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New therapies for osteoporosis: Zoledronic acid, bazedoxifene, and denosumabEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Intravenous (IV) zoledronic acid, a new once-yearly bisphosphonate therapy, is approved by the US Food and Drug Administration for treatment of postmenopausal osteoporosis, glucocorticoid-induced osteoporosis, and osteoporosis in men. IV zoledronic acid significantly reduced the risk of vertebral, nonvertebral, and hip fractures in postmenopausal women and decreased risk of clinical fracture and clinical vertebral fracture in men and women with hip fracture. Two promising new therapies are in late clinical development. Denosumab is a monoclonal receptor activator of nuclear factor-κB ligand (RANKL)...
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

From relative risk to absolute fracture risk calculation: The FRAX algorithmEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes the steps undertaken in the development of FRAX. Content Type Journal ArticleDOI 10.1007/s11914-009-0013-4Authors Eugene V. McCloskey, University of Sheffield, Sorby Wing, Northern General Hospital World Health Organization Collaborating Centre for Metabolic Bone Diseases Herries Road Sheffield S5 7AU UKHelena JohanssonAnders OdenJohn A. Kanis Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Strontium ranelate: New data on fracture prevention and mechanisms of actionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile that optimizes therapeutic adherence. Strontium ranelate is the first compound to simultaneously decrease bone resorption and stimulate bone formation. Its anti-fracture efficacy at various skeletal sites has been established for as long as 5 years through studies of the highest methodological standards. Increases in bone mineral density observed after 1 year of treatment are predictive of the long-term fracture efficacy, suggesting fo...
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Glucocorticoid-induced osteoporosis: An indication for anabolic therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0018-zAuthors Piet Geusens, University Hasselt Biomedical Research Institute Hasselt Belgium Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Clinical relevance of diagnosing vertebral fractures by vertebral fracture assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Low bone mineral density and the presence of vertebral fractures are independent predictors for future vertebral and non-vertebral fractures. Combining the conventional measurement of bone mineral density of spine and hips with the morphometry of the thoracal and lumbar vertebrae on lateral images using dual energy x-ray absorptiometry scanners, a technique called vertebral fracture assessment, facilitates detection of vertebral fractures in those patients at older age and with clinical risk factors for osteoporosis. Particularly, the finding of one or more vertebral deformities in patients with ost...
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Bone markers in osteoporosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Current biological markers of bone turnover have proven useful in improving fracture risk assessment and monitoring treatment efficacy in postmenopausal osteoporosis. Recent developments in the field of bone markers include 1) identification of new biochemical markers providing additional information on the complex pathways leading to bone fragility; 2) application of novel technologies such as proteomics for the discovery of novel markers; 3) automation and multiplexing for improving analytical performance and convenience; and 4) refinement of the clinical interpretation of markers. Currently, howe...
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Can healthy, older, nonosteoporotic men benefit from calcium supplementation?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0019-yAuthors Chin Lee, 200 Abbott Park Road Department NJ44, Building AP6C-6 Abbott Park IL 60064 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - September 3, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Wnt signaling during fracture repairEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews recent data demonstrating that Wnt pathways are active during fracture repair and that increasing the activities of Wnt pathway components accelerates bone regeneration. Content Type Journal ArticleDOI 10.1007/s11914-009-0012-5Authors Frank J. SecretoLuke H. HoeppnerJennifer J. Westendorf, Mayo Clinic Departments of Orthopedic Surgery and Biochemistry & Molecular Biology 200 First Street SW Rochester MN 55905 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 2 / July, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Assessment of material, structural, and functional properties of the human skeleton by pQCT systemsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Peripheral quantitative computed tomography (pQCT) systems measure bone parameters noninvasively using low radiation doses. This limits image resolution but is practical for the diagnosis and quantitative monitoring of the properties of the peripheral human skeleton. pQCT determines volumetric bone mineral density separately in trabecular and cortical bone. It may combine densitometry determinations with geometric estimates and use strain-stress indexes, and it may be used to analyze muscle variables in some areas, allowing the study of regional fragility. Experimental and clinical ex vivo studies s...
