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home:diseases:osteoporosis_osteopenia [10.29.2018] – [Patients experiences] +recent research Bolland, Grey and Avenell sallieq | home:diseases:osteoporosis_osteopenia [02.18.2019] – [Osteoporosis and osteopenia] sallieq | ||
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====== Osteoporosis and osteopenia ====== | ====== Osteoporosis and osteopenia ====== | ||
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Both osteoporosis and osteopenia are diseases marked by a decrease in bone mineral density. Osteopenia is a less severe form of and sometimes precursor to osteoporosis. The loss of bone mass leads to a porous bone structure, frequent fractures, and delayed healing. | Both osteoporosis and osteopenia are diseases marked by a decrease in bone mineral density. Osteopenia is a less severe form of and sometimes precursor to osteoporosis. The loss of bone mass leads to a porous bone structure, frequent fractures, and delayed healing. | ||
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===== Other treatments ===== | ===== Other treatments ===== | ||
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+ | Calcitonin | ||
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+ | Through these processes, bone matrix resorption and serum calcium are both decreased. | ||
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==== Calcium supplementation ==== | ==== Calcium supplementation ==== | ||
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==== Vitamin D supplementation ==== | ==== Vitamin D supplementation ==== | ||
- | Some clinicians encourage patients with inadequate bone density to supplement with vitamin D and calcium. While [[home: | + | Some clinicians encourage patients with inadequate bone density to supplement with vitamin D and calcium. |
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=== Interventional trials showing vitamin D is ineffective | === Interventional trials showing vitamin D is ineffective | ||
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===== Recent Research ===== | ===== Recent Research ===== | ||
- | Bolland MJ, Grey A and Avenell A. in Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, | + | //Zhao JG, Zeng XT, Wang J, Liu L. in// Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. (({{pubmed> |
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+ | A total of 33 randomized trials involving 51 145 participants fulfilled the inclusion criteria. There was no significant association of calcium or vitamin D with risk of hip fracture compared with placebo or no treatment (calcium: RR, 1.53 [95% CI, 0.97 to 2.42]; ARD, 0.01 [95% CI, 0.00 to 0.01]; vitamin D: RR, 1.21 [95% CI, 0.99 to 1.47]; ARD, 0.00 [95% CI, -0.00 to 0.01]. There was no significant association of combined calcium and vitamin D with hip fracture compared with placebo or no treatment (RR, 1.09 [95% CI, 0.85 to 1.39]; ARD, 0.00 [95% CI, -0.00 to 0.00]). No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of nonvertebral, | ||
+ | Conclusions and Relevance: | ||
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+ | In this meta-analysis of randomized clinical trials, the use of supplements that included calcium, vitamin D, or both compared with placebo or no treatment was not associated with a lower risk of fractures among community-dwelling older adults. These findings do not support the routine use of these supplements in community-dwelling older people.</ | ||
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+ | //Bolland MJ, Grey A and Avenell A. in// Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, | ||
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Our findings suggest that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density. There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health. This conclusion should be reflected in clinical guidelines.</ | Our findings suggest that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density. There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health. This conclusion should be reflected in clinical guidelines.</ | ||
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+ | This large scale GWAS meta-analysis for fracture identified 15 genetic determinants of fracture, all of which also influenced bone mineral density. Among the clinical risk factors for fracture assessed, only bone mineral density showed a major causal effect on fracture. Genetic predisposition to lower levels of vitamin D and estimated calcium intake from dairy sources were not associated with fracture risk. (({{pubmed> | ||