Skip to main content

Part of the book series: Current Clinical Practice ((CCP))

  • 989 Accesses

Abstract

Fractures caused by osteoporosis are among the most serious health risks women face as they age. Osteoporosis affects eight million American women, causing approximately 1.5 million osteoporotic fractures per year, with a direct annual expenditure of nearly $18 billion (1). Fewer than 50% of women who suffer a hip fracture will recover their previous level of function (2). A 50-year-old woman’s lifetime risk of dying from a hip fracture is equal to her risk of dying from breast cancer (3). The enormity of the impact of osteoporotic fractures on the health and quality of life of women underscores the importance of preventing and treating osteoporosis.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover 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. Gabriel SE, Tosteson AN, Leibson CL, et al. Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 2002;13:323–330.

    Article  CAS  PubMed  Google Scholar 

  2. Office of Technology Assessment. Hip Fracture Outcomes in people age 50 and over. Washington, DC: US Government Printing Office; 1994. Background paper OTA-BP-H-120.

    Google Scholar 

  3. Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Int Med 1989;149:2445–2448.

    Article  CAS  Google Scholar 

  4. NIH Consensus Development Panel on Osteoporosis. JAMA 2001;285:785–795.

    Article  Google Scholar 

  5. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series. No. 843; Geneva, Switzerland: World Health Organization; 1994.

    Google Scholar 

  6. Handy RC, Petak SM, Lenchik L. International Society for Clinical Densitometry Position Development Panel and Scientific Advisory Committee. Which central dual X-ray absorptiometry skeletal sites and regions of interest should be used to determine the diagnosis of osteoporosis? J Clin Densitom 2002;5(Suppl):S11–S18.

    Article  Google Scholar 

  7. Miller PD, Njeh CF, Jankowski LG. International Society for Clinial Densitometry Position Development Panel and Scientific Advisory Committee. What are the standards by which bone mass measurement at peripheral skeletal sites should be used in the diagnosis of osteoporosis? J Clin Densitom 2002;5(Suppl):S39–S45.

    Article  PubMed  Google Scholar 

  8. Writing Group for the ISCD Position Development Conference. Diagnosis of osteoporosis in men, premenopausal women, and children. J Clin Densitom 2004;7(1):17–26.

    Article  Google Scholar 

  9. Raisz LG, Rodan GA. Pathogenesis of osteoporosis. Endocrinol Metab Clin North Am 2003;32:15–24.

    Article  PubMed  Google Scholar 

  10. Simonet WS, Lacey DL, Dunstan CR, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell 1997;89:309–319.

    Article  CAS  PubMed  Google Scholar 

  11. Hofbauer LC, Khosla S, Dunstan CR, et al. The roles of osteoprotegerin and osteoprotegerin ligand in the paracrine regulation of bone resorption. J Bone Miner Res 2000;15(1):2–12.

    Article  CAS  PubMed  Google Scholar 

  12. Kanis JA, Meton LJ, Christiansen C, et al. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137–1141.

    Article  CAS  PubMed  Google Scholar 

  13. National Osteoporosis Foundation. Physician’s Guide to Prevention and Treatment of Osteoporosis. Washington DC: National Osteoporosis Foundation, 2003.

    Google Scholar 

  14. Siris ES, Miller PD, Barrett-Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001;286:2815–2822.

    Article  CAS  PubMed  Google Scholar 

  15. Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001;285:320–323.

    Article  CAS  PubMed  Google Scholar 

  16. Orlil ZC, Raisz LG. Causes of secondary osteoporosis. J Clin Densitometry 1999;2:79–92.

    Article  Google Scholar 

  17. Stein E, Shane E. Secondary osteoporosis. Endocrinol Metab Clin North Am 2003;32:115–134.

    Article  PubMed  Google Scholar 

  18. Preventive Services Task Force, Screening for osteoporosis in postmenopausal women:recommendations and rationale. Ann Int Med 2002;137:526–528.

    Google Scholar 

  19. Hodgson SF, Watts NB, Bilezikian JP, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract. 2003;9:544–564. Erratum in: Endocr Pract 2004;10:90.

    PubMed  Google Scholar 

  20. Leib ES, Lewiecki EM, Binkley H, et al. Official positions of the International Society for Clinical Densitometry. J Clin Densitom 2004;7:1–6.

    Article  PubMed  Google Scholar 

  21. Picard D, Brown JP, Rosenthal L, et al. Ability of peripheral DXA measurement to diagnose osteoporosis as assessed by central DXA measurement. J Clin Densitom 2004;7:111–118.

    Article  CAS  PubMed  Google Scholar 

  22. Tannebaum C, Clark J, Schwartzman K, et al. Yield of laboratory testing to identify secondary contributors to osteoporosis in otherwise healthy women. J Clin Endocrinol Metab2002;87:4431–4437.

    Article  CAS  Google Scholar 

  23. Becker C. Clinical evaluation for osteoporosis. Clin Geriatr Med 2003;19:299–320.

    Article  PubMed  Google Scholar 

  24. Hammett-Stabler CA. The use of biochemical markers in osteoporosis. Clin Lab Med 2004;24:175–197.

    Article  PubMed  Google Scholar 

  25. Rosen HN, Moses AC, Garker J, et al. Utility of biochemical markers of bone turnover in the follow-up of patients treated with bisphosphonates. Calcif Tissue Int 1998;63:363–368.

    Article  CAS  PubMed  Google Scholar 

  26. Office of Dietary Supplements. NIH. Dietary supplement fact sheet. http://ods.od.nih.gov/ fact sheets/calcium asp. Last accessed 3/16/07.

    Google Scholar 

  27. Office of the Surgeon General. Bone health and osteoporosis: report of the surgeon general. Department of Health and Human Services, Rockville MN, 2004, pp. 436.

    Google Scholar 

  28. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004;79:362–371. Erratum in: Am J Clin Nutr 2004;79:890.

    CAS  PubMed  Google Scholar 

  29. Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9:87–98.

    Article  CAS  Google Scholar 

  30. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988;67:373–378.

    Article  CAS  PubMed  Google Scholar 

  31. Chapuy MC, Preziosi P, Maamer M, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 1997;7:439–443.

    Article  CAS  PubMed  Google Scholar 

  32. Thomas MK, Llyod-Jones DH, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J Med 1998;338:777–783.

    Article  CAS  PubMed  Google Scholar 

  33. Tangpricha V, Pearce EN, Chen TC, et al. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002;112:659–662.

    Article  CAS  PubMed  Google Scholar 

  34. Dawson-Hughes B, Heaney RP, Holick MF. Estimates of optimal vitamin D status. Osteoporos Int 2005;16:713–716.

    Article  CAS  PubMed  Google Scholar 

  35. Barger-Lux MJ, Heaner RP, Dowell S, et al. Vitamin D and its major metabolites: serum levels after graded oral dosing in healthy men. Osteoporos Int 1998;8:222–230.

    Article  CAS  PubMed  Google Scholar 

  36. Tangpricha V, Koutkia P, Rieke SM, et al. Portification of orange juice with vitamin D: a novel approach for enhancing vitamin D nutritional health. Am J Clin Nutr 2003;77:1478–1483.

    CAS  PubMed  Google Scholar 

  37. Tangpricha V, Pearce EN, Chen TC, et al. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002;11:659–662.

    Article  Google Scholar 

  38. Bischoff-Fearrari H, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005;293:2257–2264.

    Article  Google Scholar 

  39. Grant AM, Avenell A, Campbell MK, et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium or Vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 2005;365:1621–1628.

    Article  CAS  PubMed  Google Scholar 

  40. Porthouse J, Cockayne S, King C, et al. Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 2005;330:1003.

    Article  CAS  PubMed  Google Scholar 

  41. Holick MR, Siris ES, Binkley N, et al. Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005;90:3215–3224.

    Article  CAS  PubMed  Google Scholar 

  42. Beard A, Bravo G, Gauthier P. Meta-analysis of the effectiveness of physical activity for the prevention of bone loss in postmenopausal women. Osteoporos Int 1997;7:331–337.

    Article  Google Scholar 

  43. Kelley GA. Exercise and regional bone mineral density in postmenopausal women: a meta-analytic review of randomized trials. Am J Phys Med Rehabil 1998;77:76–87.

    Article  CAS  PubMed  Google Scholar 

  44. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ 2004;328:680.

    Article  PubMed  Google Scholar 

  45. Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994;331:821–827.

    Article  CAS  PubMed  Google Scholar 

  46. Leipzig RM, Cumming RG, Tinette ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999;47:30–39.

    CAS  PubMed  Google Scholar 

  47. Leipzig RM, Cumming RG, Tinette ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. Am Geriatr Soc 1999;47:40–50.

    CAS  Google Scholar 

  48. Parker MJ, Gillespie LD, Gilespie WJ. Hip protectors for preventing hip fractures in the elderly. Nurs Times 2001;97:41.

    CAS  PubMed  Google Scholar 

  49. Wainwright SA, Marshall LM, Ensrund KE, et al. Study of Osteoporotic Fractures Research Group. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 2005;90:2787–2793.

    Article  CAS  PubMed  Google Scholar 

  50. Schuit SC, van der Klift M, Weel AE, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 2004;34:195–202.

    Article  CAS  PubMed  Google Scholar 

  51. Rosen CJ. Clinical practice. Postmenopausal osteoporosis. N Engl J Med 2005;353:595–603.

    Article  CAS  PubMed  Google Scholar 

  52. Cranney A, Wells G, Willan A, et al. Meta-analyses of therapies for postmenopausal osteoporosis. II. Meta-analysis of alendronate for the treatment of postmenopausal women. Endocr Rev 2002;23:508–516.

    Article  CAS  PubMed  Google Scholar 

  53. Cranney A, Tugwell P, Adachi J, et al. Meta-analyses of therapies for postmenopausal osteoporosis. III. Meta-analysis of risedronate for the treatment of postmenopausal osteoporosis. Endocr Rev 2002;23:517–523.

    Article  CAS  PubMed  Google Scholar 

  54. Guyatt GH, Cranney A, Griffith L, et al. Summary of meta-analyses of therapies for postmenopausal osteoporosis and the relationship between bone density and fractures. Endocrinol Metab Clin North Am 2002;31:659–679.

    Article  PubMed  Google Scholar 

  55. Bone HG, Hosking D, Devogelaer JP, et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 2004;350:1189–1199.

    Article  CAS  PubMed  Google Scholar 

  56. Mellstrom DD, Sorenson OH, Goemaere S, et al. Seven years of treatment with risedronate in women with postmenopausal osteoporosis. Calcif Tissue Int 2004;75:462–468.

    Article  CAS  PubMed  Google Scholar 

  57. Ruggiero SL, Mehrota B, Rosenberg TJ, et al. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004;62:527–534.

    Article  PubMed  Google Scholar 

  58. Chestnut CH III, Skag A, Christansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 2004;19:1241–1249.

    Article  CAS  Google Scholar 

  59. The Writing Group for the PEPI. Effects of hormone therapy on bone mineral density:results from the postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA 1996;276:1389–1396.

    Article  Google Scholar 

  60. The Women’s Health Initiative Steering Committee. Effects of conjugated equine estrogen in postmenopaual women with hysterectomy, JAMA 2004;291:1701–1712.

    Article  Google Scholar 

  61. Greenspan SL, Emkey RD, Bone HG, et al. Significant differential effects of alendronate, estrogen, or combination therapy on the rate of bone loss after discontinuation of treatment of postmenopausal osteoporosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2002;137:875–883.

    CAS  PubMed  Google Scholar 

  62. Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in post-menopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA1999;282:637–645. Erratum in: JAMA 1999;282:212.

    Article  CAS  PubMed  Google Scholar 

  63. Cauley J, Norton L, Lippman M, et al. Continued breast cancer risk reduction in post-menopausal women treated with raloxifene: 4-year results from the MORE trial. Multiple outcomes of raloxifene evaluation. Breast Cancer Res Treat 2001;65:125–134. Erratum in:Breast Cancer Res Treat 2001;67:191.

    Article  CAS  PubMed  Google Scholar 

  64. Chesnut CH III, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med 2000;109:267–276.

    Article  CAS  PubMed  Google Scholar 

  65. Silverman SL, Azria M. The analgesic role of calcitonin following osteoporotic fracture. Osteoporos Int 2002;13:858–867.

    Article  CAS  PubMed  Google Scholar 

  66. Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001;344:1434–1441.

    Article  CAS  PubMed  Google Scholar 

  67. Greenspan SL, Resnick NM, Parker RA. Combination therapy with hormone replacement and alendronate for prevention of bone loss in elderly women: a randomized controlled trial. JAMA 2003;289:2525–2533.

    Article  CAS  PubMed  Google Scholar 

  68. Johnell O, Scheele WH, Lu Y. Additive effects of raloxifene and alendronate on bone density and biochemical markers of bone remodeling in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 2002;87:985–992.

    Article  CAS  PubMed  Google Scholar 

  69. Black DM, Greenspan SL, Ensrud KE. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med 2003;349:1207–1215.

    Article  CAS  PubMed  Google Scholar 

  70. Black DM, Bilezikian JP, Ensrud KE. One year of alendronate after one year of parathyroid hormone (1–84) for osteoporosis. N Engl J Med 2005;353:555–565.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Veloski, C. (2008). Osteoporosis. In: Clouse, A.L., Sherif, K. (eds) Women’s Health in Clinical Practice. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-469-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-469-8_4

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-631-3

  • Online ISBN: 978-1-59745-469-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics