Later Puberty Linked To Lower Adult Bone Density

MedicalResearch.com Interview with:

Dr. Cousminer

Dr. Cousminer

Diana L. Cousminer, PhD
Division of Human Genetics
Children’s Hospital of Philadelphia
Philadelphia, PA 19104

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Osteoporosis is a significant public health burden, with origins early in life. Later puberty and lower adolescent bone mineral density are both risk factors for osteoporosis.

Geneticists have identified hundreds of genetic variants across the genome that impact pubertal timing, and we found that collectively this variation also plays a role in bone mineralization during adolescence. Additionally, we found that later puberty caused lower adult bone density.

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Children using stimulant medications may be at risk for lower bone density

MedicalResearch.com Interview with:
Alexis Jamie Feuer MD
Assistant Professor of Clinical Pediatrics
Weill Cornell Medical College

MedicalResearch.com: What is the background for this study?

Response: Osteoporosis is a debilitating disorder characterized by low bone density and increased risk of fractures. Adolescence and young adulthood are critically important times for accruing peak bone density and failure to obtain adequate bone mass by early adulthood may result in future osteoporosis. In children, the use of certain medications can lead to a decrement in the acquisition of bone mass. Past studies have shown that stimulant medications, such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD), may slow the rate of linear growth in children. To date, little research has been done to see what effects stimulant use may have on bone density and bone accrual in children. Stimulants exert their effects via activation of the sympathetic nervous system, and as there is mounting evidence that indicates the sympathetic nervous system plays a critical role in the acquisition of bone density, we sought to determine if there is any association between stimulant medication use and bone mass in the pediatric population.

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Calcium Supplements Do Not Prevent Bone Fractures

MedicalResearch.com Interview with:
Dr. Mark J Bolland
Associate professor of medicine
Department of Medicine
University of Auckland
Auckland New Zealand

Medical Research: What is the background for this study?
Dr. Bolland: Many guidelines advise older people to take at least 1000-1200 mg/day of calcium to improve bone density and prevent fractures. The average calcium intake in most countries is a lot less than these recommendations, and so many people take calcium supplements to increase their calcium intake. However, recent concerns about the safety of calcium supplements have led experts to recommend increasing calcium intake through food rather than by taking supplements, even though the effect of increasing dietary calcium intake on bone health had not been clearly established. Our study was designed to fill this evidence gap.

Medical Research: What are the main findings?

Dr. Bolland: Firstly, we found that increasing calcium intake either from the diet or by taking calcium supplements led to similar, small, one-off increases in bone density of 1-2%. These increases do not build up over time and are too small to produce significant reductions in the chance of having a fracture.

Secondly, the level of dietary calcium intake is not associated with the risk of having a fracture.

Thirdly, in clinical trials, calcium supplements have only small, inconsistent benefits on preventing fractures, with no effect on fractures seen in the highest quality trials
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Osteoporosis Medications Differ in Joint Fracture Reduction, Adverse Effects

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA  90024MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine at University of California,
Los Angeles

 

Medical Research: What are the main findings of the study?
Dr. Crandall:

1.        We found high-strength evidence that several medications decrease fracture risk when used by persons with bone density in the osteoporotic range and/or with pre-existing hip or vertebral fracture.  While many of the medications (alendronate, risedronate, zoledronic acid, ibandronate, denosumab, teriparatide, and raloxifene) reduce vertebral fractures, a reduction in the risk of hip fracture is not demonstrated for all of the medications.  In particular, hip fracture reduction is only demonstrated for alendronate, risedronate, zoledronic acid, and denosumab.  Unfortunately, due to a lack of head-to-head trials, the comparative effectiveness of the medications is unclear.

2.       The adverse effects of the medications vary.  For example, raloxifene is associated with an increased risk of thromboembolic events, whereas denosumab and the bisphosphonate medications have been associated with increased risk of osteonecrosis of the jaw and atypical subtrochanteric femoral fractures.
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Breast Cancer: Surgical Oophoretomy + Tamoxifen – Impact on Bone Loss

Richard R. Love, MD MS International Breast Cancer Research Foundation Professor of Medicine and Public Health The Ohio State University Columbus, OHMedicalResearch.com: Interview with:

Richard R. Love, MD MS
International Breast Cancer Research Foundation
Professor of Medicine and Public Health The Ohio State University
Columbus, OH
MedicalResearch.com: What are the main findings of the study?

Answer: Surgical oophorectomy and tamoxifen treatment was associated with no loss of bone mineral density (BMD) in the femoral neck, and loss of BMD in the first year, followed by stabilization in the lumbar spine.
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