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.
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).
Fall prevention with supplemental and active forms of Vitamin D
The objective of this study [1] was to test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals. This meta-analysis was performed by searching Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol)) or an active form of vitamin D (1α-hydroxyvitamin D3 or 1,25-dihydroxyvitamin D3) and with sufficiently specified fall assessment were considered for inclusion.
Increased bone resorption is associated with increased risk of cardiovascular events in men: the MINOS study
Better assessment of the association between cardiovascular disease and osteoporosis in older men may help identify shared etiologies for bone and heart health in this population. The authors of this study [1] assessed the association of BMD and bone turnover markers (BTMs) with risk of cardiovascular events (myocardial infarction or stroke) in 744 men > 50 yr of age.
 Download here the slide set presented by Prof. Friedlander, on Thursday, March 29th. |