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Mechanisms linking osteoporosis with cardiovascular calcificationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Cardiovascular calcium deposition is associated with osteoporosis through various potential mechanisms involving molecular regulatory factors at the nanoscale level that govern skeletal bone and cardiovascular tissues. In this article, several possible mechanisms linking cardiovascular calcification and osteoporosis are discussed, including aging, tissue-specific responses to chronic inflammation, flow-limiting atherosclerosis of skeletal end arteries causing ischemic abnormalities in metabolism, shared endogenous regulatory factors that affect the two tissues in a reciprocal manner, and changes in ...
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Vitamin D and immune function: Understanding common pathwaysEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Vitamin D, acting through its active metabolite 1,25(OH)2D3, exerts its influence on many physiologic processes in addition to the regulation of calcium and phosphate homeostasis. These processes include the immune system. Both the adaptive and innate immune systems are affected by 1,25(OH)2D3 and its receptor, and the cells involved express not only the vitamin D receptor but also, in most cases, the enzyme CYP27B1, which produces 1,25(OH)2D3. Both the vitamin D receptor and CYP27B1 can be constitutive or induced by the ligands that activate the immune processes in these cells, providing feedback lo...
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The influence of parathyroid hormone on the adult hematopoietic stem cell nicheEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Adult hematopoietic stem cells (HSCs) reside in the bone marrow in stable microenvironments known as the stem cell niche. One key component of the stem cell niche is cells of the osteoblastic lineage. Factors that are known to affect osteoblast activity, such as parathyroid hormone (PTH), have also been shown to affect the HSCs. Treatment of mice with PTH has led to beneficial effects on the HSC pool, which have led to clinical trials of PTH treatment to enhance HSC-based therapies. Content Type Journal ArticleDOI 10.1007/s11914-009-0010-7Authors Narges RashidiGregor B. Adams, University of Sout...
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Thyroid-stimulating hormone, thyroid hormones, and bone lossEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract It has become accepted by virtue of rich anecdotal experience and clinical research that thyrotoxicosis is associated with high-turnover osteoporosis. The bone loss, primarily due to accelerated resorption that is not compensated by a coupled increase in bone formation, has been attributed solely to elevated thyroid hormone levels. Evidence using mice lacking the thyroid hormone receptors α and β establishes a role for thyroid hormones in regulating bone remodeling but does not exclude an independent action of thyroid-stimulating hormone (TSH), levels of which are low in hyperthyroid states, even ...
Source: Current Osteoporosis Reports - July 25, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

B vitamins, homocysteine, and bone disease: Epidemiology and pathophysiologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the connections of homocysteine and B vitamins to measures of bone quality and osteoporotic fracture. Although the literature suggests that these factors may be associated with bone health, most of the epidemiologic studies are observational, limiting conclusions regarding causality. More controlled trials are needed to determine whether treatment with B vitamins would reduce fracture rates among community-dwelling cohorts. Content Type Journal ArticleDOI 10.1007/s11914-007-0026-9Authors Robert R. McLean, Hebrew SeniorLife Institute for Aging Research 1200 Centre Street Boston MA 02131 USAMari...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The RANKL/RANK/OPG pathwayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the roles of the RANKL/RANK/OPG system in bone and other tissues. Content Type Journal ArticleDOI 10.1007/s11914-007-0024-yAuthors Brendan F. Boyce, University of Rochester Medical Center Department of Pathology and Laboratory Medicine 601 Elmwood Avenue Box 626 Rochester NY 14642 USALianping Xing Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / September, 2007 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Cancer-associated bone diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews risk factors and mechanisms associated with cancer-related bone loss and metastases as well as strategies for the detection of bone-related complications of cancer and therapies to treat these complications. This article focuses on the more common cancers with adverse skeletal effects: breast cancer, prostate cancer, and multiple myeloma. Content Type Journal ArticleDOI 10.1007/s11914-007-0027-8Authors Sue A. Brown, University of Virginia Department of Medicine P.O. Box 801420 Charlottesville VA 22908 USATheresa A. Guise Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Web alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s11914-007-0022-0 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / September, 2007 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Osteogenesis imperfecta: Epidemiology and pathophysiologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteogenesis imperfecta (OI) is the most common of the inherited connective tissue disorders that primarily affect bone. However, it is a systemic disorder, as evidenced by the occurrence of ocular complications, dentinogenesis imperfecta, hearing loss, joint laxity, restrictive pulmonary disease, and short stature. The OI classification initially included four phenotypes (I–IV) involving COL1A1 and COL1A2 mutations. Three new phenotypes have been added, of which one, type VII, is the result of mutations of the cartilage-associated protein (CRTAP) gene. Investigation of recessive forms of OI parti...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Pediatric bone density and fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract As children grow, they accumulate bone mineral, which serves as a “bone bank” for the future. Any condition that interferes with normal bone mineral accrual during childhood has the potential to reduce peak bone mass and subsequently increase future risk for fracture. In contrast to adults, for whom dual-energy x-ray absorptiometry (DXA) has become the standard clinical instrument for assessing bone mineral density and criteria have been developed to define osteopenia and osteoporosis, information for children is still limited. Numerous issues confound the interpretation of DXA-derived bone mine...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Etidronate: What is its place in treatment of primary osteoporosis and other demineralizing diseases today?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Bisphosphonate drugs are the major treatment options for primary and secondary osteoporosis and other demineralizing bone diseases. This class of drugs was presaged over a decade ago when etidronate disodium, the “mother compound” for modern-day bisphosphonates, was first used in the treatment of osteoporosis. The cyclic use of etidronate in therapy, which is known mainly to specialists in the field, is not approved in the United States. The drug does, however, have a worldwide reputation as a relatively inexpensive, efficacious, and highly tolerable treatment for osteoporosis. Many studies stil...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Diabetes, fracture, and bone fragilityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Recent studies have added to the evidence that type 1 and type 2 diabetes are associated with increased risk of hip fracture and other fractures. More frequent falls probably account for some of this increased risk, but reduced bone strength may also play a role. Although type 1 diabetes is associated with lower bone density, those with type 2 diabetes usually have elevated bone density. Yet for both types of diabetes, bone appears to be more fragile for a given density. Diabetes can affect bone through multiple pathways—some with contradictory effects—including obesity, insulin levels, hypergly...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Bone biopsy in patients with osteoporosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Although rarely used to diagnose and manage patients with osteoporosis, bone biopsies are performed to establish bone quality, including degree of mineralization and microarchitecture; to assess bone turnover and bone loss mechanisms; and to analyze treatment effects on bone structure and bone turnover. Bone biopsies are also the only method to diagnose mineralization defect or frank osteomalacia. Due to the availability of antiresorptive agents and anabolic drugs, determining bone turnover and bone-loss mechanisms is critical to appropriate treatment regimen selection. Bone biopsies establish the s...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Over-suppression of bone turnover: Does it exist?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Bone-turnover suppression is central to the therapeutic benefit of many interventions used to prevent osteoporotic fractures. There are theoretical concerns that long-term suppression may have adverse effects on bone strength, although at present no direct evidence exists that this happens. Nevertheless, further research is required to establish the optimal duration of treatment with antiresorptive agents. Content Type Journal ArticleDOI 10.1007/s11914-007-0014-0Authors Juliet Compston, Addenbrooke’s Hospital Department of Medicine Box 157 Cambridge CB2 2QQ UK Journal Current Osteoporos...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Anorexia, bulimia, and the athletic triad: Evaluation and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Caloric restriction caused by undernutrition or overexercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin ...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Bone loss in patients with breast or prostate cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Cancers of the breast and prostate are very common in the general population, with breast cancer accounting worldwide for 23% of cancer cases in women and prostate cancer accounting for 12% of cases in men. During the past decade, the survival rates of patients with estrogen-dependent breast cancer and testoster-one-dependent prostate cancer have improved. This improvement has been possible thanks to the introduction of hormone treatments that suppress the synthesis or antagonize the actions of gonadal steroids. However, estrogen and testosterone deficiencies are associated with excessive bone resor...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The role of hormone therapy and calcium plus vitamin D for reduction of bone loss and risk for fractures: Lessons learned from the women’s health initiativeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoporosis, a major public health problem, is characterized by increased risk for fracture. To reduce the morbidity and excess loss of life associated with this common disease, we need to understand the efficacy of treatment strategies for fracture reduction. The Women’s Health Initiative Clinical Trials have extended our understanding of the effect of hormone therapy and calcium plus vitamin D supplements on risk for hip and total fractures. Although estrogen, with or without progestin, significantly decreases fracture risk at all skeletal sites—almost irrespective of underlying risk for oste...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Medication-induced osteoporosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoporosis, a condition of low bone mass and microarchitectural deterioration, results in fractures with minimal trauma. Secondary osteoporosis is defined as bone loss resulting from either specific clinical disorders or medications. Some medications that can induce osteoporosis are discussed. Specifically, this article reviews the pathogenesis of glucocorticoid-induced bone loss and demonstrates the means to successfully manage the condition with a combination of calcium and vitamin D supplementation and, depending on the severity of the bone loss, bisphosphonates or parathyroid hormone. In addit...
