Abstract
Skeletal pathology is a leading cause of serious morbidity and functional loss in old age. However, it is difficult to distinguish between disease and normal age changes in the clinical approach to bone disorders, and this has led to substantial controversy over the diagnosis and treatment of the most common metabolic bone disease, osteoporosis. For example, loss of skeletal calcium is a nearly universal concomitant of aging independent of body size, race, or gender, but the process does not become pathologic until it is of sufficient magnitude to lead to osteoporotic fracture, with associated adverse consequences such as pain, immobility, deformity, and (in the case of hip fracture) premature death.
Keywords
Bone Loss Bone Mass Vertebral Fracture Endometrial Cancer Postmenopausal OsteoporosisPreview
Unable to display preview. Download preview PDF.
References
- 1.Rodin A, Murby B, Smith MA, et al. Premenopausal bone loss in the lumbar spine and neck of femur: a study of 225 caucasian women. Bone. 1990; 11: 1–50.PubMedCrossRefGoogle Scholar
- 2.Falch JA, Sandvik L. Perimenopausal appendicular bone loss: a 10 year prospective study. Bone. 1990; 11: 425–428.PubMedCrossRefGoogle Scholar
- 3.Riggs BL, Melton LJ III. The prevention and treatment of osteoporosis. N Engl J Med. 1992; 327: 620–627.PubMedCrossRefGoogle Scholar
- 4.Riggs BL, Melton LJ III. Involutional osteoporosis. N Engl J Med. 1986; 314: 1676–1686.PubMedCrossRefGoogle Scholar
- 5.Gallagher JC, Riggs BL, Eisman J, et al. Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients: effect of age and dietary calcium. J Clin Invest. 1979; 64: 729–734.PubMedCrossRefGoogle Scholar
- 6.Parfitt AM. Bone remodeling: relationship to the amount and structure of bone, and the pathogenesis and prevention of fractures. In: Riggs BL, Melton LJ III, eds. Osteoporosis: Etiology, Diagnosis and Management. New York: Raven Press; 1988: 45–93.Google Scholar
- 7.Osteoporosis. In: Berg RL, Cassells JS, eds. The Second Fifty Years: Promoting Health and Preventing Disability. Washington, DC: National Academy Press; 1990: 76–100.Google Scholar
- 8.Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985; 7: 178–208.PubMedGoogle Scholar
- 9.Jensen GF, Christiansen C, Boesen J, et al. Epidemiology of postmenopausal spinal and long bone fractures: a unifying approach to postmenopausal osteoporosis. Clin Orthop. 1966; 45: 31–36.Google Scholar
- 10.Ryan PJ, Blake G, Herd R, Fogelman I. A clinical profile of back pain and disability in patients with osteoporosis. Bone. 1994; 15: 27–30.PubMedCrossRefGoogle Scholar
- 11.Owen RA, Melton LJ, Johnson KA, et al. Incidence of Colles’ fracture in a North American community. Am J Public Health. 1982; 72: 604–607.CrossRefGoogle Scholar
- 12.Kanis JA, Pitt FA. Epidemiology of osteoporosis. Bone. 1992; 13: S7 - S15.PubMedCrossRefGoogle Scholar
- 13.Gallagher JC, Melton LJ, Riggs BL. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop. 1980; 150: 163–171.PubMedGoogle Scholar
- 14.Melton LJ, Ilstrup M, Riggs B, et al. Fifty year trend in hip fracture incidence. Clin Orthop. 1982; 62: 144–149.Google Scholar
- 15.Wallace W. The increasing incidence of fractures of the proximal femur: an orthopedic epidemic. Lancet. 1983; 2: 1413–1414.CrossRefGoogle Scholar
- 16.Heyse SP. Epidemiology of hip fractures in the elderly: a cross-national analysis of mortality rates for femoral neck fractures. Osteoporosis Int. 1993;(suppl 1):516–19.Google Scholar
- 17.Eriksen EF, Colvard DS, Berg NJ, et al. Evidence of estrogen receptors in normal human osteoblast-like cells. Science. 1988; 241: 84–86.PubMedCrossRefGoogle Scholar
- 18.Komm BS, Terpening CM, Benz DJ, et al. Estrogen binding, receptor mRNA, and biologic response in osteoblastlike osteosarcoma cells. Science. 1988;241:84.Google Scholar
- 19.Cummings SR. Epidemiology of osteoporotic fractures: Selected topics. In: Roche AF, ed. Osteoporosis: Current Concepts. Report of the 7th Ross Conference on Medical Research. Columbus, OH: Ross Laboratories; 1987: 3–8.Google Scholar
- 20.Williams AR, Weiss NS, Ure CL, et al. Effect of weight, smoking, and estrogen use on the risk of hip and forearm fractures in post-menopausal women. Obstet Gynecol. 1982; 60: 695–699.PubMedGoogle Scholar
- 21.Heaney RP, Gallagher JC, Johnston CC, et al. Calcium nutrition and bone health in the elderly. Am J Clin Nutr. 1982; 36: 986–1013.PubMedGoogle Scholar
- 22.Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. N Engl J Med. 1995; 332: 767–773.PubMedCrossRefGoogle Scholar
- 23.Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC. Predictors of bone mass in perimenopausal women. Ann Intern Med. 1990; 112: 96–101.PubMedGoogle Scholar
- 24.Hui SL, Slemenda CW, Johnston CC. Baseline measurement of bone mass predicts fracture in white women. Ann Intern Med. 1989; 111: 355–361.PubMedGoogle Scholar
- 25.Cummings SR, Black DM, Nevitt MC, et al. Appendicular bone mass and age predict hip fracture in women. JAMA. 1990; 263: 665–668.PubMedCrossRefGoogle Scholar
- 26.Wasnich RD, Ross PD, Heilbrun LK, Vogel JM. Prediction of postmenopausal fracture risk with use of bone mineral measurements. Am J Obstet Gynecol. 1985; 153: 745–751.PubMedGoogle Scholar
- 27.Cummings SR, Black DM, Nevitt MC, et al. Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet. 1993; 341: 72–75.PubMedCrossRefGoogle Scholar
- 28.Faulkner KG, Cummings SR, Black D, Palermo L, Gluer GL, Genant HK. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Miner Res. 1993; 8: 1211–1217.PubMedCrossRefGoogle Scholar
- 29.Ross PD, Davis JW, Epstein R, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991; 114: 919–923.PubMedGoogle Scholar
- 30.Wasnich R. Bone mass measurement: prediction of risk. Am J Med. 1993; 95 (suppl 5A): 6S - 10S.PubMedCrossRefGoogle Scholar
- 31.Nevitt MC, Cummings SR, and Study of Osteoporotic Fractures Research Group. Type of fall and risk of hip and wrist fractures. J Am Geriatr Soc. 1993; 41: 1226–1234.Google Scholar
- 32.Lyritis GP, Tsakalakos N, Magiasis B, Karachalios T, Yiatzides A, Tsekoura M. Analgesic effect of salmon calcitonin in osteoporotic fractures: a double blind placebo controlled study. Calcif Tissue Int. 1991; 49: 369–372.PubMedCrossRefGoogle Scholar
- 33.Merli GJ. Prophylaxis for deep vein thrombosis and pulmonary embolism in the geriatric patient undergoing surgery. Clin Geriatr Med. 1990; 6: 531–542.PubMedGoogle Scholar
- 34.Hull RD, Raskob GE, Hirsh J. Prophylaxis of venous thromboembolism: an overview. Chest. 1986; 89 (suppl): 374S - 383S.PubMedGoogle Scholar
- 35.Riggs BL, Wahner HW. Bone densitometry and clinical decision-making in osteoporosis (editorial). Ann Intern Med. 1988; 108: 293–295.PubMedGoogle Scholar
- 36.Lindsay R. Osteoporosis. Clin Geriatr Med. 1988; 4: 41 1430.Google Scholar
- 37.Johnston CC Jr, Slemenda CW, Melton LJ III. Clinical use of bone densitometry. N Engl J Med. 1991; 324: 1105–1109.PubMedCrossRefGoogle Scholar
- 38.Mazess RB, Barden H, Ettinger M, Schultz E. Bone density of the radius, spine, and proximal femur in osteoporosis. J Bone Miner Res. 1988; 3: 13–18.PubMedCrossRefGoogle Scholar
- 39.Chestnut CH. The imaging and quantitation of bone by radiographic and scanning methodologies. In: Coe FL, Favus MJ, eds. Disorders of Bone and Mineral Metabolism. New York: Raven Press; 1992: 447–448.Google Scholar
- 40.Pacifici R, Rupich R, Griffin M, Chines A, Susman N, Avioli LV. Dual energy radiography vs. quantitative computer tomography for the diagnosis of osteoporosis. J Clin Endocrinol Metab. 1990; 70: 705–710.PubMedCrossRefGoogle Scholar
- 41.Ettinger B, Grady D. The waning effect of postmenopausal estrogen therapy on osteoporosis. N Engl J Med. 1993; 329: 1192–1193.PubMedCrossRefGoogle Scholar
- 42.Heaney RP. Nutritional factors in osteoporosis. Annu Rev Nutr. 1993; 13: 287–316.PubMedCrossRefGoogle Scholar
- 43.Dawson-Hughes B. Calcium supplementation and bone loss: a review of controlled clinical trials. Am J Clin Nutr. 1991; 54: 274S - 280S.PubMedGoogle Scholar
- 44.Cumming RG. Calcium intake and bone mass: a quantitative review of the evidence. Calcif Tissue Int. 1990; 47: 194201.Google Scholar
- 45.Johnston CC, Miller JZ, Slemenda CW, et al. Calcium supplementation and increases in bone mineral density in children. N Engl J Med. 1992; 327: 82–87.PubMedCrossRefGoogle Scholar
- 46.Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med. 1993; 328: 460–464.PubMedCrossRefGoogle Scholar
- 47.Aloia JF, Vaswani A, Yeh JK, Ross PL, Flaster E, Dilmanian FA. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann Intern Med. 1994; 120: 97–103.PubMedGoogle Scholar
- 48.Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992; 327: 1637–1642.PubMedCrossRefGoogle Scholar
- 49.Mckenna MJ. Differences in vitamin D status between countries in young adults and elderly. Am J Med. 1992; 93: 69–77.CrossRefGoogle Scholar
- 50.Heaney RP, Rocker RR, Saville PD. Calcium balance and calcium requirement in middle aged women. Am J Clin Nutr. 1977; 30: 1603–1611.PubMedGoogle Scholar
- 51.Chestnut CH. Bone mass and exercise. Am J Med. 1993; 95 (5A): 34S - 36S.CrossRefGoogle Scholar
- 52.Dalsky GP, Stocke KS, Ehsani AA, et al. Weight bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med. 1988; 108: 824828.Google Scholar
- 53.Krall EA, Dawson-Hughes B. Walking is related to bone density and rate of bone loss. Am J Med. 1994; 96: 20–26.PubMedCrossRefGoogle Scholar
- 54.Drinkwater BD, Nilson KC, Chestnut CH. Bone mineral content of amenorrheic and eumenorrheic athletes. N Engl J Med. 1984; 311: 277–281.PubMedCrossRefGoogle Scholar
- 55.Drinkwater BL. Exercise in the prevention of osteoporosis. Osteoporosis Int. 1993; 1: S169–171.CrossRefGoogle Scholar
- 56.Heaney RP, Recker RR, Saville PD. Menopausal changes in bone remodeling. J Lab Clin Med. 1978; 92: 964–970.PubMedGoogle Scholar
- 57.Nachtigall LE, Nachtigall RH, Nachtigall RD. Estrogen replacement therapy I: a 10 year prospective study in the relationship of osteoporosis. Obstet Gynecol. 1979; 53: 277284.Google Scholar
- 58.Lindsay R, Hart DM, MacLean A, et al. Bone response to termination of estrogen treatment. Lancet. 1978; 1: 1325 1327.Google Scholar
- 59.Horowitz MC. Cytokines and estrogen in bone: antiosteoporotic effects. Science. 1993; 206: 626–627.CrossRefGoogle Scholar
- 60.Marcus R, Cann C, Madvig P, et al. Menstrual function and bone mass in elite women distance runners. Ann Intern Med. 1985; 102: 158–163.PubMedGoogle Scholar
- 61.Ettinger B, Genant HK, Cann CE. Long term estrogen therapy prevents bone loss and fracture. Ann Intern Med. 1985; 102: 319–324.PubMedGoogle Scholar
- 62.Hutchinson TA, Polansky JM, Feinstein AR. Postmenopausal oestrogens protect against fracture of the hip and distal radius. Lancet. 1979; 2: 705–709.PubMedCrossRefGoogle Scholar
