaline-phosphatase-positive (AP+) cells are the lacking cells in osteoporosis, whose reduction is related to bone loss. Conversely, the increased number of alkaline phosphatase/CD34-positive cells may reflect the reactive bone marrow contribution to bone formation. Circulating osteoprogenitor cells mineralize in vitro and in vivo. Loss of osteogenic cells may account for bone loss in osteoporosis. We studied whether there is an association between the number of circulating osteoprogenitor cells and bone mineral density (BMD) in postmenopausal women with and without osteoporosis. The number of circulating AP+, osteocalcin-positive (OCN+), AP+/CD34+, and OCN+/CD34+ cells was quantified in 54 postmenopausal osteoporotic women and 36 age-matched nonosteoporotic controls. The number of AP+ cells was lower in osteoporotic women than in controls (127 +/- 16 vs 234 +/- 23 per microliter; p < 0.001); higher levels of AP+/CD34+, OCN+, and OCN+/CD34+ cells were found in osteoporotic than controls (p < 0.01 for all). The number of AP+ cells was correlated with lumbar BMD (rho = 0.29; p = 0.008) and proximal femur BMD (rho = 0.31; p = 0.005) whereas inverse correlations were found between AP+/CD34+ cells, OCN+, OCN+/CD34+, and BMD. Reduced AP+ cells and increased AP+/CD34 +, OCN+, and OCN+/CD34+ cells were predictors of low BMD, independent of traditional risk factors for osteoporosis. In postmenopausal osteoporotic women, a reduced number of circulating AP+ cells and increased levels of AP+/CD34+, OCN+, and OCN+/CD34+ cells are associated with reduced bone mineral density, the interpretation of such a cellular imbalance needing exploration.

International variation in proximal femur bone mineral density

We observed higher proximal femur bone mineral density (BMD) in European women compared to average values derived from US Caucasian women in the National Health and Nutrition Examination Survey (NHANES) study. Across European centres, Parisian women had lower proximal femur BMD compared to women from Kiel or Sheffield. Proximal femur BMD of US adults (NHANES III) may not accurately reflect that of European women. We examined the heterogeneity of BMD across European and US Caucasian women and across different European populations. Proximal femur BMD was measured in women ages 20–39 years (n = 258) and 55–79 years (n = 1,426) from three European centres. Cross-calibrated BMD for total hip, femoral neck, trochanter and intertrochanter were examined. International variation in BMD was assessed by comparing means and SDs in the European data with those from the US NHANES III study. European populations were stratified into 5-year age bands to establish individual centre reference intervals. Between-centre differences were assessed using ANOVA and post hoc Fisher’s least significant difference tests. European women had higher BMD than US women: The differences were 7.1% to 14.2% (p < 0.001) and 0% to 3.9% (p < 0.05) in the older and younger women, respectively. Standard deviations for BMD at the different sites were comparable to those for US women. Among older, but not younger European women, proximal femur BMD was significantly lower in French women (Paris) than in women from Germany (Kiel) or the UK (Sheffield) (difference = 5.0% to 9.6%, p < 0.05). International variation in hip BMD does exist, with international and between-centre differences being less evident at the femoral neck.

Proximal femur bone mineral density decrease is associated with bone marrow blood perfusion reduction in an orchiectomy-induced male osteoporosis model in rat

Proximal femur bone mineral density decrease is associated with bone marrow blood perfusion reduction in an orchiectomy-induced male osteoporosis model in rat

Once-Weekly Risedronate in Men With Osteoporosis: Results of a 2-Year, Placebo-Controlled, Double-Blind, Multicenter Study

Male osteoporosis is increasingly recognized as a major public health issue. This multinational, 2-yr, randomized, double-blind, placebo-controlled study was conducted to determine the efficacy and safety of 35 mg once-a-week risedronate in men with osteoporosis. Patients had to be men >or=30 yr old, with lumbar spine T-score <or= -2.5 and femoral neck T-score <or= -1 SD or lumbar spine T-score <or= -1 and femoral neck T-score <or= -2 SD (based on young normal men). Patients were randomized 2:1 to risedronate 35 mg once a week or placebo for 2 yr; all patients took 1000 mg elemental calcium and 400-500 IU vitamin D daily. Lumbar spine BMD at month 24 using last observation carried forward was the primary endpoint. Other endpoints included lumbar spine BMD at time points other than month 24, proximal femur BMD, bone turnover markers (BTMs), new vertebral fractures, clinical fractures, and adverse event (AE) assessment. There were 284 men enrolled in the study. Treatment with risedronate resulted in a significant increase from baseline to endpoint in lumbar spine BMD compared with placebo (4.5%; 95% CI: 3.5%, 5.6%; p < 0.001). Few new vertebral and nonvertebral fractures were reported, with no differences in fracture rates between the two groups. There was a significant (p < 0.01) reduction from baseline in BTMs for the risedronate group compared with placebo at all time points. No apparent differences in the pattern or distribution of AEs including serious and upper gastrointestinal AEs were observed. Risedronate therapy was well tolerated during this 2-yr study and was rapidly effective as indicated by significant BTM decreases at month 3 and BMD increases at month 6 (the earliest time points tested). The effects of risedronate treatment on BMD and BTMs in this study were similar to those previously shown to be associated with fracture risk reductions in women with postmenopausal osteoporosis.

Serum vitamin D level and bone mineral density in premenopausal and postmenopausal women in Croatia

Aim: To evaluate the vitamin D status and bone mineral density (BMD) of premenopausal and postmenopausal women in Croatia and to assess the probable correlation of vitamin D serum level with BMD. Material and methods: We conducted a cross-sectional observational study of 790 women. The age range was 44-78 years. Serum 25(OH)vitamin D was assayed in each patient. Spine and proximal femur BMD were measured by dual energy X-ray absorptiometry (DEXA). Women were divided into subgroups. The first group consisted of 70 younger women with regular menstrual status, second group was consisted of 240 postmenopausal women within 5 years since menopausa, and the third group was consisted of 480 postmenopausal women with more than 5 years since menopausa. Results: Based on data in the literature, we used four 25(OH)D cutoffs to define vitamin D deficiency: 30, 50, 75, and more than 75 nmol/L. Vitamin D serum level was found in 8.02%, 24.1%, 30.3%, and 36.7% with 30, 50, 75, and more than 75 nmol/L cutoffs, respectively. The mean serum 25(OH)D level was 60.81+/-26.1 nmol/L, 67.25 +/- 21.4 nmol/L, and 68.86 +/- 18.1 nmol/l with the first to the third group of women, respectively. 25(OH)D serum level slightly increases with age in Croatian women but not statistically significant. Measurement of BMD by DEXA have shown that osteopenia or osteoporosis are even present in younger women with regular menstrual status. Such women have lower than 30 nmol/L of serum vitamin D level. The number of women who has osteopenia or osteoporosis is increased with age. In these groups serum vitamin D level is in negative correlation with BMD. In the third group the prevalence of osteoporosis is the highest. The mean characteristics of the first group of women is that deficiency of vitamin D correlates with osteopenia or osteoporosis. Conclusion: Vitamin D deficiency is common among premenopausal and postmenopausal women with osteopenia or osteoporosis in Croatia (T-score less than or equal to -2.5). We found correlation among low serum vitamin D level and osteopenia or osteoporosis in younger women with regular menstrual status.