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Web alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s11914-007-0015-z Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 4 / December, 2007 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - April 26, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Glucocorticoid-induced osteoporosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews current information on the epidemiology, pathophysiology, and clinical studies that support using bone-active agents to prevent and treat GIO. Content Type Journal ArticleDOI 10.1007/s11914-009-0005-4Authors Stuart L. Silverman, Cedars-Sinai/UCLA and OMC Clinical Research Center 8641 Wilshire Boulevard, Suite 301 Beverly Hills CA 90211 USANancy E. Lane Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 1 / March, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Denosumab: Anti-RANKL antibodyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Denosumab (anti-receptor activator of nuclear factorκB ligand [RANKL] antibody) is a novel agent, a fully human monoclonal antibody that inhibits osteoclastic-medicated bone resorption by binding to osteoblast-produced RANKL. By reducing RANKL binding to the osteoclast receptor RANK, bone resorption and turnover decrease. In phase 2 dose-ranging studies, denosumab had a rapid onset and offset effect. Also, in patients who had received 2 years of denosumab and were discontinued for the third year, rechallenge with denosumab during the fourth year demonstrated a return of responsiveness to denosumab ...
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Bisphosphonates for postmenopausal osteoporosis: Determining duration of treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Doctors who treat patients with osteoporosis are increasingly confronted with the question of how long to continue treatment with bisphosphonates (BPs), which have the unique characteristic of accumulating in the skeleton. Limited available long-term data suggest that such decisions should be made on a case-by-case approach and guided by an individual re-evaluation of clinical fracture risks and bone mineral density, efficacy, and safety issues. In patients who still have a high fracture risk after 5 years of treatment with BPs, continuing treatment could be considered, but stopping BPs could be app...
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Nutritional therapies (including fosteum)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Nutrition is important in promoting bone health and in managing an individual with low bone mass or osteoporosis. In adult women and men, known losses of bone mass and microarchitecture occur, and nutrition can help minimize these losses. In every patient, a healthy diet with adequate protein, fruits, vegetables, calcium, and vitamin D is required to maintain bone health. Recent reports on nutritional remedies for osteoporosis have highlighted the importance of calcium in youth and continued importance in conjunction with vitamin D as the population ages. It is likely that a calcium intake of 1200 m...
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Zoledronic acid reduces recurrent clinical fracture in patients with hip fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0001-8Authors Stuart L. Silverman Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 1 / March, 2009 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Quality health care gaps in osteoporosis: How can patients, providers, and the health system do a better job?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A significant gap exists between evidence-based advances and real-world clinical practice in the diagnosis and prevention of osteoporosis. The goal of osteoporosis care is to prevent fractures and improve health-related quality of life, and ideally lower mortality. Despite recent advances in osteoporosis detection and treatment options, studies suggest underdiagnosis and undertreatment of osteoporosis, even among those who have already sustained fractures. The challenges in translating knowledge into practice are multifaceted, with efforts directed at the patient, provider, and health care system le...
Source: Current Osteoporosis Reports - March 10, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Web alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s11914-007-0001-5 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 2 / June, 2007 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Novel osteoclast signaling mechanismsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoclasts are cells of monocyte/macrophage origin that degrade bone matrix. Receptor activator of NF-κB ligand (RANKL) induces osteoclast differentiation in the presence of macrophage colony-stimulating factor. RANKL activates the tumor necrosis factor receptor-associated factor 6, c-Fos, and calcium signaling pathways, all of which are indispensable for the induction and activation of nuclear factor of activated T cells (NFAT) c1. NFATc1 is the master transcription factor for osteoclast differentiation, which regulates many osteoclast-specific genes. Multiple immunoglobulin-like receptors associ...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Wnt signaling and the regulation of bone massEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Human genetic studies have firmly established a link between bone mass in humans and gain-of-function or loss-of-function mutations in a Wnt coreceptor, low-density lipoprotein receptor-related protein 5 (LRP5), or in the Wnt antagonist sclerostin, and several molecular genetic studies in mice have consistently confirmed the critical importance of the Wnt signaling pathway in skeletal biology and disease. In what may be a novel paradigm, the ubiquitous nature of LRP5/6 and Wnt signaling is counterbalanced by the bone-restricted and regulated expression of Wnt antagonists such as sclerostin and Dickk...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The role of the collagen matrix in skeletal fragilityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The collagen network in bone provides resistance against fracture and may be susceptible to changes with aging and disease. This review identifies the changes in quality of collagen matrix as contributors to bone fragility. With aging and in diabetes, cross-links accumulate in bone collagen as a result of nonenzymatic glycation and consequently impair matrix properties, increasing bone fragility. Cell-culture and animal studies suggest that the accumulation of cross-links induced by nonenzymatic glycation may be related to a reduction in bone turnover resulting from the altered responses of osteobla...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Effects of microarchitecture on bone strengthEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Bone strength and stiffness depend strongly on bone mass, but they also depend on the microarchitecture and tissue quality of both cancellous and cortical bone. All these aspects differ between individuals and between anatomic sites. This review discusses ways to characterize the three-dimensional cancellous architecture as well as changes in architecture and bone composition caused by bone remodeling. The methods used range from detailed descriptions of sizes and distances in cancellous bone to coarser texture analysis methods using clinical data. As the resolution of clinical images increases, it ...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The biology of osteocytesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteocytes, the most abundant cell type in bone, remain the least characterized. Several theories have been proposed regarding their function, including osteolysis, sensing the strains produced in response to mechanical loading of bones, and producing signals that affect the function of osteoblasts and osteoclasts and hence, bone turnover. This review also discusses the role of osteocyte apoptosis in targeted bone remodeling and proposes that the occurrence of osteocyte apoptosis is consistent with the description of apoptosis as an essential homeostatic mechanism for the healthy maintenance of tiss...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Extending DXA beyond bone mineral density: Understanding hip structure analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the factors that govern the strength of an object, how they are used in engineering simulations, and how those properties can be extracted from DXA data. It is important to recognize that that although DXA scanners can be used to measure geometric strength, they were not designed to do so. The current HSA method is fundamentally limited to evaluating bending strength in the plane of the image, so precision is sensitive to consistent femur positioning. The positioning issue and other limitations of the HSA method are discussed, as well as the critical importance of body-size scaling when interpreti...
Source: Current Osteoporosis Reports - February 11, 2009 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Paget’s disease: Epidemiology and pathophysiologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Paget’s disease of bone is a focal disorder of aging bone. The classic late-onset Paget’s disease is often caused by a P392L mutation in the gene SQSTM1, which disturbs signaling pathways in osteoclasts on cell activation. This prevalent mutation is neither necessary nor sufficient to cause Paget’s disease. Its identification, along with the elucidation of other mutations underlying early-onset Paget’s and Paget’s disease seen in association with inclusion body myopathy and frontotemporal dementia, have redefined our understanding of genetic disorders of bone remodeling by emphasizing the ...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

The skeleton: Endocrine regulator of phosphate homeostasisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Phosphorus is an essential element in skeletal development, bone mineralization, membrane composition, nucleotide structure, and cellular signaling. Phosphate, the principal form in which phosphorus is found in the body, is regulated by the complex interplay of the hormones parathyroid hormone (PTH), calcitriol (1,25[OH]2 vitamin D3), and fibroblast growth factor 23 (FGF23). These collectively govern bone mineralization, absorption of phosphorus by the intestine, and renal tubular reabsorption of phosphate. The skeleton is the major storage pool for phosphate and the principal production site for FG...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Targeting the Wnt signaling pathway to augment bone formationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Recent discoveries in humans and mice have revealed that the Wnt (Wingless and Int-1) signaling pathway is responsible for a complex array of functions in maintaining bone homeostasis. The Wnt proteins are key modulators of mesenchymal lineage specification and regulate most aspects of osteoblast physiology and postnatal bone acquisition by controlling the differentiation and activity of osteoblasts and osteoclasts. Initial reports have indicated that activators of Wnt signaling are potent promoters of osteogenesis; however, systemic hyperactivation of the canonical Wnt pathway could potentially acc...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

OsteomalaciaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The finding of low bone mineral density with a T-score of −2.5 or below on dual energy x-ray absorptiometry is usually reported as indicating that the patient has “osteoporosis” according to the World Health Organization classification, and, in postmenopausal women, it is often assumed that this is due to estrogen deficiency. However, up to one third of postmenopausal women have a secondary cause of low density, including osteomalacia. Osteomalacia is defined as a mineralization defect caused by disorders that lead to decreased mineralization of bone. Clues from the history, physical examinati...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Web alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s11914-008-0021-9 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 4 / December, 2008 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Falls: Epidemiology, pathophysiology, and relationship to fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Falls are common in the elderly, and frequently result in injury and disability. Most falls result from an interaction between individual characteristics that increase an individual’s propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, comorbidities such as osteoarthritis, visual impairment and dementia, psychotropic medications, and certain types of footwear. Fewer studies have focused on acute precipitating factors, but environmental and situational factors are clearly importan...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Epidemiology of fracture risk in the Women’s Health InitiativeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoporosis is one of the most disabling consequences of aging in women. Strategies that permit earlier identification of women at risk for fracture are needed. The Women’s Health Initiative has extended our knowledge of clinical risk factors and biomarkers of fracture risk in postmenopausal women. Based upon 11 clinically available risk factors (age, race/ethnicity, self-reported health, weight, height, physical activity, parental hip fracture, fracture history after age 54, current smoking, corticosteroid use, and history of treated diabetes), an algorithm has been developed to predict 5-year h...
Source: Current Osteoporosis Reports - November 27, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Osteoporotic fractures: A brain or bone disease?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoporosis is a skeletal disorder that predisposes individuals to increased risk of fracture. However, most osteoporotic fractures occur in women who do not meet criteria for osteoporosis. Hence, bone density, by itself, is a relatively poor predictor of fracture. Age and age-related factors are now recognized as increasingly important in determining fracture risk. Osteoporotic fractures are associated with increased disability and mortality, suggesting that osteoporosis may be a clinical manifestation of an underlying disease process affecting multiple systems. The systems affected, the musculosk...
Source: Current Osteoporosis Reports - October 21, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals

Inhibin and the regulation of bone massEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Inhibins A and B are gonadal peptide members of the transforming growth factor-β superfamily that serve as negative feedback regulators of pituitary follicle-stimulating hormone (FSH). Accumulating evidence suggests that bone turnover and bone loss increase in women before menopause and the decrease in serum estradiol levels. Increased FSH levels have been correlated with some of these perimenopausal changes, whereas decreased inhibins strongly correlate with increases in bone formation and resorption across the menopause transition, and predict lumbar bone mass in perimenopausal women, likely resu...
Source: Current Osteoporosis Reports - October 21, 2008 Category: Orthopaedics Tags: Current Osteoporosis Reports Source Type: journals