Biomedical subjects

P J Elders

Publications and source records attributed to P J Elders.

9 recordsLinked to original sources

PubMed1999

[Summary of the guideline 'Osteoporosis' of the Dutch College of General Practitioners. Dutch College of General Practitioners].

The Dutch College of General Practitioners issued a standard 'Osteoporosis' with guidelines for prevention, diagnosis and treatment in patients who have a (probably) osteoporotic fracture, who are taking at least 7.5 mg corticosteroids per day for at least six months or who have questions about osteoporosis. The core of the management is information about lifestyle (stimulation of physical activity) and nutrition. Prevention of falling is to be stimulated; sedatives, excessive drinking and smoking are to be discouraged. Persons who cannot achieve a calcium intake of 500 mg/day, patients with osteoporotic fractures and takers of biphosphonates or corticosteroids whose calcium intake is insufficient are eligible for calcium suppletion. In patients with (probably) osteoporotic fractures and those taking 7.5 mg corticosteroids per day for longer than six months preventive treatment may be considered with alendronic acid for a maximum of 3 years, if several vertebral fractures are visible roentgenologically, the T score is < -2.5 (if age < 70 years) or the Z score < -1.0 (> 70 years).

Female↗

PubMed1997

Orientation of the trabecular pattern of the distal radius around the menopause.

The trabecular pattern depicted on radiographs of the distal radius of women around the menopause is analysed by a new method to measure orientation. It is shown that the trabecular pattern on radiographs of the distal radius is aligned preferentially along the axial direction and to a lesser extent along the transverse direction. Two minima of orientation are found at 60 degrees off the axial direction. A significant correlation is found between the average value of the orientation in the radius and the average lumbar bone mineral density. It is known that the bone mineral content decreases around the menopause. Previous reports on the present images describe several features that were found to be related to bone mineral content and to time. The orientation of the trabecular pattern, however, is found to be independent of time, at least during the two years of the investigation. Therefore, it is concluded that the orientation of the radiographic trabecular pattern tends to remain stable even if some features of the pattern evolve. Previous studies on radiographs of the radius of children and elderly women and men provide evidence for the tendency of orientation to remain stable not only in women around the menopause, but also in men and women during the entire adult life.

Analysis of Variance↗

PubMed1994

Long-term effect of calcium supplementation on bone loss in perimenopausal women.

We observed in a controlled 2 year longitudinal trial in 248 perimenopausal women that a daily calcium supplement of either 1000 or 2000 mg Ca2+ significantly reduced lumbar bone loss and bone turnover in the first year of calcium supplementation. In the second supplementation year the rate of lumbar bone loss in the treated subjects was not significantly different from that in the control group, although two of the three biochemical parameters of bone turnover remained decreased throughout the study. To quantify further the long-term effect of calcium supplementation, we extended the study for another year in 214 women. In the women of the control group who were menstruating until the last year of the trial, the mean change in lumbar bone mineral density after 3 years was -3.2% of the initial value versus 1.6% in the calcium-supplemented groups (p < 0.01). The decrease in lumbar bone loss in these supplemented premenopausal and early perimenopausal women remained statistically significant in the second and third years of supplementation. In the women who stopped menstruating before or during the study, the long-term reduction in lumbar bone loss was not significant (mean difference between control and treatment groups < 0.6% points after 3 years). The decrease in metacarpal cortical thickness (MCT) in the treated subjects during 3 years was on average -3.0% of the initial value in the control versus -2.0% in the supplemented subjects (P < 0.01). The effect of calcium supplementation on MCT was not significantly related to the menopausal status of the subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaline Phosphatase↗

PubMed1992

The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age.

It has been suggested that periodontitis and systemic bone mass might be related. In order to evaluate this possible relationship, we performed an intra-oral examination and measured lumbar bone mineral density (lumbar BMD) and metacarpal cortical thickness (MCT) in 286 female volunteers between 46 and 55 years of age. In addition, the alveolar bone height was measured on bite wing radiographs of the dentate subjects. Of the subject, n = 60 (21%) were edentulous. Compared to the dentate subjects, the lumbar BMD and MCT of the edentulous women were not significantly different. In the dentate subjects, no significant correlation was observed between the clinical parameters of periodontitis (mean probing depth, occurrence of bleeding after probing and number of missing teeth) and the bone mass parameters (lumbar BMD and MCT); nor was a significant relation observed between the bone mass measurements and alveolar bone height. We therefore suggest that systemic bone mass is not an important factor in the pathogenesis of periodontitis.

Absorptiometry, Photon↗

PubMed1991

Calcium supplementation reduces vertebral bone loss in perimenopausal women: a controlled trial in 248 women between 46 and 55 years of age.

