Premenopausal bone health assessment

Lewiecki, E. Michael

doi:10.1007/s11926-005-0008-9

Cited by 26 publications

(18 citation statements)

References 60 publications

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“…Because BMD follows a Gaussian distribution, low BMD (z score B-2.0) would be expected to be present in approximately 2.5% of men below age 50 and premenopausal women [18]. Prevalence of low BMD is much higher in individuals with MS in our study.…”

Section: Discussionmentioning

confidence: 57%

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Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis

2009

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The implications of having multiple sclerosis (MS) for bone health are incompletely understood. The aim of this population-based study is to identify past and current exposures that are associated with bone mass in fully ambulatory persons with MS up to age 50 years and to determine the prevalence of low bone mineral density (BMD) in this group. We measured BMD (hips, lumbar spine, forearms), physical function, BMI, and serum 25(OH) vitamin D in 55 women and 25 men with MS. Patients provided information on demographic variables and medical history, as well as past and current vitamin D and calcium intake, physical activity, and lifestyle habits. In regression analyses, BMD levels were adjusted for age, sex, and BMI. At the femoral neck, strong associations were found for walking distance (beta = 0.152; P < 0.001) and age (beta = -0.004; P = 0.003), and less certain associations for male sex (beta = 0.055; P = 0.014) and 10-foot timed tandem walk (-0.008; P = 0.013). At the lumbar spine, walking distance (beta = 0.013; P = 0.006) and possibly physical activity growing up (beta = 0.035; P = 0.028) and male sex (beta = -0.057; P = 0.042), were associated with BMD. At the ultradistal radius, strength of grip (beta = 0.001; P = 0.002), and, less certainly, summer outdoor activities age 16-20 (beta = 0.021; P = 0.009), and age at MS onset (beta = 0.002; P = 0.036) were associated with BMD. Low BMD (z score < or = -2) was present in 19 out of 80 patients. This study shows that MS-related variables as well as past exposures differentially affect BMD at three clinically important skeletal sites. Low BMD is prevalent in these young patients. Bone health should receive attention in care for persons with MS.

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Section: Discussionmentioning

confidence: 57%

“…The absence of associations with several known risk factors for low BMD [3,18,27,37] may be ascribed to the small number or the young age of participants in this study. Thus, negative results should not be interpreted in the sense that general risk factors are not relevant in persons with MS.…”

Section: Discussionmentioning

confidence: 67%

Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis

2009

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“…less than the young-adult mean, and w0.6% are more than 2.5 S.D. below young-adult mean bone density (17). Acquisition of normal peak bone mass is generally considered to be a polygenic process arising from the interaction of common polymorphic alleles at quantitative trait loci.…”

Section: Discussionmentioning

confidence: 99%

Variable number of tandem repeats polymorphism in parathyroid hormone-related protein as predictor of peak bone mass in young healthy Finnish males

Gupta¹,

Välimäki²,

Välimäki³

et al. 2008

European Journal of Endocrinology

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Objective: Mice with osteoblast-specific deletion of parathyroid hormone-related protein (PTHrP) exhibit impaired recruitment and increased apoptosis of osteogenic cells resulting in decreased bone formation and premature osteoporosis. The PTHrP levels within the bone microenvironment are therefore critical in influencing bone mass acquisition. Whether this is applicable in humans has not been established. Here, we studied the association of a variable number of tandem repeats (VNTR) polymorphism in PTHrP with peak bone mass. Methods: Enrolled in the study were 234 young Finnish males, with median age of 19.6 years (range 18.3-20.6 years). Lifestyle factors, serum bone markers, osteodensitometric measurements (lumbar spine and hip) and calcaneal quantitative ultrasound readings were obtained. The PTHrP VNTR length was determined by the PCR amplification of genomic DNA extracted from peripheral blood and correlated to bone parameters by the multiple regression models. Results: The presence of at least one 252 bp allele was associated with increased lumbar spine bone mineral density (BMD; P!0.0034), broadband ultrasound attenuation (BUA; P!0.0012) and speed-of-sound (SOS; P!0.0023) measurements. The correlation with increased lumbar spine BMD (PZ0.0008), BUA (PZ0.005) and SOS (PZ0.001) was further strengthened by the pairing of the 252 bp allele with a 460 bp allele in comparison with those without any 252 bp allele. Electrophoretic mobility shift assays were used to illustrate the potential transcriptional functionality of the VNTR sequence. Conclusion:The results indicate that the PTHrP VNTR sequence likely modulates local PTHrP expression within the skeletal microenvironment and could serve as a diagnostic predictor of peak bone mass acquisition. 158 755-764 European Journal of Endocrinology

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“…Instead, Z-scores, which compare women to an age matched reference population, are recommended. Young women with BMDZ-scores below − 2.0 should be categorized as having BMD that is “below expected range for age” and those with Z-scores above − 2.0 should be categorized as having BMD that is “with-in the expected range for age.” 10 Diagnostic categories of “osteoporosis” and “osteopenia” based on T-scores should not be applied to premenopausal women. An exception to these recommendations occurs in perimenopausal women, in whom the use of T-scores and T-score cut-offs is appropriate.…”

Section: Bmd Testing In Premenopausal Womenmentioning

confidence: 99%