Osteopenic Postmenopausal Women Research Articles

Influences of teriparatide administration on marrow fat content in postmenopausal osteopenic women using MR spectroscopy

Objective Teriparatide could induce osteoblast differentiation of mesenchymal stem cells while inhibiting adipocyte differentiation. However, there are significant differences between ex vivo and in vivo models. We aimed to evaluate the impact of teriparatide on marrow and abdominal fat accumulation in postmenopausal osteopenic women.Methods Postmenopausal osteopenic women were randomly assigned to receive teriparatide or placebo for 12 months. Subcutaneous (SAT) and visceral adipose tissue (VAT), marrow fat fraction (MFF), bone density (BMD) and bone biomarkers were measured at baseline, 6 and 12 months.Results At 12 months, mean percentage changes in BMD from baseline were 3.51%, 2.21% and 1.80% at lumbar spine, total hip and femoral neck for the teriparatide group, respectively. Relative to baseline conditions, teriparatide reduced MFF (–3.54% at 6 months; –5.87% at 12 months, all p < 0.01). A significant difference in MFF, but not BMD, was first detected at 6 months (p = 0.012) between groups. MFF was negatively associated with SAT (r = –0.479) and positively associated with VAT (r = 0.531) and VAT/SAT (r = 0.415, all p < 0.05). Teriparatide treatment did not alter abdominal fat composition.Conclusion Teriparatide effectively lowers marrow adiposity but not abdominal fat accumulation in postmenopausal osteopenic women.

An evaluation of homocysteine, C-reactive protein, lipid levels, neutrophils to lymphocyte ratio in postmenopausal osteopenic women

Objective: In the present study, the risk coefficients of serum homocysteine (hcy), lipid levels, C-reactive protein (CRP), neutrophils to lymphocyte ratio (NLR) in postmenopausal osteopenic women were determined.Methods: We enrolled 269 patients with postmenopausal women from Hangzhou No.1 Hospital gynecological clinic, who aged 45 to 60 years old and never received menopause hormone therapy. According to the bone mineral density determination results, subjects were divided into normal group (n = 128), osteopenia group (n = 141). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA). Serum hcy, CRP and lipid indexes were determined by enzyme chemiluminescence immunoassay.Results: The odds ratios (OR) and 95% confidence intervals (CI) of those variables (menopausal age, duration of menopause, LDL, CRP, hcy and NLR) were found significant (p < 0.05). Menopausal age, duration of menopause, LDL, CRP, hcy and NLR variables were found statistically significant in the analysis of receiver operating characteristic (ROCs).Conclusion: The present study shows that menopause age, duration of menopause, serum LDL, CRP, hcy and NLR levels are risk factors for postmenopausal osteopenic women, which may be used as the indicators of bone loss in postmenopausal women.

Evaluation of the quality of life of postmenopausal osteoporotic and osteopenic women with or without fractures.

IntroductionMost studies concerned with the quality of life (QoL) of women with reduced bone mineral density (BMD) focus on patients with vertebral and non-vertebral fractures. Our objective was to evaluate QoL among patients with reduced BMD regardless of their fracture history compared to women with normal BMD.Material and methodsEighty-five patients in the study group were classified as osteoporotic, with BMD results measured by densitometry and expressed by T-score ≤ –2.5 SD, 122 women were osteopenic, with –2.5 < T-score ≤ –1.0 SD, and 97 subjects were assessed as normal, with T-score > –1.0 SD. Mean ages of women according to groups were 59.90, 57.67 and 55.68, respectively. Assessment of life quality was conducted using the Polish version of the QUALEFFO-41 scale.ResultsThe ratings in the assessment (QUALEFFO-41) of QoL were lower for osteoporotic and osteopenic women than for the normal BMD group with regard to pain (p = 0.006), social function (p = 0.001), health perception (p = 0.001), and mental function (p = 0.001). For total QUALEFFO-41 the associated factors were: secondary and higher education (OR = 0.49; 95% CI: 0.29–0.82), self-perceived deformity of the back (OR = 4.09; 95% CI: 1.88–8.93), previous fractures (OR = 2.52; 95% CI: 1.09–5.82), reduced height (OR = 2.48; 95% CI: 1.13–5.39) and anxiety (OR = 1.42; 95% CI: 1.21–1.66).ConclusionsIt seems necessary to evaluate QoL of women with reduced BMD before fractures occur, to aid development of health education aiming to reduce the incidence of osteoporosis and prevent fractures.

Effects of strontium ranelate on markers of cardiovascular risk in postmenopausal osteoporotic women.

Recent pooled analyses have shown that strontium ranelate increases the incidence of venous thromboembolism and non-fatal myocardial infarction, but no explanations were given. The aim of our study was to assess the effects a 12-month treatment with strontium ranelate on hemostasis factors and markers of cardiovascular risk in postmenopausal osteoporotic women. Forty osteoporotic postmenopausal women received orally strontium ranelate 2g daily, plus calcium and colecalcipherol for 12months. Forty postmenopausal osteopenic women matched for age, menopausal age, and body mass index served as controls and received orally calcium and colecalcipherol for 12months. Biochemical cardiovascular risk factors and hemostatic indices were assayed prior to treatment, and after 3, 6, and 12months of therapy. These indices included fibrinogen, fasting glucose, total serum cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, plasma levels of D-dimer, homocysteine, partial thromboplastin time, and prothrombin time. In addition, we evaluated possible changes in blood pressure and occurrence of venous thromboembolic events. At baseline, no statistically significance was observed between the two groups except for bone mineral density at lumbar spine, femoral neck, and total femur, which was lower in strontium ranelate group. After 12months of treatment, there was no statistically significant change in cardiovascular risk factors and hemostatic parameters. None of the 40 women developed any clinical venous thromboembolic event. A 12-month treatment with strontium ranelate did not alter hemostasis factors or markers of cardiovascular risk, suggesting that reported increased risk of venous thromboembolism and myocardial infarction with strontium is mediated by other factors.

Combined oral administration of bovine collagen peptides with calcium citrate inhibits bone loss in ovariectomized rats.

PurposeCollagen peptides (CPs) and calcium citrate are commonly used as bone health supplements for treating osteoporosis. However, it remains unknown whether the combination of oral bovine CPs with calcium citrate is more effective than administration of either agent alone.MethodsForty 12-week-old Sprague-Dawley rats were randomly divided into five groups (n = 8) for once-daily intragastric administration of different treatments for 3 months at 3 months after ovariectomy (OVX) as follows: sham + vehicle; OVX + vehicle; OVX + 750 mg/kg CP; OVX + CP-calcium citrate (75 mg/kg); OVX + calcium citrate (75 mg/kg). After euthanasia, the femurs were removed and analyzed by dual energy X-ray absorptiometry and micro-computed tomography, and serum samples were analyzed for bone metabolic markers.ResultsOVX rats supplemented with CPs or CP-calcium citrate showed osteoprotective effects, with reductions in the OVX-induced decreases in their femoral bone mineral density. Moreover, CP-calcium citrate prevented trabecular bone loss, improved the microarchitecture of the distal femur, and significantly inhibited bone loss with increased bone volume, connectivity density, and trabecular number compared with OVX control rats. CP or CP-calcium citrate administration significantly increased serum procollagen type I N-terminal propeptide levels and reduced serum bone-specific alkaline phosphatase, osteocalcin, and C-telopeptide of type I collagen levels.ConclusionsOur data indicate that combined oral administration of bovine CPs with calcium citrate inhibits bone loss in OVX rats. The present findings suggest that combined oral administration of bovine CPs with calcium citrate is a promising alternative for reducing bone loss in osteopenic postmenopausal women.

