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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Exercise, Vision Testing and Osteoporosis Evaluation Are Keys To Fall Prevention

MedicalResearch.com Interview with:

Andrea C. Tricco PhD, MSc Scientist and Lead of the Knowledge Synthesis Team Associate Professor Dalla Lana School of Public Health, University of Toronto Associate Editor Journal of Clinical Epidemiology, BMC Medical Research Methodology, Systematic Reviews

Dr. Tricco

Andrea C. Tricco PhD, MSc
Scientist and Lead of the Knowledge Synthesis Team
Associate Professor Dalla Lana School of Public Health, University of Toronto
Associate Editor Journal of Clinical Epidemiology, BMC Medical Research Methodology, Systematic Reviews

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

Response: Falls are the leading cause of injury among older adults and account for $2 billion in direct health-care costs annually ($31 billion in costs to Medicare in the United States in 2012). We aimed to determine which types of fall-prevention programs may be effective for reducing falls in older people.

MedicalResearch.com: What are the main findings?

Response: Exercise, along with vision assessment and treatment, as well as an assessment and possible modification of a person’s living environment, reduced the risk of injurious falls by 23% compared to usual care.

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New Approach Could Lead To Osteoporosis Drugs With Fewer Side Effects

MedicalResearch.com Interview with:

Dieter Bromme, Ph.D. Professor and Canada Research Chair The University of British Columbia Faculty of Dentistry  Vancouver, BC

Dr. Bromme

Dieter Bromme, Ph.D.
Professor and Canada Research Chair
The University of British Columbia Faculty of Dentistry
Vancouver, BC

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

Response: Every three seconds somebody will fracture a bone because of osteoporosis. Several treatments are available to slow down bone loss but all of them have shortcomings ranging from poor bone quality to various side effects. Thus new treatment strategies and novel drug targets are needed that promise efficacy without significant adverse reactions.

One of the novel promising targets was cathepsin K, a protease solely responsible for the degradation of our organic bone matrix. Major efforts and funds were spent by the pharmaceutical industry to develop potent and selective cathepsin K inhibitors. These inhibitors were highly effective in preserving bone in clinical trials. Despite the good news, cathepsin K inhibitors were never approved because of various non-skeletal side effects. We hypothesized that these side effects are not caused by off-target effects (drugs react with undesired targets) but by on-target effects. Most drugs that target enzymes are active site-directed compounds and thus will stop the entire activity of the target enzyme. If the target is a multifunctional enzyme, safety problems are preprogrammed. Based on our studies to understand the molecular mechanism of collagen degradation by cathepsin K, we developed the concept of ectosteric enzyme inhibition, which allowed us to identify highly selective collagenase inhibitors of this protease.

In our study, we used a red sage-derived small molecule that selectively blocked the collagenase activity of cathepsin K and thus consequently bone degradation in an osteoporosis mouse model without affecting other known functions of the protease. The crucial difference might be that the red sage inhibitor did not block the cathepsin K-mediated degradation of TGF-ß1, a growth factor involved in fibrotic pathologies described in the clinical trials. TGF-ß1 degradation is blocked by these inhibitors and thus accumulates in tissues, causing fibrosis.

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Dabigatran is Associated With a Lower Risk of Osteoporotic Fractures Compared to Warfarin

MedicalResearch.com Interview with:
Wallis CY Lau BSc

Centre for Safe Medication Practice and Research
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

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

Response: Warfarin is a vitamin K antagonist (VKA) oral anticoagulant used for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), a common heart rhythm disorder. It works by interfering with vitamin K-dependent reactions in the process of blood clot formation. As these reactions also play a role in bone mineralization, there is concern that warfarin use may be linked with osteoporotic fracture. Despite the concerns for fracture risk, warfarin had been an inevitable treatment choice for over 50 years as there were no other alternatives available.

Dabigatran is the first non-VKA oral anticoagulant (NOAC) approved for use in patients with NVAF. Recently, an animal study reported that use of dabigatran is associated with a better bone safety profile compared to warfarin in rats, suggesting a potential for a lower risk of osteoporotic fractures over warfarin. However, the actual risk of osteoporotic fractures with dabigatran use in human remains unclear. Therefore, we conducted a population-based cohort study to compare the risk of osteoporotic fractures in patients with NVAF treated with dabigatran and warfarin.