To study the effect of calcium supplementation on perimenopausal bone loss, 295 women were randomized into a control group and 2 supplementation groups receiving, respectively, 1000 and 2000 mg elemental calcium/day for a period of 2 yr. We observed a significant decrease in lumbar bone loss in relation to the calcium supplementation (mean loss after 2 yr of 3.5% in the control group vs. 1.3% and 0.7% in the 1000 and 2000 mg groups, respectively), a significant increase in urinary calcium excretion, and a significant decrease in the urinary hydroxyproline/creatine ratio, serum alkaline phosphatase, osteocalcin, and 1,25-dihydroxyvitamin D. The effect of calcium supplementation on lumbar bone loss was significant in the first year of supplementation, but not in the second. However, the urinary hydroxyproline/creatinine ratio and the serum alkaline phosphatase level remained significantly decreased in the treatment groups at the end of the study; this was not the case for serum osteocalcin. Calcium supplementation did not have a significant effect on metacarpal cortical bone loss. The difference in biochemical parameters between the 2 supplementation groups was small. No significant interaction was observed between the menopausal status of the subjects and the effect of calcium supplementation. We conclude that calcium supplementation retards lumbar bone loss in the first year of calcium supplementation by reducing bone turnover. However, the effect on lumbar bone loss over a longer time span is still uncertain.

Alkaline Phosphatase↗

PubMed1990

A new method for automatic recognition of the radiographic trabecular pattern.

This study reports a method to describe and analyze the structure of the trabecular pattern seen on radiographs of the distal radius. The structure is measured and related to the bone mineral density (BMD) of the lumbar spine measured by dual-photon absorptiometry. Radiographs of hand and wrist combined with additional information of the bone mineral density of the vertebrae serve as testing material. With a computer-aided imaging system, a part of the depicted radius is scanned. The image is filtered and segmented into a bilevel picture consisting of a light network with dark meshes. Seven features of the bilevel picture are measured and analyzed. It is shown that six features correlate significantly with the bone mineral density measured at the lumbar spine, although the correlations between the trabecular pattern and the BMD are too weak to allow precise predictions of BMD values for individuals. Nevertheless, the correlations confirm the existence of a relationship between the radiographic trabecular pattern and the bone mineral density of the lumbar spine. The method is worth being further developed for use on individual patients. It provides a noninvasive tool to make an objective and quantitative assessment of the trabecular pattern.

Absorptiometry, Photon↗

PubMed1989

Perimenopausal bone mass and risk factors.

We studied the effect of menopausal status and risk factors on lumbar bone mineral density (BMD) and metacarpal cortical thickness (MCT) in 286 women of 46-55 years of age. Body mass index (height/weight) was measured and the family history of osteoporosis, reproductive history, menopausal status, calcium intake, amount of physical activity and the consumption of tobacco and alcohol were assessed. Lumbar BMD and MCT decreased substantially in the perimenopausal and postmenopausal period. In the premenopausal women a significant (P = 0.03) lower lumbar BMD was observed in the lowest tertile of calcium intake (less than or equal to 900 mg/day) compared to the highest tertile (greater than or equal to 1200 mg/day). This difference was not apparent in the peri- and postmenopausal women. This suggests that dietary calcium intake is more important in the development and/or maintenance of peak bone mass, than in the modulation of postmenopausal bone loss. Apart from menopausal status and low calcium intake, no other significant determinant of bone mass could be identified. We conclude, therefore, that the assessment of risk factor status is not an efficient tool for the identification of perimenopausal women with low bone mass.

Bone Density↗

PubMed1988

Accelerated vertebral bone loss in relation to the menopause: a cross-sectional study on lumbar bone density in 286 women of 46 to 55 years of age.

Bone mineral density (BMD) of the lumbar spine was measured in 286 women (46-55 years of age) using dual photon absorptiometry. The women were classified in three categories: premenopausal, perimenopausal and postmenopausal. The postmenopausal group was subdivided according to the number of years since the last uterine bleeding. With multiple linear regression analysis of lumbar BMD on age and menopausal status, an acceleration of bone loss was observed during the perimenopausal period and the following first two postmenopausal years. No significant bone loss was detected in relation to age or during the later postmenopausal years. Applying both an additive and a multiplicative model of bone loss, the mean perimenopausal bone loss was 0.061 gram-equivalents hydroxyapatite (geqHA)/cm2 and 6.4%, respectively. In the first 2 postmenopausal years the mean bone loss was 0.044 geqHA/cm2 and 5.1% per year. These results suggest a substantial menopause related acceleration of lumbar bone loss in a relatively short time span with its onset in the perimenopausal period.

Bone and Bones↗

PubMedDate not supplied

The radiographic trabecular bone pattern during menopause.

The purpose of this study is to increase the diagnostic value of radiographs by observing the radiographic trabecular pattern during occasions of changing three-dimensional bone structure. We explored how the shape of the radiographic trabecular pattern of the distal radius relates to bone mineral density, time, and menopausal status. We found that the trabecular pattern correlates with bone mineral density and time, especially in the early years of the climacterium.

Bone Density↗