Low Body Mass Index Is an Important Risk Factor for Low Bone Mass and Increased Bone Loss in Early Postmenopausal Women
Pernille RavnGiovanni CizzaN. H. BjarnasonDesmond ThompsonMarianne DaleyRichard D. WasnichMichael R. McClungD. HoskingA.J.P. YatesClaus Christiansen
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Abstract Thinness (low percentage of body fat, low body mass index [BMI], or low body weight) was evaluated as a risk factor for low bone mineral density (BMD) or increased bone loss in a randomized trial of alendronate for prevention of osteoporosis in recently postmenopausal women with normal bone mass (n = 1609). The 2-year data from the placebo group were used (n = 417). Percentage of body fat, BMI, and body weight were correlated with baseline BMD (r = −0.13 to −0.43, p < 0.01) and 2-year bone loss (r = −0.14 to −0.19, p < 0.01). Women in the lowest tertiles of percentage of body fat or BMI had up to 12% lower BMD at baseline and a more than 2-fold higher 2-year bone loss as compared with women in the highest tertiles (p ≤ 0.004). Women with a lower percentage of body fat or BMI had higher baseline levels of urine N-telopeptide cross-links (r = −0.24 to −0.31, p < 0.0001) and serum osteocalcin (r = −0.12 to −0.15, p < 0.01). To determine if the magnitude of treatment effect of alendronate was dependent on these risk factors, the group treated with 5 mg of alendronate was included (n = 403). There were no associations between fat mass parameters and response to alendronate treatment, which indicated that risk of low bone mass and increased bone loss caused by thinness could be compensated by alendronate treatment. In conclusion, thinness is an important risk factor for low bone mass and increased bone loss in postmenopausal women. Because the response to alendronate treatment is independent of fat mass parameters, prevention of postmenopausal osteoporosis can be equally achieved in thinner and heavier women.Osteoporosis has become one of the most serious medical and social problems in Japan, as the number of elderly people is increasing. Osteoporosis should be diagnosed early and treated properly to maintain the patients' quality of life before associated fractures occur. The Japanese society for bone and mineral research prepared the criteria for diagnosis of osteoporosis in 1995 and modified them in 1996. Here, we explained the 1996's modified criteria and described the actual way to diagnose osteoporosis. Low bone mass is evaluated by radiographic osteopenia or bone mineral density in lumbar body. We have to exclude the other disorders showing low bone mass.
Osteopenia
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Objective To study the relationship between life habits of postmenopausal women and osteoporosis.Methods To compare and analyse 60 postmenopausal women who suffer from osteoporosis and 60 healthy postmenopausal women.Results The elder Postmenopausal women have higher rate of osteoporosis(P0.05);Those postmenopausal women who drink milk often,take calcium tablets,like sports have lower rate of osteoporosis(P0.05);Those postmenopausal women who likes to drink coffee have the higher rate of osteoporosis(P0.05);There are no much difference between two groups who eat spicy foods and cooking methods correctly.Conclusion Old age is a risk factor for osteoporosis;healthy life habits can prevent the happening of osteoporosis.
Postmenopausal osteoporosis
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Osteoporosis could affect the life quality of post-menopausal ladies badly. The paper introduced the physiological cause of osteoporosis and the anisotropic bone modelling model with mechanostat .The model of osteoporosis was simulated and numerical calculated with finite element method . The results show that pure menopause factor results to a fall of 7%～12% bone mass. Adding the fall of 20% loads results to a fall of 25%～29% bone mass after menopause and when fall of 40% loads results to a fall of 35% .The result shows that biomechanics is primary factors leading to osteoporosis and biology factor quickens the process of osteoporosis. So the biomechanics factor is important to maintain bone mass. This result provided a new method to study osteoporosis.
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Maintenance of bone mass the endocrinology and biochemistry of osteoporosis assessment of bone mass determinants of skeletal mass and strength causes of osteoporosis consequences of osteoporosis assessment of osteoporosis prevention of osteoporosis from menarche to menopause treatment of generalized osteoporosis with inhibitors of bone resorption other agents for generalized osteoporosis treatment of secondary and focal osteoporosis.
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[Objective] The process of osteoporosis in women is studied.[Methods] Anisotropic bone modeling model with mechanostat combining with finite element method are applied.[Results] The results show that bone mass declines slowly at the beginning,loss of bone mass accelerates in postmenopause and bone mass declines 25.84%~28.63% at the age of 60 and 38.50%~40.44% at the age of 80.The result above is basically consistent with clinic result.[Conclusions] The decline of mechanical usage is primary factor leading to osteoporosis,and the menopause quickens the process of osteoporosis in women.The paper instructs the prevention and cure of osteoporosis in women clinically.
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Sequelae of osteoporosis such as fracture and deformities usually occur when the bone mass has been severely reduced. Since the lost bone mass cannot be replaced, management of osteoporosis is aimed at preventing, halting, or retarding its progression. Early detection of osteoporosis and the identification of individuals at high risk for the disease are crucial if therapy is to be effective. Several radiographic techniques are currently available for osteoporosis screening, including dual photon absorptiometry (DPA), quantitative computed tomography (QCT), and dual-energy radiographic absorptiometry (DRA). This paper discusses the relative value and limitations of these techniques.
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The revolution in the field of osteoporosis has been aided and abetted by the advent of bone mass measurement technologies. As they become more widely applicable and more affordable, it is evident that we have the potential to discover the millions of individuals at risk for or with the disease. With effective therapies at hand, it is now possible to prevent and treat osteoporosis. There is every reason, therefore, to apply bone mass measurements as widely as possible to discover those subjects at risk for osteoporosis in a manner that is effective and affordable.
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Osteoporosis is a silent disease leading to osteoporotic fractures and even death. Postmenopausal women are extremely susceptible to osteoporosis because of estrogen deficiency. But less than 1 in 4 women with an osteoporotic fracture was screened or treated for osteoporosis. Postmenopausal women have been proven to benefit from early osteoporosis detection and treatment. However, there is no current national policy on screening for postmenopausal osteoporosis before age 65. Nurse practitioners can play an important role in screening for postmenopausal osteoporosis in primary care to prevent osteoporotic fractures and improve quality of life.
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