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Extensive Undertreatment Of Osteoporosis In Older Swedish Women, Mattias Lorentzon, A. G. Nilsson, Helena Johansson, John A. Kanis, Dan Mellström, D. Sundh Jan 2019

Extensive Undertreatment Of Osteoporosis In Older Swedish Women, Mattias Lorentzon, A. G. Nilsson, Helena Johansson, John A. Kanis, Dan Mellström, D. Sundh

Faculty of Health Sciences Publications

Summary In a population-based study of older Swedish women, we investigated the proportion of women treated with osteoporosis medication in relation to the proportion of women eligible for treatment according to national guidelines. We found that only a minority (22%) of those eligible for treatment were prescribed osteoporosis medication. Introduction Fracture rates increase markedly in old age and the incidence of hip fracture in Swedish women is among the highest in the world. Although effective pharmacological treatment is available, treatment rates remain low. Limited data are available regarding treatment rates in relation to fracture risk in a population-based setting in ...


Effect Of Abaloparatide On Vertebral,Nonvertebral, Major Osteoporotic And Clinical Fractures In A Subset Of Postmenopausal Women At Increased Risk Of Fracture By Frax Probability, Eugene V. Mccloskey, Lorraine Fitzpatrick, M.-Y. Hu, G. Williams, John A. Kanis Jan 2019

Effect Of Abaloparatide On Vertebral,Nonvertebral, Major Osteoporotic And Clinical Fractures In A Subset Of Postmenopausal Women At Increased Risk Of Fracture By Frax Probability, Eugene V. Mccloskey, Lorraine Fitzpatrick, M.-Y. Hu, G. Williams, John A. Kanis

Faculty of Health Sciences Publications

Summary We evaluated the efficacy of abaloparatide in women who were at increased risk for fracture, based on CHMP recommended risk thresholds, at the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE) study baseline. Among patients at high risk based on FRAX probabilities, 18 months of abaloparatide significantly decreased risk for all fracture endpoints compared with placebo. Purpose Abaloparatide, a novel anabolic agent for the treatment of postmenopausal osteoporosis, significantly reduced the risk of vertebral and nonvertebral fractures in the ACTIVE study compared with placebo. In this post hoc analysis, we evaluated abaloparatide’s efficacy in a subset of women in ...


Romosozumab For The Treatment Of Osteoporosis, Michael Mcclung Jan 2018

Romosozumab For The Treatment Of Osteoporosis, Michael Mcclung

Faculty of Health Sciences Publications

Romosozumab, a specific inhibitor of sclerostin, is a unique approach to therapy for postmenopausal osteoporosis and related disorders. The elucidation of sclerostin deficiency as the molecular defect of syndromes of high bone mass with normal quality, and the pivotal role of sclerostin as a mediator of osteoblastic activity and bone formation, provided the platform for the evaluation of inhibitors of sclerostin to activate bone formation. An extensive preclinical program and 2 large fracture endpoint trials with romosozumab, a sclerostin-binding antibody, have been completed. This review will highlight the results of those studies and describe the current status of romosozumab as ...


Measures Of Physical Performance And Muscle Strength As Predictors Of Fracture Risk Independent Of Frax, Falls, And Abmd: A Meta-Analysis Of The Osteoporotic Fractures In Men (Mros) Study, Nicholas C. Harvey, Anders Oden, E. Orwoll, Jodi Lapidus, T. Kwok, Magnus Karlsson, Björn E. Rosengren, Eva Ribom, Cyrus Cooper, Peggy M. Cawthon, John A. Kanis, Claes Ohlsson, Dan Mellström, Helena Johansson, Eugene Mccloskey Jan 2018

Measures Of Physical Performance And Muscle Strength As Predictors Of Fracture Risk Independent Of Frax, Falls, And Abmd: A Meta-Analysis Of The Osteoporotic Fractures In Men (Mros) Study, Nicholas C. Harvey, Anders Oden, E. Orwoll, Jodi Lapidus, T. Kwok, Magnus Karlsson, Björn E. Rosengren, Eva Ribom, Cyrus Cooper, Peggy M. Cawthon, John A. Kanis, Claes Ohlsson, Dan Mellström, Helena Johansson, Eugene Mccloskey

Faculty of Health Sciences Publications

Measures of muscle mass, strength, and function predict risk of incident fractures, but it is not known whether this risk information is additive to that from FRAX (fracture risk assessment tool) probability. In the Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, Hong Kong, United States), we investigated whether measures of physical performance/appendicular lean mass (ALM) by DXA predicted incident fractures in older men, independently of FRAX probability. Baseline information included falls history, clinical risk factors for falls and fractures, femoral neck aBMD, and calculated FRAX probabilities. An extension of Poisson regression was used to investigate the relationship between ...


High-Impact Mechanical Loading Increases Bone Material Strength In Postmenopausal Women—A 3-Month Intervention Study, Daniel Sundh, Martin Nilsson, Michail Zoulakis, Courtney Pasco, Melis Yilmaz, Galateia J. Kazakia, Martin Hellgren, Mattias Lorentzon Jan 2018

High-Impact Mechanical Loading Increases Bone Material Strength In Postmenopausal Women—A 3-Month Intervention Study, Daniel Sundh, Martin Nilsson, Michail Zoulakis, Courtney Pasco, Melis Yilmaz, Galateia J. Kazakia, Martin Hellgren, Mattias Lorentzon

Faculty of Health Sciences Publications

Bone adapts to loading in several ways, including redistributing bone mass and altered geometry and microarchitecture. Because of previous methodological limitations, it is not known how the bone material strength is affected by mechanical loading in humans. The aim of this study was to investigate the effect of a 3‐month unilateral high‐impact exercise program on bone material properties and microarchitecture in healthy postmenopausal women. A total of 20 healthy and inactive postmenopausal women (aged 55.6 ± 2.3 years [mean ± SD]) were included and asked to perform an exercise program of daily one‐legged jumps (with incremental number ...


Advances And Unmet Needs In The Therapeutics Of Bone Fragility, S. K. Ramchand, Ego Seeman Jan 2018

Advances And Unmet Needs In The Therapeutics Of Bone Fragility, S. K. Ramchand, Ego Seeman

Faculty of Health Sciences Publications

The prevalence of fragility fractures increases as longevity increases the proportion of the elderly in the community. Until recently, the majority of studies have targeted women with osteoporosis defined as a bone mineral density (BMD) T score of < −2.5 SD, despite evidence that the population burden of fractures arises from women with osteopenia. Antiresorptive agents reduce vertebral and hip fracture risk by ~50 percent during 3 years but efficacy against non-vertebral fractures, 80% of all fractures in the community, is reported in few studies, and of those, the risk reduction is only 20–30%. Recent advances in the use of antiresorptives and anabolic agents has addressed some of these unmet needs. Zoledronic acid is now reported to reduce vertebral and non-vertebral fractures rates in women with osteopenia. Studies using teriparatide demonstrate better vertebral and clinical (symptomatic vertebral and non-vertebral) antifracture efficacy than risedronate. Abaloparatide, a peptide sharing amino acid sequences with teriparatide, reduces vertebral and non-vertebral fractures. Romosozumab, a monoclonal antibody suppressing sclerostin, reduces vertebral and non-vertebral fractures within a year of starting treatment, and does so more greatly than alendronate. Some recent studies signal undesirable effects of therapy but provide essential cautionary insights into long term management. Cessation of denosumab is associated with a rapid increase in bone remodeling and the uncommon but clinically important observation of increased multiple vertebral fractures suggesting the need to start alternative anti-resorptive therapy around the time of stopping denosumab. Antiresorptives like bisphosphonates and denosumab suppress remodeling but not completely. Antifracture efficacy may be limited, in part, as a consequence of continued unsuppressed remodeling, particularly in cortical bone. Bisphosphonates may not distribute in deeper cortical bone, so unbalanced intracortical remodeling continues to cause microstructural deterioration. In addition, suppressed remodeling may compromise the material composition by increasing matrix mineral density and glycosylation of collagen. As antiresorptive agents do not restore microstructural deterioration existing at the time of starting treatment, under some circumstances, anabolic therapy may be more appropriate first line treatment. Combining antiresorptive and anabolic therapy is an alternative but whether anti-fracture efficacy is greater than that achieved by either treatment alone is not known.


Clinically Relevant Doses Of Vitamin A Decrease Cortical Bone Mass In Mice, Vikte Lionikaite, Karin L. Gustafsson, Anna Westerlund, Sara H. Windahl, Antti Koskela, Juha Tuukkanen, Helena Johansson, Claes Ohlsson, H. Herschel Conaway, Petra Henning, Ulf H. Lerner Jan 2018

Clinically Relevant Doses Of Vitamin A Decrease Cortical Bone Mass In Mice, Vikte Lionikaite, Karin L. Gustafsson, Anna Westerlund, Sara H. Windahl, Antti Koskela, Juha Tuukkanen, Helena Johansson, Claes Ohlsson, H. Herschel Conaway, Petra Henning, Ulf H. Lerner

Faculty of Health Sciences Publications

Excess vitamin A has been associated with decreased cortical bone thickness and increased fracture risk. While most studies in rodents have employed high dosages of vitamin A for short periods of time, we investigated the bone phenotype in mice after longer exposure to more clinically relevant doses. For 1, 4 and 10 weeks, mice were fed a control diet (4.5 µg retinyl acetate/g chow), a diet modeled from the human upper tolerable limit (UTL; 20 µg retinyl acetate/g chow) and a diet three times UTL (supplemented; 60 µg retinyl acetate/g chow). Time-dependent decreases in periosteal circumference ...


Management Of Patients With High Baseline Hip Fracture Risk By Frax Reduces Hip Fractures—A Post Hoc Analysis Of The Scoop Study, Eugene Mccloskey, Helena Johansson, Nicholas C. Harvey, L. Shepstone, E. Lenaghan, Ric Fordham, I. Harvey, Amanda Howe, Cyrus Cooper, Shane Clarke, Neil Gittoes, A. Heawood, R. Holland, Tarnya Marshall, T. W. O'Neill, T. J. Peters, Niamh Redmond, David Torgerson, John A. Kanis Jan 2018

Management Of Patients With High Baseline Hip Fracture Risk By Frax Reduces Hip Fractures—A Post Hoc Analysis Of The Scoop Study, Eugene Mccloskey, Helena Johansson, Nicholas C. Harvey, L. Shepstone, E. Lenaghan, Ric Fordham, I. Harvey, Amanda Howe, Cyrus Cooper, Shane Clarke, Neil Gittoes, A. Heawood, R. Holland, Tarnya Marshall, T. W. O'Neill, T. J. Peters, Niamh Redmond, David Torgerson, John A. Kanis

Faculty of Health Sciences Publications

The Screening for Osteoporosis in Older Women for the Prevention of Fracture (SCOOP) study was a community‐based screening intervention in women aged 70 to 85 years in the United Kingdom. In the screening arm, licensed osteoporosis treatments were recommended in women identified to be at high risk of hip fracture using the FRAX risk assessment tool (including bone mineral density measurement). In the control arm, standard care was provided. Screening led to a 28% reduction in hip fractures over 5 years. In this planned post hoc analysis, we wished to examine for interactions between screening effectiveness on fracture outcome ...


Lactobacillus Reuteri Reduces Bone Loss In Older Women With Low Bone Mineral Density: A Randomized, Placebo-Controlled, Double-Blind, Clinical Trial, A. G. Nilsson, D. Sundh, F. Bäckhed, Mattias Lorentzon Jan 2018

Lactobacillus Reuteri Reduces Bone Loss In Older Women With Low Bone Mineral Density: A Randomized, Placebo-Controlled, Double-Blind, Clinical Trial, A. G. Nilsson, D. Sundh, F. Bäckhed, Mattias Lorentzon

Faculty of Health Sciences Publications

Background: The importance of the gut microbiome for bone metabolism in mice has recently been demonstrated, but no studies are available in humans. Lactobacillus reuteri ATCCPTA 6475 (L. reuteri 6475) has been reported to increase bone mineral density (BMD) in mice but its effect on the human skeleton is unknown. The objective of this trial was to investigate if L. reuteri 6475 affects bone loss in older women with low BMD. Methods: In this double‐blind, placebo‐controlled study, women from the population who were 75 to 80 years old and had low BMD were randomized to orally receive 1010 ...


Osteoporosis Costing Northern Territory: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Northern Territory: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in the Northern Territory


Which Measuring Site In Ankylosing Spondylitis Is Best To Detect Bone Loss And What Predicts The Decline: Results From A 5-Year Prospective Study, Anna Deminger, Eva Klingberg, Mattias Lorentzon, Mats Geijer, Jan Göthlin, Martin Hedberg, Eva Rehnberg, Hans Carlsten, Lennart T. Jacobsson, Helena Forsblad-D'Elia Jan 2017

Which Measuring Site In Ankylosing Spondylitis Is Best To Detect Bone Loss And What Predicts The Decline: Results From A 5-Year Prospective Study, Anna Deminger, Eva Klingberg, Mattias Lorentzon, Mats Geijer, Jan Göthlin, Martin Hedberg, Eva Rehnberg, Hans Carlsten, Lennart T. Jacobsson, Helena Forsblad-D'Elia

Faculty of Health Sciences Publications

Background: Studies have shown increased prevalence of osteoporosis and increased risk for vertebral fractures in patients with ankylosing spondylitis (AS). Measurements of bone mineral density (BMD) in the lumbar spine anterior-posterior (AP) projection may be difficult to interpret due to the ligamentous calcifications, and the lateral projection might be a better measuring site. Our objectives were to investigate BMD changes after 5 years at different measuring sites in patients with AS and to evaluate disease-related variables and medications as predictors for BMD changes. Methods: In a longitudinal study, BMD in Swedish AS patients, 50 ± 13 years old, was measured with ...


Increased Cortical Porosity In Women With Hip Fracture, Daniel Sundh, A. G. Nilsson, Martin Nilsson, L. Johansson, Dan Mellström, Mattias Lorentzon Jan 2017

Increased Cortical Porosity In Women With Hip Fracture, Daniel Sundh, A. G. Nilsson, Martin Nilsson, L. Johansson, Dan Mellström, Mattias Lorentzon

Faculty of Health Sciences Publications

Background: Hip fractures cause increased mortality and disability and consume enormous healthcare resources. Only 46% of hip fracture patients have osteoporosis at the total hip according to dual‐energy X‐ray absorptiometry (DXA) measurement. Cortical porosity increases with ageing and is believed to be important for bone strength. Objective: To investigate whether older women with hip fracture have higher cortical porosity than controls, and if so whether this difference is independent of clinical risk factors and areal bone mineral density (aBMD). Methods: From an ongoing population‐based study, we identified 46 women with a prevalent X‐ray‐verified hip fracture ...


Osteoporosis Costing Nsw And Act: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Nsw And Act: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in NSW and ACT


Osteoporosis Costing Queensland: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Queensland: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in Queensland


Osteoporosis Costing South Australia: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing South Australia: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in South Australia


Osteoporosis Costing Tasmania: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Tasmania: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in Tasmania


Osteoporosis Costing Victoria: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Victoria: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in Victoria


Osteoporosis Costing Western Australia: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza Jan 2017

Osteoporosis Costing Western Australia: A Burden Of Disease Analysis - 2012 To 2022, Kerrie Sanders, Jennifer Watts, J. Abimanyi-Ochom, Ghulam Murtaza

Faculty of Health Sciences Publications

Burden of Disease Reports
This report outlines osteoporosis prevalence and cost in Western Australia


The Association Of Time And Medications With Changes In Bone Mineral Density In The 2 Years After Critical Illness, Neil R. Orford, Michael Bailey, Rinaldo Bellomo, Julie A. Pasco, Claire Cattigan, Tania Elderkin, Sharon L. Brennan-Olsen, David J. Cooper, Mark A. Kotowicz Jan 2017

The Association Of Time And Medications With Changes In Bone Mineral Density In The 2 Years After Critical Illness, Neil R. Orford, Michael Bailey, Rinaldo Bellomo, Julie A. Pasco, Claire Cattigan, Tania Elderkin, Sharon L. Brennan-Olsen, David J. Cooper, Mark A. Kotowicz

Faculty of Health Sciences Publications

Background: Critical illness is associated with increased risk of fragility fracture and loss of bone mineral density (BMD), although the impact of medication exposures (bone anti-fracture therapy or glucocorticoids) and time remain unexplored. The objective of this study was to describe the association of time after ICU admission, and post-ICU administration of bone anti-fracture therapy or glucocorticoids after critical illness, with change in BMD. Methods: In this prospective observational study, conducted in a tertiary hospital ICU, we studied adult patients requiring mechanical ventilation for at least 24 hours and measured BMD annually for 2 years after ICU discharge. We performed ...


