Vitamin D insufficiency is a major cause of postmenopausal osteoporosis worldwide
Poor vitamin D status is common in the elderly and is associated with bone loss and fractures. The aim of this study [1] was to assess worldwide vitamin D status in postmenopausal women with osteoporosis according to latitude and economic status, in relation to parathyroid function, bone turnover markers, and BMD. The study was performed in 7441 postmenopausal women from 29 countries participating in a clinical trial, with BMD T-score at the femoral neck or lumbar spine < -2.5 or one to five mild or moderate vertebral fractures. Serum 25(OH)D, PTH, alkaline phosphatase (ALP), bone turnover markers osteocalcin (OC) and C-terminal cross-linked telopeptides of type I collagen (CTX), and BMD of the lumbar spine, total hip, femoral neck, and trochanter were measured.
Bcl-xL inhibits the bone-resorbing activity of osteoclasts
The B cell lymphoma 2 (Bcl-2) family member Bcl-xL has a well-characterized antiapoptotic function in lymphoid cells. However, its functions in other cells - including osteoclasts, which are of hematopoietic origin - and other cellular processes remain unknown. The authors of a recent study [1] report an unexpected function of Bcl-xL in attenuating the bone-resorbing activity of osteoclasts in mice. To investigate the role of Bcl-xL in osteoclasts, they generated mice with osteoclast-specific conditional deletion of Bcl-x.
Childhood fractures do not predict future fractures
Childhood fractures are common. Their clinical relevance to osteoporosis and fractures in later life is unclear. The aim of this study [1] was to determine the predictive risk of childhood fracture on the risk of fracture in later life. Men and women >50 y of age were recruited from population registers for participation in the European Prospective Osteoporosis Study (EPOS). Subjects completed an interviewer-administered questionnaire that included questions about previous fractures and the age at which the first of these fractures occurred. Lateral spine radiographs were performed to ascertain prevalent vertebral deformities. Subjects were followed prospectively by postal questionnaire to determine the occurrence of clinical fractures. A subsample of subjects had BMD measurements performed. A cox proportional hazards model was used to determine the predictive risk of childhood fracture between the ages of 8 and 18 y on the risk of future limb fracture and logistic regression was used to determine the association between reported childhood fractures and prevalent vertebral deformity.
Hip fracture incidence in relation to age, menopausal status, and age at menopause
Bone mineral density is known to decrease rapidly after the menopause. There is limited evidence about the separate contributions of a woman’s age, menopausal status and age at menopause to the incidence of hip fracture. Over one million middle-aged women joined the UK Million Women Study in 1996–2001 providing information on their menopausal status, age at menopause, and other factors, which was updated, where possible, 3 y later. All women were registered with the UK National Health Service (NHS) and were routinely linked to information on cause-specific admissions to NHS hospitals. 561,609 women who had never used hormone replacement therapy and who provided complete information on menopausal variables (at baseline 25% were pre/perimenopausal and 75% postmenopausal) were followed up for a total of 3.4 million woman-years (an average 6.2 y per woman).
 Download here the slide set presented by Prof. Friedlander, on Thursday, November 10th. |
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