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Regular, Long-term Resistance Training or Jump-Training Increases Bone Mass

MedicalResearch.com Interview with:

Pamela S. Hinton, Ph.D. Associate Professor & Director of Graduate Studies Department of Nutrition and Exercise Physiology Columbia MO 65211

Dr. Hinton

Pamela S. Hinton, Ph.D.
Associate Professor & Director of Graduate Studies
Department of Nutrition and Exercise Physiology
Columbia MO 65211

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

Response: This study builds on our previous work showing that weight-bearing, high-impact physical activity throughout the lifespan is associated with greater bone mass in men.  We previously conducted a 12-month randomized trial of the effectiveness of resistance training versus jump training to increase bone mass in men with low bone density of the hip or lumbar spine.

The current study is a follow up study investigating how exercise might work to increase bone mass.

The main findings are that exercise reduced circulating levels of a bone protein that inhibits bone formation (sclerostin) and increased levels of insulin-like growth factor-I (IGF-I), a hormone with osteogenic effects.

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Compared To Other Blood Pressure Medications Diuretics Have Bone Protective Effect

MedicalResearch.com Interview with:

Joshua I. Barzilay, MD Kaiser Permanente of Georgia Duluth, GA 30096

Dr. Joshua I. Barzilay

Joshua I. Barzilay, MD
Kaiser Permanente of Georgia
Duluth, GA 30096

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

Response: Hypertension (HTN) and osteoporosis (OP) are age-related disorders. Both increase rapidly in prevalence after age 65 years. Prior retrospective, post hoc studies have suggested that thiazide diuretics may decrease the risk of osteoporosis. These studies, by their nature, are open to bias. Moreover, these studies have not examined the effects of other anti HTN medications on osteoporosis.

Here we used a prospective blood pressure study of ~5 years duration to examine the effects of a thiazide diuretic, a calcium channel blocker and an ACE inhibitor on hip and pelvic fractures. We chose these fractures since they are almost always associated with hospitalization and thus their occurrence can be verified.

After the conclusion of the study we added another several years of follow up by querying medicare data sets for hip and pelvic fractures in those participants with medicare coverage after the study conclusion.

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Menopausal Hormone Therapy Benefits Bone Health For Several Years After Discontinuation

MedicalResearch.com Interview with:

Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne

Dr Georgios Papadakis

Dr Georgios Papadakis
FMH, Médecin InternenMédecin assistant
Service d’endocrinologie, diabétologie et métabolisme
Lausanne

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

Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal.

We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture.

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Clinical Practice Guidelines For Diagnosis and Treatment of Postmenopausal Osteoporosis

MedicalResearch.com Interview with:

Pauline Camacho, MD, FACE Professor, Endocrinology Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Fellowship Program Director, Endocrinology, Medical Director, Osteoporosis Center

Dr. Pauline Camacho

Pauline Camacho, MD, FACE
Professor, Endocrinology
Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Fellowship Program Director, Endocrinology, Medical Director, Osteoporosis Center

MedicalResearch.com: What is the background for this report? What is the prevalence and significance of osteoporosis in US women?

Response: Osteoporosis is widely prevalent and is increasing in prevalence not only in the US but also around the world. 10.2 million Americans have osteoporosis and that an additional 43.4 million have low bone mass. More than 2 million osteoporosis-related fractures occur annually in the US, more than 70% of these occur in women ( from National Osteoporosis Foundation (NOF) estimates).

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Romosozumab Has Potential To Reduce New Vertebral Fractures at 12 Months

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Felicia Cosman, M.D.

Dr. Felicia Cosman

Felicia Cosman, M.D.
Medical Director of the Clinical Research Center
Helen Hayes Hospital
Professor of Medicine
Columbia University College of Physician and Surgeons
New York
Editor-in-Chief, Osteoporosis International

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

Response: Amgen and UCB presented detailed data from the Phase 3 FRAME study in an oral session at ASBMR 2016, and the data were also published in the New England Journal of Medicine. Additionally, the FRAME abstract has been awarded the 2016 ASBMR Most Outstanding Clinical Abstract Award. The FRAME data show significant reductions in both new vertebral and clinical fractures in postmenopausal women with osteoporosis.

Patients receiving a monthly subcutaneous 210 mg dose of romosozumab experienced a statistically significant 73 percent reduction in the relative risk of a vertebral (spine) fracture through 12 months, the co-primary endpoint, compared to those receiving placebo (fracture incidence 0.5 percent vs. 1.8 percent, respectively [p<0.001]). By six months, new vertebral fractures occurred in 14 romosozumab and 26 placebo patients; between six to 12 months, fractures occurred in two versus 33 additional patients in each group, respectively.

Patients receiving romosozumab experienced a statistically significant 36 percent reduction in the relative risk of a clinical fracture, a secondary endpoint, through 12 months compared to those receiving placebo (fracture incidence 1.6 percent vs. 2.5 percent, respectively [p=0.008]).

In patients who received romosozumab in year one, fracture risk reduction continued through month 24 after both groups transitioned to denosumab treatment through the second year of the study: there was a statistically significant 75 percent reduction in the risk of vertebral fracture at month 24 (the other co-primary endpoint) in patients who received romosozumab followed by denosumab vs. placebo followed by denosumab (fracture incidence 0.6 percent vs. 2.5 percent, respectively [p<0.001]).

Clinical fractures encompass all symptomatic fractures (both non-vertebral and painful vertebral fractures; all clinical fractures assessed in the FRAME study were symptomatic fragility fractures. A 33 percent reduction in relative risk of clinical fracture was observed through 24 months after patients transitioned from romosozumab to denosumab compared to patients transitioning from placebo to denosumab (nominal p=0.002, adjusted p=0.096).

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Long-Term Bone Loss Linked to Antidepressants May Be Ameliorated By Beta Blockers

MedicalResearch.com Interview with:

Patricia Ducy, PhD Associate Professor Department of Pathology & Cell Biology Columbia University New York, NY 10032

Dr. Patricia Ducy

Patricia Ducy, PhD
Associate Professor
Department of Pathology & Cell Biology
Columbia University
New York, NY 10032

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

Response: In the past few years, several large clinical studies have reported an association between the use of selective serotonin reuptake inhibitors (SSRIs) and an increased risk of bone fractures. Yet, a few studies conducted on small cohorts using these drugs for a short time showed a decrease in bone resorption parameters and thus minor bone gain.

To understand this paradox and to define how the deleterious effect of SSRIs could be prevented we conducted a series of studies in mice treated with fluoxetine, the active molecule of the widely prescribed SSRI Prozac.

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Patients Remain On High Risk Drugs Even After A Fragility Fracture

MedicalResearch.com Interview with:

Jeffrey Munson, MD, MSCE Assistant Professor The Dartmouth Institute for Health Policy & Clinical Practice Assistant Professor, Department of Medicine Geisel School of Medicine at Dartmouth

Dr. Jeffrey Munson

Jeffrey Munson, MD, MSCE
Assistant Professor
The Dartmouth Institute for Health Policy & Clinical Practice
Assistant Professor, Department of Medicine
Geisel School of Medicine at Dartmouth

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

Response: Fragility fractures due to osteoporosis are a common and costly event among older Americans. Patients who experience one fragility fracture are at increased risk to have a second fracture. Our group is interested in exploring ways in which the risk of a second fracture could be reduced.

In this paper, we studied prescription drug use both before and after fracture. We know many prescription drugs have been shown to increase the risk of fracture, but we don’t know whether doctors try to reduce the use of these drugs after a fracture has occurred. Our study was designed to answer this question.

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Some Populations Are Genetically Immune to Osteoporosis

MedicalResearch.com Interview with:
Dr. Constance Hilliard
Department of History
University of North Texas
Denton, TX

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

Response: As an evolutionary historian, I have devoted the last several years to researching the health implications of genetic diversity. I was particularly concerned with the tendency of medical researchers to unwittingly use the biology of people with Northern European ancestry as a universal standard for everyone. For instance, lactose intolerance may be a disorder in that community, which suffers high rates of osteoporosis. But since 65% of the world’s population are lactose intolerant and have low rates of osteoporosis, a one-size-fits-all approach to bone health can prove dangerous for those whose ethnic-specific biological needs are overlooked.