Type 2 Diabetes Mellitus Is Associated With Better Bone Microarchitecture But Lower Bone Material Strength And Poorer Physical Function In Elderly Women: A Population-Based Study, Anna G. Nilsson, Daniel Sundh, Lisa Johansson, Martin Nilsson, Dan Mellström, Robert Rudäng, Michail Zoulakis, Märit Wallander, Anna Darelid, Mattias Lorentzon Jan 2017

Type 2 Diabetes Mellitus Is Associated With Better Bone Microarchitecture But Lower Bone Material Strength And Poorer Physical Function In Elderly Women: A Population-Based Study, Anna G. Nilsson, Daniel Sundh, Lisa Johansson, Martin Nilsson, Dan Mellström, Robert Rudäng, Michail Zoulakis, Märit Wallander, Anna Darelid, Mattias Lorentzon

Faculty of Health Sciences Publications

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fractures according to several studies. The underlying mechanisms remain unclear, although small case‐control studies indicate poor quality of the cortical bone. We have studied a population‐based sample of women aged 75 to 80 years in Gothenburg, randomly invited from the population register. Areal bone mineral density (aBMD) was measured by dual‐energy X‐ray absorptiometry (Hologic Discovery A), bone microarchitecture by high‐resolution peripheral quantitative computed tomography (HR‐pQCT; ExtremeCT from Scanco Medical AG), and reference point indentation was performed with Osteoprobe (Active Life Scientific). Women ...


Effectiveness Of A Minimal Resource Fracture Liaison Service, K. F. Axelsson, R. Jacobsson, D. Lund, Mattias Lorentzon Jan 2016

Effectiveness Of A Minimal Resource Fracture Liaison Service, K. F. Axelsson, R. Jacobsson, D. Lund, Mattias Lorentzon

Faculty of Health Sciences Publications

Purpose The purpose of this study was to investigate if a 2-year intervention with a minimal resource fracture liaison service (FLS) was associated with increased investigation and medical treatment and if treatment was related to reduced re-fracture risk. Methods The FLS started in 2013 using existing secretaries (without an FLS coordinator) at the emergency department and orthopaedic wards to identify risk patients. All patients older than 50 years of age with a fractured hip, vertebra, shoulder, wrist or pelvis were followed during 2013–2014 (n = 2713) and compared with their historic counterparts in 2011–2012 (n = 2616) at the same ...


High Serum Shbg Predicts Incident Vertebral Fractures In Elderly Men, Liesbeth Vandenput, Dan Mellström, Andreas Kindmark, Helena Johansson, Mattias Lorentzon, Jason Leung, Inga Redlund-Johnell, Björn E. Rosengren, Magnus K. Karlsson, Yi-Xiang Wang, Timothy Kwok, Claes Ohlsson Jan 2016

High Serum Shbg Predicts Incident Vertebral Fractures In Elderly Men, Liesbeth Vandenput, Dan Mellström, Andreas Kindmark, Helena Johansson, Mattias Lorentzon, Jason Leung, Inga Redlund-Johnell, Björn E. Rosengren, Magnus K. Karlsson, Yi-Xiang Wang, Timothy Kwok, Claes Ohlsson

Faculty of Health Sciences Publications

Previous prospective cohort studies have shown that serum levels of sex steroids and sex hormone‐binding globulin (SHBG) associate with nonvertebral fracture risk in men. The predictive value of sex hormones and SHBG for vertebral fracture risk specifically is, however, less studied. Elderly men (aged ≥65 years) from Sweden and Hong Kong participating in the Osteoporotic Fractures in Men (MrOS) study had baseline estradiol and testosterone analyzed by gas chromatography–mass spectrometry (GC‐MS) and SHBG by immunoradiometric assay (IRMA). Incident clinical vertebral fractures (n = 242 cases) were evaluated in 4324 men during an average follow‐up of 9.1 ...


Low-Level Cadmium Exposure Is Associated With Decreased Bone Mineral Density And Increased Risk Of Incident Fractures In Elderly Men: The Mros Sweden Study, Maria Wallin, Lars Barregard, Gerd Sallsten, Thomas Lundh, Magnus K. Karlsson, Mattias Lorentzon, Claes Ohlsson, Dan Mellström Jan 2016

Low-Level Cadmium Exposure Is Associated With Decreased Bone Mineral Density And Increased Risk Of Incident Fractures In Elderly Men: The Mros Sweden Study, Maria Wallin, Lars Barregard, Gerd Sallsten, Thomas Lundh, Magnus K. Karlsson, Mattias Lorentzon, Claes Ohlsson, Dan Mellström

Faculty of Health Sciences Publications

One risk factor for osteoporosis that has attracted increasing attention in recent years is exposure to cadmium. The aim of this study was to examine the associations between low‐level cadmium exposure, from diet and smoking, and bone mineral density (BMD) and incident fractures in elderly men. The study population consisted of 936 men from the Swedish cohort of the Osteoporotic Fractures in Men (MrOS) study, aged 70 to 81 years at inclusion (years 2002 to 2004), with reliable data on cadmium in urine (U‐Cd) analyzed using inductively coupled plasma mass spectrometry in baseline samples. The participants also answered ...


A High Amount Of Local Adipose Tissue Is Associated With High Cortical Porosity And Low Bone Material Strength In Older Women, Daniel Sundh, Robert Rudäng, Michail Zoulakis, Anna G. Nilsson, Anna Darelid, Mattias Lorentzon Jan 2016

A High Amount Of Local Adipose Tissue Is Associated With High Cortical Porosity And Low Bone Material Strength In Older Women, Daniel Sundh, Robert Rudäng, Michail Zoulakis, Anna G. Nilsson, Anna Darelid, Mattias Lorentzon

Faculty of Health Sciences Publications

Obesity is associated with increased risk of fractures, especially at skeletal sites with a large proportion of cortical bone, such as the humerus and ankle. Obesity increases fracture risk independently of BMD, indicating that increased adipose tissue could have negative effects on bone quality. Microindentation assesses bone material strength index (BMSi) in vivo in humans. The aim of this study was to investigate if different depots of adipose tissue were associated with BMSi and cortical bone microstructure in a population based group of 202 women, 78.2 ± 1.1 (mean ± SD) years old. Bone parameters and subcutaneous (s.c.) fat ...


Increased Cortical Porosity In Older Men With Fracture, Daniel Sundh, Dan Mellström, Martin Nilsson, Magnus Karlsson, Claes Ohlsson, Mattias Lorentzon Jan 2015

Increased Cortical Porosity In Older Men With Fracture, Daniel Sundh, Dan Mellström, Martin Nilsson, Magnus Karlsson, Claes Ohlsson, Mattias Lorentzon

Faculty of Health Sciences Publications

Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 ± 3.5 (mean ± SD) years, with available high‐resolution peripheral quantitative computed tomography measurements at the tibia from the 5‐year follow‐up exam, was drawn from the prospective MrOS Gothenburg study. Dual‐energy X‐ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases ...


Reproducibility Of A Peripheral Quantitative Computed Tomography Scan Protocol To Measure The Material Properties Of The Second Metatarsal, Elodie Chaplais, David Greene, Anita Hood, Scott Telfer, Verona Du Toit, Davinder Singh-Grewal, Joshua Burns, Keith Rome, Daniel Schiferl, Gordon Hendry Jan 2014

Reproducibility Of A Peripheral Quantitative Computed Tomography Scan Protocol To Measure The Material Properties Of The Second Metatarsal, Elodie Chaplais, David Greene, Anita Hood, Scott Telfer, Verona Du Toit, Davinder Singh-Grewal, Joshua Burns, Keith Rome, Daniel Schiferl, Gordon Hendry

Faculty of Health Sciences Publications

Background Peripheral quantitative computed tomography (pQCT) is an established technology that allows for the measurement of the material properties of bone. Alterations to bone architecture are associated with an increased risk of fracture. Further pQCT research is necessary to identify regions of interest that are prone to fracture risk in people with chronic diseases. The second metatarsal is a common site for the development of insufficiency fractures, and as such the aim of this study was to assess the reproducibility of a novel scanning protocol of the second metatarsal using pQCT.

