Skip to main content
SpringerLink
Log in

Prevention and Treatment of Osteoporosis

  • Conference paper
HRT and Osteoporosis

  • 99 Accesses

Abstract

The most serious complication of osteoporosis is fracture. The occurrence of fracture is dependent on a number of factors: these include the frequency of falls, the type of fall involved, the quality of the bone tissue, and most importantly the amount of bone tissue present. As bone tissue is lost the density of the skeleton decreases, reducing its structural integrity. Bone density is directly related to fracture prevalence [1] and incidence [2]. Thus, whilst measures to reduce the chance of falls are clearly important, the prevention of bone loss and maintenance of bone density are the major aims of therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Melton LJ, Wahner HW, Richelson L, O’Fallon WM, Dunn WL, Riggs BL. Bone density specific fracture risk: a population based study of the relationship between osteoporosis and vertebral fractures. J Nucl Med 1985; 26:24.

    Google Scholar 

  2. Melton LJ, Wahner HW, Richelson L, O’Fallon WM, Riggs BL. Osteoporosis and the risk of hip fracture. Am J Epidemiol 1986: 124:254–61.

    PubMed  Google Scholar 

  3. Gilsanz V, Gibbens DT, Carlson M, Boechet MI, Cann CE, Schulz EE. Peak trabecular vertebral density: a comparison of adolescent and adult females. Calcif Tissue Int 1988; 43:260–2.

    Article  PubMed  CAS  Google Scholar 

  4. Meema S, Meema HE. Menopausal bone loss and estrogen replacement. Isr J Med Sci 1976; 12:601–6.

    PubMed  CAS  Google Scholar 

  5. Riggs BL, Wahner HW, Seeman E et al. Changes in bone mineral density of the proximal femur and spine with aging. J Clin Invest 1982; 70:716–23.

    Article  PubMed  CAS  Google Scholar 

  6. Gallagher JC, Goldger D, Moy A. Total body calcium in normal women: effect of age and menopause state. J Bone Miner Res 1987; 2:491:6.

    PubMed  Google Scholar 

  7. Hui SL, Slemenda CW, Johnston CC, Appledorn CR. Effects of age and menopause on vertebral bone density. Bone Miner 1987; 2:141–6.

    PubMed  CAS  Google Scholar 

  8. Schaadt O, Bohr H. Different trends of age-related diminution of bone mineral content in the lumbar spine, femoral neck and femoral shaft in women. Calcif Tissue Int 1988; 42:71–6.

    Article  PubMed  CAS  Google Scholar 

  9. Stevenson JC, Lees BL, Devenport M, Cust MP, Ganger KF. Determinants of bone density in normal women: risk factors for future osteoporosis? Br Med J 1989; 298:924–8.

    Article  CAS  Google Scholar 

  10. Smith DM, Nance WE, Kang KW, Christian JC, Johnston CC. Genetic factors in determining bone mass. J Clin Invest 1973; 52:2800–8.

    Article  PubMed  CAS  Google Scholar 

  11. Matkovic V, Chesnut C, Genetic factors and acquisition of bone mass. J Bone Miner Res 1987; 2 suppl 1:329.

    Google Scholar 

  12. Cohn SH, Abesamis C, Yasamura S, Aloia JF, Zanzi I, Ellis KJ. Comparative skeletal mass and radial bone mineral content in black and white women. Metabolism 1977; 26:171–8.

    Article  PubMed  CAS  Google Scholar 

  13. Seeman E, Hopper JL, Bach LA et al. Reduced bone mass in daughters of women with osteoporosis. N Engl J Med 1989; 320:554–8.

    Article  PubMed  CAS  Google Scholar 

  14. Richelson LS, Wahner HW, Melton LJ, Riggs BL. Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med 1984; 311:1273–5.

    Article  PubMed  CAS  Google Scholar 

  15. Stevenson JC, Banks LM Spinks TJ et al. Regional and total skeletal measurements in the early postmenopause. J Clin Invest 1987; 80:258–62.

    Article  PubMed  CAS  Google Scholar 

  16. Lindsay R, Hart DM, Aitken JM, MacDonald EB, Anderson JB, Clarke AC. Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet 1976; i:1038–41.

    Article  Google Scholar 

  17. Horsman A, Gallagher JC, Simpson M. Nordin BEC. Prospective trial of oestrogen and calcium in postmenopausal women. Br Med J 1977; ii:789–92.

    Article  Google Scholar 

  18. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy. A 10-year prospective study in relationship to osteoporosis. Obstet Gynecol 1979; 53:277–81.

    PubMed  CAS  Google Scholar 

  19. Hutchinson TA, Polansky SM, Feinstein A. Postmenopausal oestrogens protect against fractures of hip and distal radius. Lancet 1979; ii:706–9.

    Google Scholar 

  20. Lindsay R, Hart DM, Forrest C, Baird C. Prevention of spinal osteoporosis in oophorectomised women. Lancet 1980; ii:1151–4.

    Article  Google Scholar 

  21. Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med 1980; 303:1195–8.

    Article  PubMed  CAS  Google Scholar 

  22. Paganini-Hill A, Ross RK, Gerkins VR, Henderson BE, Arthur M, Mack TM. A case-control study of menopausal estrogen therapy and hip fractures. Ann Intern Med 1981; 95:28–31.

    PubMed  CAS  Google Scholar 

  23. Christiansen C, Christensen MS, Transbol I. Bone mass in postmenopausal women after withdrawal of oestrogen/gestagen replacement therapy. Lancet 1981; i:459–61.

    Article  Google Scholar 

  24. Dempster DW, Shane E, Herbert W, Lindsay R. A simple method for correlative light and scanning electron microscopy of human iliac crest bone biopsies: qualitative observations in normal and osteoporotic subjects. J Bone Miner Res 1986; 1:15–21.

    Article  PubMed  CAS  Google Scholar 

  25. Gruber HE, Ivey JL, Baylink DJ et al. Long-term calcitonin therapy in postmenopausal osteoporosis. Metabolism 1984; 33:295–303.

    Article  PubMed  CAS  Google Scholar 

  26. MacIntyre I, Stevenson JC, Whitehead MI, Wimalawansa SJ, Banks LM, Healy MJR. Calcitonin for prevention of postmenopausal bone loss. Lancet 1988; ii:1481–3.

    Google Scholar 

  27. Reginster JY, Denis D, Albert A et al. 1-year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet 1987; ii:1481–3.

    Article  Google Scholar 

  28. Overgaard K, Riis BJ, Christiansen C, Podenphant J, Johansen JS. Nasal calcitonin for treatment of established osteoporosis. Clin Endocrinol 1989; 30:435–42.

    Article  CAS  Google Scholar 

  29. Genant HK, Harris ST, Steiger P, Davey PF, Block JE. The effect of etidronate therapy in postmenopausal osteoporotic women: preliminary results. In: Christiansen C, Johansen JS, Riis BJ, eds. Osteoporosis 1987. Copenhagen: Osteopress ApS, 1987:1177–81.

    Google Scholar 

  30. Storm T, Thamsborg G, Sorensen OH, Lund B. The effect of etidronate therapy in postmenopausal osteoporotic women: preliminary results. In: Christiansen C, Johansen JS, Riis BJ, eds. Osteoporosis 1987. Copenhagen: Osteopress ApS, 1987:1172–6.

    Google Scholar 

  31. Reginster JY, Deroisy R, Denis D et al. Prevention of postmenopausal bone loss by tiludronate. Lancet 1989; ii:1469–71.

    Article  Google Scholar 

  32. Horowitz M, Need AG, Philcox JC, Nordin BEC. The effect of calcium supplements on plasma alkaline phosphatase and urinary hydroxyproline in postmenopausal women. Horm Metab Res 1985; 17:311–12.

    Article  PubMed  CAS  Google Scholar 

  33. Steiniche T, Hasling C, Charles P, Eriksen EF, Mosekilde L, Meisen F. A randomized study on the effects of estrogen/gestagen or high dose oral calcium on trabecular bone remodeling in postmenopausal osteoporosis. Bone 1989; 10:313–20.

    Article  PubMed  CAS  Google Scholar 

  34. Riis B, Thomsen K, Christiansen C. Does calcium supplementation prevent postmenopausal bone loss? N Engl J Med 1987; 316:173–7.

    Article  PubMed  CAS  Google Scholar 

  35. Stevenson JC, Osteoporosis: pathogenesis and risk factors. In: Martin TJ, ed. Bailliere’s clinical endocrinology and metabolism. Vol 2, no. 1. Metabolic bone disease. London: Bailliere Tindall 1988; 87–101.

    Google Scholar 

  36. Kanis JA, Passmore R. Calcium supplementation of the diet. I. Br Med J 1989; 293:137–40.

    Article  Google Scholar 

  37. Kanis JA, Passmore R. Calcium supplementation of the diet. II. Br Med J 1989; 293:205–8.

    Article  Google Scholar 

  38. Wickham CAC, Walsh K, Cooper C et al. Dietary calcium, physical activity, and the risk of hip fracture: a prospective study. Br Med J 1989; 299:889–92.

    Article  CAS  Google Scholar 

  39. Riggs BL, Warmer HW, Melton LJ et al. Dietary calcium intake and rate of bone loss in women. J Clin Invest 1987; 80:979–82.

    Article  PubMed  CAS  Google Scholar 

  40. Stevenson JC, Whitehead MI, Padwick M et al. Dietary intake of calcium and postmenopausal bone loss. Br Med J 1988; 297:15–17.

    Article  CAS  Google Scholar 

  41. Nordin BEC, Horsman A, Crilly RG, Marshall DH, Simpson M. Treatment of spinal osteoporosis in postmenopausal women. Br Med J 1980; i:451–4.

    Article  Google Scholar 

  42. Ott SM, Chesnut CH. Calcitriol treatment is not effective in postmenopausal osteoporosis. Ann Intern Med 1989; 110:267–74.

    PubMed  CAS  Google Scholar 

  43. Riggs BL, Hodgson SF, Muhs J, Wahner HW. Fluoride treatment of osteoporosis: clinical and bone densitometric responses. In: Christiansen C, Johansen JS, Riis BJ, eds. Osteoporosis 1987. Copenhagen: Osteopress ApS, 1987; 817–23.

    Google Scholar 

  44. Duursma SA, Glerum JH, Van Dijk A et al. Responders and non-responders after fluoride therapy in osteoporosis. Bone 1987; 8:131–6.

    Article  PubMed  CAS  Google Scholar 

  45. Hedlund LR, Gallagher JC. Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride. J Bone Miner Res 1989; 4:223–5.

    Article  PubMed  CAS  Google Scholar 

  46. Vaishnav R, Beresford JN, Gallagher JA, Russell RGG. Effects of the anabolic steroid stanozolol on cells derived from human bone. Clin Sci 1988; 74:455–60.

    PubMed  CAS  Google Scholar 

  47. Chesnut CH, Treatment of postmenopausal osteoporosis: some current concepts. Scott Med J 1981; 26:72–80.

    PubMed  Google Scholar 

  48. Hassager C, Borg J, Christiansen C. The effect of subcutaneous fat on single-photon 125I absorptiometry measurement of bone mineral content in the distal forearm. In:Christiansen C, Johansen JS, Riis BJ, eds. Osteoporosis 1987. Copenhagen: Osteopress ApS, 1987; 399–401.

    Google Scholar 

  49. Stevenson JC, Lees B, Fielding C, Cust MP, Ganger KF, Hillard TC. Exercise and the skeleton. In: Smith R, ed. Osteoporosis 1990. London: Royal College of Physicians, 1990; 119–24.

    Google Scholar 

  50. Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy women. Br Med J 1987; 295:1441–4.

    Article  CAS  Google Scholar 

  51. Cooper C, Barker DJP, Wickham C. Physical activity, muscle strength and calcium intake in fracture of the proximal femur in Britain. Br Med J 1988; 287:1443–6.

    Article  Google Scholar 

  52. Drinkwater BL, Nilson K. Chesnut CH et al. Bone mineral content of amenorrhoeic and eumenorrhoeic athletes. N Engl J Med 1984; 311:277–81.

    Article  PubMed  CAS  Google Scholar 

  53. Lloyd T, Myers C, Buchanan JR, Demers LM. Collegiate women athletes with irregular menses during adolescence have decreased bone density. Obstet Gynecol 1988; 72:639–42.

    PubMed  CAS  Google Scholar 

  54. Stevenson JC. Post-menopausal bone loss and osteoporosis. In: Zichella L, Whitehead MI, van Keep PA, eds. The climacteric and beyond, Carnforth, England: Parthenon Publishing, 1988; 125–35.

    Google Scholar 

Download references

Authors
  1. J. C. Stevenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. C. Hillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Ellerington
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clarendon Wing, Leeds General Infirmary, Leeds, LS1 3EX, UK

    James O. Drife MD, FRCS Ed, FRCOG (Professor of Obstetrics and Gynaecology) (Professor of Obstetrics and Gynaecology)

  2. King’s College Hospital, London, SE5 9RS, UK

    John W. W. Studd MD, BS, FRCOG (Consultant Obstetrician and Gynaecologist, Director) (Consultant Obstetrician and Gynaecologist, Director)

  3. The Menopause Clinic, Dulwich Hospital, East Dulwich Grove, London, SE22 8PT, UK

    John W. W. Studd MD, BS, FRCOG (Consultant Obstetrician and Gynaecologist, Director) (Consultant Obstetrician and Gynaecologist, Director)

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag London Limited

About this paper

Cite this paper

Stevenson, J.C., Hillard, R.C., Ellerington, M. (1990). Prevention and Treatment of Osteoporosis. In: Drife, J.O., Studd, J.W.W. (eds) HRT and Osteoporosis. Springer, London. https://doi.org/10.1007/978-1-4471-1799-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-1799-5_23

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1801-5

  • Online ISBN: 978-1-4471-1799-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation