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Biomedical subjects

D Mellström

Publications and source records attributed to D Mellström.

At least 37 records · Page 2Linked to original sources
PubMed1996

An earlier fracture as a risk factor for new fracture and its association with smoking and menopausal age in women.

OBJECTIVES: The purpose of this study was to investigate whether a previous fracture is a risk factor for fracture later in life and its association with tobacco smoking, menopausal age and the use of oral contraceptives. This is an epidemiological population study based on a questionnaire. A sample of 10000 women from seven birth cohorts between 1900-1940 was obtained at random from the population register. The overall response rate was 74.6%. The responders (n = 7459) represented 53% of the total population. METHODS: The women from all these birth cohorts were questioned regarding a possible history of fractures and the year in which they were sustained. The questionnaire also included questions about menopausal age, use of oral contraceptives, previous gynaecological operations and possible oestrogen medication. The women from the 1900-1920 birth cohorts were questioned in detail about urogenital disorders, while tobacco smoking data were recorded only for the 1930 and 1940 birth cohorts. RESULTS: The relative risk of sustaining a further fracture was significantly related to fracture premenopausally before 40 years of age and later fracture postmenopausally after 60 years of age (1.29; 0.97-1.70) compared to controls (0.78; 0.59-1.03)(P = 0.03). Both an early menopause and tobacco smoking were associated significantly with repeated fractures, while use of oral contraceptives had a protective effect against repeated fractures in the 1940 birth cohort. Logistic multiple regression showed that a fracture was a significant independent risk factor for further fracture in both cohorts 1900-1920 (P < 0.01) and 1930-1940 (P < 0.05). CONCLUSIONS: This study suggests poorer protective resources against new fractures among women with previous fractures, and that lack of oestrogen menopausally can partly explain the enhanced risk of fracture, not only during the menopause but also later in life when a hip fracture may have immense consequences. The results should draw our attention to emphasise the need for active treatment of patients with established osteoporosis because of the increased risk of new fractures later in life.

Age Factors↗
PubMed1996

Bone density, bone markers and bone radiological features in mastocytosis.

We examined the association between severity of disease in mastocytosis and skeletal manifestation and bone markers in 16 patients varying in extent of mastocytosis as determined by the urine excretion of methylimidazoleacetic acid. Both osteoporosis and osteosclerosis were found. Bone density in the hip was significantly higher (p < 0.05) in both men and women with an enhanced histamine metabolite excretion. Patients with only moderately increased mast cell mass had low bone mineral density in the hip, osteoporosis and vertebral fractures. The different skeletal disease patterns in mastocytosis might be the effect on osteoblasts and osteoclasts of biologically active substances. Mast cells release a number of vasoactive substances, including histamine which promotes osteoblasts and heparin and prostaglandin D2 which induce bone resorption by activation of osteoclasts. Systemic mastocytosis is a rare disease characterized by multi-organ infiltration by mast cells and with varying skeletal manifestations including osteoporosis. Treatment with bisphosphonates may be beneficial in arresting osteoporosis in this disorder.

Acid Phosphatase↗
PubMed1996

Bone mineral and related biochemical variables in patients with Kock ileal reservoir or Bricker conduit for urinary diversion.

PURPOSE: Bone material content was studied with single photon absorptiometry and dual energy x-ray absorptiometry , and the various biochemical parameters related to bone metabolism in patients with Kock reservoirs or Bricker conduits for urinary diversion. MATERIALS AND METHODS: We examined 34 patients with Kock ileal reservoirs to the skin (29) or urethra (5) and 14 with Bricker conduits 2 to 17 years after urinary diversion. Bone mineral density was measured in the radius with single photon absorptiometry, and in th femur, lumbar spine and whole body with dual x-ray absorptiometry. Serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium were determined. Arterial blood gases were analyzed. RESULTS: The mean values for bone mineral density did not differ from age-matched controls in either group and no signs of decrease were observed with followup. Vitamin D serum concentration values remained within normal limits in all patients. Most patients had normal blood gas values. Mean values for osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium also were within normal limits, although a few patients had elevated osteocalcin values indicating increased bone turnover. CONCLUSION: Urinary diversion with a Kock reservoir or Bricker conduit did not cause bone demineralization of significant changes in different markers of bone metabolism in patients examined 2 to 17 years after urinary diversion.

Absorptiometry, Photon↗
PubMed1995

A life span perspective on patterns of physical activity and functional performance at the age of 76.

In a population study, involving 293 women and 233 men, the relation between level of physical activity in earlier life and both physical activity and performance at age 76 has been analysed. The life span was divided into five age periods from the age of 10 and described as competition sport, recreational sport, occupational physical load, household work and means of transportation. The results revealed that when all fields of activity were combined into a total measure of physical activity, created through weighting, the earliest periods alone could not explain activity patterns or performance late in life. After the age of 35 years in men and 50 years in women, however, the associations grew stronger and the activity level of the last life period (66-76) was strongly correlated to all variables incorporated in the study. When, on the other hand, each field of activity was treated alone, above all recreational sport turned out to be positively related to walking speed and physical activity at age 76 in both women and men for most life periods.

Aged↗
PubMed1995

[Vitamin D and osteoporosis].

Vitamin D constitutes a complex endocrine-regulated system, and is both a prohormone for the endogenous synthesis of the active hormone, calcitriol, and a vitamin which may be administered to supply the organism's requirements. No single test or investigation is available for the demonstration of vitamin D deficiency. Both vitamin D intake and ability to synthesise vitamin D decrease with increasing age, and particularly the elderly in institutionalised care are at risk of developing vitamin D deficiency. Iceland excepted, mean daily vitamin D consumption in the Nordic countries is less then 5 micrograms; and in approximately 10-25 per cent of the population, daily intake is less than 2.5 micrograms which is insufficient to maintain an adequate serum calcidiol concentration in individuals unexposed to sunlight. The recommended daily intake of 5 micrograms, currently adopted in the Nordic countries, may be too low-an intake of 10 micrograms is probably necessary to satisfy requirements in the elderly.

Adrenal Cortex Hormones↗
PubMed1994

A community-based population study of vertebral fractures in 85-year-old men and women.

Radiographic examinations for the presence of vertebral fracture between T4 and L5 were performed in a random sample of 85-year-old women (n = 304) and men (n = 158) who participated in a longitudinal study in Gothenburg. A vertebral fracture was defined as an anterior/posterior (A/P) vertebral height ratio of 0.66 or less. A severe vertebral fracture was defined as a compression of vertebral height of more than 33% both at the anterior and posterior edges compared to the posterior edge of the adjacent vertebral body. Bone mineral density was measured with dual photon absorptiometry in the right calcaneus. The most common site for vertebral fractures was L1 in women and Th12 in men. Bone mineral density in men at the age of 75 showed a significant correlation with vertebral fractures at 85 years of age (p < 0.001). This was not the case for women. Stepwise logistic analysis revealed that women with vertebral fractures at 85 years of age had more significant back pain, shorter stature, and more often a history of another fracture and/or chronic treatment with corticosteroids. In men, muscle strength, marital status and body weight at age 85 were the only factors significantly associated with vertebral fractures.

Aged↗
PubMed1994

Risk factors for bone loss in chronic active hepatitis and primary biliary cirrhosis.

BACKGROUND: Data on risk factors for bone loss in chronic active hepatitis (CAH) and primary biliary cirrhosis (PBC) are scanty and/or conflicting. METHODS: Bone mineral density (BMD) in the distal forearm was measured using single-photon absorptiometry in 39 patients with CAH and 32 patients with PBC. We also attempted to identify risk factors for bone loss by means of a questionnaire and through a wide range of biochemical analyses. RESULTS: In the CAH patients BMD is inversely related to the duration of steroid treatment and to age at menarche. In the PBC patients there was a strong correlation between BMD and serum gastrin concentrations. CONCLUSIONS: Bone loss in CAH is to some extent explained by steroid treatment and delayed menarche. Bone loss in PBC may be reduced by increased calcitonin secretion induced by gastrocalcin.

Adrenal Cortex Hormones↗
PubMed1993

Reproductive factors as predictors of bone density and fractures in women at the age of 70.

The importance of reproductive and other health and social factors as predictors of bone mineral density (BMD) and fractures was investigated in a longitudinal study of 70-year-old women. At 70 years of age there was no correlation between menarcheal age, menopausal age, duration of fertile period and parity and BMD or a history of fractures. Bilateral oophorectomy (mean age at surgery 45.3 +/- 3.6 years) and the duration of tobacco smoking were negatively correlated to BMD at 70 years of age. Tobacco smoking was positively correlated to a history of fractures and body mass index (BMI) was negatively correlated to a history of fractures at 70 years of age. In a stepwise multiple regression model, height, body mass index and a history of hysterectomy were found to have a contributory, positively-correlated independent explanatory value for BMD at 70 years. In a logistic multiple regression analysis, bilateral oophorectomy was the only independent explanatory factor for fractures at 70 years of age. BMD was lower in women who had undergone bilateral oophorectomy compared with controls at 70 years of age. Hysterectomized women without bilateral oophorectomy showed a higher BMD in the right calcaneus at 70 years of age compared with controls. When comparing the reduction in bone mineral density between 70 and 76 years of age, the fifth quintile (women with the highest BMD) at 70 years of age decreased 2.7 times more (P < 0.01) than the first quintile. A longitudinal examination between 70 and 76 years revealed that BMD at the age of 70 was a significant (P < 0.01) predictor for fractures occurring between 70 and 76 years of age.

Aged↗
PubMed1993

Prevalence of vertebral fractures in 85-year-olds. Radiographic examination of 462 subjects.

Radiographic examinations for the presence of vertebral fracture between Th4-L5 were performed in a random sample of 85-year-old women (n 304) and men (n 158) who participated in a longitudinal population study. A moderate vertebral fracture was defined as an anterior/posterior vertebral height ratio of 0.66 or less. A severe vertebral fracture was defined as a compression of vertebral height of more than 33 percent both at the anterior and posterior edges compared to the posterior edge of the adjacent vertebral body. The prevalence of vertebral fractures was 25 percent in women and 13 percent in men. The ratio between moderate and severe grades of vertebral fracture was 1.5 for women and 2.1 for men. The most common site for vertebral fracture was L1 in women and Th12 in men. Women with vertebral fracture at 85 years of age had more back pain.

Aged↗
PubMed1993

Osteoporosis, metabolic aberrations, and increased risk for vertebral fractures after partial gastrectomy.

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)

Absorptiometry, Photon↗
PubMed1992

Caffeine has the capacity to stimulate calcium release in organ culture of neonatal mouse calvaria.

In view of the possible association between ingestion of caffeine (a constituent of coffee, tea, and several beverages) and osteoporosis, we have studied the effect of caffeine on bone resorption in vitro. Caffeine caused a dose-dependent increase of the spontaneous release of 45Ca from neonatal mouse calvarial bones. The effect of caffeine was less pronounced than that of parathyroid hormone (PTH), but of the same magnitude as that of theophylline, a structurally related methylxanthine. The enhancement of 45Ca release induced by caffeine and PTH was observed in 5 days culture. In 2 days culture, however, only PTH stimulated mineral mobilization. The delayed stimulatory effect of caffeine in long-term cultures was abolished by indomethacin and flurbiprofen. In indomethacin-treated bones, however, caffeine potentiated the stimulatory effect on 45Ca release induced by choleratoxin and forskolin. In contrast, caffeine did not potentiate 45Ca release stimulated by PTH. These data show that caffeine can stimulate calcium release from bone in vitro and that this effect is due to potentiation of a stimulatory action of a bone resorptive agonist acting via the adenylate cyclase-cyclic AMP system.

Animals↗
PubMed1992

Coffee drinking: a minor risk factor for bone loss and fractures.

The influence of coffee drinking as a possible risk factor for loss of bone mass was assessed in a cohort of 619 70-year-old men and women who were examined with dual photon absorptiometry of the right calcaneum. A high consumption of coffee was significantly associated with a lower bone mass, deteriorated dental state, lower socio-economic level and a higher consumption of tobacco. In non-smoking women a bivariate relationship was found between the daily consumption of three or more cups of coffee and a low bone mass (p less than 0.01). However, in a stepwise logistic regression model, only tobacco smoking, body mass index, body height, physical activity and a deteriorated dental state were found to be significant predictive factors for a low bone mineral content. Bone mass and tobacco smoking were the only significant predictive factors for fractures before the ages of 70 and 76 years. Coffee drinking was not a contributory independent risk factor for loss of bone mass and fractures in this population study.

Aged↗
PubMed1991

Vaginal immunoglobulin A (IgA) levels in post-menopausal women: influence of oestriol therapy.

The concentration of secretory immunoglobulin A (IgA) in the vaginal fluid of 20 untreated post-menopausal women (aged 75.4 +/- 1.4 years) was compared with the levels in a group of 20 post-menopausal women (aged 73.2 +/- 1.5 years) treated with oral oestriol (E3) (2 mg/day) and a further group of 20 healthy, non-pregnant, fertile women (aged 28.2 +/- 1.8 years). Secretory IgA was determined using a paper disc modification of the single radial immunodiffusion technique. The vaginal concentration of IgA in the untreated women was 41.5 +/- 5.7 mg/l, which was higher than that recorded in those treated with E3 (20.8 +/- 5.7 mg/l, P less than 0.05) and in the fertile women (16.4 +/- 3.7 mg/l, P less than 0.01). Epithelial cells predominated in the wet smear preparations obtained from the women who received E3 and the fertile women, while a predominance of leucocytes was observed in the untreated women. Lactobacilli were found more frequently in the vaginal flora of the women in the E3 group (P less than 0.001) and the fertile women (P less than 0.001) than the untreated group. Faecal-type bacteria were seen more frequently in the vaginal flora of the untreated women than the E3 group (P less than 0.01) or the fertile women (P less than 0.001). The possible implications of the present findings with regard to the individual variation in the intensity of symptoms experienced by women suffering from the oestrogen deficiency syndrome are discussed.

Adult↗
PubMed1991

Prevalence of fractures among 10,000 women from the 1900 to 1940 birth cohorts resident in Gothenburg.

The prevalence of fractures in women aged 45-86 years resident in the city of Gothenburg, Sweden, was investigated by means of a postal questionnaire. A sample of 10,000 women from seven birth cohorts (1900-1940) was obtained at random from the population register. The response rate was 70.1% in the 1900-1920 and 81.0% in the 1930 and 1940 birth cohorts. When the prevalence of fractures sustained between 25 and 46 years of age was analyzed a higher figure emerged for women from the 1930 and 1940 birth cohorts than for those from the 1900-1920 cohorts, indicating an increasing incidence of fractures over time. There was a significant independent correlation between early menopausal age and a high rate of fractures. Menopausal age decreased with increasing tobacco consumption. There was also a significant independent correlation between tobacco-smoking and a high fracture rate. The prevalence of tobacco-smoking increased from 30.0 to 38.1% between the 1930 and 1940 birth cohorts, which may further increase the fracture risk in future years. Despite increasing vitality and longevity among the elderly in Gothenburg, there are indications that the number of fractures will increase in the future.

Age Factors↗
PubMed1991

Peptic ulcer disease in older age groups in Gothenburg in 1985: the association with smoking.

The prevalences of peptic ulcer and smoking were assessed by a questionnaire sent to 6726 residents of Gothenburg selected at random from the birth cohorts 1945, -35, -25, -15, and -05. The point prevalence of peptic ulcer was in all age groups significantly higher among smokers than among non-smokers. The incidence of peptic ulcer in 1985 was deduced from records of ulcers detected at gastroscopy and/or radiography and/or emergency surgery (n = 1402). Smoking habits and previous episodes of peptic ulcer disease were evaluated. The estimated risk of getting peptic ulcer was significantly higher among smokers in all age groups and of both sexes than among non-smokers. Among non-smokers the risk of getting peptic ulcer was significantly higher in men than in women, whereas the risk among smokers showed no sex difference. In people aged 35-84 years, 25.4% (n = 101) of ulcers diagnosed for the first time and 42.0% (n = 246) of relapsing ulcers were estimated to be caused by smoking. The number of smoking years, however, could not be shown to influence the risk of peptic ulcer.

Adult↗