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H Mallmin

Publications and source records attributed to H Mallmin.

53 records · Page 3Linked to original sources
PubMed1995

Diet, bone mass, and osteocalcin: a cross-sectional study.

To determine the relationships among nutrients intake, bone mass, and bone turnover in women we have investigated these issues in a population-based, cross-sectional, observational study in one county in central Sweden. A total of 175 women aged 28-74 at entry to the study were included. Dietary assessment was made by both a semiquantitative food frequency questionnaire and by four 1-week dietary records. Dual energy X-ray absorptiometry was performed at five sites: total body, L2-L4 region of the lumbar spine, and three regions of the proximal femur. Serum concentrations of osteocalcin (an osteoblast-specific protein reflecting bone turnover) were measured by a radioimmunoassay. Linear regression models, with adjustment for possible confounding factors were used for statistical analyses. A weak positive association was found between dietary calcium intake as calculated from the semiquantitative food frequency questionnaire and total body bone mineral density (BMD) among premenopausal women. No association emerged between dietary calcium intake and site-specific bone mass, i.e., lumbar spine and femoral neck, nor was an association found between dietary calcium intake and serum osteocalcin. BMD at some of the measured sites was positively associated with protein and carbohydrates and negatively associated with dietary fat. In no previous studies of diet and bone mass have dietary habits been ascertained so carefully and the results adjusted for possible confounding factors. Neither of the two methods of dietary assessment used in this study revealed any effect of calcium intake on BMD at fracture-relevant sites among these healthy, mostly middle-aged women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Heel ultrasound in women after long-term ERT compared with bone densities in the forearm, spine and hip.

To compare heel ultrasound values with bone densities at different measurement sites as determined by single photon absorptiometry (SPA) and dual-energy X-ray absorptiometry (DXA) in long-term users of estrogen replacement therapy (ERT), we analyzed data from 30 users of estradiol implants (mean duration of treatment 16 years) and 32 non-users, comprising 28 complete age-matched pairs. The precision errors in vivo of ultrasound measurements were 0.18%, 1.3% and 1.5% for speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index, respectively. In the controls, ultrasound parameters correlated well with values from SPA and DXA measurements (r = 0.51-0.63, p < 0.004). In long-term users of ERT, however, measurements with ultrasound did not correlate with DXA in the spine and hip (r = 0.01-0.31, NS) but correlated well with SPA in the forearm (r = 0.47-0.66, p < 0.009). Implant users, compared with non-users, had small and just significantly different values when measured by ultrasound (at most 12%, p = 0.03-0.04) but significantly higher bone mineral densities (18%-25%, p = 0.0001-0.01) in the forearm, spine and hip when measured by SPA or DXA. Data indicated that a substantial proportion of long-term users of estrogen may be non-responders concerning the effect of estrogen on bone qualities expressed in heel ultrasound values. In a multivariate regression analysis the effect of increasing age and increasing treatment duration were both negative for the ultrasound parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1995

Diet and hip fracture risk: a case-control study. Study Group of the Multiple Risk Survey on Swedish Women for Eating Assessment.

BACKGROUND: The role of diet as a risk factor for osteoporotic fractures is unclear. Earlier studies have yielded conflicting results. METHODS: In two counties in central Sweden we investigated the association between dietary intake and the risk of proximal femoral fractures in a case-control study nested in a cohort. Women born in 1914-1948 were asked to fill out a food frequency questionnaire when invited to attend for mammographic screening between the years 1987 and 1990. More than 65,000 women completed the questionnaire. Those who had participated in the enquiry and subsequently sustained a first hip fracture were defined as cases. For every case, four individually matched controls, by age and county of residence, were selected from the cohort. A second questionnaire concerning confounding factors was mailed to controls and cases. In all, 247 cases and 893 controls could finally be included. Monthly intake of foods and daily intake of nutrients were calculated. RESULTS: When highest quartile of intake was compared to lowest, intakes of iron (adjusted odds ratio [OR] of 3.3, 95% confidence interval [CI]: 1.6-6.9), magnesium (adjusted OR = 2.7, 95% CI: 1.3-6.0) and vitamin C (adjusted OR = 1.9, 95% CI: 1.2-3.1) were found to be independent risk factors for hip fracture. High calcium intake did not protect against hip fracture. Smoking, low physical activity in leisure time, low body mass index, earlier fracture of the distal forearm and diabetes were all risk factors while postmenopausal hormone replacement therapy protected against hip fracture. DISCUSSION: This large study indicates new dietary risk factors for hip fracture. The association between high dietary intake of iron, magnesium and vitamin C and risk of hip fracture has not been reported previously. Further clinical and experimental studies are needed to confirm these findings and to investigate their mechanism of action.

Adult↗
PubMed1995

Cortisone injection with anesthetic additives for radial epicondylalgia (tennis elbow).

In a prospective, randomized, double-blind study of radial epicondylalgia (tennis elbow), 109 patients with an average symptom duration of 8 months were considered for treatment with a single 1-mL injection of the steroid triamcinolone combined with either lidocaine or bupivacaine. The patients received clinical examinations at regular intervals for 1 year, and followup included visual analog pain scale and questionnaires. The 2 groups were comparable and for many factors distributed completely evenly with respect to gender, age, symptom duration, side dominance, type of pain onset, earlier treatment, and occupational loading. The only difference between the groups receiving lidocaine or bupivacaine was found at 2 weeks, when the bupivacaine additive yielded a better outcome for patients who had not been treated in any way before, for those with a short history of epicondylalgia, or both. The steroid injection treatment, regardless of which local anesthetic was given, presented a typical pattern, with symptoms relieved quickly by 2 weeks and then deterioration for many patients at 3 months, indicating a tendency to recurrence. A considerable loss of patients to other treatments at the 1-year followup indicated an equivocal long-term result. Patients who had not been treated earlier in any way had a more favorable prognosis, as did those with a history of epicondylalgia to 3 months.

Adolescent↗
PubMed1994

Risk factors for fractures of the distal forearm: a population-based case-control study.

To evaluate the risk factors for early osteoporosis in consecutive patients with fracture of the distal forearm, a population-based case-control study was carried out using postal questionnaires supplemented by interviews when necessary. All men and women between the ages of 40 and 80 years who were resident in the County of Uppsala (population 265,000) and who sustained a fracture of the distal forearm during a defined 12-month period were initially included. Of 427 cases, 385 (90.2%) replied. Those with previous fragility fractures were excluded, leaving 367 patients in the study (mean age 61.9 +/- 10.6 years): 302 women (mean age 62.8 +/- 10.1 years) and 65 men (mean age 57.5 +/- 11.8 years). For each patient an age- and sex-matched control without previous fragility fractures was selected from the population register. The questionnaire concerned heredity, diseases and medications, general health, tobacco smoking and physical activity. Reproductive variables and postmenopausal hormone replacement therapy were analyzed extensively. In neither sex were any significant, consistent differences found with regard to chronic diseases, medications, physical activity or smoking. In females heredity for fractures (odds ratio, OR = 1.46) was associated with an increased risk. Nulliparous women had an increased risk of forearm fractures (OR = 1.72) while late menopause (OR = 0.95) and postmenopausal oestrogen therapy > 2 years (OR = 0.44) appeared to be protective. It is concluded that lifestyle factors did not discriminate between fracture patients and controls in this strict population-based investigation, suggesting that in affluent Western societies, with their high fracture rate, most individuals have an osteoporosis-prone way of life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Distal radius fracture is an early sign of general osteoporosis: bone mass measurements in a population-based study.

To evaluate the bone mass by bone density measurements in patients with distal radius fracture, a prospective open case-control study was carried out in the county of Uppsala, Sweden, with population-based cases and controls. There were 111 patients with a distal radius fracture who were otherwise healthy and aged 53-76 years, together with 60 healthy controls of similar age, sex and menopausal status. The main outcome measures were bone mineral density (BMD) in the lumbar spine and hip measured with dual-energy X-ray absorptiometry, and in the (non-fractured) distal forearm determined by single-photon absorptiometry. It was found that at all measuring sites BMD was significantly lower in cases than in controls. The difference in the distal forearm was around 20% (p < 0.001) and in the spine and hip 5%-8% (p < 0.05-0.001). In the healthy subjects there were positive correlations (r = 0.39-0.65; p < 0.002) between the forearm BMD and that of both the spine and hip, whereas in the patients with distal radius fracture there was only a weak correlation between the forearm and spine BMD (r = 0.28; p < 0.05) and no association between the BMD of the forearm and hip (r < 0.01). It is concluded that patients with distal radius fracture who are otherwise healthy have a preferential bone loss at the distal forearm but also a generally low bone mass. Patients with fracture of the distal radius fracture should be considered for prophylactic measures against osteoporosis.

Age Factors↗
PubMed1993

Fracture of the distal forearm as a forecaster of subsequent hip fracture: a population-based cohort study with 24 years of follow-up.

OBJECTIVE: To determine the long-term risk of hip fracture following fracture of the distal forearm. DESIGN: Registry-based cohort study comparing patients with a fracture of the distal forearm with a population-based cohort. FRACTURE COHORT: All women and men above 40 years of age with a radiologically verified fracture of the distal forearm during a 5-year period, 1968-1972, in all 1,126 women and 212 men. CONTROL COHORT: An equal number of population-based, age- and sex-matched control persons selected from a population register. MEASUREMENTS: All cohort members were followed up individually through record linkage until the first hip fracture, emigration, death, or the end of 1991. The cohort members contributed a total of 40,832 person-years of observation, and altogether 365 cases of hip fractures were observed. RESULTS: Both women and men with a fracture of the distal forearm ran an increased risk of sustaining a subsequent hip fracture. The overall relative hazard for the women was 1.54 and for men 2.27. The increased risk in the women was independent of age at inclusion, but that in the men was more pronounced in the younger age groups. CONCLUSIONS: Patients with a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. They therefore appear to constitute a group in which appropriate prophylactic measures against osteoporosis and fractures should be considered.

Adult↗
PubMed1993

The quantification of bone tissue regeneration after electromagnetic stimulation.

In this study a titanium implant, the bone harvest chamber (BHC), was used to evaluate the effect of electromagnetic stimulation on osteogenesis. The BHC was inserted with a minimum of surgical trauma in the proximal tibial metaphysis in six adult lop-eared rabbits. Bone anchorage occurred after 4 weeks. After implant incorporation bone tissue was harvested at 3-week intervals with the implant in situ without killing the animal. The regenerated bone tissue was analysed by means of microradiography and densitometry. A test group and a control group each comprised six rabbits. The test group was stimulated with a 72-Hz electromagnetic field. Bone tissue was harvested from each tibia six times during the stimulation time and twice after the stimulation had been turned off. The control group had the same harvest procedure performed from one leg. Results showed that electromagnetic stimulation can maintain constant high osteogenetic activity. After the electromagnetic stimulation was turned off the osteogenetic activity diminished rapidly and osteogenesis was significantly lower than during stimulation.

Animals↗
PubMed1993

Insulin-like growth factor I enhances the formation of type I collagen in hydrocortisone-treated human osteoblasts.

We have studied the effect of insulin-like growth factor I (IGF-I) on the formation of osteocalcin and type I collagen in isolated human osteoblasts. IGF-I at and above 0.1 nM stimulated the formation of type I collagen as measured by the type I procollagen carboxyterminal peptide (PICP), in human osteoblasts, incubated for 72 hrs in serum free conditions. The secretion of osteocalcin was not affected by IGF-I while 1,25(OH)2vitamin D3 significantly enhanced the formation of osteocalcin. When human osteoblast-like cells were incubated with hydrocortisone (1 microM), a significant decrease in the release of both PICP and osteocalcin was seen. Addition of IGF-I to human osteoblasts also treated with hydrocortisone normalized the PICP-formation but did not affect the suppressed osteocalcin-formation. These data indicate that IGF-I reverses selective effects of hydrocortisone on bone.

Calcitriol↗
PubMed1993

Determination of body composition--a comparison of dual-energy x-ray absorptiometry and hydrodensitometry.

Determination of body composition by dual-energy x-ray absorptiometry (DEXA) was evaluated in healthy men, by using underwater weighing (UWW), skinfold thickness measurement, and bioimpedance analysis. There were strong correlations between percent body fat obtained by all techniques, but DEXA gave significantly lower values (P < 0.001). The influence of differences in bone mineral density (BMD) on fat content determined by UWW was also studied. The individual differences between UWW and DEXA fat estimates were calculated and there was a negative correlation with BMD (r = -0.50, P < 0.05). There was also a negative correlation between body fat by UWW and BMD (r = -0.71, P < 0.01) in the subjects with lowest fat by DEXA, indicating that high or low BMD gave false values by UWW. In conclusion, DEXA and UWW provide complementary information and a combination of these techniques seems to offer new opportunities in evaluations of body composition.

Absorptiometry, Photon↗
PubMed1993

Maintained bone density at advanced ages after long term treatment with low dose oestradiol implants.

OBJECTIVE: To investigate whether the bone preserving effect of low dose oestrogen replacement therapy (20 mg oestradiol implanted subcutaneously every six months) persists during continuous long term treatment through advanced ages. DESIGN: Cross sectional clinical study of postmenopausal women treated with oestradiol implants as compared with nonusers matched for age. SETTING: Outpatient research unit at a university hospital. SUBJECTS: Thirty-five women with a mean age of 67 years (range 47-83 years) at the time of investigation who, after a prior hysterectomy, had been treated with oestradiol implants for climacteric symptoms for a mean period of 16 years (range 5.5-31 years). The results were compared with those in women matched for age and without any diseases or medications known to affect the bone metabolism. MAIN OUTCOME MEASURES: Bone mineral densities (BMD) in the distal forearm, vertebrae and hip analysed by study group, age and duration of treatment. RESULTS: Implant users had a median serum oestradiol concentration in the luteal range, 313 (range 126-1711) pmol/l, and premenopausal levels of follicle stimulating hormone (FSH). All women except one who were given the standard dose at the standard intervals had serum oestradiol levels below 650 pmol/l. Compared with nonusers, women treated with oestradiol implants had 20 to 25% higher BMD at all measurement sites: distal radius (P < 0.0001), lumbar vertebrae (P < 0.0002) and femoral neck (P < 0.0001). These differences also remained after adjustment for potential confounders (height, age at menarche, parity, smoking habits, physical exercise and education) (P < or = 0.01 at all sites). In a multiple regression analysis the negative effect of advancing age was more than compensated by the positive effect of increasing treatment duration with a higher BMD at all measurement sites in women with a longer as compared with shorter, duration of treatment; the regression coefficients were significant (P < 0.05) in the spine and hip measurements. CONCLUSIONS: Continuous long term treatment with low dose oestradiol implants yielding physiological levels of serum oestradiol preserves both compact and cancellous bone and the effect seems to persist into advanced ages without any inevitable age related bone loss.

Aged↗
PubMed1993

Biochemical markers of bone metabolism in patients with fracture of the distal forearm.

Biomarkers for bone turnover have established a place in the investigation and follow-up examinations of patients with osteoporosis, but has received little attention for the possibility that the fracture itself might interfere with the interpretation of the results. In this investigation of patients with fracture of the distal forearm, biomarkers for bone formation (serum osteocalcin and alkaline phosphatases) and for resorption (urinary calcium and hydroxyproline) were determined together with serum calcium and parathyroid hormone (PTH) in longitudinal and cross-sectional studies. During 16 weeks of follow-up examinations, starting on the day of the fracture, 13 patients with Colles' fracture displayed a consistent pattern with a moderate increase in serum alkaline phosphatase and osteocalcin, whereas the indices of bone resorption appeared unaffected. There was also a significant increase in the serum calcium concentration and a reciprocal decrease in serum PTH. A cross-sectional comparison between 99 patients and controls showed elevated osteocalcin levels in the patients and an inverse relationship between these levels and bone mineral density. The findings demonstrate that fracture healing should be considered in the interpretation of biomarkers in osteoporotic patients, and that among patients with a fracture of the distal forearm, those with biochemical evidence of increased bone turnover have the lowest bone mass.

Aged↗
PubMed1992

Colles' fracture associated with reduced bone mineral content. Photon densitometry in 74 patients with matched controls.

In a prospective population-based investigation, we measured bone mineral density (BMD) of the forearm using single-photon absorptiometry at both a distal and a more proximal site in 74 Colles'-fracture patients who were compared with controls matched for age, sex, and years after menopause. For both groups there was a marked inverse relationship between age and bone mass. However, over the entire age range, the probands had 11 percent reduced BMD when compared with the controls. Our findings confirm that patients with fracture of the distal forearm have reduced BMD. They constitute an appropriate group for studies aimed at prevention of fracture in the elderly.

Absorptiometry, Photon↗
PubMed1992

Incidence of Colles' fracture in Uppsala. A prospective study of a quarter-million population.

In a prospective study in Uppsala County (Sweden), certain characteristics of distal forearm fractures (DFFs) were investigated during a 1-year period in a mixed rural-urban population comprising all 214,000 persons above the age of 15 years. During the study period, 625 DFFs occurred, with a female/male ratio of 3.2:1. There was an age-related increase in DFFs among females that started as early as 40 years of age. In the males the incidence of DFFs was constant up to 70 years of age, and thereafter there was only a slight increase. The annual incidence of DFFs for women above aged 70 years was 115/10,000 and that for men 29/10,000.

Adolescent↗
PubMed1991

Short-term effects of pamidronate on biochemical markers of bone metabolism in osteoporosis--a placebo-controlled dose-finding study.

The bisphosphonates are potent inhibitors of osteoclastic bone resorption that mainly have been used for treatment of hypercalcaemia secondary to malignancy. We have performed a controlled dose-finding study of oral pamidronate that was given to 60 patients with a history of fracture of the distal forearm, an enhanced bone turnover and a lowered bone mineral density. Different doses of pamidronate, 75 mg and 150 mg daily, or placebo were given to parallel groups. Fasting specimens of blood and urine were collected before the treatment period and at regular intervals. Oral pamidronate caused a dose-related reduction on the biochemical markers of bone resorption, i.e. fasting urinary calcium, hydroxyproline, pyridinoline and deoxypyridinoline that was seen already after the first week. The inhibition was evident during the treatment period and 4 weeks thereafter but not 12 weeks after cessation of therapy. Also the levels of serum osteocalcin, a marker of bone formation, were lowered during treatment with the higher dose.

Administration, Oral↗