Effects of long-term low-dose dietary creatine supplementation in older women

ObjectiveWe aimed to investigate the effects of a one-year low-dose creatine supplementation trial on bone health, lean mass, and muscle function in older postmenopausal women. MethodsA double-blind, randomized, parallel-group, placebo controlled trial was conducted between November 2011 and November 2013 in Sao Paulo, Brazil. Postmenopausal osteopenic women were randomly allocated (1:1) into creatine (n=56; 1g/d) or placebo group (n=53; dextrose at same dose). At baseline and after one year of intervention, we assessed parameters of bone health, body composition, and muscle function. Blood parameters were also assessed before and after the intervention and adverse events were recorded throughout the trial. Possible differences in dietary intake were assessed by three 24-h dietary recalls. ResultsBone mineral density at lumbar spine, femoral neck, total femur, and whole body did not differ within- or between-groups. No significant changes in body weight, BMI, absolute and relative body fat, and body lean mass were observed. Muscle function, as assessed by timed-up-and-go and timed-stands tests, were not significantly changed within- or between-groups. Safety laboratory parameters remained unaltered. ConclusionA one-year low-dose creatine supplementation (1g/d) was free of adverse effects, but did not affect bone health parameters, lean mass, or muscle function in older women. Further studies with longer follow-up periods and higher doses of creatine supplementation are warranted. (Registered at clinicaltrials.gov as NCT01472393).

Melatonin improves bone mineral density at the femoral neck in postmenopausal women with osteopenia: a randomized controlled trial.

Melatonin is known for its regulation of circadian rhythm. Recently, studies have shown that melatonin may have a positive effect on the skeleton. By increasing age, the melatonin levels decrease, which may lead to a further imbalanced bone remodeling. We aimed to investigate whether treatment with melatonin could improve bone mass and integrity in humans. In a double-blind RCT, we randomized 81 postmenopausal osteopenic women to 1-yr nightly treatment with melatonin 1 mg (N = 20), 3 mg (N = 20), or placebo (N = 41). At baseline and after 1-yr treatment, we measured bone mineral density (BMD) by dual X-ray absorptiometry, quantitative computed tomography (QCT), and high-resolution peripheral QCT (HR-pQCT) and determined calciotropic hormones and bone markers. Mean age of the study subjects was 63 (range 56-73) yr. Compared to placebo, femoral neck BMD increased by 1.4% in response to melatonin (P < 0.05) in a dose-dependent manner (P < 0.01), as BMD increased by 0.5% in the 1 mg/day group (P = 0.55) and by 2.3% (P < 0.01) in the 3 mg/day group. In the melatonin group, trabecular thickness in tibia increased by 2.2% (P = 0.04), and volumetric bone mineral density (vBMD) in the spine, by 3.6% (P = 0.04) in the 3 mg/day. Treatment did not significantly affect BMD at other sites or levels of bone turnover markers; however, 24-hr urinary calcium was decreased in response to melatonin by 12.2% (P = 0.02). In conclusion, 1-yr treatment with melatonin increased BMD at femoral neck in a dose-dependent manner, while high-dose melatonin increased vBMD in the spine. Further studies are needed to assess the mechanisms of action and whether the positive effect of nighttime melatonin will protect against fractures.

Effects of low dose dried plum (50 g) on bone mineral density and bone biomarkers in older postmenopausal women.

Our previous findings in osteopenic postmenopausal women indicated that daily consumption of 100 g dried plum for one year is highly effective in increasing bone mineral density (BMD), as well as improving indices of bone turnover. The objective of our current study was to examine whether 50 g dried plum would be as effective as 100 g dried plum in reversing bone loss in osteopenic older postmenopausal women. Forty Eight osteopenic women (65‐79 years old) were randomly assigned into one of three treatment groups: 1) 50 g dried plum; 2) 100 g dried plum; and 3) control (0 g dried plum) with forty two subjects completing the study. All groups received 500 mg calcium and 400 IU vitamin D as a daily supplement. Blood samples were collected at baseline, three and six months to assess biomarkers of bone turnover. Physical activity recall and three‐day food records were obtained at baseline, three and six months to examine physical activity and dietary confounders as potential covariates. Both doses of dried plum significantly increased total body BMD. Tartrate resistant acid phosphatase‐5b (TRAP‐5b, a marker of bone resorption) decreased at three months and six months in both dried plum groups. These results confirm the ability of dried plum in improving BMD in older postmenopausal women and suggest that lower doses of dried plum (i.e. 50 g) may be as effective as 100 g dried plum in reversing bone loss in older, osteopenic postmenopausal women. Hence, our findings suggest that the consumption of a reasonable amount of dried plum is beneficial for older, osteopenic women.

