scholarly journals Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism

2014 ◽  
Vol 171 (3) ◽  
pp. 399-406 ◽  
Author(s):  
Cristina Eller-Vainicher ◽  
Claudia Battista ◽  
Vito Guarnieri ◽  
Silvana Muscarella ◽  
Serena Palmieri ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Primary Hyperparathyroidism ◽  
Pcr Amplification ◽  
Mineral Density ◽  
Cross Sectional ◽  
Casr Gene ◽  
Calcium Sensing ◽  
Vertebral Fracture Risk ◽  
Sectional Analysis ◽  
Design And Methods

ObjectiveTo examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT).Design and methodsA cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Serum calcium (sCa) phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (expressed as Z-score) at lumbar spine (Z-LS) and femoral neck, morphometric VFx by radiograph, and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing.ResultsFractured patients (n=100, 37.6%) had lower sCa (10.8±0.7 mg/dl) and Z-LS BMD (−1.0±1.44), higher age (61±10 years), and prevalence (51%) of ≥1 S alleles of the CASR A986S single-nucleotide polymorphism (SNP; AS/SS), than those not fractured (n=166, 11.2±1.0 mg/dl, −0.57±0.97, 58±13 years, and 38% AS/SS, respectively, P<0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01–1.06, P=0.006), decreased sCa (OR 1.86, 95% CI 1.28–2.7, P=0.001), and Z-LS BMD (OR 1.4, 95% CI 1.12–1.7, P=0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1–2.9, P=0.05). The presence of two out of three factors (age ≥58 years, sCa <10.8 and Z-LS BMD≤−1.0, and AS/SS genotype) gave an overall OR of 4.2 (95% CI 2.25–7.85, P<0.0001).ConclusionsIn PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.

scholarly journals Adequacy of androgen replacement influences bone density response to testosterone in androgen-deficient men

2005 ◽  
Vol 152 (6) ◽  
pp. 881-886 ◽  
Author(s):  
Ashraf Aminorroaya ◽  
Sharyn Kelleher ◽  
Ann J Conway ◽  
Lam P Ly ◽  
David J Handelsman
Keyword(s):  
Osteoporotic Fractures ◽  
Testosterone Replacement ◽  
Longitudinal Assessment ◽  
Mineral Density ◽  
Cross Sectional ◽  
X Ray ◽  
Dexa Scan ◽  
Density Response ◽  
Sectional Analysis ◽  
Design And Methods

Objective: Androgen deficiency (AD) leads to bone loss and contributes to osteoporotic fractures in men. Although low bone mineral density (BMD) in AD men is improved by testosterone replacement, the responses vary between individuals but the determinants of this variability are not well defined. Design and methods: Retrospective review of dual energy X-ray absorptiometry (DEXA) of the lumbar spine and proximal femur in men with established AD requiring regular androgen replacement therapy (ART). After a DEXA scan all men were treated with testosterone implants (800 mg, ~6 month intervals). Patients were classified as having a congenital, childhood, or post-pubertal onset, as well as according to the adequacy of treatment prior to their first DEXA scan as untreated, partially treated or well treated. Results: Men with AD requiring regular ART (n = 169, aged 46.3±1.1 years, range 22–84 years) underwent a DEXA scan prior to being treated with testosterone implants (800 mg, ~6 month intervals). In cross-sectional analysis at the time of the first DEXA scan untreated men (n = 24) had significantly reduced age-adjusted BMD at all four sites (L1–L4, femoral neck, Ward’s triangle and trochanter). Well-treated men (n = 77) had significantly better age-adjusted BMD at all four sites compared with those who were partially treated (n = 66) or untreated (n = 24) with their age-adjusted BMD being normalized. In a longitudinal assessment of men (n = 60) who had two or more serial DEXA scans, at the second DEXA scan after a median of 3 years, men who were previously partially treated (n = 19) or untreated (n = 11) had proportionately greater improvements in BMD, significantly for Ward’s triangle (P = 0.025) and the trochanter (P = 0.044) compared with men (n = 30) previously well treated. Conclusions: The present study demonstrates a positive relationship between adequacy of testosterone replacement and BMD in men with overt organic AD. Additionally, the BMD of well-treated AD men approximates that of age-matched non-AD controls. The greatest BMD gains are made by those who have been either untreated or partially treated, and optimal treatment over time (median 3 years) normalizes BMD to the level expected for healthy men of the same age.

Comparative Efficacy of Alendronate upon Vertebral Bone Mineral Density and Fracture Rates in East Asians Versus Non-East Asians with Postmenopausal Osteoporosis: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 50 (10) ◽  
pp. 738-746 ◽  
Author(s):  
Yexin Wang ◽  
Gongwei Jia ◽  
Jin Song ◽  
Xiangqing Kong ◽  
Weihong Zhang ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Fracture Risk ◽  
Postmenopausal Osteoporosis ◽  
Meta Analysis ◽  
East Asian ◽  
Bisphosphonate Therapy ◽  
Mineral Density ◽  
East Asians ◽  
Vertebral Fracture Risk ◽  
Lumbar Spinal

AbstractBisphosphonates, such as alendronate, have become the most widely used and effective anti-resorptive therapy for postmenopausal osteoporosis. Previous genetic studies suggest that ethnicity may drive differing responses to bisphosphonate therapy in East Asians and non-East Asians. Therefore, the aim of this study was to comparatively evaluate the efficacy of alendronate upon lumbar spinal BMD and vertebral fracture rates in East Asians and non-East Asians with postmenopausal osteoporosis. MEDLINE, EMBASE, and Cochrane CENTRAL were searched for relevant randomized controlled trials (RCTs) comparing the efficacy of alendronate versus placebo (or calcium/mineral and/or Vitamin D or hormone replacement therapy) in primary postmenopausal osteoporotic women. We calculated the weighted mean differences (WMDs) for lumbar spinal BMD and the risk ratios (RRs) for vertebral fracture risk along with their respective 95% confidence intervals (CIs). From an initial set of 445 non-duplicate records, 13 full-text articles were finally included in this meta-analysis consisting of four East Asian RCTs and nine non-East Asian RCTs. Alendronate therapy displayed significant effects in improving lumbar spinal BMD in both East Asians [WMD (95% CI)=5.30 (0.32–10.29), p=0.037] and non-East Asians [WMD (95% CI)=5.73 (3.61–7.85), p=0.000]. Alendronate therapy did not display significant effects upon vertebral fracture risk in East Asians [RR (95% CI)=0.41 (0.06–2.73), p=0.358] but did display a significant effect upon lowering vertebral fracture risk in non-East Asians [RR (95% CI)=0.55 (0.42–0.72), p=0.000]. These findings suggest that ethnicity may affect the efficacy of bisphosphonate therapy in postmenopausal osteoporotic women.

scholarly journals Resistance training versus weight-bearing aquatic exercise: a cross-sectional analysis of bone mineral density in postmenopausal women

2013 ◽  
Vol 53 (2) ◽  
pp. 193-198 ◽  
Author(s):  
Sandor Balsamo ◽  
Licia Maria Henrique da Mota ◽  
Frederico Santos de Santana ◽  
Dahan da Cunha Nascimento ◽  
Lídia Mara Aguiar Bezerra ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Resistance Training ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Weight Bearing ◽  
Aquatic Exercise ◽  
Mineral Density ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Association of PLXNA2 polymorphisms with vertebral fracture risk and bone mineral density in postmenopausal Korean population

2006 ◽  
Vol 17 (11) ◽  
pp. 1592-1601 ◽  
Author(s):  
J. -Y. Hwang ◽  
J. -Y. Lee ◽  
M. -H. Park ◽  
K. -S. Kim ◽  
K. -K. Kim ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vertebral Fracture ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Korean Population ◽  
Mineral Density ◽  
Vertebral Fracture Risk

352 The Effect of Epidural Steroid Injections on Bone Mineral Density and Vertebral Fracture Risk: A Systematic Review and Critical Appraisal of Current Literature

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 280-280
Author(s):  
Panagiotis Kerezoudis ◽  
Lorenzo Rinaldo ◽  
Mohammed Ali Alvi ◽  
Sandy Goncalves ◽  
Christine Hunt ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Femoral Neck ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Vertebral Fracture Risk ◽  
Patients At Risk ◽  
One Year ◽  
Epidural Steroid

Abstract INTRODUCTION Epidural steroid injections (ESIs) are a common treatment for the management of patients with radicular back pain. It is also known that the long-term enteral administration of exogenous steroids disrupts bone health and skeletal micro-architecture METHODS A systematic and critical review of recent literature was conducted in accordance with PRISMA guidelines. RESULTS >A total of 8 studies were included in the analysis (6 retrospective, 2 prospective). A total of 7233 patients with a mean age ranging between 49 and 74 years and an average follow-up between 6 and 60 months were studied. Steroids that were used included triamcinolone, dexamethasone, and methylprednisolone (MP), with a mean number of injections ranging from 1 to 14.7 and average cumulative dose in MP equivalents between 80 and 8130 mg. A single ESI was shown to decrease BMD as measured at the femoral neck by 1.8%, and increase the risk of vertebral fracture by 21%. Significant reductions in BMD were associated with a cumulative MP dose of 200 mg over a one year period and 400 mg over three years, but not in doses of less than 200 mg of MP equivalents for postmenopausal women and at least 3 g for healthy men. The risk of osteopenia and osteoporosis was lower in patients that were receiving anti-osteoporotic medication during the treatment course. CONCLUSION ESIs can decrease BMD, both locally (lumbar spine) and systemically (femoral neck) and increase the risk of vertebral fracture. Therefore, ESIs should be recommended with caution, especially in patients at risk for osteoporotic fractures, such as women of postmenopausal age. Anti-osteoporotic medication might be considered prior to ESI.

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