Bone mass density

Bone mass density (T-score, hip, spine), N-telopeptide serum calcium (adjusted forhypoalbuminemia), phosphorus, magnesium, renal function, liverfunction, serum electrolytes, signs and symptoms of toxicity (i.e., esophageal irritation)... 

In contrast, in a longitudinal study of 32 patients with juvenile rheumatoid arthritis, there was no evidence of deleterious effects of long-term, low-dose methotrexate on bone mass density (88). The cumulative dose of glucocorticoids, weight, and height were the main determinants of bone mass changes. 

Epidemiological studies (Aldercreutz et al., 1991 Aldercreutz, 1998) indicate that consumption of tofu and other soy foods may be associated with the low incidence of breast cancer in Japanese women. This discovery has led numerous researchers in recent years to search for the biochemical components in soybean that are responsible for the cancer risk-lowering effect. Aside from the potential cancer prevention effect (Wu et al., 1996 Cline and Hughes, 1998 Griffiths et al., 1998 Messina and Bennink, 1998 Stephens, 1999), isoflavones also have been found to have other potential health benefits, including heart disease prevention (Anthony et al., 1998), bone mass density increase to prevent osteoporosis (Anderson and Camer, 1997) and the reduction of postmenopausal syndromes in women (Knight et al., 1996). 

Once the bone mineral density report is available, T-scores and Z-scores are useful tools in interpreting the data. The T-score is the number of standard deviations from the mean bone mineral density in healthy young white women. Osteoporosis is defined as a T-score at least -2.5 standard deviations below the mean (Table 53-3). Osteopenia, or low bone mass that eventually may lead to osteoporosis, is defined as a T-score between -2.5 and -1.0 standard deviations below the mean. The International Society for Clinical Densitometry recommends use of the WHO definition and T-scores for diagnosis of osteoporosis in postmenopausal women and men... 

Bantu women and 800-900 mg/d among the white women. In the United States, Marsh, et al. (J7) reported significant differences in bone mass in age and height-matched lacto-ovo vegetarian Seventh Day Adventist women compared with omnivores. This was true in the women over 60 years of age premenopausal S.D.A. women had bone densities which were similar to those of white omnivorous women. 

Bone mineral density (BMD) measured using dual x-ray absorptiometry (DEXA) is the current standard method by which to assess BMD in children and adolescents (Loud and Gordon, 2006). It has some limitations in that it only measures bone in two dimensions (g/cm ) and by utilizing the projected area for areal measurements does not account for bone volume or distance of the subject from the beam [i.e., surrounding tissue mass and (re)positioning]. Moreover, the continuous changes in... 

Slemenda, C. W., Peacock, M., Hui, S., Zhou, L., and Johnston, C. C. (1997). Reduced rates of skeletal remodeling are associated with increased bone mineral density during the development of peak skeletal mass. ]BMR 12, 676-682. 

Osteoporosis is a metabolic bone disease characterized by low bone mass and micro-architectural deterioration of bone tissue. This will lead to bone fragility and consequent increase in bone fracture risk. Mean bone mineral density (BMD) is measured with dual X-ray absorptiometry (DEXA) and expressed in Tsc (Tscore). WHO standards are a Tsc that is 1 standard deviation (SD) below mean BMD is graded as normal bone, Tsc between 1 and 1.5 SD below mean BMD is graded as osteopenia and a Tsc of more than 2.5 SD below mean BMD is graded as osteoporosis. When the Tsc is below 1.5 SD mean BMD prevention of osteoporosis must be initiated. Primary osteoporosis is caused mainly by hormone deflciency in both women and men. Secondary osteoporosis may result from endocrine, metabolic, nutritional and autoimmune causes or from immobility because of trauma. Also the use of medicaments such as corticosteroids may be contributing. 

She should be encouraged to take calcium and vitamin D supplementation immediately. She should be scheduled for baseline determination of her bone density so that any evidence of loss of bone mass can be ascertained. 

Clinical trials have been reported, and these are not subject to the same levels of uncertainty. They have concentrated on bone mineral density, because this parameter is an acceptable measure of bone mass, is sensitive to the occurrence of osteoporosis and correlates well with the likelihood of bone fracture in patients affected by osteoporosis. Bone mineral density is known to increase in childhood and adolescence, to reach a maximum around the age of 40, then to decline [110,111]. In women in the years immediately following the menopause, it may sharply reduce, and if it reaches a level TA standard deviations below the young adult mean value, the condition is defined by the WHO as osteoporosis [110,111]. 

Shown to preserve bone mass, increase bone mineral density, and reduce fracture rate relative to calcium alone... 

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