The Effects Of A Calcium‐Collagen Chelate Dietary Supplement on Molecules Regulating Osteoclastogenesis In Osteopenic Postmenopausal Women

The use of hydrolyzed collagen dietary supplements as a means to aid in the prevention of bone loss has received considerable attention. Thirty‐nine osteopenic postmenopausal women were randomized to receive either a chelated supplement of calcium (500 mg) and enzymatically hydrolyzed collagen (5 g) (CC), and 200 IU of vitamin D3 or the same dose of calcium and vitamin D3 alone as control for one year. We found that the loss of whole body bone mineral density in women consuming CC was significantly lower than that of the control group at 12 months in those who completed the study (CC: ‐1.33% and ‐0.33% vs. control: ‐3.75% and ‐2.17%; P = .026, P = .035). In addition, serum concentrations of tartrate‐resistant acid phosphatase, an osteoclast‐derived degradative enzyme, were significantly reduced at six months in the CC group. In order to determine whether CC reduces fracture risk and better understand the mode of action by which CC and similar dietary collagen formulations act, we will assess hip fracture risk using FRAX®, and serum concentrations of osteoprotegerin (OPG) and receptor activator of nuclear factor‐κB ligand (RANKL) using enzyme‐linked immunosorbent assays. We anticipate that at six‐ and twelve‐month time points, levels of RANKL in the CC group compared to the control will be significantly lower with OPG levels unaltered, representing decreased maturation and activation of bone‐resorbing osteoclasts. The regulation of these important molecules has been reported to occur in a similar fashion with other hydrolyzed collagen formulations in rodents, but has yet to be confirmed in humans.

Bone quality in osteopenic postmenopausal women is not improved after 12 months of whole-body vibration training.

Whole-body vibration training may improve bone quality through structural adaptation. We tested if 12 months of training affects bone structure in osteopenic postmenopausal women by using advanced 3-dimensional high-resolution imaging techniques. We found that whole-body vibration training did not improve bone structure compared to inactive controls. Whole-body vibration training (WBVT) has been suggested as a preventive measure against bone loss. Contradicting results of previous studies may be confounded by insufficiently sensitive bone density measures to detect relevant bone changes. WBVT may improve bone quality through structural adaptations, without increasing bone mineral density (BMD). We hypothesized that 12 months of WBVT will improve or maintain bone microarchitecture and bone strength in osteopenic postmenopausal women. Twenty-two women received WBVT for 2-3 sessions/week and were compared with 20 controls. Bone outcomes were measured by high-resolution peripheral quantitative CT (HR-pQCT, XtremeCT, Scanco Medical) and finite element estimated bone strength. Balance and jump performance and maximum voluntary contraction (MVC) of knee flexor and extensor muscles were recorded. All measurements were taken at baseline, 4, 8, and 12 months and a reduced data set at 4 and 8 months follow-up and compared using a mixed model repeated measures ANOVA. Thirty-one women completed the study with 90 % compliance (WBVT: n = 17, control n = 14). Total BMD (p < 0.001), cortical area*(p = 0.004), cortical thickness (p = 0.011), and cortical porosity (p = 0.024) all significantly decreased over time in both groups; WBVT did not affect the response. All other bone outcomes were not affected by WBVT or time. No difference in measures of balance, jump height, and MVC due to WBVT were detected. In our cohort, WBVT did not lead to improved bone quality in postmenopausal osteopenic women after 12 months of training compared to controls, and there were no detected benefits related to balance and muscle strength outcomes.

Comparison of body composition, nutritional status, functional status, and quality of life between osteoporotic and osteopenic postmenopausal women

Background and objectiveOsteoporosis is a condition that affects body composition, physical activity, and psychological state. We aimed to examine the differences between osteoporotic and osteopenic postmenopausal women with respect to body composition, nutrition, functional status, and quality of life. Materials and methodsA total of 102 osteopenic (Group 1) and 100 osteoporotic (Group 2) patients were enrolled in the study. Bone mineral density (BMD), fat tissue mass (FTM), lean tissue mass (LTM), and bone mineral content (BMC) were evaluated using dual-energy X-ray absorbtiometry. Nutritional status of the patients was assessed with the Mini Nutritional Assessment (MNA), functional status with the Nottingham Extended Activities of Daily Living (NEADL) scale, and quality of life with the assessment of health-related quality of life in osteoporosis (ECOS-16). ResultsGroup 2 had significantly lower FTM, LTM, and MNA scores than Group 1 (P<0.05). NEADL and ECOS-16 scores did not differ between the groups (P>0.05). A significant correlation was found between MNA and FTM, LTM, BMC, and BMD (P<0.05). Whereas the assessment of functional status showed a significant positive correlation with BMD and a significant negative correlation with age (P<0.05), no significant correlation was found between functional status and body composition (P>0.05). ConclusionsWe found lower FTM and LTM values and a poorer nutritional status in osteoporotic patients than in osteopenic ones. Nutritional status was correlated with body composition and BMD, and functional status was correlated with age and BMD.

Effect of Alendronate on Bone Mineral Density in Post Menopausal Women with Type 2 Diabetes Mellitus

Aim: To perform a retrospective study to determine the effect of Bisphophanates on bone mineral density (BMD) in the late post-menopausal (PM) osteoporatic and osteopenic women with Type 2 Diabetes Mellitus (DM). Method: In this retrospective case control study, 114 PM diabetic women over age 65 who took alendronate for at least 3 years, 43 of them had osteoporosis and 71 with osteopenia. The efficacy of therapy was measured by comparing a minimum of two BMD studies. Result: The study (n=114) demonstrated statistically significant BMD gain (+3.1% and +1.9%) at the spine and hip respectively but statistically significant loss of BMD (-9.8%) at forearm (FA). There was statistically significant correlation between body mass index (BMI) and BMD, in spine and hip but not in FA. We found negative correlation between A1C and BMD at all 3 sites, with a statically significant correlation observed at FA. Conclusion: It appears that Bisphosphonates are not effective in preventing bone loss in the FA of diabetic post-menopausal women. In addition bisphosphonates therapy resulted in significant gains of BMD at the spine and hip. A larger study should be done to compare bisphosphonates to other modalities of therapy for osteoporosis in diabetic post menopausal patients.

A calcium-collagen chelate dietary supplement attenuates bone loss in postmenopausal women with osteopenia: a randomized controlled trial.

Menopause leads to an increased risk for osteoporosis in women. Although drug therapies exist, increasing numbers of people prefer alternative therapies such as dietary supplements, for example, calcium, vitamin D, and collagen hydrolysates for the prevention and treatment of osteoporosis. We have previously shown that a 3-month intervention using a calcium-collagen chelate (CC) dietary supplement was efficacious in improving bone mineral density (BMD) and blood biomarkers of bone turnover in osteopenic postmenopausal women. This study reports the long-term efficacy of CC in reducing bone loss in postmenopausal women with osteopenia. Thirty-nine women were randomly assigned to one of two groups: 5 g of CC containing 500 mg of elemental calcium and 200 IU vitamin D (1,25-dihydroxyvitamin D3) or control (500 mg of calcium and 200 IU vitamin D) daily for 12 months. Total body, lumbar, and hip BMD were evaluated at baseline, 6 and 12 months using dual-energy X-ray absorptiometry. Blood was collected at baseline, 6 and 12 months to assess levels of blood biomarkers of bone turnover. Intent-to-treat (ITT) analysis was performed using repeated measures analysis of variance pairwise comparisons and multivariate analysis to assess time and group interactions. The loss of whole body BMD in women taking CC was substantially lower than that of the control group at 12 months in those who completed the study and the ITT analysis, respectively (CC: -1.33% and -0.33% vs. control: -3.75% and -2.17%; P=.026, P=.035). The CC group had significantly reduced levels of sclerostin and tartrate-resistant acid phosphatase isoform 5b (TRAP5b) (P<.05), and higher bone-specific alkaline phosphatase/TRAP5b ratio (P<.05) than control at 6 months. These results support the use of CC in reducing bone loss in osteopenic postmenopausal women.

