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  • 1
    ISSN: 1433-2965
    Keywords: Key words:COL1A1 – Collagen – Fracture – Genetic – Osteoporosis – Polymorphism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Previous studies have identified an association between osteoporotic fracture and a polymorphism affecting a Sp1 binding site in the first intron of the collagen type I alpha 1 gene (COL1A1). It is currently unclear, however, whether this association is direct or the result of linkage disequilibrium with other polymorphisms situated nearby. In this study we analyzed the relationship between four well-characterized single-nucleotide polymorphisms at the COL1A1 locus and osteoporotic fracture in 93 patients with vertebral fracture and 88 age-matched controls randomly selected from the community. We studied a Msp I polymorphism 26 kb upstream of the COLIA1 gene, the Sp1 binding site polymorphism in intron 1, a Rsa I polymorphism in intron 5 and a Mnl I polymorphism in exon 52. The Sp1 and Rsa I polymorphisms were in strong linkage disequilibrium (χ2=77.87, p〈0.001) and weaker linkage disequilibrium was detected between the Sp1 and Mnl I polymorphisms (χ2=5.54, p〈0.025). There was a significant association between COL1A1 haplotypes that included the Sp1 and Rsa I polymorphisms and fracture (p〈0.05–0.001), but no association with haplotypes that included only the Msp I and Mnl I polymorphisms. This association with fracture was strongest when haplotypes were grouped by Sp1 alleles (χ2=11.15, d.f. = 1; p= 0.001). Furthermore, logistic regression analysis showed that of all the polymorphisms tested, only the Sp1 binding site polymorphism acted as an independent predictor of fracture: odds ratio [95% CI] = 2.26 [1.09–4.69]. These data suggest that it is the Sp1 polymorphism rather than other polymorphisms at the COL1A1 locus which act as a marker for osteoporotic fractures.
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  • 2
    ISSN: 1433-2965
    Keywords: Bone densitometry ; Broadband ultrasound attenuation ; Dual-energy X-ray absorptiometry ; Osteoporosis ; Perimenopausal women ; Screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper compares dual-energy X-ray absorptiometry (DXA) of the spine and hip and broadband ultrasound attenuation (BUA) of the os calcis in 1000 perimenopausal women aged between 45 and 49 years who attended a randomized Osteoporosis Screening Programme. Significant correlations were found between all DXA results and BUA, with the trochanter giving the best numerical correlation with BUA (r=0.354,p〈0.0001). BUA was not successful in predicting women with low DXA measurements, with only 44.0% of the women whose spinal DXA falls within the lowest quartile being in the lowest quartile of BUA. Although BUA is a poor predictor of spinal and hip bone mineral density it may provide additional structural information important in fracture prediction.
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  • 3
    ISSN: 1433-2965
    Keywords: Body weight ; Non-attendance ; Osteoporosis ; Response bias ; Risk factors ; Screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Poor compliance may be detrimental to the effectiveness of a screening programme if those at greatest risk of the disease do not attend. Therefore we undertook a study to test whether non-attenders to a screening programme for low bone density, a risk factor for osteoporosis, were at a differential risk of low bone density compared with attenders. Seven hundred and eighty-nine women aged 45–49 years living within 32 km of Aberdeen were selected at random from the Community Health Index and invited to attend for screening for low bone density as a risk of factor for osteoporosis. Attenders and non-attenders were surveyed regarding their risk factors for osteoporosis. Non-attenders were significantly heavier than attenders. In addition, 6 non-attenders who subsequently chose to attend had significantly higher body weight and bone mineral density, at Ward's triangle, than initial attenders. Non-attenders to a screening service for bone density may be at lower risk of developing osteoporosis. Non-attendance, therefore, would not be detrimental to the cost-effectiveness of a screening service for bone density. However, this study indicates there is a potential for response bias in studies of bone density and osteoporosis.
