Femoral bone density

A 2-year randomized controlled study in 90 women compared the effects of oral tibolone doses of 1.25 mg/day and 2.5 mg/day on bone loss in the early postmenopausal period all took calcium 1000 mg/day. Vertebral and femoral bone density rose in both treated groups but fell in the control group, and bone turnover markers (urinary excretion of hydroxyproline/creatinine and plasma osteocalcin concentrations) were similarly affected favorably in the treated groups, as was the incidence of hot flushes/ flashes (5). Studies such as this still leave open the question of the advisability of continuing tibolone treatment over a longer period. While tibolone has indeed been shown to benefit mineral bone density, few data are available to show whether it lowers fracture incidence nor is it clear whether there is a link between tibolone and breast cancer (6). 

Deroisy R, Collette J, ChevaUier T, BreuU V, Reginster JY. Effects of two 1-year calcium and vitamin D3 treatments on bone remodehng markers and femoral bone density in elderly women. Curr Ther Res Clin Exp 1998 59 850-62. 

Looker AC, OrwollES, Johnston CC Jr., et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 1997 12 1761-1768. 

Antioxidants in fruits and vegetables including vitamin C and (3-carotene reduce oxidative stress on bone mineral density, in addition to the potential role of some nutrients such as vitamin C and vitamin K that can promote bone cell and structural formation (Lanham-New 2006). Many fruits and vegetables are rich in potassium citrate and generate basic metabolites to help buffer acids and thereby may offset the need for bone dissolution and potentially preserve bone. Potassium intake was significantly and linearly associated with markers of bone turnover and femoral bone mineral density (Macdonald and others 2005). 

Daily doses studied have ranged from 9 to 22.6 mg of fluoride over time periods of 1-4 years [98]. These trials were particularly concerned with the use of slow-release NaF [112,113] or sodium monofluorophosphate preparations [114,115], and they generally led to reductions in the incidence of bone fracture, as shown in Table 3. In addition, they typically caused increased bone density at the neck of the femur, the femoral condyle and the lower spine [98] (Table 3). 

Salmon calcitonin nasal spray prevented bone loss in the lumbar spine of 31 patients treated with prednisone for polymyalgia rheumatica (SEDA-22, 448) (9). They were randomized to salmon calcitonin nasal spray 200 IU/day or matched placebo for 1 year. Both groups were treated with calcium supplements if their dietary intake was below 800 mg/day. With calcitonin the mean bone mineral density in the lumbar spine fell by 1.3% and with placebo by 5% after 1 year. There were no differences in the hip, including the femoral neck and trochanter, or in total body bone density. 

Judge JO, Kleppinger A, Kenny A, et al. Home-based resistance training improves femoral bone mineral density in women on hormone therapy. Osteoporos Int. 2005 16 1096-1108. 

Adequate calcium nutrition during childhood and adolescence is thought to bean important deterrent to osteoporosis in later life. A one-year study of 149 girls (8 years old) revealed the effects of consuming a typical diet (900 mg Ca/day) or a diet supplemented with an additional 850 mg Ca/day Bonjour el al, 1997). The Ca supplement was supplied by specially prepared biscuits, juices, and candy bars (rather thar pills) to assure compliance. To view some of the data, the density at the femoral diaphysis increased by 5% (unsupplemented) and by 6% (plus calcium) during the 1-ycar period. The density at the lumbar spine increased by 4% (unsupplemented) and by 4% (plus calcium). The data dernonstrated a dear and definite increase in bone density at some sites, but not at others. This study, as well as others Johnston et al., 1992), tend to show that caicium supplements to children can benefit bones of the appendicular skeleton, but not the axial skeleton. The appendicular skeleton includes the pelvis, arm bones, and leg bones. The axial skeleton includes the skull, vertebra, ribs, and sternum. 

Fluoride is a potent stimulator of trabecular bone formation. Sodium monofluorophosphate was given to 48 patients with osteoporosis due to glucocorticoids (more than 10 mg of prednisone equivalents/day). Patients were randomly allocated to 1 g of calcium carbonate (control) or 200 mg of sodium monofluorophosphate plus 1 g of calcium carbonate for 18 months. At the end of the study lumbar spine bone density had increased by 7.8% in the fluoride group versus 3.3% in the controls. There were no changes in femoral neck density (SEDA-20, 376) (222). 

Musculoskeletal In 55 patients with type 2 diabetes, mean age 66 years, who were randomized to pioglitazone 15-30 mg/day or metformin for 12 months, osteocalcin concentrations fell significantly in those taking pioglitazone at 6 months, but were nearly back to baseline concentrations at 12 months [73 ]. There was reduced femoral bone mineral density at 6 months but there was no significant effect at 12 months. The number of subjects in this study was small and sex-spedfic data were not available. 

Femoral neck bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Osteoporos Int 11 714-720... 

All women included in MORE met criteria for osteoporosis defined as a lumbar spine or femoral neck bone mineral density (BMD) T score equal to or less than 2.5 or as the presence of a radiographic vertebral fracture. These women are considered to be at lower risk for breast cancer than women with normal BMD since this parameter could partially reflect a woman s lifetime exposure to estrogens (Zhang et al. 1997). After the start of MORE, NHANES III criteria standardizing total hip BMD measurements became available allowing part of... 

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