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Introduction: The predictive value of biochemical markers of bone turnover for subsequent change in bone density in a population sample of healthy women with a wide range of ages has not been fully established. Methods: We followed 1,283 women aged 15-79 years at baseline selected randomly from the inhabitants of three areas in Japan for 6 years, and examined 1,130 subjects with no disease or administration of drugs affecting bone metabolism. The annual change in bone density at the spine, total hip, and distal one third of the radius was determined during the follow-up period by dual x-ray absorptiometry and was compared among the groups using different levels of biochemical markers at baseline, including serum osteocalcin (OC) and bone-specific alkaline phosphatase (bone ALP), free and total (tDPD) forms of immunoreactive deoxypyridinoline, and type I collagen crosslinked C-terminal telopeptide (CTX) in urine. Results: Premenopausal women aged 45 years or older with elevated levels of OC, bone ALP, CTX, or tDPD showed significantly greater bone loss at most skeletal sites during the follow-up period than those with lower levels, after adjustment for the effects of age, height, weight, dietary calcium intake, regular exercise, and current smoking. The greatest coefficient of determination of the model was observed in the association between CTX and bone loss at the hip during the first 3 years of follow-up (42.8%). These subjects were pooled with perimenopausal women at baseline, and those who still menstruated at follow-up in this pooled group showed significant but more modest associations, whereas those who entered menopause during the follow-up period showed clear associations. However, early postmenopausal women with less than 5 or 10 years since menopause showed an association that was limited mostly to the distal radius, and other postmenopausal groups had virtually no association. Conclusion: Biochemical markers of bone turnover may predict bone loss in women undergoing menopausal transition but may not predict bone loss in postmenopausal women. Keywords Bone mineral density * Bone turnover markers * Japanese women * Longitudinal study * Population-based epidemiologic study * Random sample

Byline: M. Zhang (1), T. Shimmura (1), L. F. Bi (2), H. Nagase (1), H. Nishino (3), E. Kajita (4), M. Eto (4), H. B. Wang (5), X. L. Su (2), H. Chang (2), T. Aratani (1), S. Kagamimori (5) Keywords: Bone mass; Inner Mongolia; Japan; Lifestyle; Premenopause Abstract: The purpose of this study was to evaluate the ethnic difference in bone mass between Japanese and Inner Mongolian young premenopausal women and to assess the contribution of lifestyle related and anthropometric factors to bone mass. We studied 33 Japanese and 44 Inner Mongolian healthy young women, aged 20--34 years, in urban area. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) were measured at the calcaneus using quantitative ultrasound (QUS) analysis. Age at menarche, regularity of menstruation and lifestyle related factors were estimated by a self-reported questionnaire. There were no differences between the two groups in age, height, weight, BMI, regularity of menstruation, frequency of meat intake, frequency of yellow-green vegetable intake and exercise habit. Japanese women had significantly lower age at menarche and higher proportion of milk consumption habit at junior high school, senior school and present. Before adjustment, Japanese women had significantly higher SOS and SI than Inner Mongolian women. However, after adjustment for age at menarche and milk consumption habit at junior high school, both of which were significantly different between groups, no group-differences remained in either SOS or SI. These results suggest that the differences in age at menarche and milk consumption habit at junior high school, which relate to hormonal and nutritional status during puberty, may account for the differences in bone mass between Japanese and Inner Mongolian young women. Author Affiliation: (1) Department of Environmental Health, Toyama Institute of Health, Nakataikoyama 17-1, Kosugi, 939-0363, Toyama, Japan (2) Inner Mongolia Medical College, 010059, Hohhot, China (3) Toyama Red Cross Blood Center, 930-0003, Toyama, Japan (4) Department of Nursing Community Nursing, Nagoya University School of Health Science, 461-8673, Nagoya, Japan (5) Department of Welfare Promotion and Epidemiology, Toyama Medical and Pharmaceutical University, 930-0194, Toyama, Japan Article History: Registration Date: 16/12/2003 Received Date: 17/07/2003 Accepted Date: 11/12/2003 Online Date: 03/02/2004

Byline: M. Iki (1), S. Kagamimori (2), Y. Kagawa (3), T. Matsuzaki (4), H. Yoneshima (5), F. Marumo (6) Keywords: Key words:Bone mineral density -- Diagnostic criteria for osteoporosis -- DXA -- Japanese women -- Population-based epidemiologic study -- Prevalence rate of osteoporosis Abstract: Low bone mineral density (BMD) is one of the most important elements for the diagnosis of osteoporosis and screening people with higher risk of fractures. To establish the criterion value of BMD for the diagnosis of osteoporosis and to estimate the prevalence rate of osteoporosis in Japanese women, we performed a Japanese population-based osteoporosis (JPOS) study. The subjects were 4550 women aged 15 through 79 years randomly selected from seven municipalities throughout Japan. The sample size was determined to ensure that the observed mean BMD would remain within 2.5% from the real value with a probability of 0.95 in each of the 5-year age groups. The study comprised bone mass measurements by dual-energy X-ray absorptiometry at the spine (L2--4), hip and distal forearm, body size measurements and detailed interviews on medical and gynecologic history. After excluding those subjects with apparent or suggested abnormalities affecting bone mass from 3985 women (87.6%) who completed the study, 3465 women remained and served as the subjects. We present 5-year age-specific mean values of BMD and cut-off values for the diagnosis of osteoporosis according to World Health Organization (WHO) and the Japanese Society of Bone and Mineral Research (JSBMR) criteria. The cut-off levels at the spine and the distal radius proposed in this study were similar to those proposed by the JSBMR but the cut-off level at the femoral neck in this study was 4.7% higher than that of the JSBMR. The prevalence rates of osteoporosis according to WHO criteria in the present subjects aged 50 through 79 years were calculated as 38.0% at the spine, 11.6% at the femoral neck and 56.8% at the distal one-third site of the radius, and those in the Japanese female population of the same age were estimated to be 35.1%, 9.4% and 51.2%, respectively. A fivefold difference was observed among the prevalence rates at different skeletal sites, which suggests that the different definitions of osteoporosis should be established for the different skeletal sites. The prevalence rate diagnosed at the femoral neck seemed to be lower in the present study than those reported for Caucasians. This might account for a lower incidence rate of hip fracture in Japanese women. Author Affiliation: (1) Department of Public Health, Kinki University School of Medicine, Osaka-Sayama, Japan, JP (2) Department of Welfare Promotion and Epidemiology, Toyama Medical and Pharmaceutical University, Toyama, Japan, JP (3) Kagawa Nutrition University, Tokyo, Japan, JP (4) Institute of Comprehensive Community Care, Tokyo, Japan, JP (5) Kasukabe Shuuwa Hospital, Kasukabe, Japan, JP (6) Department of Homeostasis Medicine and Nephrology, Graduate School of Tokyo Medical and Dental University, Tokyo Japan, JP Article note: Received: 6 June 2000 / Accepted: 5 January 2001

Byline: T. Matsukura (1), S. Kagamimori (2), T. Yamagami (3), H. Nishino (4), M. Iki (5), E. Kajita (6), Y. Kagawa (7), H. Yoneshima (8), T. Matsuzaki (9), F. Marumo (10) Keywords: Key words:Bone mineral density -- Cross-sectional study -- Physiological development -- Teenager Abstract: Osteoporosis is a major public health problem in Japan. The second decade is an important period in which to attain a high peak bone mass. However, normal values of forearm bone mineral density (BMD) are not well known in children and adolescents. BMD at one-third of forearm length proximal to the ulnar end plate (BMD1/3) and the ultradistal forearm (BMDud) was measured using dual-energy X-ray absorptiometry (DXA) in 1207 (631 males, 576 females) Japanese subjects aged 9--18 years. Puberty onset was assessed by questionnaire, by obtaining the time that pubic hair appeared in males and the time that menstruation started in females. BMD1/3 and BMDud increased steadily with age in males. In relation to puberty development, these parameters also increased after puberty onset although the increase in BMD1/3 was not statistically significant after the fifth year from puberty onset and that of BMDud was not significant after the sixth year from puberty onset. BMD1/3 and BMDud increased with age and then plateaued in females. The increase in BMD1/3 was not statistically significant after 15--16 years of age and that of BMDud was not significant after 13--14 years of age. In relation to puberty development, the increase in BMD1/3 leveled out after the fourth year from puberty onset and that of BMDud also plateaued after the third year from puberty onset. We provide reference values of forearm BMD in Japanese children and adolescents by DXA according to calendar age and puberty development. Peak bone mass of the forearm may be in the late second decade in Japanese females. Author Affiliation: (1) Medical Affairs Division, Health and Welfare Department, Toyama Prefectural Government, Toyama, JP (2) Department of Welfare Promotion and Epidemiology, School of Medicine, Toyama Medical and Pharmaceutical University, Toyama, JP (3) Hokuriku Health Service Association, Toyama, JP (4) Department of Environmental Health, Toyama Institute of Health, Toyama, JP (5) Department of Public Health, Kinki University School of Medicine, Osaka-Sayama, JP (6) Department of Community Health and Gerontological Nursing, School of Medicine, Toyama Medical and Pharmaceutical University, Toyama, JP (7) Kagawa Nutrition University, Tokyo, JP (8) Kasukabe Shuwa Hospital, Saitama, JP (9) Institute for Comprehensive Community Care, Tokyo, JP (10) Second Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan, JP Article note: Received: 10 October 1999 / Accepted: 25 April 2000

Experiments to determine the oxidation-reduction potential to pH relationship of vital water in different foods and human fluids are discussed.