What Is Osteoporosis?

Osteoporosis is a pathological condition that affects whole of skeleton and is characterized by a low bone mass in combination with microarchitectural changes particularly in cancellous bone.

Both the factors make the bones fragile.

In a normal skeleton, bone remodeling is a quite a regulated procedure where bone resorption is coupled with bone formation.

Osteoporosis can be viewed as an imbalance of remodeling where bone loss is higher as compared to bone formation.

Two factors determine the bone mass [Bone mineral density] in later life are [Read more...]

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Use of Bisphosphonates In Osteoporosis Associated With Higher Risk Of Subtrochanteric or Femoral Shaft Fractures

Osteoporosis as a disease is associated with significant morbidity and mortality. The studies done in the past have suggested that bisphosphonate use is associated with reduction of hip and other fractures that occur as a result of osteoprosis.

But a new study has found that women who take bisphosphonates for  five or more years have a high risk of getting a fracture in subtrochanteric or shaft of femur.

The study has been done by Laura Y. Park-Wyllie and colleagues and has been published in JAMA [Journal of American Medical Association] [Read more...]

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Nutrient Rich Diet May Reduce Risk Of Low Trauma Fracture

A diet containing dense quantities of nutrients [High in vegetables, fruit and whole grains] may reduce the risk for low-trauma fracture, especially in older women. This has been suggested by the  results of a retrospective cohort study reported online November 10 in the American Journal of Clinical Nutrition.

The study composed of randomly selected, population-based cohort enrolled in the Canadian Multicentre Osteoporosis Study, the investigators aimed to determine the association between dietary patterns and incident fracture and to evaluate whether body mass index (BMI), BMD, or falls affected this relationship.

In second year of the study (1997-1999), they used self-administered food frequency questionnaires to evaluate dietary patterns.

The main study endpoint was low-trauma fracture occurring before the 10th annual follow-up in 2005 to 2007.

Two dietary patterns were observed

  • Nutrient dense, which emphasized intake of fruit, vegetables, and whole grains
  • Energy dense, which had higher intake of soft drinks, potato chips, French fries, meats, and desserts.

Nutrient Dense Pattern was associated with lower rate of fractures occuring as a result of low trauma. These associations were independent of BMI, BMD, falls, and demographic factors.

No associations with fracture were identified for the energy-dense pattern.

Limitations of this study acknowledged by the study authors include

  • Lack of assessment of possible intermediate factors such as weight or BMD change
  • Limited scope and specified portion size of the food frequency questionnaire
  • Underrepresentation of ethnic minorities
  • Possible residual confounding.

The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research, Merck-Frosst Canada Ltd, Eli Lilly Canada Inc, Novartis Pharmaceuticals Inc, The Alliance for Better Bone Health, Sanofi-Aventis, Procter & Gamble Pharmaceuticals Canada Inc, The Dairy Farmers of Canada, and The Arthritis Society.

Am J Clin Nutr. Published online November 10, 2010.

Note:

It is time to drop that cola and throw those chips. Healthy eating habits can be cutivated and go long way in protecting our body from the sickness. The new study in fact emphasizes the importance of fruits, vegetables and wholegrains.

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Bisphosphonate Therapy Does Not Require Bone Mineral Density Monitoring Up to 3 Years After Starting

In a recent online publication dated June 24th, a study has quoted in British Medical Journal that monitoring bone mineral density  in postmenopausal women in the first 3 years after starting treatment with a potent bisphosphonate is not needed and may even be misleading. Bisphosphnates are very commonly prescribed for postmenopausal osteoporosis.

It is further reported that there is a difference in guidelines for treatment of postmenopausal osteoporosis. The US National Osteoporosis Foundation and the American Association of Clinical Endocrinologists recommend routine monitoring of bone mineral density within two years of starting treatment. The UK guidelines recommend that further research is needed and the North American guidelines recommend that treatment should not be stopped or changed because of a modest observed loss in density. [Read more...]

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Oral Bisphosphonates May Cause Esophageal Cancer

N Engl J Med. 2009;1360:89-90

There have been reports of esophageal cancer in patients who had been taking oral bisphosphonate drugs for osteoporosis. This has been reported by an official from the Food and Drug Administration (FDA) in the January 1 issue of the New England Journal of Medicine.

Twenty-three cases including 8 fatal reported in the United States, between October 1995 May 2008, all of them in association with alendronate. Fosamax, a popular band from Merck contains alendronate. [Read more...]

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Vertebroplasty Provides Significant Pain Relief In Osteoporotic Fractures

In osteoporosis patients with spinal fractures, vertebroplasty provides significant pain relief and helps decrease disability, according to a new study.

Vertebroplasty is a procedure that involves injection of medical-grade bone cement into a fractured vertebra to shore up the fracture and provide pain relief. It’s used to treat painful vertebral compression fractures that don’t respond to conventional medical therapy with analgesics or narcotics. [Read more...]

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Study Indicates Teriparatide As Useful Drug In Osteoporosis Treatment

Teriparatide, a drug that contains a synthetic form of a natural human hormone call parathyroid hormone, is a useful treatment for the bone-thinning disease osteoporosis even in patients who have already been treated with “bisphosphonate” drugs, such as Allendronate or zoledronate, new research shows.

Bisphosphonate drugs strengthen bones by blocking the body’s cells that break down bone. Teriparatide, works by enhancing the activity of cells that build bone.

Teriparatide may be prescribed as a second-line treatment for severe osteoporosis, but the effect of prior bisphosphonate therapy on the response to the drug is unclear, according to the report in the Journal of Clinical Endocrinology and Metabolism. [Read more...]

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Variants In LRP5 Gene Affect Bone Density-Linked With Osteoporosis

Common variants in a gene called LRP5 affect bone density and the risk of developing osteoporosis, according to a new study.

However, the impact of these variants on risk is modest. [Read more...]

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Fractures Common After Osteoporosis Therapy Fails

Women who fail to respond to, or stop taking, their medication to fight the bone-thinning condition osteoporosis are at high risk of suffering a bone fracture, a new study suggests.

British researchers found that among nearly 2,000 older women with an “inadequate response” to osteoporosis medication, 9 percent suffered a fracture over the next year. [Read more...]

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