Methods Eleven embalmed cadaveric leg specimens were scanned six ...


Femoral And Vertebral Strength Improvements In Postmenopausal Women With Osteoporosis Treated With Denosumab, Tony M. Keaveny, Michael R. Mcclung, Harry K. Genant, Jose Ruben Zanchetta, David Kendler, Jacques P. Brown, Stefan Goemaere, Christopher Recknor, Maria Luisa Brandi, Richard Eastell, David L. Kopperdahl, Klaus Engelke, Thomas Fuerst, Hoi-Shen Radcliffe, Cesar Libanati Jan 2014

Femoral And Vertebral Strength Improvements In Postmenopausal Women With Osteoporosis Treated With Denosumab, Tony M. Keaveny, Michael R. Mcclung, Harry K. Genant, Jose Ruben Zanchetta, David Kendler, Jacques P. Brown, Stefan Goemaere, Christopher Recknor, Maria Luisa Brandi, Richard Eastell, David L. Kopperdahl, Klaus Engelke, Thomas Fuerst, Hoi-Shen Radcliffe, Cesar Libanati

Faculty of Health Sciences Publications

In the randomized, placebo-controlled FREEDOM study of women aged 60 to 90 years with postmenopausal osteoporosis, treatment with denosumab once every 6 months for 36 months significantly reduced hip and new vertebral fracture risk by 40% and 68%, respectively. To gain further insight into this efficacy, we performed a nonlinear finite element analysis (FEA) of hip and spine quantitative computed tomography (QCT) scans to estimate hip and spine strength in a subset of FREEDOM subjects (n = 48 placebo; n = 51 denosumab) at baseline, 12, 24, and 36 months. We found that, compared with baseline, the finite element estimates of hip ...


Health Technology Assessment In Osteoporosis, Mickaël Hiligsmann, John A. Kanis, Juliet Compston, Cyrus Cooper, Bruno Flamion, Pierre Bergmann, Jean-Jaques Body, Steven Boonen, Olivier Bruyère, Jean-Pierre Devogelaer, Stefan Goemaere, Jean-Marc Kaufman, Serge Rozenberg, Jean-Yves Reginster Jan 2013

Health Technology Assessment In Osteoporosis, Mickaël Hiligsmann, John A. Kanis, Juliet Compston, Cyrus Cooper, Bruno Flamion, Pierre Bergmann, Jean-Jaques Body, Steven Boonen, Olivier Bruyère, Jean-Pierre Devogelaer, Stefan Goemaere, Jean-Marc Kaufman, Serge Rozenberg, Jean-Yves Reginster

Faculty of Health Sciences Publications

We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of ...


Scope: A Scorecard For Osteoporosis In Europe, John A. Kanis, F. Borgström, Juliet E. Compston, K. Dreinhöfer, E. Nolte, L. Jonsson, Willem F. Le, Eugene Mccloskey, R. Rizzoli, J. Stenmark Jan 2013

Scope: A Scorecard For Osteoporosis In Europe, John A. Kanis, F. Borgström, Juliet E. Compston, K. Dreinhöfer, E. Nolte, L. Jonsson, Willem F. Le, Eugene Mccloskey, R. Rizzoli, J. Stenmark

Faculty of Health Sciences Publications

The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe.


Osteo-Cise: Strong Bones For Life: Protocol For A Community-Based Randomised Controlled Trial Of A Multi-Modal Exercise And Osteoporosis Education Program For Older Adults At Risk Of Falls And Fractures, Jenny Gianoudis, Christine A. Bailey, Kerrie M. Sanders, Caryl A. Nowson, Keith Hill, Peter R. Ebeling, Robin M. Daly Jan 2012

Osteo-Cise: Strong Bones For Life: Protocol For A Community-Based Randomised Controlled Trial Of A Multi-Modal Exercise And Osteoporosis Education Program For Older Adults At Risk Of Falls And Fractures, Jenny Gianoudis, Christine A. Bailey, Kerrie M. Sanders, Caryl A. Nowson, Keith Hill, Peter R. Ebeling, Robin M. Daly

Faculty of Health Sciences Publications

Background: Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition.