Prevalence, Pathogenesis and Treatment of Post‐menopausal Osteoporosis

Crilly, Richard G.; Horsman, A.; Marshall, D. H.; Nordin, B. E. C.

doi:10.1111/j.1445-5994.1979.tb04108.x

Cited by 26 publications

(8 citation statements)

References 13 publications

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“…In the published literature, the overall prevalence of diagnosed OP in healthy population over 45 years is 6.3 and 9.7%, respectively, and this prevalence increases linearly with age [20,21,22]. Other studies have reported almost similar prevalence of OP in a healthy population aged 65–85 years [21,22].…”

Section: Discussionmentioning

confidence: 59%

“…Other studies have reported almost similar prevalence of OP in a healthy population aged 65–85 years [21,22]. …”

Section: Discussionmentioning

confidence: 60%

“…The fracture prevalence in our cohort is in sharp contrast to the fracture prevalence in postmenopausal osteoporotic population, i.e. about 11% according to the established data [22]. …”

Section: Discussionmentioning

confidence: 61%

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High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population

Akheel¹,

Khan²,

Galvin

et al. 2009

Eur Neurol

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Background/Aims: Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP. Methods: Over a 6-month period, 50 post-polio patients attending outpatient clinics completed a questionnaire, and subsequently their medical records were reviewed. Demographic data and details of treatment were extracted. The patients underwent a dual-energy X-ray absorptiometry scanning to quantify bone mineral density. Results: Thirty subjects (60%) were females (26 were postmenopausal). The average age of females was 60 ± 13.4 years and of men 59 ± 16.8 years. Overall, 41 (82%) of the patients had experienced falls in the last 5 years and 32 (64%) in the last 6 months. Nineteen (38%) of the patients had experienced a bone fracture in the last 5 years. Based on the bone mineral density data, 28 (56%) of the patients were diagnosed with OP and 20 (40%) had osteopenia, but only 8 (16%) received anti-resorptive therapy. Of the 19 patients who had a fracture, 14 (74%) had OP and 5 (26%) had osteopenia, of whom only 6 (32%) received anti-resorptive therapy. Eight out of 9 fractures of the neck of femur occurred in the weaker leg. Conclusions: Post-polio patients are a high-risk group for fracture, and thus bone density assessment, review of falls risk and therapeutic intervention should be considered for all patients. Both osteopenia and OP are associated with increased fracture risk.

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Section: Discussionmentioning

confidence: 59%

“…Other studies have reported almost similar prevalence of OP in a healthy population aged 65–85 years [21,22]. …”

Section: Discussionmentioning

confidence: 60%

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High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population

Akheel¹,

Khan²,

Galvin

et al. 2009

Eur Neurol

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“…There is of course continual loss of calcium both from endogenous secretion into the gut and through the kidneys and skin.

^{(^{(16)})}

If insufficient calcium is ingested or absorbed, bone is resorbed to maintain the plasma calcium. This sequence can be seen in postmenopausal women with vertebral fractures,

^{(^{(17–19)})}

in which the level of bone resorption is inversely related to calcium absorption

^{(^{(19)})}

just as it is in severe vitamin D deficiency. ALP is probably raised because of increased bone formation in response to increased bone resorption.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Metabolites and Calcium Absorption in Severe Vitamin D Deficiency

Need

O’Loughlin

Morris

et al. 2008

Journal of Bone and Mineral Research

233

127

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Contrary to frequent claims, vitamin D insufficiency does not generally cause malabsorption of calcium because serum 1,25(OH) 2 D, which is the major determinant of calcium absorption, is maintained by secondary hyperparathyroidism. Nevertheless, because malabsorption of calcium has been described in osteomalacia, there must be a 25(OH)D level below which the serum 1,25(OH) 2 D can no longer be sustained, although it has never been defined. This paper seeks to define it. We examined the records of 3661 patients and found 319 with a serum 25(OH)D Յ40 nM, in whom calcium absorption, serum calcium, PTH, bone markers, and vitamin D metabolites had been measured. They were grouped according to their serum 25(OH)D into four categories, 0-10, 11-20, 21-30, and 31-40 nM, and differences between the groups were tested by ANOVA. Correlations between the variables were also examined. Serum calcium, 1,25(OH) 2 D, and calcium absorption were significantly decreased and serum PTH and alkaline phosphatase (ALP) and urine hydroxyproline were increased in those with 25(OH)D Յ10 nM. Serum ALP and urine hydroxyproline were more strongly related, inversely, to calcium absorption than to the vitamin D metabolites. We conclude that vitamin D deficiency does not reduce serum 1,25(OH) 2 D, and therefore calcium absorption, until the serum 25(OH)D falls to ∼10 nM. At this level, the substrate concentration seems to be insufficient to maintain the level of the dihydroxy metabolite despite secondary hyperparathyroidism. Further studies are needed to see how these changes correlate with the histological changes of osteomalacia.

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“…A significant loss of trabecular bone probably accounts for the high incidence, in elderly women, of fractures of the proximal femur as well as Colles' fractures of the wrist, and vertebral crush fractures (Crilly, Horsman, Marshall & Nordin, 1979). An association between fracture of the femoral neck and osteoporosis has also been shown (Stevens, Freeman, Nordin & Barnett, 1962;Wootton, Brereton, Clark, Hesp, Hodkinson, Klenerman, Reeve, Slavin & Tellez-Yudilevich, 1979 by a positive correlation between shortening of the spine, probably due to vertebral crush fractures, and fractures of the upper end of the femur (Saville & Nilsson, 1966).…”

Section: Introductionmentioning

confidence: 99%

Deficit of Trabecular and Cortical Bone in Elderly Women with Fracture of the Femoral Neck

et al. 1980

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1. The mean attenuation coefficients of trabecular and cortical bone in the radius were measured in 32 female patients with fractured proximal femur, and in 28 age-matched female controls, with a special-purpose computed tomography-scanner. 2. The largest difference between the two groups was in the mean attenuation coefficients for trabecular bone in the distal radius. The mean value for fracture patients (0.53 cm-1) was significantly lower (P < 0.02) than the mean value for the controls (0.62 cm-1). These results are consistent with the view that a loss of trabecular bone predisposes to fractures of the proximal femur.

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Prevalence, Pathogenesis and Treatment of Post‐menopausal Osteoporosis

Cited by 26 publications

References 13 publications

High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population

High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population

Vitamin D Metabolites and Calcium Absorption in Severe Vitamin D Deficiency

Deficit of Trabecular and Cortical Bone in Elderly Women with Fracture of the Femoral Neck

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