This study shows that osteoporosis is not a global problem. It has a strong and devastating impact in dairy-farming societies and is virtually non-existent in the tsetse zone of West Africa, where cattle rearing and dairying are not possible. Previous studies have tried to correlate the degenerative bone disease with socio-economic income. However, this study compares two regions of Africa with similar socio-economic conditions. In dairy-farming East Africa, the incidence of osteoporosis is 245 per 100,000. However in the tsetse belt of West Africa, where people do not consume dairy products, it is 3 per 100,000. When regression analyses are performed on 40 countries around the world, the association between dairy consumption and osteoporosis is high (0.851). It only correlates with national Gross National Product at a regression rate of 0.447.

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Risk of Second Fracture Highest Immediately After First Fracture from Osteoporosis

MedicalResearch.com Interview with:

Professor Nicholas C W Harvey, MA MB BChir PhD FRCP Professor of Rheumatology and Clinical Epidemiology Honorary Consultant Rheumatologist MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK

Prof. Harvey

Professor Nicholas C W Harvey, MA MB BChir PhD FRCP
Professor of Rheumatology and Clinical Epidemiology
Honorary Consultant Rheumatologist
MRC Lifecourse Epidemiology Unit
University of Southampton
Southampton General Hospital
Southampton UK

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

Prof. Harvey:  It is well established that fracture risk is substantially increased by having had a previous fracture. A previous study suggested that fracture risk soon after a spine fracture might be greater than the risk later on, and if the risk varies with time, it would be sensible to identify the time at greatest risk, so intervention can be given.

The risk of a second osteoporotic fracture was greatest immediately after the first fracture and thereafter decreased with time though remained higher than the population risk throughout follow up. For example, 1 year after the first fracture the risk of a second fracture was three times higher than the population risk. After 10 years it was two times higher.

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Humanized Antibody Romosozumab May Increase Bone Mass In Resistant Osteoporosis Patients

MedicalResearch.com Interview with:

Bente Langdahl Professor, Consultant, PhD, DMSc Department of Endocrinology and Internal Medicine THG Aarhus University Hospital Aarhus Denmark

Dr. Bente Langdahl

Bente Langdahl
Professor, Consultant, PhD, DMSc
Department of Endocrinology and Internal Medicine THG
Aarhus University Hospital
Aarhus Denmark

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

Response: Romosozumab is a humanised antibody against sclerostin currently in development for the treatment of osteoporosis. Romosozumab has a dual effect on bone; it stimulates bone formation and inhibits bone resorption. If this new treatment obtains regulatory approval and becomes available for the treatment of osteoporosis, some of the patients who will be candidates for this new treatment will already have been treated with other available treatments, for example, bisphosphonates. This study compared the effects of romosozumab and teriparatide, a currently available bone forming treatment, on bone mass, bone structure and bone strength. The results showed that the percent change from baseline in BMD at the total hip through month 12 (the primary endpoint) was significantly greater with romosozumab compared with teriparatide: 2.6 percent versus –0.6 percent, respectively (p<0.0001). For the secondary endpoints; lumbar spine BMD by DXA, total hip and femoral neck BMD by DXA and QCT and bone strength estimated by finite element analysis patients treated with romosozumab had significantly larger increases from baseline compared with those taking teriparatide, with mean differences ranging from 3.1 percent to 4.6 percent (all p-values <0.0001).

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Growth Hormone Reduced Fractures in Osteoporosis Patients

MedicalResearch.com Interview with:
Emily Krantz (né Amundson) MD
Södra Älvsborgs Hospital
Borås, Sweden

Medical Research: What is the background for this study? What are the main findings?

Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group.

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Vitamin D Did Not Improve Bone or Muscle Health in Post-Menopausal Women

MedicalResearch.com Interview with:
Karen E. Hansen, M.D., M.S.
Associate Professor of Medicine
University of Wisconsin School of Medicine and Public Health
Madison, WI 53705-2281

Medical Research: What is the background for this study?

Dr. Hansen: The USPTF says to older community dwelling adults, “don’t bother taking vitamin D”, the Endocrine Society says “take 2,000-4,000 IU daily” and the Institute of Medicine gave an RDA of 600-800 IU daily. The Endocrine Society argues that optimal vitamin D levels are 30 ng/mL and higher, while the Institute of Medicine concludes that 20 ng/mL and higher indicates optimal vitamin D status. The disagreement between experts prompted my study.

Medical Research: What are the main findings?

Dr. Hansen: Among postmenopausal women whose vitamin D level was ~21 ng/mL at baseline, there was no benefit of high-dose or low-dose vitamin D, compared to placebo, on spine/hip/total body bone mineral density, muscle fitness by 5 sit to stand test or Timed Up and Go, or falls. We did see a small 1% increase in calcium absorption in the high-dose vitamin arm, but this small increase did not translate into clinically meaningful changes in bone density or muscle tests.

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No Association Between Kidney Stones and Osteoporosis or Fractures in Women

Monique Bethel, MD Subspecialty Service, Department of Veterans Affairs Medical Center, Department of Medicine, Section of Rheumatology Georgia Regents University Augusta, GAMedicalResearch.com Interview with:
Monique Bethel, MD
Subspecialty Service, Department of Veterans Affairs Medical Center,
Department of Medicine, Section of Rheumatology
Georgia Regents University
Augusta, GA

MedicalResearch: What is the background for this study?

Dr. Bethel: Osteoporosis and kidney stones share several risk factors, including elevated calcium in the urine (hypercalciuria), low potassium intake, and possibly, diets high in sodium. Accordingly, several studies have shown a significant relationship between kidney stones and osteoporosis in men. However, it is unclear if this relationship is also true for women. Previous studies examining this association have been small and inconclusive.   With the Women’s Health Initiative, we had data available from approximately 150,000 postmenopausal women in the US. Using this database, we were able to study the relationship between kidney stones and changes in bone mineral density and fractures.

MedicalResearch: What are the main findings?

Dr. Bethel: We found no association between the presence of kidney stones and changes in bone mineral density over time at the hip, lumbar spine, or the whole body. Also, there was no association between the presence of kidney stones and fractures. We also found that 14% of women who had a history of kidney stones upon entering the studies had another one occur during the course of the study (approximately 8 years).

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Osteoporosis May Increase Risk of Hearing Loss

Dr. Kai-Jen Tien MD Division of Endocrinology and Metabolism, Department of Internal Medicine Chi Mei Medical Center, Tainan, TaiwanMedicalResearch.com Interview with:
Dr. Kai-Jen Tien MD
Division of Endocrinology and Metabolism, Department of Internal Medicine
Chi Mei Medical Center, Tainan, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Response: Previous studies investigating the relationship between osteoporosis and sudden sensorineural hearing loss were rare. Most of the studies were of small sample size, or cross-sectional designs and their results were inconclusive. Our population-based study found an approximately 1.76-fold increase in the incidence of sensorineural hearing loss for patients with osteoporosis compared with the comparison group.Patients with more severe osteoporosis may have a higher risk of SSNHL than patients with osteoporosis of milder severity.

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Space Flight Model Links Aging, Osteoporosis and Immunity

Dr. Jean-Pol Frippiat Stress, Immunity and Pathogens Laboratory at Lorraine University Vandoeuvre-lès-Nancy, FranceMedicalResearch.com Interview with:
Dr. Jean-Pol Frippiat
Stress, Immunity and Pathogens Laboratory
Lorraine University
Vandoeuvre-lès-Nancy, France 


What is the background for this study? What are the main findings?

Dr. Frippiat: Osteoporosis is associated to spaceflight. Consequently, we wondered whether changes in bone micro-structure induced by a ground-based model of spaceflight, hindlimb unloading (HU) that simulates some of the effects of spaceflight on mice, induces changes in B lymphocyte production in the bone marrow.

To this end, we analyzed both bone parameters and the frequency of cells of the B lineage in the bone marrow of young, old and HU mice. We found that HU leads to a decrease in both bone micro-structure and the frequency of B cell progenitors in the bone marrow. A major block at the pro-B to pre-B cell transition was observed indicating a decrease in the formation of B cells in the bone marrow. Interestingly, the modifications in B cell production were similar to those observed in aged mice.

These findings demonstrate that mechanical unloading, to which astronauts are subjected during spaceflight, results in a decrease in B cell differentiation that resemble age-related modifications in B lymphopoiesis.

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Weight Loss May Be Better For Bone Health in Obese Men

Sue Shapses, PhD Professor, Department of Nutritional Sciences Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University New Brunswick, NJ 08901-8525MedicalResearch.com Interview with:
Sue Shapses, PhD

Professor, Department of Nutritional Sciences
Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University
New Brunswick, NJ 08901-8525

MedicalResearch: What is the background for this study?

Dr. Shapses: Improving health outcomes through dieting and weight loss is encouraged for the majority of Americans who are either overweight or obese. However, while most studies show that a moderate reduction in body weight decreases obesity related comorbidities, there may also be loss of bone and muscle in older individuals. Specifically in postmenopausal women, intentional moderate weight loss results in a 1-2.5% bone loss when compared to a weight stable group. Studies in men, designed to address the effect of weight reduction at multiple bone sites, compartments and geometry, are currently lacking. In addition, while a higher body weight is associated with higher bone mass, evidence indicates that bone quality, a predictor of fracture risk, is compromised in the obese. It is possible that frequent dieting or weight cycling in these obese individuals may have deleterious effects on bone. Therefore, understanding whether bone quality changes with weight loss, is important to better predict osteoporosis risk in this population. In this controlled trial, the effect of dietary restriction on bone mineral density (BMD), geometry and strength were examined in middle aged and older obese/overweight men. In addition, we addressed whether endocrine changes associated with weight loss explain bone changes.

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Recommended Osteoporosis Screening May Not Effectively Screen Younger Patients

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
UCLA Medicine/GIM Los Angeles, CA 90024

Medical Research: What are the main findings of the study?

Dr. Crandall: Clinical guidelines recommend that women aged ≥ 65 years should be screened for osteoporosis.  However, for younger postmenopausal women aged between 50 and 64 years, the United States Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women who have a 10-year predicted risk of osteoporosis fracture that is ≥9.3%.  We tested the ability the USPSTF strategy, and two other strategies (called OST and SCORE), to distinguish between women who did and did not experience a fracture in the subsequent 10 years.  We found that the USPSTF strategy did not identify the majority of who experienced osteoporotic fracture in the subsequent 10 years.  Especially in women aged 50-54 years, the USPSTF strategy identified fewer than 5% of women who experienced fracture over 10-year follow-up.

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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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Obstructive Sleep Apnea Raises Risk of Osteoporosis

Kai-Jen Tien, MD Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center Assistant Professor, Center of General Education Chia Nan University of Pharmacy and Science Tainan, TaiwanMedicalResearch.com Interview with:
Kai-Jen Tien, MD
Division of Endocrinology and Metabolism,
Department of Internal Medicine,  Chi Mei Medical Center
Assistant Professor, Center of General Education
Chia Nan University of Pharmacy and Science
Tainan, Taiwan

MedicalResearch.com: What are the main findings of the study?

Answer:  We conducted the first and largest population-based cohort study to evaluate the association of obstructive sleep apnea (OSA) and osteoporosis in a 6-year follow-up investigation of an Asian population. OSA is characterized by repetitive episodes of apnea/hypopnea and hypoxia in tissue, which might impact the bone metabolism. The results of the study showed that patients with obstructive sleep apnea had 2.74 times the risk of osteoporosis than patents without obstructive sleep apnea after adjustment for the patient`s characteristics and comorbidities. Across all age groups and sex groups, individuals with OSA had higher incidence rate of osteoporosis than individuals without obstructive sleep apnea. Subgroup analysis showed that older patients and female patients had a higher risk for osteoporosis than their younger and male counterparts.
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Osteoporosis: Improving Bone Mineral Density Postmenopause with Monoclonal Antibody Romosozumab

Michael McClung, MD Founding Director, Oregon Osteoporosis Center 5050 NE Hoyt Street, Suite 626 Portland, OR 97213MedicalResearch.com Interview with
Michael McClung, MD
Founding Director, Oregon Osteoporosis Center
5050 NE Hoyt Street, Suite 626
Portland, OR 97213


MedicalResearch.com: What are the main findings of the study?

Dr. McClung: In this Phase 2 trial, each of five romosozumab dose regimens significantly increased BMD compared with pooled placebo groups at the lumbar spine, total hip and femoral neck regions (all p<0.001). The largest increases were observed with the romosozumab 210 mg once-monthly dose, with mean increases, compared with baseline, of 11.3 percent at the lumbar spine, 4.1 percent at the total hip and 3.7 percent at the femoral neck.
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