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1. Parenteral Nutrition-Associated Metabolic Bone Disease: Pathophysiology, Evaluation, and Treatment

Author

Douglas L. Seidner and Angelo Licata

Subjects
0303 health sciences, medicine.medical_specialty, Nutrition and Dietetics, 030309 nutrition & dietetics, business.industry, Medicine (miscellaneous), medicine.disease, Pathophysiology, Metabolic bone disease, 03 medical and health sciences, 0302 clinical medicine, Parenteral nutrition, Normal bone, Medicine, 030211 gastroenterology & hepatology, In patient, Medical prescription, business, Intensive care medicine
Abstract

Parenteral nutrition (PN) is generally given to provide adequate amounts of macronutrients and micronutrients to allow recovery after injury and illness. Maintenance of the skeleton is often neglected when one prepares a PN prescription. Although this may not be critical for the brief length of time that most patients receive PN, it becomes an important consideration in patients who need long-term PN, during which time metabolic bone disease (MBD) can develop. It is therefore important to have an understanding of the factors involved in normal bone metabolism and the impact that PN has on this process. This review describes some of the important factors that may play a role in the development of parenteral nutrition-associated metabolic bone disease (PN-MBD) and discusses a strategy for the diagnosis and treatment of this problem.

Published
2000
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2. Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

Author

Eastell, R, Lang, T, Boonen, S, Cummings, S, Delmas, Pd, Cauley, Ja, Horowitz, Z, Kerzberg, E, Bianchi, G, Kendler, D, Leung, P, Man, Z, Mesenbrink, P, Eriksen, Ef, Black, Dm, Eduardo, Kerzberg, Zulema, Man, Carlos, Mautalen, Maria, Ridruejo, Guillermo, Tate, Jorge, Velasco, Michael, Hooper, Mark, Kotowicz, Peter, Nash, Richard, Prince, Anthony, Roberts, Philip, Sambrook, Harald, Dobnig, Gerd, Finkenstedt, Guenter, Hoefle, Klaus, Klaushofer, Martin, Pecherstorfer, Peter, Peichl, Jean, Body, Steven, Boonen, JEAN PIERRE DEVOGELAER, Piet, Geusens, Jean, Kaufman, João, Brenol, Jussara, Kochen, Rubem, Lederman, Sebastiao, Radominski, Vera, Szejnfeld, Cristiano, Zerbini, Jonathan, Adachi, Jacques, Brown, Denis, Choquette, David, Hanley, Robert, Josse, David, Kendler, Richard, Kremer, Frederic, Morin, Wojciech, Olszynski, Alexandra, Papaioannou, Chiu, Kinyuen, Baoying, Chen, Shouqing, Lin, Nohemi, Casas, Monique, Chalem, Juan, Jaller, Jose, Molina, Hannu, Aro, Jorma, Heikkinen, Heikki, Kröger, Lasse, Mäkinen, Juha, Saltevo, Jorma, Salmi, Matti, Välimäki, CLAUDE LAURENT BENHAMOU, Pierre, Delmas, Patrice, Fardellone, Georges, Werhya, Bruno, Allolio, Dieter, Felsenberg, Joachim, Happ, Manfred, Hartard, Johannes, Hensen, Peter, Kaps, Joern, Kekow, Ruediger, Moericke, Bernd, Ortloff, Peter, Schneider, Siegfried, Wassenberg, PING CHUNG LEUNG, Adam, Balogh, Bela, Gomor, Tibor, Hidvégi, Laszlo, Koranyi, Péter, Lakatos, Gyula, Poór, Zsolt, Tulassay, RIVKA DRESNER POLLAK, Varda, Eshed, JOSEPH FOLDES, A., SOPHIA ISH SHALOM, Iris, Vered, Mordechai, Weiss, Silvano, Adami, Antonella, Barone, Gerolamo, Bianchi, Giannini, Sandro, GIOVANNI CARLO ISAIA, Luisetto, Giovanni, Salvatore, Minisola, Nicola, Molea, Ranuccio, Nuti, Sergio, Ortolani, Mario, Passeri, Alessandro, Rubinacci, Bruno, Seriolo, Luigi, Sinigaglia, WOONG HWAN CHOI, MOO II KANG, GHI SU KIM, HYE SOON KIM, YONG KI KIM, SUNG KIL LIM, HO YOUNG SON, HYUN KOO YOON, Carlos, Abud, Pedro, Garcia, Salomon, Jasqui, Luis, Ochoa, Javier, Orozco, Javier, Santos, Ian, Reid, Sigbjørn, Elle, Johan, Halse, Arne, Høiseth, Hans, Olav, HØIVIK INGUN RØED, Arne, Skag, Jacob, Stakkestad, Unni, Syversen, Janusz, Badurski, Edward, Czerwinski, Roman, Lorenc, EWA MARCINOWSKA SUCHOWIERSKA, Andrzej, Sawicki, Jerzy, Supronik, Eduard, Ailamazyan, Lidiya, Benevolenskaya, Alexander, Dreval, Leonid, Dvoretsky, Raisa, Dyomina, Vadim, Mazurov, Galina, Melnichenko, Ashot, Mkrtoumyan, ALEXANDER ORLOV MOROZOV, Olga, Ostroumova, Eduard, Pikhlak, Tatiana, Shemerovskaya, Nadezhda, Shostak, Irina, Skripnikova, Vera, Smetnik, Evgenia, Tsyrlina, Galina, Usova, Alsu, Zalevskaya, Irina, Zazerskaya, Eugeny, Zotkin, Osten, Ljunggren, Johan, Lofgren, Mats, Palmér, Maria, Saaf, Martin, Stenström, Paul, Hasler, Olivier, Lamy, Kurt, Lippuner, Claude, Merlin, René, Rizzoli, Robert, Theiler, Alan, Tyndall, Daniel, Uebelhart, JUNG FU CHEN, PO QUANG CHEN, LIN SHOW CHIN, JAWL SHAN HWANG, TZAY SHING YANG, Mayuree, Jirapinyo, Rojanasthien, Sattaya, Sutin, Sriussadaporn, Soontrapa, Supasin, Nimit, Taechakraichana, Kittisak, Wilawan, Hugh, Donnachie, Richard, Eastell, William, Fraser, Alistair, Mclellan, David, Reid, John, Abruzzo, Ronald, Ackerman, Robert, Adler, John, Aloia, Charles, Birbara, Barbara, Bode, Henry, Bone, Donald, Brandon, Jane, Cauley, Felicia, Cosman, Daniel, Dionne, Robert, Downs, James, Dreyfus, RONALD EMKEY, VICTOR E. L. I. N. O. F. F., Joseph, Fanciullo, Darrell, Fiske, Palmieri, Genaro, Gollapudi, M., Richard, Gordon, James, Hennessey, Paul, Howard, Karen, Johnson, Conrad, Johnston, Risa, Kagan, Shelly, Kafka, Jeffrey, Kaine, Terry, Klein, William, Koltun, Meryl, Leboff, Bruce, Levine, MICHAEL LEWIECKI, E., CORA ELIZABETH LEWIS, Angelo, Licata, Michael, Lillestol, Barry, Lubin, Raymond, Malamet, Antoinette, Mangione, Velimir, Matkovic, Daksha, Mehta, Paul, Miller, Sam, Miller, Murphy, FREDERIK T., Susan, Nattrass, David, Podlecki, Christopher, Recknor, Clifford, Rosen, Daniel, Rowe, Robert, Rude, Thomas, Schnitzer, Yvonne, Sherrer, Stuart, Silverman, Kenna, Stephenson, Barbara, Troupin, Joseph, Tucci, Reina, Villareal, Nelson, Watts, Richard, Weinstein, Robert, Weinstein, Michael, Weitz, and Richard, White

Subjects
musculoskeletal diseases, medicine.medical_specialty, Compressive Strength, Bone density, Endocrinology, Diabetes and Metabolism, Osteoporosis, Lumbar vertebrae, Zoledronic Acid, Article, Drug Administration Schedule, Bone densitometry, Absorptiometry, Photon, Clinical trials, Bone Density, Humans, Medicine, Quantitative computed tomography, Osteoporosis, Postmenopausal, Aged, Aged, 80 and over, Bone mineral, Lumbar Vertebrae, Bone Density Conservation Agents, Diphosphonates, medicine.diagnostic_test, Femur Neck, business.industry, musculoskeletal, neural, and ocular physiology, Imidazoles, Bone QCT, Bisphosphonates, musculoskeletal system, medicine.disease, body regions, Zoledronic acid, medicine.anatomical_structure, Female, Hip Joint, sense organs, Radiology, Tomography, X-Ray Computed, business, Densitometry, Follow-Up Studies, medicine.drug
Abstract

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p0.01) and QCT (5.7%, p0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p0.0001), total hip (10.8%, p0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p0.0001).Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.

Published
2010
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