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PubMed1993

Characterization of heparin-induced osteopenia in rats.

Heparin has been known to induce osteopenia, but its precise mechanism of action is unknown. In the present study, we examined the effect of heparin on the rat femur using single photon absorptiometry and characterized the osteopenia biochemically and pharmacologically. Daily heparin injection dose dependently induced osteopenia in rats. Significant bone loss was observed from 2 weeks after starting heparin treatment (2000 U/kg.day) and peaked at 4 weeks. Serum PTH levels were significantly elevated from 1 week onward after starting heparin treatment, whereas no significant changes were seen in serum total calcium or ionized calcium levels. A bone resorption inhibitor, FR78844 (a bisphosphonate compound), significantly attenuated the heparin-induced osteopenia, as did 1 alpha-hydroxyvitamin D3; with the latter, the effective dose was 10 times lower than that needed for a similar effect against immobilization and ovariectomy-induced osteopenia, suggesting an up-regulation of 1 alpha, 25-dihydroxyvitamin D3 receptors in the heparin-treated rats. This speculation was supported by the finding that serum 1 alpha, 25-dihydroxyvitamin D levels were significantly decreased by 54% in the heparin-treated rats compared to those in normal rats. These results suggest that the enhanced bone resorption by high PTH blood levels and the reduction of 1 alpha, 25-dihydroxyvitamin D are involved in the pathogenesis of heparin-induced osteopenia.

Absorptiometry, Photon↗

PubMed1994

The effect on vertebral bone mass and strength of long term treatment with antiresorptive agents (estrogen and calcitonin), human parathyroid hormone-(1-38), and combination therapy, assessed in aged ovariectomized rats.

The aim of the study was to assess the long term effect of the antiresorptive agents estrogen and salmon calcitonin, the anabolic drug PTH, and combination therapy on vertebral bone mass and bone biomechanical competence in aged osteopenic ovariectomized (OVX) rats. Seventy-nine 1-yr-old retired breeder Wistar rats were randomized into seven groups: 1) sham-operated, 2) OVX, 3) OVX plus estrogen, 4) OVX plus salmon calcitonin, 5) OVX plus human (h) PTH-(1-38), 6) OVX plus hPTH-(1-38) and estrogen, and finally, 7) OVX plus hPTH-(1-38) and calcitonin. Treatment regimens were initiated 8 weeks after ovariectomy and continued for 24 weeks. Whole body bone mass was measured by dual photon absorptiometry at intervals of 4 weeks and at death. Changes in spinal bone mass (BMC), biomechanical competence, and structure were assessed from the lumbar vertebral bodies. The results revealed a protective effect of both estrogen and calcitonin on ovariectomy-induced loss of whole body bone mass, but only estrogen had a significant effect on spinal BMC. hPTH-(1-38) monotherapy increased vertebral bone mass (BMC and ash content), size, and biomechanical parameters 20-80% over OVX levels. A more rapid effect on vertebral bone mass was seen when hPTH-(1-38) was combined with estrogen or salmon calcitonin. The study has shown that in aged OVX osteopenic rats, hPTH-(1-38) therapy increases vertebral bone mass and bone quality and also maintains trabecular connectivity. Both estrogen and calcitonin reduce the ovariectomy-induced bone loss, but cannot restore bone mass to sham-operated levels. On the basis of this study, it is concluded that PTH therapy seems to hold promise in the management of postmenopausal and age-related osteoporosis.

Absorptiometry, Photon↗

PubMed1990

Bone mass reduction after estrogen deprivation by long-acting gonadotropin-releasing hormone agonists and its relation to pretreatment serum concentrations of 1,25-dihydroxyvitamin D3.

Estrogen deficiency results in bone mass reduction of largely varying extent in postmenopausal females, indicating that additional mechanisms influence the response of bone. They are by no ways identified in either the animal experiment or under clinical conditions. In search for factors, conditioning the response of bone to estrogen deficiency, we have conducted a study in females under treatment with the GnRH agonist decapeptyl (D-Trp6-LHRH). This drug blocks ovarian function and was administered for treatment of endometriosis or uterine leiomyoma. We determined spinal (dual photon absorptiometry) and forearm (single photon absorptiometry) bone mineral density before and 3 and 6 months after the onset of therapy and measured biochemical parameters of bone metabolism. Our results showed an increase in bone turnover after initiation of estrogen deficiency, as indicated by the elevation of alkaline phosphatase and osteocalcin. This resulted in a secondary decrease in serum intact PTH and 1,25-dihydroxy-vitamin D3. Furthermore, we found a positive correlation between pretreatment values of serum 1,25-dihydroxyvitamin D3 as well as its decrease and the reduction in bone mass during GnRH agonist treatment. This demonstrates that the patients' metabolic conditions predict their response to estrogen deficiency.

Adult↗

PubMed1990

The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men.

To evaluate the influence of extravertebral calcification on spinal bone density determinations, we measured lumbar vertebral density in 71 hospitalized and 58 normal men using dual photon absorptiometry. The extent of vascular and osteophytic calcification was graded from lateral lumbar radiographs. Fifty-five (43%) of the subjects had identifiable osteophytes, and 86 (67%) had vascular calcifications. Despite similar ages and weights in subjects with and without ostephytes, those with osteophytes had greater spinal density (1.34 vs. 1.17 g/cm2; P less than 0.001), and there was a strong correlation between osteophyte severity and spinal density (r = 0.41; P less than 0.00001). Proximal femoral density was not different in those with and without osteophytes. The distribution of osteophytes in this population was not random, and as a result, the presence of osteophytes obscured the the relationship of bone density to age as well as the comparison of hospitalized to normal men. Vascular calcification had a minimal effect on vertebral density. In summary, osteophytic calcification exerted an important influence on the measurement of spinal bone density in men. This effect should be considered in both clinical and research applications of integral vertebral density measures.

Absorptiometry, Photon↗

PubMed1992

Longitudinal changes in lumbar bone density among thyrotoxic patients after attainment of euthyroidism.

Hyperthyroidism increases bone turnover, which, in turn, may lead to bone loss from the spine and hip. Treatment of thyrotoxicosis may restore bone mass, but there are few long term prospective studies. We examined lumbar bone mineral density (BMD) in 21 subjects [11 with hyperthyroidism (HT) and 10 controls of similar age] by dual photon absorptiometry in 1986 and by dual energy x-ray densitometry in 1991. All 11 HT patients were successfully treated and remained euthyroid (mean TSH, 2.25 +/- 0.80 mU/L) for more than 3 yr. Lumbar BMD increased 11.03 +/- 2.38% (P < 0.001) in HT patients, but only 2.6 +/- 2.15% (P = 0.10) in control subjects. Among HT patients, the higher the T3 concentration during hyperthyroidism, the greater the subsequent increase in lumbar BMD (r = 0.72; P < 0.03). Age at treatment, in contrast, was not a significant predictor of eventual spinal bone mass. In conclusion, successful treatment of hyperthyroidism produced a significant increase in lumbar BMD. Hence, bone loss associated with thyrotoxicosis may not be permanent. Future work designed to examine the effect of thyroid hormone on skeletal homeostasis should include large scale longitudinal studies of both men and women.

Absorptiometry, Photon↗

PubMed1993

Turner syndrome adolescents receiving growth hormone are not osteopenic.

Deficits in bone mineral have been widely reported in Turner syndrome. The bone mineral status of 19 adolescents with Turner syndrome (16 receiving GH therapy) was evaluated by dual photon absorptiometry of the lumbar spine and whole body and compared with a normal female control group (n = 45) with the same mean age (14.3 yr). The conventional measurements of bone mass, bone mineral content (BMC = g), and bone mineral density (BMD = g/cm2), as well as bone mineral apparent density (BMAD = g/cm3), an expression of bone mineral adjusted for bone volume, were determined for both sites. Although mean BMC was decreased in Turner females, mean BMD and BMAD in the two groups were not significantly different. Analyzed in relation to chronologic age, bone age, height, and pubertal status, mean BMD and BMAD values in Turner subjects were equal to or greater than that of controls. BMD and BMAD were elevated in the Turner group vs. controls matched for height. In subjects with bone age less than or equal to 12.5 yr, mean spinal BMAD was unexpectedly greater in Turner patients compared with controls (0.148 +/- 0.011 vs. 0.134 +/- 0.013, P = 0.009). When data were analyzed by pubertal status, mean spinal BMD and BMAD in subjects with Tanner breast stages 1-2 were higher in the Turner group than in the controls (BMAD 0.146 +/- 0.011 vs. 0.132 +/- 0.015, P = 0.015). No differences were seen in mid- to late pubertal females. Bone mineral properties were additionally reassessed after a mean interval of 1.3 yr in 10 of the subjects with Turner syndrome. Percentage increases in mean follow-up spinal BMD and BMAD were greater in 5 subjects begun on estrogen replacement than in 5 untreated patients. We conclude that: 1) bone mineral values in adolescents with Turner syndrome on GH therapy are not abnormal, 2) lumbar bone mineral is greater in younger Turner adolescents matched with controls for bone age or pubertal status, a difference which could relate to GH therapy, and 3) estrogen therapy may augment bone mineral accretion in Turner syndrome, but early estrogen replacement cannot be justified on the basis of bone mineral status.

