Non HRT Options for the Treatment of Osteoporosis

1998 ◽  
Vol 4 (3) ◽  
pp. 96-101
Author(s):  
Michael Davies
Keyword(s):  
Vitamin D ◽  
Vertebral Fracture ◽  
Bone Fractures ◽  
The Elderly ◽  
Long Bone ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Supplemental Calcium ◽  
Treatable Condition

Osteoporosis is now a treatable condition with an abundance of evidence for the efficacy of certain therapeutic strategies in preventing recurrent fractures. Most of these treatments act by improving bone mineral density through inhibition or reduction of bone resorption. For those women who are unable to take HRT; bisphosphonates, calcium, vitamin D, calcitriol or calcitonin may confer certain benefits. The bisphosphonate alendronate reduces both vertebral and long bone fractures, an effect seen soon after starting treatment. The changes in BMD and fracture reduction are less with the use of etidronate but it is certainly beneficial in reducing recurrent vertebral fracture. In the elderly calcium and vitamin D in combination can reduce non-vertebral and hip fracture and supplemental calcium of 1 g/day has been predicted to reduce bone loss and thus hip fractures by 22%. Evidence that calcitriol or calcitonin reduce fracture incidence is not good but calcitonin has been shown to have analgesic properties in those with acute vertebral fracture. The role of calcitriol is less certain and should be reserved for women with vertebral fractures in whom HRT or bisphosphonates cannot be used.

Role of Calcium, Vitamin D and Bisphosphonates in the Treatment of Osteoporosis in patients with Cirrhosis

2021 ◽  
Vol 15 (9) ◽  
pp. 2147-2149
Author(s):  
Intikhab Alam ◽  
Muhammad Rafique Khan ◽  
Zahoor Ur Rehman ◽  
Younas Ahmed ◽  
Faizan Ayub ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Transplantation ◽  
Female Gender ◽  
The Elderly ◽  
Cholestatic Liver Disease ◽  
Biliary Cirrhosis ◽  
Treatment Of Osteoporosis ◽  
Women Alcoholics

Osteoporosis is a significant and prevalent consequence of cirrhosis due to its detrimental influence on quality of life through persistent pain and immobility. Additionally, its significant morbidity necessitates early detection and treatment. BD is most frequently encountered in the elderly, smokers, postmenopausal women, alcoholics, malnourished individuals, and those with cholestatic liver disease. The prevalence of osteoporosis has been observed to range between 12--55% in patients with cirrhosis. Patients with primary biliary cirrhosis (PBC) have a higher prevalence due to persistent cholestasis and female gender. Prior to orthotopic liver transplantation, about 60% of cases with PBC and primary sclerosing cholangitis (PSC) have osteoporosis. It is critical to diagnose and treat osteoporosis prior to liver transplantation because of deterioration in early months i.e. 6—12 after transplantation. This resulted in much fractures due to trauma i.e. 25—35%. This osteoporosis may be due to toxic effect of immune compromised therapy after transplantation. Keywords: Role of calcium, cirrhosis, vitamin D

scholarly journals Pentosidine and carboxymethyl-lysine associate differently with prevalent osteoporotic vertebral fracture and various bone markers

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Masaki Nakano ◽  
Yukio Nakamura ◽  
Takako Suzuki ◽  
Akiko Miyazaki ◽  
Jun Takahashi ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Postmenopausal Women ◽  
Bone Markers ◽  
Bone Fractures ◽  
Osteoporotic Fractures ◽  
Long Bone ◽  
Severe Illness ◽  
Mineral Density ◽  
Prevalent Vertebral Fracture ◽  
Carboxymethyl Lysine

AbstractPentosidine (PEN) and carboxymethyl-lysine (CML) are well-recognized advanced glycation end products (AGEs). However, how these AGEs affect the pathophysiology of osteoporosis and osteoporotic fractures remains controversial. This cross-sectional study aimed to investigate the associations of PEN and CML with bone markers, bone mineral density (BMD), and osteoporotic fractures in postmenopausal women from the Nagano Cohort Study. A total of 444 Japanese postmenopausal outpatients (mean ± standard deviation age: 69.8 ± 10.2 years) were enrolled after the exclusion of patients with acute or severe illness or secondary osteoporosis. The relationships among urinary PEN and serum CML levels, various bone markers, lumbar and hip BMD, and prevalent vertebral and long-bone fractures were evaluated. PEN associated significantly with prevalent vertebral fracture after adjustment for other confounders (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.22–2.07; P < 0.001), but not with lumbar BMD. In contrast, a significant negative correlation was found between CML and lumbar BMD (r =  − 0.180; P < 0.001), and this relationship was significant after adjustment for confounders (OR 0.84, 95% CI 0.76–0.93; P < 0.01). Although patients with prevalent vertebral fracture had significantly higher CML levels, the association between CML and prevalent vertebral fracture did not reach significance in the multivariate regression model. Both PEN and CML may play important roles in bone health for postmenopausal women, possibly via different mechanisms.

scholarly journals Management of primary and secondary osteoporosis in children

2020 ◽  
Vol 12 ◽  
pp. 1759720X2096926
Author(s):  
Sophia D. Sakka ◽  
Moira S. Cheung
Keyword(s):  
Bone Fractures ◽  
Bone Biopsy ◽  
Treatment Options ◽  
Quantitative Computed Tomography ◽  
Fragility Fractures ◽  
Secondary Osteoporosis ◽  
Long Bone ◽  
Vertebral Fracture Assessment ◽  
Primary Osteoporosis ◽  
Mineral Density

Osteoporosis in children differs from adults in terms of definition, diagnosis, monitoring and treatment options. Primary osteoporosis comprises primarily of osteogenesis imperfecta (OI), but there are significant other causes of bone fragility in children that require treatment. Secondary osteoporosis can be a result of muscle disuse, iatrogenic causes, such as steroids, chronic inflammation, delayed or arrested puberty and thalassaemia major. Investigations involve bone biochemistry, dual-energy X-ray absorptiometry scan for bone densitometry and vertebral fracture assessment, radiographic assessment of the spine and, in some cases, quantitative computed tomography (QCT) or peripheral QCT. It is important that bone mineral density (BMD) results are adjusted based on age, gender and height, in order to reflect size corrections in children. Genetics are being used increasingly for the diagnosis and classification of various cases of primary osteoporosis. Bone turnover markers are used less frequently in children, but can be helpful in monitoring treatment and transiliac bone biopsy can assist in the diagnosis of atypical cases of osteoporosis. The management of children with osteoporosis requires a multidisciplinary team of health professionals with expertise in paediatric bone disease. The prevention and treatment of fragility fractures and improvement of the quality of life of patients are important aims of a specialised service. The drugs used most commonly in children are bisphosphonates, that, with timely treatment, can give good results in improving BMD and reshaping vertebral fractures. The data regarding their effect on reducing long bone fractures are equivocal. Denosumab is being used increasingly for various conditions with mixed results. There are more drugs trialled in adults, but these are not yet licenced for children. Increasing awareness of risk factors for paediatric osteoporosis, screening and referral to a specialist team for appropriate management can lead to early detection and treatment of asymptomatic fractures and prevention of further bone damage.

The role of vitamin D and related compounds in the treatment of bone disease in the elderly

Bone ◽  
1994 ◽  
Vol 15 (6) ◽  
pp. 727-728 ◽  
Author(s):  
J.A. Kanis ◽  
C. Cooper ◽  
R. Francis ◽  
N. Hamdy ◽  
P. Selby ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Disease ◽  
The Elderly ◽  
Related Compounds

Low vitamin D status is associated with hearing loss in the elderly: a cross-sectional study

2020 ◽  
Author(s):  
Betsy Szeto ◽  
Chris Valentini ◽  
Anil K Lalwani
Keyword(s):  
Vitamin D ◽  
Hearing Loss ◽  
Low Frequency ◽  
The Elderly ◽  
Vitamin D Status ◽  
Total Calcium ◽  
Mineral Density ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk

ABSTRACT Background The elderly are at increased risk of both hearing loss (HL) and osteoporosis. Bone mineral density (BMD) has been putatively linked to HL. However, the roles of serum calcium concentrations and vitamin D status have yet to be elucidated. Objectives The purpose of this study was to examine the relation between vitamin D status, parathyroid hormone (PTH), total calcium, BMD, and HL in a nationally representative sample of elderly adults. Methods Using the NHANES (2005–2010), audiometry and BMD data of 1123 participants aged ≥70 y were analyzed in a cross-sectional manner. HL was defined as pure tone averages &gt;25 dB HL at 500, 1000, and 2000 Hz (low frequency); 500, 1000, 2000, and 4000 Hz (speech frequency); and 3000, 4000, 6000, and 8000 Hz (high frequency) in either ear. Multivariable logistic regression was used to examine the relation between HL and total 25-hydroxyvitamin D [25(OH)D], PTH, total calcium, and BMD, adjusting for covariates. Results In multivariable analyses, total 25(OH)D &lt; 20 ng/mL was found to be associated with greater odds of low-frequency HL (OR: 2.02; 95% CI: 1.28, 3.19) and speech-frequency HL (OR: 1.96; 95% CI: 1.12, 3.44). A 1-unit decrease in femoral neck BMD (OR: 4.55; 95% CI: 1.28, 16.67) and a 1-unit decrease in total spine BMD (OR: 6.25; 95% CI: 1.33, 33.33) were found to be associated with greater odds of low-frequency HL. Serum PTH and total calcium were not found to be associated with HL. Conclusions In the elderly, low vitamin D status was associated with low-frequency and speech-frequency HL. Low vitamin D status may be a potential risk factor for age-related HL.

Role of APOE Gene in Bone Mineral Density and Incidence of Bone Fractures in Brazilian Postmenopausal Women

2018 ◽  
Vol 21 (2) ◽  
pp. 227-235 ◽  
Author(s):  
Leticia S. Souza ◽  
Neuza Felix Rochette ◽  
Diego França Pedrosa ◽  
Rafaella P. Lopes Magnago ◽  
Teodiano B. Freire Filho ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Bone Fractures ◽  
Apoe Gene ◽  
Mineral Density

scholarly journals Osteoporosis in Men with Diabetes Mellitus

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Claire Issa ◽  
Mira S. Zantout ◽  
Sami T. Azar
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Vitamin D ◽  
Risk Factor ◽  
Bone Fractures ◽  
Mineral Density ◽  
Vitamin D Intake ◽  
Osteoporosis In Men ◽  
Patients With Diabetes ◽  
Male Patients

Osteoporosis is more common in women than in men. The prevalence in men is not defined yet; however it is becoming much more recognized as its prevalence and impact have become explicable. It is estimated that around 1% of bone mineral density is lost in men every year. Studies show that secondary osteoporosis is the major cause thus, making it important to define the disorders associated with male osteoporosis. Diabetes is a risk factor for bone fractures. In male patients with diabetes measures should be undertaken such as encouraging exercise, assuring adequate calcium and vitamin D intake, and treating diabetic complications.

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