blogger delicious digg diigo facebook googleplus linkedin netlog reddit twitter
Skip Navigation LinksJRI > Archive > January-March 2005, Volume 6, Issue 1 > Osteoporosis, prevention, diagnosis and treatment



Volume 6, Issue 1, Number 21 / January-March
(pages 5-24)


Osteoporosis, prevention, diagnosis and treatment




 Corresponding Author
Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran

Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran

Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran

Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran

Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran


Related Articles
in Google Scholar in PubMed

 

Other Format
pdfPDF Full Text (En) pdfPDF Full Text (Fa) pdfePUB Full Text (En) pdfPDF Abstract (En) pdfPDF Abstract (Fa) pdf BibTeX pdfRefMan pdfEndNote xmlPMC XML online readerPMC Reader

 


Abstract
Osteoporosis, a disease, characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enlarged bone fragility and a consequent increase in fracture risk is a leading cause of morbidity and mortality in elderly people. The mortality rate in elderly persons with hip fracture approaches 20%. Half of them will be disabled in the remained life; it is caus-ed when bone resorption proceeded bone formation. Peak bone mass and bone loss are major determinants for risk of fragility fractures in people .Dangerous complication of osteoporosis is pathologic fracture that can cause even death among patients. Now a days multiple treatments are available and more are being developed. From prevention to treatment of established disea-se, the goal is to intervene as early as possible to ensure saving of bone mass and to preserve structural integrity of the skeleton, thus preventing pathologic fractures Currently available dru-gs are anti-resorptive and focus on decreasing bone turnover. Newer therapies with the aim of increaseing bone formation are being studied and are about to be released. This document outlines all aspects of osteoporosis including risk factors, diagnosis, treatment and prevention all over the world and Iran.

Keywords: Osteoporosis, Pathologyic fracture, DXA, QUS, Bisphosphonates, Calcitonin, PTH, SERMs, HRT


To cite this article:


