Some light on the mystery of calcitonin and bone
The absence of significant changes in bone mineral density caused by decline or overproduction of calcitonin (CT) in humans has raised the question of whether the pharmacological action of CT as an inhibitor of bone resorption is also of physiological relevance.
Impact of genetics on low bone mass in adults
Low bone mass in adults is a major risk factor for low-impact fractures, and is considered to be of complex origin because of interaction of environmental and genetic factors, each with modest effect. The objective of this study [1] was to assess the relative impact of genetics and environment, and quantify the risk in relatives of osteopenic individuals. The authors studied 440 Icelandic nuclear families with 869 first-degree relatives of both sexes. Index cases (male or female) had BMD in the lumbar spine or hip >1.5 SD less than sex-matched controls. Heritability of BMD was estimated by maximum likelihood method, and variance component analysis was used to partition the genetic and environmental effects. Relative risk of low BMD (< −1 SD) in first-degree relatives was estimated, and heritable decrement in BMD was calculated compared with controls.
Low body weight is a major risk factor for low bone mass in healthy 40 to 60 year old women
Bone mineral density (BMD) testing of perimenopausal women is increasing, but may be unnecessary as fracture risk is low. Appropriate assessment among younger women requires identification of risk factors for low BMD specific to this population. The authors of a recent study [1] conducted a systematic literature review of risk factors for low BMD in healthy women aged 40 to 60 years. Articles were retrieved from six databases and reviewed for eligibility and methodological quality. A grade for overall strength of evidence for each risk factor was assigned.
Redesigning care to improve detection and treatment of osteoporosis
The objective of a recent study [1] was to determine whether a process redesign could improve detection and treatment of osteoporosis in at-risk women over the age of 65 through increased BMD testing, and to determine if a shared medical appointment (SMA) improved treatment for high-risk women. Two primary care sites received the redesign intervention and two other sites served as the usual-care controls. At the intervention sites, all women 65 who had not had a DXA scan performed in the prior 2 years were contacted by mail and phone calls. High-risk patients were invited to attend a SMA or follow-up visit with their primary physician.
 Download here the slide set presented by Prof. Friedlander, on Thursday, November 10th. |
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