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  • 1
    Electronic Resource
    Electronic Resource
    When should bone density measurements be repeated? (1994)
    Springer
    Calcified tissue international 55 (1994), S. 243-248 
    Details
    ISSN: 1432-0827
    Keywords: Osteoporosis ; Bone density ; Longitudinal studies ; Statistical models ; Decision models
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract We calculated how long to wait before repeating bone mineral density (BMD) measurements to reassess fracture risk. Correlation results from serial measurements of 495 postmenopausal Japanese-American women were used to estimate 95% confidence intervals (CI) for future BMD. After 7 years of follow-up, BMD correlations with the initial measurement ranged between 0.81 and 0.94, depending on age group and measurement site. In this analysis, the period between measurements was defined as the time required for the lower 95% CI to fall below the BMD value corresponding to doubling of fracture risk. Progressive bone loss causes fracture risk to double after 10 years, on average. However, the 95% CIs indicate that a second BMD measurement will detect risk doubling after only 2 or 3 years for some women. For untreated, early postmenopausal women, the period between measurements was approximately 2–5 years for the radius and 4–6 years for the calcaneus, depending on the initial BMD level. The period was approximately 1 year longer for women age 60 and older. Treatments that halve the bone loss rate would increase the period by 1–3 years. In the absence of a second measurement of BMD, the CI will continue to expand with time, corresponding to a wider range in risk between individuals, and a greater proportion of women will be at increased fracture risk. Obtaining a second BMD measurement pinpoints the patient's status within the precision of the measurement. We conclude that repeated BMD measurements will provide a more accurate estimate of fracture risk than a single, baseline measurement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00310399
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  • 2
    Electronic Resource
    Electronic Resource
    Ethnic, Anthropometric, and Lifestyle Associations with Regional Variations in Peak Bone Mass (1999)
    Springer
    Calcified tissue international 65 (1999), S. 100-105 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Bone density — Bone mineral content — Anthropometry — Lifestyle — Ethnicity.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. The study investigated the ability of ethnicity and anthropometric and lifestyle factors to account for differences within subjects in bone mass at different skeletal sites. The subjects were young, adult, Japanese, Filipino, Hawaiian, and white women ages 25–34. In the preliminary analyses, they were divided into thirds based on their BMD z-scores. Thirty-five percent exhibited high variability in bone mass: they were in the upper third at one or more bone sites and in the lower third at one or more sites. Other women had more generalized low bone mass: 25% were in the lowest third for two or more sites, and there were no sites with low bone mass in the upper third. In subsequent analyses, ethnicity, anthropometry, and lifestyle influences were examined as possible predictors of differences in bone mineral content (BMC) between bone sites in bone-size adjusted models. White women had greater BMC at the proximal radius and calcaneus than at the distal radius compared with other ethnic groups. This may be explained by the fact that they had exceptionally wide bone widths at the distal radius. Of the anthropometric variables, fat mass was associated with higher bone mass at sites with higher proportions of cancellous tissue (calcaneus 〉 spine 〉 radius sites). Muscle mass was associated with greater bone mass at the calcaneus and proximal radius than at the spine. For the lifestyle variables, women with greater milk consumption between the ages of 10–24 years had higher spine bone mass than expected from their measurements at the proximal radius. Women 12–17 years of age who had been more active in sports had higher calcaneous bone mass than expected from their spine measurements. As the study participants were still young women, the results suggest that regional differences in bone mass may partly derive from anthropometric and lifestyle influences during skeletal maturation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900664
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  • 3
    Electronic Resource
    Electronic Resource
    Users of low-dose glucocorticoids have increased bone loss rates: A longitudinal study (1995)
    Springer
    Calcified tissue international 57 (1995), S. 115-119 
    Details
    ISSN: 1432-0827
    Keywords: Glucocorticoid ; Bone density ; Bone loss rates ; Longitudinal study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Although high doses of glucocorticoids are believed to cause bone loss, the effects of low glucocorticoid doses are still controversial. Our study examined the effects of low-dose glucocorticoids on the rate of bone loss at three appendicular bone sites. The study population was a cohort of elderly Japanese-Americans, 1094 women and 1378 men. The women were all postmenopausal. At the baseline examination the mean age of the women was 64 years (range 45–81), and the mean age of the men was 68 years (range 61–82). Glucocorticoid users (19 women and 21 men) had used oral systemic or inhaled glucocorticoids on a regular schedule for more than 1 month (mean use was 2.1 years for the women and 1.9 years for the men). The most common dose was equivalent to 5 mg/day of prednisone; fewer than 15% of users had taken doses equivalent to 10 mg/day or more. Changes in bone mass at the calcaneus, distal radius, and proximal radius were documented using bone densitometry at 1 to 2-year intervals over an 8-year period. The initial bone mass of the glucocorticoid users and controls was similar at the baseline examination. The subsequent loss rates among females during glucocorticoid use, however, were approximately double that of the controls. Among males, bone loss rates during glucocorticoid use were 2–3 times that of controls for the calcaneus and radius sites. The differences between glucocorticoid users and controls persisted after adjusting for confounding variables such as age and use of thiazides and estrogens. We conclude that users of low-dose glucocorticoids have increased rates of bone loss at appendicular sites among both elderly women and men.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00298431
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  • 4
    Electronic Resource
    Electronic Resource
    Prediction of Fracture Risk by Radiographic Absorptiometry and Quantitative Ultrasound: A Prospective Study (1998)
    Springer
    Calcified tissue international 63 (1998), S. 380-384 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Fracture risk — Radiographic absorptiometry — Quantitative ultrasound — Prospective study.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Recent developments in computer-assisted radiographic absorptiometry (RA) and quantitative ultrasound techniques (QUS) provide readily accessible and relatively inexpensive methods for assessing bone mineral status. However, few population-based studies have investigated the ability of RA and ultrasound to predict fracture risk prospectively. We explored the ability of RA and QUS to predict fracture risk among 560 postmenopausal women from the Hawaii Osteoporosis Study; average follow-up was 2.7 years. An incident vertebral fracture was defined as a decrease of more than 15% in vertebral heights on subsequent films. Self-reported nonspine fractures were verified by medical records. The prospective associations of vertebral fractures, nonspine fractures, and any (spine or nonspine) fractures with bone measurements were examined using logistic regression, adjusting for age. Both phalangeal bone mineral density (BMD) and metacarpal BMD, measured using RA, predicted future fracture risk. The age-adjusted odds ratios (corresponding to 1 SD decrease in BMD) for vertebral fractures, nonspine fractures, and any fractures were 3.41, 1.50, and 1.91, respectively, for phalangeal BMD, and 1.71, 1.49, 1.55, respectively for metacarpal BMD. Calcaneal broadband ultrasound attenuation (BUA) also showed significant association with fracture risk, with age-adjusted odds ratios of 1.50, 1.89, and 1.72 for vertebral fractures, nonspine fractures, and any fractures, respectively. We conclude that hand RA and calcaneal BUA are significant predictors of nonspine fracture, vertebral fracture, and overall fracture risk. The attractive features of these techniques, such as portability, relatively low cost, and ease of use, make them promising alternatives to conventional bone measurement techniques used for the assessment of fracture risk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900544
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  • 5
    Electronic Resource
    Electronic Resource
    The peak bone mass of Hawaiian, Filipino, Japanese, and white women living in Hawaii (1994)
    Springer
    Calcified tissue international 55 (1994), S. 249-252 
    Details
    ISSN: 1432-0827
    Keywords: Bone mass ; Ethnicities ; Hawaiian ; Filipino ; Japanese ; White
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Our study compares the bone mass of Hawaiian, Filipino, Japanese, and white women living in Oahu, Hawaii. Eligible women ranged in age from 25 to 34; all had bone mass measurements at the spine, calcaneus, and proximal and distal radius. Their average bone mineral density (BMD) remained stable with age at all four bone sites, indicating that the age range 25–34 may represent the peak bone mass. Bone mass varied, however, between ethnicities; differences in BMD up to 11% were observed. The Hawaiian women had the greatest BMD, and whites had the second greatest BMD at the spine and calcaneus. The Japanese most frequently had the lowest BMD. Differences in body size partly explained the differences; most ethnic differences were reduced or eliminated after adjusting for height and weight. At the spine, the ethnic differences for BMD were also apparent with BMC and with vertebral area. Hawaiian and white women had greater values than Japanese or Filipino women. Differences at the proximal radius resembled the spine, except that whites had the widest proximal widths. The results were more complex for the distal radius. At the distal radius whites had the lowest BMD of the four ethic groups. The difference between whites and Hawaiians derived from the greater bone mineral content (BMC) of the Hawaiian women. By contrast, the difference between whites and the Japanese and Filipinos derived from the wider distal widths of the white women. Compared with the Japanese and Filipino women, the white women appeared to disperse their BMC at the distal radius across a wider bone width. Such differences in bone distributions might lead to an altered risk of distal radius (wrist) fractures. Within ethnicities there was marked variation among individuals in bone mass. At the extremes, women differed by 50–100% or more within all four ethnic groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00310400
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