References
  1. Eastell R. Treatment of postmenopausal osteo-porosis. N Engl J Med.1998;338:736-746.
  2. WHO study group. Assessment of fracture risk and its application to screening for postmeno-pausal osteoporosis. Technical report series 843. Geneva: WHO, 1994.
  3. Shepherd A. J., An overview of osteoporosis Altern ther Health Med.2004;10:26-34.
  4. Cooper C., Walker-Bone K., Arden N. Novel insights into the pathogenesis of the role of intrau-terine programming. Rheumatology.2000;39:1312 -15.
  5. Cooper C., Eriksson J.G., Forson T. Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporos Int. 2001;12:623-9.
  6. Anderson F.H., Francis R.M., Selby P.L. Sex hormones and osteoporosis in men. Calcif Tissue Int 1998;62:185-8.
  7. Amin S., Yuquing Z., Clark T. Association of hypogonadism and oestradiol levels with bone mineral density in elderly men from the Fram-ingham Study. Ann Intern Med.2000;133:951-63.
  8. Barrett-Conner E., Mueller J.E., Von Muhlen D.G. Low levels of oestradiol are associated with vertebral fractures in older men, but not women: the Rancho Bernardo Study. J Clin Endocrinol Metab.2000;85:219-23.
  9. Larijani B., Soltani A., Pajouhi M. Bone mine-ral density variation in 20-69 y/o population of Tehran/Iran. Iranian South Med J.2002;5:41-49.
  10. Larijani B. An overview of osteoporosis in Iran. 1th international osteoporosis seminar in Iran. Tehran, Iran.2004.
  11. Royal College of Physicians of London. Fractured neck of femur: prevention and manage-ment. London: Royal College of Physicians, 1989.
  12. Looker A.C., Orwoll E.S., Johnston C.C., Lin-dsay R.L., Wahner H.W., Dunn W.L., Calvo M.S., Narris T.B., Neyse S.P. Prevalence of low femoral bone density in older US adults from NHANES III. J Bone Miner Res.1997;12:1761-1768.
  13. Abdollah Shamshirsaz A., Bekheirnia M.R., Kamgar M., Pourzahedgilani N., Habibzadeh M. R., Hashemi S.R., Abdollah Shamshirsaz A.H., Aghkhani S., Homayoun H., Larijani B. Meta-bolic and Endocrinological complication in Beta-thalassemia major: A multicenter study in Tehran. BMC Endocr Disord.2003;3:4.
  14. Chapuy M.C., Arlot M.E., Duboeuf F.vitamine D3 and calcium to prevent hip fracture s in elderly women. N Engl J Med.1992;327:1637-1642.
  15. Dawson-Hughes B., Harris S.S., Krall EA., Dallal G.E. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997; 337:670-676.
  16. Hashemipour S., Larijani B., Adibi H., Javadi E., Sedaghat M., Pajouhi M., Soltani A., Shafaei A.R. Hamidi Z., Fard A.R., Hossein-Nezhad A., Booya F. Vitamin D deficiency and causative fac-tors in the population of Tehran. BMC Public Health.2004;4:38.
  17. Mc Kenna M.J. Differences in vitamin D stat-us between countries in young adults and the elderly. Am J Med.1992;93:69-77.
  18. Larijani B., Bekheirnia M.R., Soltani A., Khalili-Far A.R., Adibi H., Jalili R.B. Bone mine-ral density is related to blood pressure in men. Am J Hum Biol.2004;16:168-71.
  19. Hossein-nezhad A., Soltani A., Rahimi I., Shafaie A., Maghbooli Z., Larijani B. Relation between tea drinking and bone mineral density. Tabib-Shargh.2003;2:29-38.
  20. حقيقيان رودسري آرزو، طاهباز فريده، ارجمندي بهرام، لاريجاني باقر، كيمياگر مسعود. تأثير پروتئين سويا بر شاخص‌هاي متابوليسم استخوان در زنان يائسه متبلا به استئوپروز، فصلنامه پزشكي باروري و ناباروري. سال ششم، شماره اول، زمستان 1383، صفحات 68-62.
  21. 22- Bekheiia M.R., Abllah Shahirsaz A., Kamgar M., Bouzari N., Erfanzadeh G., Pourzahedgilani N., Tataie S.M., Abllah Shahirsaz A., Kimiagar M., Ezzati F., Larijani B., Serum zinc and its relation to bone mineral density in beta-thalasse-mic adolescents. Biol Trace Elem Res.2004;97: 215-24.
  22. Brown J.P. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Canadian Med Assoc J.2002;167:sl-s34.
  23. Marshall D., Johnell O., Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractu-res. BMA.1996;312:1254-9.
  24. Cummings S.R., Nevitt M.C., Browner W.S., Stone K., Fox K.M., Ensrud K.E. Risk factors for hip fracture in white women. Study of Osteoporo-tic Fractures Research Group. N Engl J Med 1995;332:767-73.
  25. Wasnich R.D., Davis J.W., Ross P.D. Spine fracture risk is predicted by nonspine fractures. Osteoporos Int.1994;4:1-5.
  26. Davis J.W., Grove J.S., Wasnich R.D., Ross P.D. Spatial relationships between prevalent and incident spine fractures. Bone.1999;24:261-4.
  27. Ismail A.A., Cockerill W., Cooper C., Finn J.D., Abendroth K., Parisi G. Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European prosp-ective osteoporosis.Osteoporos Int.2001;12:85-90.
  28. Klotzbuecher C.M., Ross P.D., Landsman P., Abbott T.A.I., Berger M. Patients with prior fractures have an increased risk of future frac-tures: a summary of the literature and statistical synthesis. J Bone Miner Res.2000;15:721-39.
  29. Ross P.D., Davis J.W., Epstein R.S., Wasnich R.D. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med.1991;114:919-23.
  30. Tromp A.M., Smit J.H., Deeg D.J.H., Bouter L.M., Lips P. Predictors for falls and fractures in the longitudinal aging study Amsterdam. J Bone Miner Res.1998;13:1932-9.
  31. Black D.M., Palermo L., Nevitt M.C., Genant H.K., Christensen L., Cummings S.R. Defining incident vertebral deformity, a prospective com-pareison of several approaches. The Study of Ost-eoporotic Fractures Research Group. J Bone Miner Res.1999;14:90-101.
  32. Fox K.M., Cummings S.R., Williams E., Stone K. Study of Osteoporotic Fractures. Femo-ral neck and intertrochanteric fractures have diff-erent risk factors, a prospective study. Osteoporos Int.2000;11:1018.
  33. Ettinger B., Black D.M., Mitlak B.H., Knick-erbocker R.K., Nickelsen T., Genant H.K. Reduc-tion of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: Results from a 3-year randomized clinical trial. JAMA.1999;282:637-45.
  34. Black D.M., Arden N.K., Palarmo L., Pearson J., Cummings S.R. Prevalent vertebral deformities predict hip fractures and new vertebral deformi-ties but not wrist fractures. J Bone Miner Res. 1999;14:821-8.
  35. Lindsay R., Silverman S.L., Cooper C., Han-ley D.A., Barton I., Broy S.B. Risk of new verte-bral fracture in the year following a fracture. JAMA.2001;285:320-3.
  36. McClung M.R., Geusens P., Miller P.D., Zip-pel H., Bensen W., Roux C. Effects of risedronate on the risk of hip fracture in elderly women. N Engl Med.2001;344:333-40.
  37. Kanis J.A., Melton L.J. III, Christiansen C., Johnston C.C., Khaltaev N. The diagnosis of oste-oporosis. J Bone Miner Res.1994;9:1137-41.
  38. Cadarette S.M., Jaglal S.B., Murray T.M., McIsaac W.J., Joseph L., Brown J.P. Evaluation of decision rules for referring women for bone densitometry by dual-energy X-ray absorption-metry. JAMA.2001;286:57-63.
  39. Cummings S.R., Black D.M., Nevitt M.C., Browner W.S., Cauley J.A., Genant H.K. Appen-dicular bone density and age predict hip fracture in women. JAMA.1990;263:665-8.
  40. Kanis J.A., Johnell O., Oden A., Dawson A., De Laet C., Jonsson B. Ten years probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int.2001;12: 989-95.
  41. Torgerson D.J., Campbell M.K., Thomas R.E., Reid D.M. Prediction of perimenopausal fractures by bone mineral density and other risk factors. J Bone Miner Res.1996;11:293 -7.
  42. Dargent-Molina P., Favier F., Grandjean H., Baudoin C., Schott A.M., Hausherr E. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Erratum in: Lancet 1996;348: 4161.
  43. Dargent-Molina P., Schott A.M., Hans D., Favier F., Grandjean H., Baudoin C. Separate and combined value of bone mass and gait speed measurements in screening for hip fracture risk: results from the EPIDOS study. Osteoporos Int. 1999;9:188-92.
  44. Adachi J.D., Olszynski W.P., Hanley D.A., Hodsman A.B., Kendler D.L., Siminoski K.G. Management of corticosteroid-induced osteo-porosis. Semin Arthritis Rheum.2000;29:228-51.
  45. Hodgson S.F., Watts N.B. American associa-tion of clinical endocrinologists medical guide-lines for clinical practice for the prevention and treatment of postmenopausal osteoporosis. Endo-crine Practice.2003;9:554-564.
  46. Dabbaghmanesh M.H., Pajouhi M., Larijani B. How is the agreement of QUS of heel and DXA in diagnosis of osteoporosis. Iran South Med J.2002;5:50-55.
  47. Yeap S.S., pearson D., cawte S.A. The relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women. Osteoporosis Int.1998;8:141-6.
  48. Larijani B., Dabbaghmanesh M.H., Sedaghat M., Akrami M., Hamidi Z., Rahimi I. Defining cut-off values for diagnosis of osteoporosis in postmenopausal women by quantitative heel ultra-sonography (QUS). Iran J Endocrin Met.2004; 69:39-45.
  49. Sedaghat M., Hamidi. Z., Soltani. A., Rahimi. E., Maghbooli. Z., Larijani. B. Defining cut-off values for diagnosis of osteoporosis in postmeno-pausal women by quantitative phalanx ultrasono-graphy (QUS). 1th international osteoporosis semi-nar in Iran.Tehran, Iran, (2004).
  50. 51- NIH Consensus Development Panel on Osteo-porosis Prevention,Diagnosis, and therapy JAMA. 2001;285:785-95.
  51. 52- Bonjour J.P., Carrie A.L., Ferrari S., Clavien H., Slosman D., Theintz G., Rizzoli R. Calcium-enriched foods and bone mass growth in prepu-bertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest.1997;99:1287-94.
  52. Lloyd T., Martel J.K., Rollings N., Andon M. B., Kulin H., Demers L.M. The effect of calcium Supplementation and tanner stage on bone den-sity, content and area in teenage women. Osteo-poros Int.1996;6:286-3.
  53. Rico H., Revilla M., Villa L.F., Alvarez de Buergo M., Arribas I. Longitudinal study of the effect of calcium pidolate on bone mass in eugo-nadal women. Calcif Tissue Int.1994;54:477-80. 55- Holbrook T.L., Barrett-Connor E.L., Wingard D.L. Dietary calcium and risk of hip fracture:14-year prospective population study. Lancet.1988; 2:1046 -9.
  54. Baeksgaard L., Andersen K.P., Hyldstrup L. Calcium and vitamin D Supplementation incre-ases spinal BMD in healthy, postmenopausal women. Osteoporos Int.1998;8:255-60.
  55. Kalkwarf H.J., Specker B.L., Bianchi D.C., Ranz J., Ho M. The effect of calcium Supplemen-tation on bone density during lactation and after weaning. N Engl J Med.1997;337:523-8.
  56. Reid I.R., Mason B., Horne A. Effects of calcium supplementation on serum lipid concen-trations in normal older women: a randomized controlled trial. Am J Med.2002;112:343-7.
  57. Vieth R., Cole D.E., Hawker G.A., Trang H. M., Rubin L.A. Wintertime vitamin D insufficie-ncy is common in young Canadian women, and their vitamin D intake does not prevent it. Eur J Clin Nutr. 2001;55:1091-7.
  58. Munger R.G., Cerhan J.R., Chiu B.C. Pros-pective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr.1999;69:147-52.
  59. Hernandez-Avila M., Colditz G.A., Stampfer M.J, Rosner B., Speizer F.E., Willett W.C. Coff-eine, moderate alcohol intake and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr.1999;54:157-63.
  60. Devine A., Criddle R.A., Dick I.M., Kerr D. A., Prince R.L. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am J Clin Nutr. 1995;62:740-5.
  61. Byrjalsen I., Haarbo J., Christiansen C. Role of cigarette smoking on the postmenopausal endo-metrium during sequential estrogen and proges-togen therapy. Obstet Gynecol.1993;81:1016.
  62. Greendale G.A., Wells B., Marcus R., Barrett-Connor E. How many women lose bone mineral density while taking hormone replacement ther-apy? Results from the postmenopausal Estrogen/ Progestin interventions trial. Arch Intern Med. 2000;160:3065.
  63. Russell R.G., Rogers M.J. Bisphosphonates: from the laboratory to the clinic and back again. Bone.19999;25:97-106.
  64. Liberman U.A., Weiss S.R., Broll J. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteopo-rosis. N Engl J Med.1995;333:1437-43.
  65. Bauer D.C., Black D., Ensrud K. Upper gast-rointestinal tract safety profile of alendronate: the fracture intervention trial. Arch Intern Med.2000; 160:517.
  66. Levine J., Nelson D. Esophageal stricture associated with alendronate therapy. Am J Med. 1997;102:489.
  67. Schussheim D.H., Jacobs T.P., Silverberg S.J. Hypocalcemia associated with alendronate[letter]. Ann Intern Med.1999;130:329.
  68. Bone H.G., Greenspan S.L., McKeever C., Alendronate and estrogen effects in postmenopa-usal women with low bone mineral density. Alen-dronate/Estrogen Study Group. J Clin Endocrinol Metab.2000;85:720-6.
  69. Heaney R.P. Bone mass, bone loss, and osteo-porosis prophylaxis.Ann Intern Med.1998;128: 313-4.
  70. Fraunfelder F.W., Fraunfelder F.T. Bisphos-phonates and ocular inflammation. N Engl J Med. 2003;348:1187-8.
  71. The Writing Group for the PEPI.Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin inter-venetions (PEPI) trial. JAMA.1996;276:1389-96.
