scholarly journals Plenary Lecture: Strategies for skeletal health in the elderly

2002 ◽  
Vol 61 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Richard Eastell ◽  
Helen Lambert
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mass ◽  
Bone Mineral ◽  
Peak Bone Mass ◽  
The Elderly ◽  
Mineral Density ◽  
Skeletal Health ◽  
Nutritional Factors ◽  
Age Related

Osteoporosis is a common disease in the elderly, and the fractures that result from this disorder affect 40 % of women and 14 % of men over the age of 50 years. The risk of fracture relates to bone mineral density and the risk of falling, among other factors. Low bone mineral density in the elderly can result from either low peak bone mass or accelerated bone loss, or a combination of the two. Nutritional factors play a role in both the attainment of peak bone mass and in the rate of age-related bone loss. The main determinants of peak bone mass are genetic factors, early-life nutrition, diet and exercise. Of the nutritional factors Ca, and particularly milk, are the most important contributors to peak bone mass. Some of these factors may interact; for example, a low dietary Ca in addition to an unfavourable vitamin D receptor gene polymorphism may result in low peak bone mass. The age-related changes in bone mass may also have a genetic basis, but deficiency of oestrogen is a major contributor. In addition, undernutrition is common in the elderly, and lack of dietary protein contributes both to impaired bone mineral conservation and increased propensity to fall. There is a decreased ability of the intestine to adapt to a low-Ca diet with increasing age. Other dietary factors include vitamin K, Zn and fruit and vegetables. Adequate nutritional status, particularly of Ca and vitamin D, is essential for the successful pharmaceutical treatment of osteoporosis. Thus, strategies for enhancing skeletal health in the elderly must begin in early childhood, and continue throughout life.

scholarly journals Nutritional factors associated with femoral neck bone mineral density in children and adolescents

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Guo-Hau Gou ◽  
Feng-Jen Tseng ◽  
Sheng-Hao Wang ◽  
Pao-Ju Chen ◽  
Jia-Fwu Shyu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Femoral Neck ◽  
Children And Adolescents ◽  
Bone Mineral ◽  
Age Group ◽  
Mineral Density ◽  
Nutrient Intakes ◽  
Nutritional Factors ◽  
Daily Total

Abstract Background Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents. Methods Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD. Results Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 ×  10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification. Conclusion The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.

scholarly journals Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia

2018 ◽  
Vol 18 (2) ◽  
pp. 206-210 ◽  
Author(s):  
Mehmet Dagli ◽  
Ali Kutlucan ◽  
Sedat Abusoglu ◽  
Abdulkadir Basturk ◽  
Mehmet Sozen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Formation ◽  
Bone Mass ◽  
Bone Mineral ◽  
Type I ◽  
Healthy Controls ◽  
Mineral Density ◽  
Lymphocyte Ratio ◽  
Significant Difference

A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.

scholarly journals O13 Pregnancy vitamin D supplementation leads to greater offspring bone mineral density at 4 years: the MAVIDOS randomised placebo controlled trial

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Elizabeth M Curtis ◽  
Rebecca J Moon ◽  
Stefania D'Angelo ◽  
Sarah R Crozier ◽  
Nicholas J Bishop ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mass ◽  
Bone Mineral ◽  
Controlled Trial ◽  
Vitamin D Supplementation ◽  
Whole Body ◽  
Mineral Density ◽  
Double Blind ◽  
Randomised Controlled

Abstract Background Observational studies have demonstrated associations between maternal gestational vitamin D status and offspring bone health. We have recently shown, in a randomised controlled trial, that pregnancy vitamin D supplementation leads to improved offspring bone mass at birth amongst winter deliveries (when background 25(OH)-vitamin D levels are lowest). In the present analysis, we aimed to evaluate whether the beneficial effect of pregnancy vitamin D supplementation on neonatal bone mass is sustained into early childhood, with bone indices assessed at age 4 years in a subset of participants of the MAVIDOS trial. Methods Pregnant women were randomised in Southampton, Oxford and Sheffield, in a double-blind design, to 1000 IU/day cholecalciferol or matched placebo from 14 weeks’ gestation to birth. At 4 years of age (Southampton participants only, n = 723 births), offspring assessments included anthropometry, whole-body dual-energy x-ray absorptiometry (DXA) [Hologic Horizon, yielding whole body less head (WBLH) bone mineral content (BMC), bone mineral density (BMD), bone area (BA) and lean mass (LM)], and a maternal questionnaire. Linear regression was used to estimate the mean difference (represented by β) in outcomes between the two randomisation arms, adjusted for sex and age at DXA. Further models were additionally adjusted for gestational age, maternal BMI, and child’s sedentary time. All outcomes were standardised to a standard deviation scale, for ease of comparison. Full ethics and MHRA approvals were granted. Results 564 children attended the 4-year visit; 452 had a useable DXA with minimal movement artefact. Maternal pregnancy vitamin D supplementation led to greater offspring indices of bone mass compared with placebo, irrespective of season. For example, WBLH BMD at age 4 years was greater in the offspring of supplemented mothers [β = 0.18 SD (95%CI: 0.00, 0.35), p = 0.047]; there was also evidence of greater LM in the intervention group [β = 0.15 SD (95%CI: -0.02, 0.31), p = 0.081]. In fully adjusted models associations were consistent for lumbar spine indices and for BA and BMC. In keeping with the offspring findings, maternal vitamin D supplementation led to significantly higher maternal plasma 25(OH)D concentrations in late pregnancy (34 weeks’ gestation): placebo group (median(IQR)): 42.4 nmol/l (23.3, 56.4); vitamin D group: 67.4 nmol/l (56.2, 80.3); p &lt; 0.001. Conclusion This is the first ever demonstration in a large placebo-controlled, double-blind randomised controlled trial that maternal pregnancy vitamin D supplementation leads to improved bone and lean mass in children. Our findings suggest that maternal cholecalciferol supplementation may have lasting benefits for offspring musculoskeletal health and thus represent an important public health message. This work was supported by grants from Versus Arthritis 17702, Medical Research Council (MRC #405050259; #U105960371), Bupa Foundation, NIHR Southampton Biomedical Research Centre (BRC), University of Southampton, and NIHR Oxford BRC, University of Oxford. EC was supported by the Wellcome Trust (#201268/Z/16/Z). Disclosures E.M. Curtis None. R.J. Moon None. S. D'Angelo None. S.R. Crozier None. N.J. Bishop None. S. Gopal- Kothandapani None. S. Kennedy None. A.T. Papageorghiou None. R. Fraser None. S.V. Gandhi None. I. Schoenmakers None. A. Prentice None. H.M. Inskip None. K.M. Godfrey None. K. Javaid None. R. Eastell None. C. Cooper None. N.C. Harvey None.

scholarly journals The contribution of the endocrine system to the development of osteoporosis in the elderly and senile (review)

2021 ◽  
Vol 7 (3) ◽  
pp. 308-321
Author(s):  
Svetlana V. Bulgakova ◽  
◽  
Dmitriy P. Kurmaev ◽  
Marina V. Silyutina ◽  
Elena A. Voronina ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Loss ◽  
Bone Mineral ◽  
Endocrine System ◽  
The Elderly ◽  
Published Data ◽  
Social Significance ◽  
Mineral Density ◽  
Stimulating Hormone

Osteoporosis is increasingly found in the elderly and senile, maintaining its enormous medical and social significance. The effect of hormones on bone metabolism is beyond doubt. However, currently the data on the effect of sex hormones on bone tissue prevails. As for the other hormones, sometimes, there are conflicting opinions. The aim of the study: Based on published data, to study the contribution of the endocrine system to the development of osteoporosis in the elderly. Materials and methods: Literature data was analyzed using the following search words: osteoporosis, bone mineral density, FSH, estrogens, testosterone, cortisol, vitamin D, IGF1 for 1998-2020 in computer databases PubMed, Scopus, Medical- Science, Elibrary, Web of Science, Ceeol. Results: Analysis of the literature showed that the increase of levels of thyroid stimulating hormone (TSH) plays an osteoprotective role; the decrease of levels of estrogen, testosterone, insulin-like growth factor 1 (IGF1) and vitamin D, as well as the increase in the levels of cortisol, parathyroid hormone and follicle-stimulating hormone (FSH) contribute to bone loss in the elderly and senile. In addition, the FSH receptor (FSHR) genotype AA rs6166 is associated with low bone mineral density, regardless of estrogen level. A polyclonal antibody with an FSHR-binding sequence against mouse β-subunit of FSH is likely to be an effective tool for reducing bone loss in mice subjected to ovariectomy. Conclusion: A comprehensive assessment of the hormonal profile in the elderly and senile is needed to identify the causes of osteoporosis and the formation of an individual program of medical diagnostic and rehabilitation measures. Currently, there are all prerequisites for the development of new diagnostic and therapeutic interventions for the correction of low bone density.

scholarly journals Diagnosed Changes of Bone Mineral Density and Level of Calciotropic Hormones in Juvenile Hyperthyroidism

2021 ◽  
Author(s):  
Shakhlo Muratova
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mass ◽  
Children And Adolescents ◽  
Bone Mineral ◽  
Control Group ◽  
Childhood And Adolescence ◽  
Healthy Children ◽  
Mineral Density ◽  
Calciotropic Hormones

Abstract In childhood and adolescence, a genetically determined bone mass accumulates, which ensures the strength of the skeleton throughout life. But with thyrotoxicosis, a separation of the processes of bone resorption and synthesis and the formation of sites of osteoporosis and osteosclerosis occur, leading to the loss of 10% of bone mass in 1 cycle of remodeling. Because of the lack of information about this phenomenon, our work aimed to study the state of bone mineral density and levels of calciotropic hormones in children and adolescents with thyrotoxicosis. The study was conducted by 19 children and adolescents with thyrotoxicosis. The control group consisted of 23 healthy children and adolescents. All studies were conducted in the RSSPMCE. Thyroid status, PTH and vitamin D were determined using a closed-type immunochemistry analyser Cobas e 411 Hitachi company HoffmanLeRoche (Switzerland) and its reagents. Bone mineral density was evaluated by dual-energy absorptiometry on a Stratos X-ray densitometer from DMS, France. The results of the study showed that the average value of the level of vitamin D in the group with thyrotoxicosis was 12.3 ± 1.1 ng/ml, against 20.4 ± 6.2 ng/ml of the control group, while its deficiency was diagnosed in 84.2%, and its insufficiency - in 15.8% of pediatric patients. In the group with thyrotoxicosis, the average level of PTH was lower and amounted to 45.1 ± 23.9 ng/ml (p < 0.05) compared with the control (49.2 ± 21.3 ng/ml); hypoparathyroidism was found in 4.9 times more often than among healthy children, and 21.1% showed an increase in the level of PTH. In children and adolescents with thyrotoxicosis Z- index of the femoral neck, lumbar vertebrae and the general body were significantly lower than in the control group. 36.8% of children with thyrotoxicosis have osteoporosis. Conclusion: Thyrotoxicosis in children and adolescents causes a decrease in BMD and majorly increases the development of osteoporosis.

Hip fractures and bone mineral density of the elderly: importance of serum 25-hydroxy vitamin D

2013 ◽  
Author(s):  
Laufey Steingrimsdottir ◽  
Thorhallur Halldorsson ◽  
Kristin Siggeirsdottir ◽  
Mary Frances Cotch ◽  
Gudny Eiriksdottir ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Hip Fractures ◽  
The Elderly ◽  
Mineral Density ◽  
25 Hydroxy Vitamin D

scholarly journals Influence of Age at Menarche on Forearm Bone Microstructure in Healthy Young Women

2008 ◽  
Vol 93 (7) ◽  
pp. 2594-2601 ◽  
Author(s):  
Thierry Chevalley ◽  
Jean-Philippe Bonjour ◽  
Serge Ferrari ◽  
Rene Rizzoli
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Bone Mass ◽  
Bone Mineral ◽  
Peak Bone Mass ◽  
Adult Women ◽  
Mineral Density ◽  
T Score ◽  
Estrogen Exposure ◽  
Volumetric Bmd

Abstract Background: Shorter estrogen exposure from puberty onset to peak bone mass attainment may explain how late menarche is a risk factor for osteoporosis. The influence of menarcheal age (MENA) on peak bone mass, cortical, and trabecular microstructure was studied in 124 healthy women aged 20.4 ± 0.6 (sd) yr. Methods: At distal radius, areal bone mineral density (aBMD) was measured by dual-energy x-ray absorptiometry, and volumetric bone mineral density (BMD) and microstructure were measured by high-resolution peripheral computerized tomography, including: total, cortical, and trabecular volumetric BMD and fraction; trabecular number, thickness, and spacing; cortical thickness (CTh); and cross-sectional area (CSA). Results: Median MENA was 12.9 yr. Mean aBMD T score of the whole cohort was slightly positive. aBMD was inversely correlated to MENA for total radius (R = −0.21; P = 0.018), diaphysis (R = −0.18; P = 0.043), and metaphysis (R = −0.19; P = 0.031). Subjects with MENA more than the median [LATER: 14.0 ± 0.7 (±sd) yr] had lower aBMD than those with MENA less than the median (EARLIER: 12.1 ± 0.7 yr) in total radius (P = 0.026), diaphysis (P = 0.042), and metaphysis (P = 0.046). LATER vs. EARLIER displayed lower total volumetric BMD (315 ± 54 vs. 341 ± 56 mg HA/cm3; P = 0.010), cortical volumetric BMD (874 ± 49 vs. 901 ± 44 mg HA/cm3; P = 0.003), and CTh (774 ± 170 vs. 849 ± 191 μm; P = 0.023). CTh was inversely related to CSA (R = −0.46; P &lt; 0.001). In LATER reduced CTh was associated with 5% increased CSA. Conclusions: In healthy young adult women, a 1.9-yr difference in mean MENA was associated with lower radial aBMD T score, lower CTh without reduced CSA, a finding compatible with less endocortical accrual. It may explain how late menarche is a risk factor for forearm osteoporosis.

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