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In order to explain the higher prevalence of fractures in urban compared with rural areas, 782 residents in the city of Malmö, Sweden and 486 inhabitants from the nearby rural municipality of Sjöbo were invited to participate in a sex- and age-matched cross-sectional study on life-style differences; 73 and 80% respectively responded. Responders answered a questionnaire on medical and social background and were interviewed on past and present physical activity. The men and women of the rural area were found to be significantly more active physically at work and during spare time. Housing was larger in the rural area. For women, these differences are decreasing in the younger age groups. Bone mass was found to be correlated to heavier work load for men. Other life-style variable such as dairy calcium intake, coffee drinking, estrogen medication, and morbidity, could not explain this difference. Higher prevalence of fractures in the city could therefore be explained by physically less active life-style. [ABSTRACT FROM AUTHOR]

This is a follow-up of a previous study on the predictive power of bone mineral measurements; two more observation years have been added. A group of women (n = 1076) had their forearm bone mineral content (BMC) measured from 1970-1976. All fractures that occurred in 1975-1987 (13 years) were recorded. Four hundred sixty-nine fragility fractures occurred during the collection period. Again, it was found that BMC at the distal end of the forearm is a good predictor of future fracture before the age of 70. The measurement at the proximal site (forearm shafts), however, in contrast to our previous study, has a capacity of predicting fracture also in the age group 70-80. BMC measurements were good predictors of vertebral crush fractures and trochanteric hip fracture but lesser predictors of fractures of the distal end of the forearm. In age groups 40-70, BMC was a stronger predictor of fracture than age, and the risk associated with a 1 SD decrease of BMC 6 was 3.2 for a hip fracture as compared with those without any fragility fracture, even when adjusted for age. In addition to BMC, low body weight was a fracture predictor. Body weight 5 kg below age-adjusted mean increased the risk of a trochanteric hip fracture by 30%. The data are used in hypothetical calculations of the effects of screening. [ABSTRACT FROM AUTHOR]

The effect of intense physical training on the bone mineral content (BMC) and soft tissue composition, and the development of these values after cessation of the active career, was studied in 40 nationally or internationally ranked male weight lifters. Nineteen were active and 21 had retired from competition sports. Fifty-two age- and sex-matched nonweight lifters served as controls. The bone mineral density (BMD) in total body, spine, hip, and proximal tibial metaphysis was measured with a Lunar Dual-energy X-ray absorptiometry (DXA) apparatus and the BMD of the distal forearm was measured with single photon absorptiometry (SPA). Seventeen of the lifters had been measured earlier with SPA in the forearm and 23 in the tibial condyle during their active career in 1975. The BMD was significantly higher in the weight lifters compared with the controls (10% in the total body P < 0.001, 12% in the trochanteric region P < 0.001, and 13% in the lumbar spine P < 0.001). All measured regions except the head showed significant higher bone mass in the weight lifters compared with the controls. In older lifters, the difference from the controls seemed to increase in total body and lumbar vertebrae (BMD), but remained unchanged in the hip. Significant correlation was found between the SPA measurements in 1975 and the corresponding measurements 15 years later in both the forearm (r = 0.51, P < 0.05 at the 1-cm level and r = 0.87, P < 0.001 at the 6-cm level) and in the tibial condyle (r = 0.61, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

Fifteen years after their forearm bone mineral content was measured, 366 women were measured again with the same single photon technique. 96 of the women had sustained one or more fragility fractures during that period. The initial bone mineral content was less in those women who were to have fractures. The rate of loss over the years did not differ between fracture and non-fracture women--the initial bone mass was the better predictor. Peak bone mass in the women in this study occurred before the age of 40. [ABSTRACT FROM AUTHOR]

In 1,076 women who had been interviewed from 1970 to 1976 with regard to previous fracture and disease, all fragility fractures that occurred from 1975 to 1985 were recorded. Hip and vertebral fractures were good predictors of future fragility fractures but mainly in younger women (less than 70 years) and this was also the case for fracture of the distal end of the forearm in the age group 40-59. Later in life, falling tendency became the important predictor. [ABSTRACT FROM AUTHOR]

In 1,076 women the forearm bone mineral content (BMC) had been measured with single photon gamma absorptiometry (SPA) 10-16 years ago. The incidence of fractures incurred in the ensuing years (1975-1985) was recorded. The BMC had been significantly less in those women who were to have the types of fractures that are related to bone fragility but only in women measured during the first post- menopausal decades. From age 50-69, diminished BMC at the distal forearm site was associated with a threefold increase of relative risk whereas at the proximal site there was about a sixfold increase in relative risk. This association was not evident in the population over 70 years of age because of a high frequency of fractures (mostly of the spine) in subjects with relatively high BMC values. Body weight and grip strength were significantly lower in the fracture group over 70 years of age. [ABSTRACT FROM AUTHOR]

The age and sex-specific incidence and prevalence of vertebral compression fractures were compared between the 1950s and 1980s in an urban population. In women over 80 years of age the incidence of symptomatic vertebral fractures has increased approximately four times; in elderly men even more. Mainly, low-energy trauma has caused these fractures. Thus, one clinical manifestation of osteoporosis--vertebral fracture--has increased in number, incidence, and prevalence over the last 30 years. [ABSTRACT FROM AUTHOR]

A placebo-controlled, double-blind study was carried out over 4 months to evaluate two doses of synthetic human calcitonin (0.25 and 0.125 mg) given s.c. three times per week. Enrolled were 60 women, aged 56-82 years, who had experienced a vertebral fracture due to low-energy trauma within the preceding year. During active treatment there was within the first month a dose-dependent decrease of the indices of bone resorption (fasting urinary calcium and hydroxyproline excretions), whereas only the higher dose and a treatment period of 4 months produced a reduction of bone formation (serum osteocalcin). The bone mineral content (BMC) of the nondominant forearm was unchanged. Treatment with calcitonin also had significant, dose-dependent, analgetic effects. The amelioration of pain was, in multivariate analyses, related to a reduction in parameters felt to be markers for bone resorption. In the placebo group there was a significant reduction of the BMC of the forearm but no changes of any of the biochemical markers for bone turnover and no improvement of pain. In conclusion, treatment with two low doses of calcitonin induced changes of the biochemical markers of bone turnover in a dose-dependent manner. The analgetic properties of calcitonin were also of salient clinical importance. The knowledge derived from this study could be adapted to the dosage schedule in long-term trials in osteoporosis. [ABSTRACT FROM AUTHOR]

A case-control study compared 129 men with earlier partial gastrectomy (operation during the period 1952-1961) with 216 men from a community-based population study. All were born 1910-1915 and the mean age was 72 years. Men with a previous partial gastrectomy had vertebral fractures in 19% compared with 4% (P < 0.01) in the control population. Bone mineral density (BMD) in the right calcaneus measured with dual energy photon absorptiometry was 20% lower in men with a Billroth II operation (P < 0.001) and 8% lower with a Billroth I operation (ns). In comparison with the controls, the men subjected to partial gastrectomy had higher serum concentrations of osteocalcin and alkaline phosphatase activity, a lower serum concentration of 25-hydroxyvitamin D (25OHD) and a lower body mass index (BMI). There were no difference in serum concentrations of free calcium, intact parathyroid hormone (PTH), or free thyroxine. The smoking prevalence was significantly higher in men with partial gastrectomy than in controls. Smokers had significantly lower serum concentrations of intact PTH and 25OHD than nonsmokers and also lower BMD and BMI. The relationships between intact PTH on one hand, and ionized calcium (inverse relationship) and osteocalcin (direct relationship) on the other were preserved in smokers, however. Gastroscopy was performed in 78 men with multiple biopsies in the gastric remnant and also in the small intestine. All but two subjects had chronic gastritis. Examination of sternal bone marrow smears showed that 40% of the Billroth-operated men lacked bone marrow reticular iron.(ABSTRACT TRUNCATED AT 250 WORDS)

The bone mineral content of the forearms was measured in 395 women, aged 49, and correlated with menarche, menopause, parity, lactation, contraceptives, diet, smoking, and physical activity. Late menarche and early menopause were associated with a lower than average bone mineral content whereas the life-style parameters were not.

In 31 epileptics, most of whom had been on anticonvulsive drugs for decades, the amount of osteoid--active and inactive--and the osteoclast activity were measured in iliac crest biopsies and compared with the same variables from a control group. Although falling within normal limits, the amount of osteoid, in particular the inactive osteoid, was significantly increased in the epileptics. The osteoclast activity was also significantly increased in the epileptics.