Absorptiometry, Photon↗

PubMed1993

Bone mineral density in patients with chronic hypoparathyroidism.

Photon absorptiometry was used to measure skeletal mass in the proximal femur, lumbar spine, and distal radius in 19 females with hypoparathyroidism after operation for either thyroid carcinoma or hyperparathyroidism. Healthy subjects as well as normocalcemic patients who had undergone the same surgical procedure without developing hypoparathyroidism were used as controls. Skeletal mass was measured after a mean postoperative time of 13 and 10 yr in patients operated on for thyroid carcinoma and hyperparathyroidism, respectively. Bone mass was 10-32% greater in hypoparathyroid patients than in controls. In patients with retained parathyroid function after total thyroidectomy and surgical treatment of hyperparathyroidism, bone mass did not differ from that in age-matched healthy controls. Long term T4 medication in doses that suppressed endogenous TSH production was not associated with a decreased bone mass. Reduced PTH production, vitamin D treatment, and calcium supplementation may all have contributed to the increased bone mass found in the patients with postsurgical hypoparathyroidism.

Absorptiometry, Photon↗

PubMed1994

Reduced bone mineral density in patients with adult onset growth hormone deficiency.

We have demonstrated previously that adults with isolated GH deficiency of childhood onset have a reduced bone mineral density (BMD) of vertebral trabecular bone [quantitative computed tomography (QCT): median Z score -1.3, P < 0.01, n = 12] and of cortical bone in the forearm [single photon absorptiometry (SPA): median Z score -2.9, P = 0.001, n = 7]. We have now examined BMD in 26 patients (13 men, 13 women), aged between 23.6 and 59.5 (mean 42.4) yr, with adult onset GH deficiency, defined as a GH response of less than 5 micrograms/L to provocative testing, of at least two years duration. BMD was measured using QCT for vertebral trabecular bone, dual energy x-ray absorptiometry (DXA) in the lumbar spine and femoral neck, and SPA in the forearm. There was a highly significant reduction in QCT (median Z score -1.07, P < 0.00005), in DXA of the lumbar spine (median Z score -0.76, P = 0.0001) and in SPA of the forearm (median Z score -0.86, P = 0.0001) but not in DXA of the femoral neck (median Z score -0.38, P = 0.35). There were no significant differences in Z scores between those patients with isolated GH deficiency and those with GH and gonadotrophin deficiency. There was a significant positive correlation between age at which BMD was measured and Z score (the older the patient, the higher the Z score) for QCT (r = 0.38, P < 0.05) and SPA (r = 0.48, P < 0.01) with a trend to a positive correlation for DXA of the lumbar spine and femoral neck. Patients were grouped according to estimated duration of GH deficiency (less than 5 yr, n = 7; 5-10 yr, n = 10; greater than 10 yr, n = 9). These groups did not show a significant difference in BMD at any site. We conclude that patients with adult onset GH deficiency (isolated or in conjunction with other pituitary hormone deficiencies) have a reduced BMD. Age at development of GH deficiency may be more important than duration of GH deficiency in determining the degree of reduction in bone mass. The impact of GH treatment on BMD in adults with adult onset GH deficiency requires investigation.

Absorptiometry, Photon↗

PubMed1997

Diabetes during pregnancy does not alter whole body bone mineral content in infants.

A previous study using single photon absorptiometry has reported low bone mineral density of the radius in infants of diabetic mothers. The aim of this study was to assess by dual x-ray absorptiometry the whole body bone mineral content (WbBMC) and the body composition of 40 infants of diabetic mothers at birth (mean gestational age +/- SD, 37.5 +/- 1.3 weeks; mean birth weight +/- SD, 3815 +/- 641 g). WbBMC was not correlated with gestational age, but was well correlated with birth weight (r = 0.73; P = 0.0001) and also with fat mass (r = 0.87; P = 0.0001) and lean mass (r = 0.42; P = 0.008). The z-scores +/- SD adjusted for weight for WbBMC and fat mass were significantly increased (1.3 +/- 0.9 and 2.6 +/- 1.3, respectively (P < 0.0001), but were not significantly influenced either by in utero growth or by the type of the diabetes mellitus of the mother. Bone mineralization and fat mass studied by whole body dual x-ray absorptiometry are increased at birth in these infants compared with reference curves.

Absorptiometry, Photon↗

PubMed1990

Bone density in eumenorrheic female college athletes.

Information is limited on the effect of exercise on bone density in young eumenorrheic athletes. We studied 12 Caucasian intercollegiate volleyball players (V), nine basketball players (B), ten swimmers (S), and 13 non-athletes (N) with bone density measurements by photon absorptiometry of their calcaneus and lumbar spine (L2-L4). The effect of athletic status on bone density was analyzed by multivariate analysis of covariance, with height and weight as covariates. The bone densities reported below are mean +/- SE, adjusted for the covariates; units = g.cm-2, P less than 0.005. The swimmers had a significantly lower mean density in the lumbar spine than all other groups; the non-athletes' mean density was also lower than that of volleyball players (V = 1.31 +/- 0.03, B = 1.26 +/- 0.04, N = 1.18 +/- 0.03, S = 1.05 +/- 0.03). The volleyball and basketball players' mean calcaneal densities were greater than those of the swimmers and non-athletes (V = 0.530 +/- 0.017, B = 0.564 +/- 0.023, N = 0.438 +/- 0.018, S = 0.375 +/- 0.019). The higher bone densities for athletes in vertical weight-bearing activities are consistent with some but not all published data. The swimmers' low bone density in the lumbar spine, less than published values for amenorrheic runners, was unexpected.

Absorptiometry, Photon↗

PubMed1992

The spine deformity index in osteoporosis is not related to bone mineral and ultrasound measurements.

In 34 female patients suffering from osteoporotic vertebral compression fractures, the spine deformity index (SDIM) was determined, according to the method of Minne et al (1988), to reflect the radiological severity of established osteoporosis. Peripheral (single-photon absorptiometry (SPA) of the non-dominant distal forearm) and axial (quantitative computed tomography (QCT) of the lumbar spine) bone mineral measurements, as well as the broadband ultrasound attenuation of the os calcis, were performed in the osteoporotic patients and in a control group of 20 age-matched women. No correlation could be found between bone mineral measurements and radiological severity of osteoporosis, expressed as SDIM. All three densitometry methods showed clearly reduced values in patients with vertebral crush fractures. Correlations established in the control group between peripheral and axial bone mass (SPA versus QCT) could no longer be found in the osteoporotic group, thus indicating changes in bone mineral density of the spine after the occurrence of osteoporotic fractures. Our data show that SDIM is an additional parameter of osteoporotic change in the spine, independent from bone mass measurements. In the management of osteoporotic patients, quantitative radiological methods (i.e. SDIM) in addition to densitometry might be of value for grading and monitoring the progress of disease.

Absorptiometry, Photon↗

PubMed1993

Relationships between metacarpal morphometry, forearm and vertebral bone density and fractures in post-menopausal women.

The relationships between metacarpal morphometric, vertebral and forearm density measurements and the prevalence of vertebral and peripheral fractures were examined in 239 postmenopausal women (median age 63, range 32-84 years). Metacarpal cortical area/total area ratio (CA/TA) was measured with needle calipers, forearm mineral density (FMD) by single photon absorptiometry and vertebral mineral density (VMD) by single energy quantitative computed tomography. Of the 239 subjects 97 had not suffered any fractures, 44 had at least one previous vertebral fracture but no peripheral fractures, 41 had a history of peripheral fracture but no vertebral fracture and 57 had suffered both peripheral and vertebral fractures. There were significant correlations between a single measurement of CA/TA and both FMD (r = 0.65, p < 0.001) and VMD (r = 0.41, p < 0.001). Similar correlations existed between the mean of multiple measurements of CA/TA and both FMD and VMD. CA/TA (p < 0.001), FMD (p < 0.001) and VMD (p < 0.001) were reduced in subjects who had suffered fractures, when compared with the no fracture group. The percentage of cases in each of the four fracture groups (vertebral fracture only, peripheral fracture only, peripheral and vertebral fracture, peripheral or vertebral fracture) misclassified with reference to the no fracture group were similar with CA/TA, FMD or VMD measurements. We suggest that metacarpal morphometry, which is widely available at relatively low cost, yields cross-sectional information about bone density and fracture risk, comparable with that obtained by forearm and vertebral densitometry.

Absorptiometry, Photon↗

PubMed1999

Geometry of proximal femur in the prediction of hip fracture in osteoporotic women.

111 White post-menopausal women with hip fracture and 329 healthy controls were studied in order to determine whether proximal femur geometry predicts hip fracture and improves the discriminant ability of femoral neck bone mineral density (BMD) in elderly women. All subjects underwent dual X-ray photon absorptiometry (DXA) of the hip from which the femoral neck BMD, hip axis length, femoral neck width and femoral neck-shaft angle were measured. Fractured subjects had a lower femoral neck BMD, a longer hip axis length and a more valgus neck-shaft angle. The hip axis length correlated significantly with neck-shaft angle, femoral neck width and age. No significant correlation was found between neck-shaft angle and age. On standardized logistic regression, the hip axis length and the neck-shaft angle predicted fracture independently of BMD after correction for age, weight and femoral neck BMD. The femoral neck BMD significantly discriminated fractured subjects after correction for all potential confounders. The logistic models containing simultaneously one femoral geometric parameter and the neck BMD discriminated significantly better than those containing the same variables as single predictor. Our data suggest that hip axis length may play a role in fracture risk and supports a similar role for neck-shaft angle. Combining proximal femur geometric measurements and femoral neck BMD improved the discriminant ability of each measurement.

Absorptiometry, Photon↗

PubMed1992

Radiological characteristics of lead foils in dental film packets: analysis of components and shielding effect.

The radiological characteristics of the lead in five different dental film packets currently on the market in Japan were studied with monochromatic X-rays. Four packets were of a foil type while in the fifth, the lead was incorporated in the vinyl of the film packet. The samples were analysed by polychromatic photon absorptiometry, and the main component found to be lead with tin and/or antimony in smaller amounts. The shielding effect was calculated and, with the exception of the lead vinyl type, all found to exceed the ISO standard 3665. The lead foils attenuated the primary beam by, on average, 77% and 56% at 60 and 90 kVp respectively: in contrast, the reduction with the lead vinyl packet was only 38% and 23%. Using a 7 cm round beam, the lead foils reduced the dose by an average of 15% compared with 30% with a rectangular beam; the average dose reduction with the lead vinyl type was 8% and 15% respectively. These data show that the lead vinyl packet is unsuitable for clinical use and confirm the importance of optimum beam collimation for the reduction of patient risk.

Absorptiometry, Photon↗

PubMed1991

Bone structure after removal of internal fixation plates.

We used single-photon absorptiometry to assess the forearm bones after the removal of internal fixation plates in 14 patients. We found convincing evidence of cortical atrophy in only one patient, in whom the plates had been removed prematurely after only 16 months. It is suggested that such plates should be retained for at least 21 months, to allow bone density to return to its prefracture level. The recommendations of the AO/ASIF group are supported.

Absorptiometry, Photon↗

PubMed2006

Leptin predicts BMD and bone resorption in older women but not older men: the Rancho Bernardo study.

UNLABELLED: We studied the relation of leptin to bone, bone loss, and bone turnover in community-dwelling men and women. Leptin predicted higher BMD and lower bone turnover only in women. Leptin was not associated with 4-year bone loss in either sex. INTRODUCTION: Leptin, the protein product of the obesity (OB) gene produced in fat tissue, was originally thought to be involved only in the regulation of food intake and energy balance. Recent evidence suggests that leptin may play a role in the pathophysiology of several chronic diseases. Studies of the association between leptin and bone have been numerous yet inconclusive. Only one previous longitudinal study has been reported, which showed no association of leptin with BMD after adjusting for body size. MATERIALS AND METHODS: We report the association of serum leptin with BMD at the hip, spine, and midshaft radius in community-dwelling men (n = 498) and nonestrogen-using postmenopausal women (n = 411) 45-92 years of age. Serum leptin was measured in blood obtained between 1984 and 1987. Between 1988 and 1991, BMD was measured at the midshaft radius by single photon absorptiometry and at the femoral neck, total hip, and lumbar spine by DXA; at the same visit, height, weight, and body fat (by bioelectrical impedance analysis) were measured, and bone resorption was assessed in a subset of men (n = 286) and women (n = 241) using urine N-telopeptide (NTX). Four years later, axial BMD was remeasured in 536 participants. Sex-specific associations of leptin with BMD, NTX, and bone loss were tested using regression analysis. RESULTS: In unadjusted analyses, leptin was associated with BMD at the femoral neck, total hip, lumbar spine, and midshaft radius in both sexes (p < 0.01). In multiple regression analyses, adjusted for age, BMI, and other bone-related factors, only women showed a graded stepwise positive association between serum leptin and BMD at all sites and a negative stepwise association with NTX (all p for trend < 0.01). Baseline leptin levels did not predict 4-year bone loss in either sex. CONCLUSIONS: A favorable dose-dependent leptin-BMD association unexplained by obesity was observed only in women. The reason for the sex difference is unknown.

Absorptiometry, Photon↗

PubMed2006

Ghrelin and bone: is there an association in older adults?: the Rancho Bernardo study.

UNLABELLED: Laboratory studies suggest that ghrelin is involved in bone metabolism, but studies of ghrelin and bone in humans are limited. We studied sex-specific associations of ghrelin with BMD, NTX, and bone loss. Ghrelin was not associated with BMD or bone loss in either sex. There was a significant inverse association with NTX in men but not in women. INTRODUCTION: Ghrelin is a gastric hormone recently shown to be associated with bone metabolism in animal and in vitro studies. Studies in humans are limited. We investigated the association of ghrelin with BMD, the bone resorption marker N-telopeptide (NTX), and bone loss in older men and women. MATERIALS AND METHODS: Participants were 977 community-dwelling men and non-estrogen-using postmenopausal women, 50-91 years of age. Plasma ghrelin was measured by radioimmunoassay from blood obtained between 1984 and 1987. Between 1988 and 1991, BMD was measured at the midshaft radius by single photon absorptiometry and at the femoral neck, total hip, and lumbar spine by DXA. Axial BMD measurements were repeated an average of 4 years later in 544 participants. Bone turnover was assessed by NTX in urine obtained at the same time as the initial BMD. Multiple regression analyses were used to test sex-specific associations of ghrelin with BMD, NTX, and bone loss in both sexes. RESULTS: No significant ghrelin-BMD or ghrelin-bone loss associations were observed in either sex, after adjusting for age and body mass index (BMI). Ghrelin was inversely associated with NTX in men and positively associated with NTX in women, independent of age. After adjusting for both age and BMI, this association reached statistical significance in men and was weakened in women. CONCLUSIONS: Ghrelin may be associated with bone turnover, but there is no evidence for an association with BMD or short-term change in BMD in older adults.

Absorptiometry, Photon↗

PubMed1998

Nonsteroidal anti-inflammatory drugs and bone mineral density in older women: the Rancho Bernardo study.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to inhibit synthesis of prostaglandins and may help prevent bone loss, but no study has shown the differential association of type or dose of NSAID compound with bone mineral density (BMD). The purpose of this study was to determine the relation of NSAIDs by type and dose to BMD. Participants were 932 Caucasian, community-dwelling women aged 44-98 years from southern California. Data were collected from 1988 to 1991 through the use of standardized medical questionnaires. Medication use was validated by a nurse. BMD at the ultradistal and midshaft radii were measured using single-photon absorptiometry, and at the hip and lumbar spine using dual-energy X-ray absorptiometry. Women (mean age, 72 years) were classified into 818 nonusers and 114 regular daily users of NSAIDs, of which 84 used propionic acid NSAIDs and the remainder used acetic acid NSAIDs. Occasional NSAID users were excluded. Women who used propionic acid NSAIDs, but not acetic acid NSAIDs, had higher BMD at all five sites and significantly higher BMD at the midshaft radius and lumbar spine. These differences remained after controlling for known covariates of osteoporosis. When women with self-reported osteoarthritis were excluded from the model, significantly higher BMD in propionic acid NSAID users was also observed at the femoral neck and total hip. Those who concurrently used estrogen and propionic acid NSAIDs had the highest BMD at all sites, suggesting an additive effect. We conclude that regular daily use of propionic acid NSAIDs, with or without simultaneous use of estrogen, may be helpful in preventing bone loss in older women. However, further research is needed to confirm these results before any clinical practice guidelines can be recommended due to the increased risk of serious complications associated with NSAID use.

Absorptiometry, Photon↗