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home:diseases:osteoporosis_osteopenia [11.29.2018] – [Recent Research] sallieqhome:diseases:osteoporosis_osteopenia [02.18.2019] – [Osteoporosis and osteopenia] sallieq
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 ====== Osteoporosis and osteopenia ====== ====== Osteoporosis and osteopenia ======
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 +<relatedarticle> [[home:diseases:hyperparathyroidism|Secondary hyperparathyroidism]] </article>
  
 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    (({{pubmed>long:    30725954}}))
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 +<blockquote>Salmon calcitonin (after this referred to as “calcitonin”) is an analog of human calcitonin used in the treatment of postmenopausal osteoporosis, Paget disease of bone, and hypercalcemia. Its clinical importance derives from its ability to inhibit osteoclasts and increase renal excretion of calcium. 
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 +Through these processes, bone matrix resorption and serum calcium are both decreased.
 +</blockquote>
 +
  
 ==== 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:food:calcium|calcium]] has been shown to be somewhat helpful in certain patient cohorts, both controlled trials and molecular evidence do not support supplementation with vitamin D to reverse bone loss as, over the long term, it only exacerbates the disease process. +Some clinicians encourage patients with inadequate bone density to supplement with vitamin D and calcium. (({{pubmed>long:30293909}})) While [[home:food:calcium|calcium]] has been shown to be somewhat helpful in certain patient cohorts, both controlled trials and molecular evidence do not support supplementation with vitamin D to reverse bone loss as, over the long term, it only exacerbates the disease process. 
  
-<blockquote>Web of industry, advocacy, and academia in the management of osteoporosis http://www.bmj.com/content/351/bmj.h3170+<blockquote>Calcium supplements have been widely used by older men and women. However, in little more than a decade, authoritative recommendations have changed from encouraging the widespread use of calcium supplements to stating that they should not be used for primary prevention of fractures. This substantial shift in recommendations has occurred as a result of accumulated evidence of marginal antifracture efficacy, and important adverse effects from large randomized controlled trials of calcium or coadministered calcium and vitamin D supplements. In this review, we discuss this evidence, with a particular focus on increased cardiovascular risk with calcium supplements, which we first described 5 years ago. Calcium supplements with or without vitamin D marginally reduce total fractures but do not prevent hip fractures in community-dwelling individuals. They also cause kidney stones, acute gastrointestinal events, and increase the risk of myocardial infarction and stroke. //Bolland MJ, Grey A, and Reid IR// 2013  (({{pubmed>long:25114781}}))</blockquote>
  
-"Calcium and vitamin D supplementation continue to be recommended to prevent and treat osteoporosis despite evidence of lack of benefit, say Andrew Grey and Mark Bolland. They examine why change is difficult and call for advocacy organisations, academics, and specialist societies to abandon industry ties"</blockquote>+<blockquote>Web of industry, advocacy, and academia in the management of osteoporosis   [[http://www.bmj.com/content/351/bmj.h3170| BMJ 2015;351:h3170 ]] 
 + 
 +"Calcium and vitamin D supplementation continue to be recommended to prevent and treat osteoporosis despite evidence of lack of benefit, say Andrew Grey and Mark Bolland. They examine why change is difficult and call for advocacy organisations, academics, and specialist societies to abandon industry ties" </blockquote>
 === 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, and trial sequential analysis.  (({{pubmed>long:30293909}}))+//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>long:29279934}})) 
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 +<blockquote>Results: 
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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, vertebral, or total fractures. Subgroup analyses showed that these results were generally consistent regardless of the calcium or vitamin D dose, sex, fracture history, dietary calcium intake, and baseline serum 25-hydroxyvitamin D concentration. 
 +Conclusions and Relevance: 
 + 
 +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.</blockquote> 
 + 
 + 
 +//Bolland MJ, Grey A and Avenell A. in// Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis.  (({{pubmed>long:30293909}}))
  
  
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-Rivadeneira F.+//Rivadeneira F.//
 <blockquote>Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study. <blockquote>Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study.
  
home/diseases/osteoporosis_osteopenia.txt · Last modified: 09.14.2022 by 127.0.0.1
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