- 63.Kreiger N, Kelsey JL, Holford TR. An epidemiological study of hip fracture in postmenopausal women. Am J Epidemiol. 1982; 116: 141–148.PubMedGoogle Scholar
- 64.Smith DM, Khairi MRA, Johnston CC. The loss of bone mineral with aging and its relationship to risk of fracture. J Clin Invest. 1975; 56: 311–318.PubMedCrossRefGoogle Scholar
- 65.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: 1195–1198.PubMedCrossRefGoogle Scholar
- 66.Lindsay R, Tohme JF. Estrogen treatment of patients with established osteoporosis. Obstet Gynecol. 1990; 76: 290295.Google Scholar
- 67.Lufkin EG, Wahner HW, O’Fallon WM, et al. Treatment of postmenopausal osteoporosis with transdermal estrogen. Ann Intern Med. 1992; 117: 1–9.PubMedGoogle Scholar
- 68.Lobo RA. Cardiovascular implications of estrogen replacement therapy. Obstet Gynecol. 1990;75(suppl):18S255.Google Scholar
- 69.Barrett-Connor E, Bush TL. Estrogen and coronary heart disease in women. JAMA. 1991; 265: 1861–1867.PubMedCrossRefGoogle Scholar
- 70.Stampfer MJ, Colditz GA, Willett WC, et al. Postmenopausal estrogen therapy and cardiovascular disease-ten year follow-up from the Nurses’ Health Study. N Engl J Med. 1991; 325: 756–762.PubMedCrossRefGoogle Scholar
- 71.Williams JK, Adams MR, Klopfenstein HS. Estrogen modulates responses of atherosclerotic coronary arteries. Circulation. 1990; 81: 1680–1687.PubMedCrossRefGoogle Scholar
- 72.Colditz GA, Hankinson SE, Hunter DJ, et al. The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engl J Med. 1995; 332: 1589 1593.Google Scholar
- 73.Shapiro S, Kelley JP, Rosenberg L. Risk of localized and widespread endometrial cancer in relation to recent and discontinued use of conjugated estrogens. N Engl J Med. 1985; 313: 969–972.PubMedCrossRefGoogle Scholar
- 74.Horowitz RI, Feinstein AR. Alternative analytic methods for case control studies of estrogens and endometrial cancer. N Engl J Med. 1978; 299: 1088–1094.CrossRefGoogle Scholar
- 75.Chu J, Schweed AI, Weiss NS. Survival among women with endometrial cancer: a comparison of estrogen users and nonusers. Am J Obstet Gynecol. 1982; 143: 569573.Google Scholar
- 76.Voight LF, Weiss NS, Chu J, Daling JR, McKnight B, Van Belle G. Progestogen supplementation of exogenous oestrogens and risk of endometrial cancer. Lancet. 1991; 338: 274–277.CrossRefGoogle Scholar
- 77.Gambrell RD, Massey FM, Castaneda TA, et al. Reduced incidence of endometrial cancer among postmenopausal women treated with progestogens. J Am Geriatr Soc. 1979; 27: 389–394.PubMedGoogle Scholar
- 78.Grady D, Rubin SM, Petitti DB, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992; 117: 1016–1037.PubMedGoogle Scholar
- 79.Steinberg KK, Thacker SB, Smith SJ, et al. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA. 1991; 265: 1985–1990.PubMedCrossRefGoogle Scholar
- 80.Colditz GA, Stampfer MJ, Willett WC, et al. Postmenopausal hormone use and the risk of breast cancer: 12 year follow-up of the Nurses’ Health Study. In: Mann RD, ed. Hormone Replacement Therapy and Breast Cancer Risk. Carnforth, England: Parthenon; 1992: 63–77.Google Scholar
- 81.Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989; 149: 2445–2448.PubMedCrossRefGoogle Scholar
- 82.Ettinger B, Genant HK, Cann CE. Long term estrogen therapy prevents bone loss and fracture. Ann Intern Med. 1985; 102: 319–324.PubMedGoogle Scholar
- 83.Ott SM. Estrogen therapy for osteoporosis-even in the elderly. Ann Intern Med. 1992; 117: 85–86.PubMedGoogle Scholar
- 84.Marx CW, Daily GE, Cheney C, Vint VC, Muchmore DB. Do estrogens improve bone mineral density in osteoporotic women over age 65? J Bone Miner Res. 1992; 7: 1275–1279.PubMedCrossRefGoogle Scholar
- 85.Felson DT, Zhang Y, Hannan MT, et al. Effect of postmenopausal estrogen therapy on bone density in elderly women. N Engl J Med. 1993; 329: 1141–1146.PubMedCrossRefGoogle Scholar
- 86.Kiel DP, Felson DT, Anderson JJ, Wilson PWF, Moskowitz MA. Hip fracture and the use of estrogen in postmenopausal women: the Framingham Study. N Engl J Med. 1987; 317: 1169–1174.PubMedCrossRefGoogle Scholar
- 87.Cauley JA, Seeley DG, Ensrud K, et al. Estrogen replacement therapy and fractures in older women. Ann Intern Med. 1995; 122: 9–16.PubMedGoogle Scholar
- 88.McDermott MT, Kidd GS. The role of calcitonin in the development and treatment of osteoporosis. Endocr Rev. 1987; 8: 377–390.PubMedCrossRefGoogle Scholar
- 89.Gruber HE, Ivey JL, Baylink DL, et al. Long term calcitonin therapy in postmenopausal osteoporosis. Metabolism. 1984; 33: 295–303.PubMedCrossRefGoogle Scholar
- 90.Mazzuoli GF, Passeri M, Gennari C, et al. Effects of salmon calcitonin in postmenopausal osteoporosis: a controlled double-blind clinical study. Calcif Tissue Int. 1986; 38: 3–8.PubMedCrossRefGoogle Scholar
- 91.Reginster JY. Calcitonin for prevention and treatment of osteoporosis. Am J Med. 1993; 95 (suppl 5A): 44S - 47S.PubMedCrossRefGoogle Scholar
- 92.Overgaard K, Hansen MA, Jensen SB, Christiansen C. Effect of salcalcitonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose response study. Br Med J. 1992; 305: 56–61.CrossRefGoogle Scholar
- 93.Kanis JA, Johnell O, Gullberg B, et al. Evidence for efficacy of drugs affecting bone metabolism in preventing hip fracture. Br Med J. 1992; 305: 1124–1128.CrossRefGoogle Scholar
- 94.Rico H, Hernandez ER, Revilla M, Gomez-Castresana F. Salmon calcitonin reduces vertebral fracture rate in postmenopausal crush fracture syndrome. Bone Miner. 1992; 16: 131–138.PubMedCrossRefGoogle Scholar
- 95.Wimalawansa SJ. Long and short term side effects and safety of calcitonin in man. Calcif Tissue Int. 1993; 52: 90–93.PubMedCrossRefGoogle Scholar
- 96.Muff R, Dambacher MA, Fischer JA. Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatment of postmenopausal osteoporosis. Osteoporosis Int. 1991; 1: 72–75.CrossRefGoogle Scholar
- 97.Riggs BL, Hodgson SF, O’Fallon WM, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med. 1990; 322: 80 2809.Google Scholar
- 98.Kleerekoper M, Peterson EL, Nelson DA, et al. A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporosis Int. 1991; 1: 155–161.CrossRefGoogle Scholar
- 99.Pak CYC, Sakhaee K, Adams-Huet B, et al. Treatment of postmenopausal osteoporosis with slow-release sodium fluoride: final report of a randomized controlled trial. Ann Intern Med. 1995; 123: 401–408.PubMedGoogle Scholar
- 100.O’Duffy JD, Wahner HW, O’Fallon WM, et al. Mechanism of acute lower extremity pain syndrome in fluoridetreated osteoporotic patients. Am J Med. 1986; 80: 561–566.PubMedCrossRefGoogle Scholar
- 101.Baylink DJ, Ivey JL. Sodium fluoride for osteoporosis-some unanswered questions. JAMA. 1980; 245: 463–464.CrossRefGoogle Scholar
- 102.Wasnich RD, Benfante RJ, Yano K, et al. Thiazide effect on the mineral content of bone. N Engl J Med. 1983; 309: 344–347.PubMedCrossRefGoogle Scholar
- 103.Wasnich RD, Ross PD, Heilbrun LK, et al. Differential effects of thiazide and estrogen upon bone mineral content and fracture prevalence. Obstet Gynecol. 1986; 67: 457–462.PubMedGoogle Scholar
- 104.Wasnich R, Davis J, Ross P, Vogel J. Effect of thiazide on rates of bone mineral loss: a longitudinal study. Br Med J. 1990; 301: 1303–1305.CrossRefGoogle Scholar
- 105.Cauley JA, Cummings SR, Seeley DG, et al. Effects of thiazide diuretic therapy on bone mass, fractures and falls. Ann Intern Med. 1993; 118: 666–673.PubMedGoogle Scholar
- 106.LaCroix AZ, Weinpahl J, White LR, et al. Thiazide diuretic agents and the incidence of hip fracture. N Engl J Med. 1990; 322: 286–290.PubMedCrossRefGoogle Scholar
- 107.Felson DT, Sloutskis D, Anderson JJ, et al. Thiazide diuretics and the risk of hip fracture. Results from the Framingham Study. JAMA. 1991; 265: 370–373.PubMedCrossRefGoogle Scholar
- 108.Ray WA, Griffin MR, Downey W. Long term-use of thiazide diuretics and risk of hip fracture. Lancet. 1989; 1: 687–690.PubMedCrossRefGoogle Scholar
- 109.Heidrich FE, Stergachis A, Gross KM. Diuretic drug use and the risk for hip fracture. Ann Intern Med. 1991; 115: 1–6.PubMedGoogle Scholar
- 110.Multiple Risk Factor Intervention Trial Research Group. Multiple risk factor intervention trial: risk factor changes and mortality results. JAMA. 1982; 248: 1465–1477.CrossRefGoogle Scholar
- 111.Thapa PB, Ray WA. Can thiazide diuretics be recommended routinely to reduce hip fracture risk? Drugs Aging 1993; 3: 99–105.PubMedCrossRefGoogle Scholar
- 112.Papapoulos SE. The role of bisphosphonates in the prevention and treatment of osteoporosis. Am J Med. 1993; 95 (suppl 5A): 48S - 52S.PubMedCrossRefGoogle Scholar
- 113.Harris ST, Watts NB, Jackson RD, et al. Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med. 1993; 95: 557–567.PubMedCrossRefGoogle Scholar
- 114.Storm T, Thamsborg G, Steiniche T, et al. Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med. 1990; 332: 1265–1271.CrossRefGoogle Scholar
- 115.Liberman UA, Weiss SR, et al. Effect of treatment with oral alendronate on bone mineral density and fracture incidence in postmenopausal osteoporosis. N Engl J Med. 1995; 333; 1437–1443.PubMedCrossRefGoogle Scholar
- 116.Struys A. Snelder AA, Mulder H. Cyclical etidronate reverses bone loss of the spine and proximal femur in patients with established corticosteroid-induced osteoporosis. Am J Med. 1995; 99: 235–242.CrossRefGoogle Scholar
- 117.Riggs BL. Formation stimulating regimens other than sodium fluoride. Am J Med. 1993; 95 (suppl 5A): 62S - 68S.PubMedCrossRefGoogle Scholar
- 118.Slovik DM, Adams JS, Neer RM, et al. Deficient production of 1,25 dihydroxy vitamin D in elderly osteoporotic patients. N Engl J Med. 1981; 305: 37 2374.Google Scholar
- 119.Brandi ML. New treatment strategies: ipriflavone, strontium, vitamin D metabolites and analogs. Am J Med. 1993; 95 (suppl 5A): 69S - 74S.PubMedCrossRefGoogle Scholar
- 120.Heikinheimo RJ, Inkovaara JA, Hurju EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int. 1992; 51: 105–110.PubMedCrossRefGoogle Scholar
- 121.Sambrook P, Birmingham J, Kelly P. Prevention of corticosteroid osteoporosis: a comparison of calcium, calcitriol and calcitonin. N Engl J Med. 1993; 328: 1747–1752.PubMedCrossRefGoogle Scholar
- 122.Reid IR. Steroid osteoporosis. Osteoporosis Int. 1993; (suppl 1):S 144–146.Google Scholar
- 123.Diamond T, McGuigan L, Barbagello S, Bryant C. Cyclical etidronate plus ergocalciferol prevents glucocorticoidinduced bone loss in postmenopausal women. Am J Med. 1995; 98: 459–463.PubMedCrossRefGoogle Scholar
- 124.Seeman E, Melton LJ, O’Fallon WM, et al. Risk factors for spinal osteoporosis in men. Am J Med. 1983; 75: 977983.Google Scholar
- 125.Kelepouris N, Harper KD, Gannon F, et al. Severe osteoporosis in men. Ann Intern Med. 1995; 123: 45 2460.Google Scholar
- 126.Orwoll ES, Oviatt SK, McClung MR, et al. The rate of bone mineral loss in normal men and the effects of calcium and cholecalciferol supplementation. Ann Intern Med. 1990; 112: 29–34.PubMedGoogle Scholar
- 127.Seeman E. Osteoporosis in men: epidemiology, pathophysiology, and treatment possibilities. Am J Med. 1993; 95 (suppl 5A): 25S - 28S.CrossRefGoogle Scholar
- 128.Frame B, Parfitt AM. Osteomalacia: current concepts. Ann Intern Med. 1978; 89: 976–982.Google Scholar
- 129.Holick MF. Vitamin D requirements for the elderly. Clin Nutr. 1986; 5: 121–129.Google Scholar
- 130.Bingham CT, Fitzpatrick LA. Noninvasive testing in the diagnosis of osteomalacia. Am J Med. 1993; 95: 519523.Google Scholar
- 131.Heath H, Hodgson SF, Kennedy MA. Primary hyperparathyroidism. Incidence, morbidity and potential economic impact in a community. N Engl J Med. 1980; 302: 189–193.PubMedCrossRefGoogle Scholar
- 132.Solomon BL, Schaaf M, Smallridge RC. Psychologie symptoms before and after parathyroid surgery. Am J Med. 1994; 96: 101–106.PubMedCrossRefGoogle Scholar
- 133.Mallette LE. Primary hyperparathyroidism: clinical and biochemical features. Medicine. 1974; 53: 127–146.PubMedCrossRefGoogle Scholar
- 134.Karpati G, Frame B. Neuropsychiatrie disorders in primary hyperparathyroidism. Arch Neurol. 1964; 10: 387–397.PubMedCrossRefGoogle Scholar
- 135.Clarke OH, Wilkes W, Siperstein AE, Duh QY. Diagnosis and management of asymptomatic hyperparathyroidism: safety, efficacy, and deficiencies in our knowledge. J Bone Miner Res. 1991; 6: 135–142.CrossRefGoogle Scholar
- 136.Consensus Development Conference Panel 1991. Diagnosis and management of asymptomatic primary hyperparathyroidism: Consensus development conference statement. Ann Intern Med. 1991; 114: 593–597.Google Scholar
- 137.Marcus R, Madvig P, Crim M, et al. Conjugated estrogens in the treatment of postmenopausal women with hyperparathyroidism. Ann Intern Med. 1984; 100: 633–640.PubMedGoogle Scholar
- 138.Selby PL, Peacock M. Ethinyl estradiol and norethindrone in the treatment of primary hyperparathyroidism in postmenopausal women. N Engl J Med. 1986; 314: 1481–1485.PubMedCrossRefGoogle Scholar
- 139.McDermott MT, Perloff JJ, Kidd GS. Effect of mild asymptomatic primary hyperparathyroidism on bone mass in women with and without estrogen replacement therapy. J Bone Miner Res. 1994; 9: 509–514.PubMedCrossRefGoogle Scholar
- 140.Cosman F, Shen V, Xie F, Seibel M, Ratcliffe A, Lindsay R. Estrogen protection against bone resorbing effects of parathyroid hormone infusion. Ann Intern Med. 1993; 118: 337–343.PubMedGoogle Scholar
- 141.Scholz DA, Purnell DC. Asymptomatic primary hyperparathyroidism-10 year prospective study. Mayo Clin Proc. 1981; 56: 473–478.PubMedGoogle Scholar
- 142.Singer FR, Wallach S. Paget’s Disease of Bone. New York: Elsevier; 1991.Google Scholar
- 143.Singer FR, Fredericks RS, Minkin C. Salmon calcitonin therapy for Paget’s disease of bone. The problem of acquired clinical resistance. Arthritis Rheum. 1980; 23: 1143 1154.Google Scholar
- 144.Hosking DJ. Advances in the management of Paget’s disease of bone. Drugs. 1990; 40: 829–840.PubMedCrossRefGoogle Scholar
- 145.Patel S, Stone MD, Coupland C, Hosking DJ. Determinants of remission of Paget’s disease of bone. J Bone Miner Res. 1993; 8: 1467–1473.PubMedCrossRefGoogle Scholar
- 146.Reginster JY, Treves R, Renier JC, et al. Efficacy and tolerability of a new formulation of oral tiludronate in the treatment of Paget’s disease of bone. J Bone Miner Res. 1994; 9: 615–619.PubMedCrossRefGoogle Scholar