  72. Riggs B.L., Hartmann L.C. Selective estrogen-receptor modulators mechanisms of action and application to clinical practice. N Engl J Med. 2003;348:618.
  73. Cauley J., Norton L., Lippman M., Eckert S., Krueger K., Purdie D. Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-years results form the MORE trial. Breast Cancer Res Treat.2001;65:125-34.
  74. Cummings S.R., Eckert S., Krueger K.A., Grady D., Powles T.J., Cauley J.A. The effect of raloxifene on risk of breast cancer in postmeno-pausal women: Results from the MORE rando-mized trial. JAMA.1999;281:2189-97.
  75. Mosselman S., Polman J., Dijkema R.ER beta: identification and characterization of a novel human estrogen receptor. FEBS Lett.1996;392: 49-35.
  76. Dempster D.W., Cosman F., Parisien M. Ana-bolic actions of parathyroid hormone on bone. Endocr Rev.1993;14:690-709.
  77. Neer R.M., Arnaud C.D., Zanchetta J.R. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med.2001;344:1434-41.
  78. Chesnut C.H. III, Silverman S., Andriano K., Genant H.K., Gimona A., Harris S.,A randomized trial of nasal spray salmon calcitonin in postmeno-pausal women with established osteoporosis: the Prevent Recurrence of Osteoporotic Fractures Study. Am J Med.2000; 109:267-76.
  79. Meunier P.J., Sebert J.L., Reginster J.Y., Bria-ncon D., Appelboom T., Netter P. Fluoride salts are no better at preventing new vertebral fractures than calcium-vitamin D in postmenopausal osteo-porosis: the FAVO Study. Osteoporos Int.1998; 8:4-12.
  80. Scheiber M.D., Rebar R.W. Isoflavones and postmenopausal bone health: a viable alternative to estrogen therapy?. Menopause.1999;6(3):233-41.
  81. Alexandersen P., Toussaint A., Christiansen C., Devogelaer J.P., Roux C., Fechtenbaum J. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trail. JAMA. 2001;285:1482-8.
  82. Feskanich D., Weber P., Willett W.C., Rock-ett H., Booth S.L., Colditz G.A. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr.1999;69:74-9.
  83. Modelska K., Cummings S. Tibolone for post-menopausal women: systematic review of rando-mized trials. J Clin Endocrinol Metab.2002;87:16.
  84. Bjarnason N.H., Bjarnason K., Haarbo J. Tibolone: influence on markers of cardiovascular disease. J Clin Endocrinol Metab.1997;82:1752-6.
  85. Erdtsieck R.J., Van Kujik C., Birkenhager-Frenkel D.H. Course of bone mass during and after hormonal replacement therapy with and without addition of nandrolone decanoate. J Bone Miner Res. 1994;9:277-83.
  86. Canalis E.M., Hintz R.L., Dietrich J.W. Effect of somatomedin and growth hormone on bone collagen synthesis in vitro. Metabolism.1997;26: 1079.
  87. Baum H.B.A., Biller B.M.K., Finkelstein J.S. Effects of physiologic growth hormone therapy on bone density and body composition in patients with adult-onset growth hormone deficiency- a randomized, placebo-controlled trial. Ann Intern Med.1996;125:883-90.
  88. Meunier P.J., Slosman D.O., Delmas P.D. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteopo-rosis-a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab.2002;87 :2060-6.
  89. Christodoulou C., Cooper C. What's osteo-porosis? Postgraduate Med J.2003;79:133-138.
  90. Holbrook T.L., Barrett-Connor E.L., Wingard D.L. Dietary calcium and risk of hip fracture:14-year prospective population study. Lancet.1988; 2:1046 -9.
  91. Hergenroeder A.C., O'Brian Smith E., Shy-pailo R. Bone mineral changes in young women with hypothalamic amenorrhea treated with oral contraceptives, medroxyprogesterone, or placebo over 12 months. Am J Obstet Gynecol.1997;176: 1017.
  92. Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estr-ogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative Randomized Controlled Trial. JAMA.2002;288:321-33.



Home | About Us | Current Issue | Past Issues | Submit a Manuscript | Instructions for Authors | Subscribe | Search | Contact Us

"Journal of Reproduction & Infertility" is owned, published, and copyrighted by Avicenna Research Institute .
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

Journal of Reproductoin and Infertility (JRI) is a member of COMMITTEE ON PUBLICATION ETHICS . Verify here .

©2016 - eISSN : 2251-676X, ISSN : 2228-5482, For any comments and questions please contact us.