The Effects of Circuit Training on Bone Mineral Density, Physical Fitness, and Quality of Life in Postmenopausal Osteopenic Women

The Effects of Circuit Training on Bone Mineral Density, Physical Fitness, and Quality of Life in Postmenopausal Osteopenic Women

The Comparison of Impact of Circuit Exercise Training and Tai-Chi Exercise on Multiple Fracture-Related Risk Factors in Postmenopausal Osteopenic Women

The Comparison of Impact of Circuit Exercise Training and Tai-Chi Exercise on Multiple Fracture-Related Risk Factors in Postmenopausal Osteopenic Women

The effect of dried plum on serum levels of receptor activator of NF-κB ligand, osteoprotegerin and sclerostin in osteopenic postmenopausal women: a randomised controlled trial.

Although several studies have confirmed the bone-protective properties of dried plum, its exact mechanisms of action remain unclear. Recent research has shown that osteocytes may control bone formation via the production of sclerostin and bone resorption via the receptor activator of NF-κB ligand (RANKL) and its inhibitor osteoprotegerin (OPG). To investigate the mechanism of action of dried plum in reversing bone loss, we measured serum levels of RANKL, OPG and sclerostin in osteopenic postmenopausal women (n 160). Participants were randomly assigned to the treatment group of either 100 g dried plum/d or 75 g dried apple/d (comparative control) for 1 year. All participants received 500 mg Ca plus 400 IU (10 μg) vitamin D daily. Bone mineral densities (BMD) of the lumbar spine, forearm, hip and whole body were assessed at baseline and at the end of the study using dual-energy X-ray absorptiometry. Blood samples were collected at baseline and after 12 months to assess bone biomarkers. Dried plum significantly increased the BMD of the ulna and spine in comparison with the control group. In comparison with corresponding baseline values, dried plum increased the RANKL levels by only +1·99 v. +18·33% and increased the OPG levels by +4·87 v. - 2·15% in the control group. Serum sclerostin levels were reduced by - 1·12% in the dried plum group v. +3·78% in the control group. Although percentage changes did not reach statistical significance (P≤ 0·05), these preliminary data may indicate that the positive effects of dried plum on bone are in part due to the suppression of RANKL production, the promotion of OPG and the inhibition of sclerostin.

The effectivness of daily consumption of 50 g dried plum on improving indices of bone turnover in osteopenic postmenopausal women (1027.5)

Our findings in osteopenic postmenopausal women indicated that daily consumption of 100 g dried plum for one year is highly effective in increasing bone mineral density as well as improving the indices of bone turnover. The objective of our current study was to examine whether 50 g dried plum will be as effective as 100 g dried plum in reversing bone loss in osteopenic older postmenopausal women. Forty five osteopenic 65 to 79 year old women were randomly assigned into one of the three groups: 1) 50 g dried plum; 2) 100 g dried plum; and 3) control. All groups received 500 mg calcium and 400 IU vitamin D daily. Blood samples were collected at baseline, 3‐, and 6‐month to assess bone biomarkers and bone metabolism measurements. Physical activity recall and 3‐day food records were obtained at baseline, 3‐, and 6‐month to examine physical activity and dietary confounders as potential covariates. Initial preliminary analyses of bone specific alkaline phosphatase (BAP; a marker of bone formation) showed increase at 3‐months and 6‐months in 50 g and 100 g dried plum groups. Interestingly, tartrate resistant acid phosphatase‐5b (TRAP5b, a marker of bone resorption) decreased at 3‐months and 6‐months intervals in 50 g and 100 g dried plum groups. These results even though preliminary suggest that 50 g dried plum possibly could be as effective as 100 g dried plum in reversing bone loss in older osteopenic postmenopausal women.

A calcium‐collagen chelate dietary supplement prevents bone loss in postmenopausal women with osteopenia (LB421)

Menopause leads to an increased risk for osteoporosis in women. Although drug therapies exist, increasing numbers of people prefer natural therapies such as dietary supplements, e.g. calcium, vitamin D, and collagen, for the treatment of osteoporosis. We have previously shown that a three‐month intervention using a calcium‐collagen chelate dietary supplement (CC) was efficacious in improving bone mineral density (BMD) and reducing markers of bone turnover in osteopenic postmenopausal women. The present study reports the long‐term efficacy of CC in reducing bone loss in postmenopausal women with osteopenia. Thirty‐nine women were randomly assigned to receive either 5 g of CC containing 500 mg of elemental calcium in the form of calcium carbonate and 200 IU vitamin D (1,25‐dihydroxyvitamin D3) or 500 mg of calcium and 200 IU vitamin D (control). Total body BMD and BMD of the lumbar spine and hip were evaluated at baseline, six and twelve months using dual‐energy x‐ray absorptiometry. Blood was collected at baseline, six and twelve months to assess serum biomarkers of bone turnover using enzyme‐linked immunosorbant assay methods. Intention‐to‐treat analysis was performed using repeated measures ANOVA pairwise comparisons as well as multivariate analysis to assess time and group interactions. CC prevented the loss of whole body BMD (CC: ‐0.004 vs. control: ‐0.011; P &lt; 0.05) at twelve months when compared to control. The CC group had reduced levels of tartrate‐resistant acid phosphatase (TRAP5b) (P &lt; 0.05) at six months and higher bone‐specific alkaline phosphatase (BAP)/TRAP5b concentrations (P &lt; 0.05) at six and tended (P &lt; 1.0) to be higher at twelve months whereas there were no changes in control. Sclerostin levels tended (P &lt; 1.0) to be lower at six months in the CC group whereas there were no changes in control. These results support use of CC in attenuating the loss of bone mass in osteopenic postmenopausal women.Grant Funding Source: AIDP, Inc.

Rationale, baseline characteristics and methodology of the non-interventional VIVA study in postmenopausal osteoporosis

SummaryIt is important to understand compliance and persistence with medication use in the clinical practice of osteoporosis treatment. The purpose of this work is to describe the “intravenous ibandronate versus oral alendronate” (VIVA) study, a non-interventional trial to assess the compliance and persistence of osteopenic postmenopausal women with treatment via weekly oral alendronate or intravenous ibandronate (Bonviva®) every three months.4477 patients receiving ibandronate 3 mg i. v. quarterly and 1491 patients receiving alendronate 70 mg orally weekly were included in the study. Matched pairs of 901 subjects in each group were also generated. Matching was performed on the basis of age, body mass index, fracture history at study inclusion, prior treatment with bisphosphonates and the number of concomitant disorders. Secondary outcome measures of osteoporosis related fractures, mobility restriction and pain, analgesia, quality of life questionnaires as well as attitudes to medications were assessed. The primary outcome parameters of compliance and persistence will be tracked in these subjects.At baseline, the entire collectives differed significantly on body weight (less in ibandronate group), duration since osteo - porosis diagnosis (longer in ibandronate), and incidence of prior osteoporotic fracture (higher in ibandronate group). The matched-pairs differed only on mobility restriction and quality of life (both worse in ibandronate group).The results from the VIVA study trial will provide scientific rationale for clinical recommendations in the pharmacological treatment of postmenopausal osteoporosis.

Tea and bone health: steps forward in translational nutrition

Osteoporosis is a major health problem in the aging population worldwide. Cross-sectional and retrospective evidence indicates that tea consumption may be a promising approach in mitigating bone loss and in reducing risk of osteoporotic fractures among older adults. Tea polyphenols enhance osteoblastogenesis and suppress osteoclastogenesis in vitro. Animal studies reveal that intake of tea polyphenols have pronounced positive effects on bone as shown by higher bone mass and trabecular bone volume, number, and thickness and lower trabecular separation via increasing bone formation and inhibition of bone resorption, resulting in greater bone strength. These osteoprotective effects appear to be mediated through antioxidant or antiinflammatory pathways along with their downstream signaling mechanisms. A short-term clinical trial of green tea polyphenols has translated the findings from ovariectomized animals to postmenopausal osteopenic women through evaluation of bioavailability, safety, bone turnover markers, muscle strength, and quality of life. For future studies, preclinical animal studies to optimize the dose of tea polyphenols for maximum osteoprotective efficacy and a follow-up short-term dose-response trial in postmenopausal osteopenic women are necessary to inform the design of randomized controlled studies in at-risk populations. Advanced imaging technology should also contribute to determining the effective dose of tea polyphenols in achieving better bone mass, microarchitecture integrity, and bone strength, which are critical steps for translating the putative benefit of tea consumption in osteoporosis management into clinical practice and dietary guidelines.