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  • 4
    ISSN: 1433-2965
    Keywords: Key words:Epidemiology – Mortality – Osteoporosis – Vertebral deformity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Clinically apparent vertebral deformities are associated with reduced survival. The majority of subjects with radiographic vertebral deformity do not, however, come to medical attention. The aim of this study was to determine the association between radiographic vertebral deformity and subsequent mortality. The subjects who took part in the analysis were recruited for participation in a multicentre population-based survey of vertebral osteoporosis in Europe. Men and women aged 50 years and over were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Radiographs were evaluated morphometrically and vertebral deformity defined according to established criteria. The participants have been followed by annual postal questionnaire – the European Prospective Osteoporosis Study (EPOS). Information concerning the vital status of participants was available from 6480 subjects, aged 50–79 years, from 14 of the participating centres. One hundred and eighty-nine deaths (56 women and 133 men) occurred during a total of 14 380 person-years of follow-up (median 2.3 years). In women, after age adjustment, there was a modest excess mortality in those with, compared with those without, vertebral deformity: rate ratio (RR) = 1.9 (95% confidence interval (CI) 1.0,3.4). In men, the excess risk was smaller and non-significant RR = 1.3 (95% CI 0.9,2.0). After further adjusting for smoking, alcohol consumption, previous hip fracture, general health, body mass index and steroid use, the excess risk was reduced and non-significant in both sexes: women, RR = 1.6 (95% CI 0.9,3.0); men RR = 1.2 (95% CI 0.7,1.8). Radiographic vertebral deformity is associated with a modest excess mortality, particularly in women. Part of this excess can be explained by an association with other adverse health and lifestyle factors linked to mortality.
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  • 5
    ISSN: 1433-2965
    Keywords: Key words:Anxiety – Bone density – Direct disclosure – Knowledge of risk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: If bone mineral density (BMD) screening is to achieve the aim of preventing the complications of osteoporosis, women with low BMD measurements must learn that they are at risk, and women at risk must know about and be willing to adopt and persist with measures that can prevent osteoporosis. In this paper we present the results of a randomized controlled trial designed to examine whether disclosing the results of a BMD scan directly to women, as well as through their general practitioners (GPs), improves their knowledge of their bone density results without adverse psychological sequelae. Direct disclosure resulted in 19% (59% vs 40%; 95% CI for difference in proportions: 9.8% to 27.8%) more women being aware of their BMD status at the spine and 22% (58% vs 36%; 95% CI for difference: 12.2% to 29.8%) at the hip. These differences were observed irrespective of risk status. There was no significant difference in anxiety levels between the randomized groups. We conclude, therefore, that direct disclosure of BMD results to women, as well as to their GPs, leads to increased knowledge of BMD status without increasing anxiety, and that BMD measurement services should consider informing women routinely of their results directly as well as through their GPs.
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  • 6
    ISSN: 1432-0827
    Keywords: Osteoporosis ; Ultrasound ; Hip fractures ; Bone density ; DXA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract There is considerable interest in predicting risk of hip fracture in order to allow targeting of preventive care. This study aimed to determine which of two methods best discriminates a hip fracture population from controls. Fifty women with fractured neck of femur, and 50 control subjects were scanned using dual energy X-ray absorptiometry (DXA) of the spine and hip and broadband ultrasound attenuation (BUA) of the os calcis. Significant differences between the two populations could be found for both DXA and BUA, with BUA showing the largest percentage difference (27%). The mean z-scores showed that BUA had the lowest, with the exception of DXA trochanter. However, no significant difference between BUA and DXA trochanter Z-scores was found. A receiver operator characteristic (ROC) analysis showed that BUA has a superior sensitivity and specificity compared with DXA measurements, with DXA of the hip being better than the spine. This retrospective study shows that BUA is a better discriminator of hip fracture than DXA lumbar spine of DXA hip, which may have important implications for predicting those at risk of future hip fracture.
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  • 7
    ISSN: 1432-0827
    Keywords: Key words: Bone mineral density — Epidemiology — Osteoporosis — Menopause — Medication use.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract: We have previously shown considerable between-center variation in bone mineral density (BMD) in the 13 EVOS centers that performed bone densitometry on their sex- and age-stratified population samples, after adjusting for weight and age. We have now investigated whether part of the between-center variability may be attributed to between-center variations in the use of medications. Information was collected from 2088 women and 1908 men at baseline on whether the subjects had ever been prescribed calcium, calcitonin, anabolic steroids, fluoride, vitamin D, or glucocorticoids and, for the women, whether they had ever used the oral contraceptive pill (OCP) or hormone replacement therapy (HRT). Each of these variables was fitted into a regression model adjusted for age, height, weight, and center. Only OCP and HRT significantly affected BMD. Those who had ever used OCPs had spinal BMD 0.029 g/cm2 greater than those who had never used them. Users of HRT had higher BMD than nonusers: 0.037 g/cm2 at the spine, 0.018 g/cm2 at the trochanter, and 0.018 g/cm2 at the femoral neck. As expected, there was a great variation between centers in the use of OCP and HRT, but there were no significant correlations between mean BMD at any site in a given center and the prevalence of OCP or HRT use in that center. The between-center variance in BMD at all three sites remained highly significant after adjusting for treatment (P 〈 0.001). We conclude that HRT and OCP use are associated with moderate increases in BMD. The geographical variability of BMD in Europe was not explained by treatment with pharmaceuticals.
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  • 8
    ISSN: 1432-0827
    Keywords: Key words: Corticosteroid — Risedronate — Calcium — Vitamin D — BMD
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Men and women (n = 518) receiving moderate-to-high doses of corticosteroids were enrolled in two studies with similar protocols and randomly assigned to receive either placebo or risedronate (2.5 or 5 mg) for 1 year. All patients received daily calcium supplementation (500–1000 mg), and most also received supplemental vitamin D (400 IU). The primary endpoint was the difference between the placebo and active groups in lumbar spine bone mineral density (BMD) at 1 year; changes in BMD at other sites, biochemical markers of bone turnover, and the incidence of vertebral fractures were also assessed. In the overall population, the mean (SE) lumbar spine BMD increased 1.9 ± 0.38% from baseline in the risedronate 5 mg group (P 〈 0.001) and decreased 1.0 ± 0.4% in the placebo group (P= 0.005). BMD at the femoral neck, trochanter, and distal radius increased or was maintained with risedronate 5 mg treatment, but decreased in the placebo group. Midshaft radius BMD did not change significantly in either treatment group. The difference in BMD between the risedronate 5 mg and placebo groups was significant at all skeletal sites (P 〈 0.05) except the midshaft radius at 1 year. The 2.5 mg dose also had a positive effect on BMD, although of a lesser magnitude than that seen with risedronate 5 mg. A significant reduction of 70% in vertebral fracture risk was observed in the risedronate 5 mg group compared with the placebo group (P= 0.01). Risedronate was efficacious in both men and women, irrespective of underlying disease and duration of corticosteroid therapy, and had a favorable safety profile, with a similar incidence of upper gastrointestinal adverse events in the placebo and active treatment groups. Daily treatment with risedronate 5 mg significantly increases BMD and decreases vertebral fracture risk in patients receiving moderate-to-high doses of corticosteroid therapy.
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  • 9
    ISSN: 1420-9071
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Zusammenfassung Die Xylemsäfte vonAcer pseudoplatanus undBetula pubescens enthalten vor dem Austreiben der Knospen im Frühjahr Cytokinine und Gibberellin-ähnliche Stoffe. Diese stammen entweder aus den Wurzeln oder aus dem Xylemparenchym.
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  • 10
    ISSN: 1399-3054
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: The morphological changes of the shoots of Helianthus annuus cv. Russian caused by varying periods of flooding of the roots were studied. Attention was focused on adventitious root formation and hypocotyl hypertrophy which are known to be caused by excess water around the roots in the absence of anoxia. Twenty-four hours of flooding was found to be sufficient to cause both of these responses. Experiments involving flooding, leaf removal, shoot apical bud removal, two different light intensities, and a treatment in which only a small proportion of the roots were flooded suggested that a major factor causing the flood-induced changes in the hypocotyl arises in the root but other factors may come from the leaves. In the longer-term experiments other flood-induced changes in shoot morphology were leaf epinasty, death of shoot apex, extreme chlorosis and hypertrophy of nodes and internodes. There was no apparent contribution of adventitious roots to the survival of flooded plants.
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