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In this population-based study, the relationship between childhood weight and height, and adolescent bone mass and muscle strength have been studied in 39 girls and 48 boys. Total body and femoral neck bone mass measurements (bone mineral content, BMC and bone mineral density, BMD) were made by dual X-ray absorptiometry. Quadriceps muscle strength was measured. Mean age at the time of measurement was 15.1 years for girls and boys. Results were individually linked to data on childhood (birth to 6 years of age) weight and height, taken from community health records. Childhood weight was found to be predictive of adolescent total body BMC (TBMC). However, this was not the case when correlating childhood weight and total body BMD (TBMD), suggesting that growth determines the size of the skeleton, whereas the density within that bone envelope is to a greater extent governed by other factors. Further, in a multiple regression model we found that the combined effect of childhood weight and height was significantly correlated with adolescent quadriceps muscle strength. [ABSTRACT FROM AUTHOR]

This study evaluates the effect on the skeleton of physical activity from age 9 to 16. In 42 girls and 44 boys, bone mass and bone size were evaluated longitudinally by dual-energy X-ray absorptiometry (DXA) from ages 13 to 16. Physical activity from ages 9 to 13 was cross-sectionally evaluated at baseline (age 13). Girls with high physical activity from ages 9 to 13 at baseline had higher femoral neck bone mineral content (FN BMC; g) (P = 0.07), higher FN areal bone mineral density (FN aBMD; g/cm2), and higher FN volumetric BMD (FN vBMD; g/cm3) (both P <0.05) compared with girls of low activity. FN width (cm) and head aBMD (an unloaded region) showed no differences when comparing the two groups. Three years of further high and low activity (from ages 13 to 16) did not yield any increased differences between the two groups. Boys with high physical activity from ages 9 to 13, had at baseline higher FN BMC, FN aBMD, and FN width (all P <0.05) compared with boys with low activity. FN vBMD and head aBMD showed no differences when comparing the two groups. Three years of further high and low activity did not yield any increased differences between the two groups. We conclude that exercise may yield skeletal benefits before age 13, and that 3 years of continued high or low level activity up to age 16 did not yield any increased differences in bone size or bone mass in either girls or boys. [ABSTRACT FROM AUTHOR]

Based on the population of the city of Malmö, Sweden, we performed a retrospective cohort study. By choosing patients who had fractures of the upper end of the femur in the 1950s as an indication of senile osteoporosis, and by studying the roentgenographic records of their children from the 1950s and on we concluded that this type of osteoporosis is not a condition that is aggravated in certain families. Offspring of parents who had a hip fracture in the 1950s are not more prone to have fractures than a control group. [ABSTRACT FROM AUTHOR]

We performed ultrasound measurements (QUS) of the calcaneus in a population-based setting on 280 healthy children, aged 11–16 years, from a small urban area in southern Sweden. The results are compared with dual-energy X-ray absorptiometry (DXA) measurements in the total body, the lumbar spine and the hip, as well as single-energy X-ray absorptiometry (SXA) of the forearm. Normative data and correlations between the three different techniques were determined. We found significant correlations between QUS and age ( r= 0.34–0.54), height ( r= 0.13–0.56) and weight ( r= 0.30–0.60), and between QUS and bone mineral density (BMD) measurements ( r= 0.44–0.70). Boys increased all their bone mineral variables with age, whereas girls showed a decreasing trend from age 15 years. QUS had a significantly higher increase in standardized value with age than Ward's triangle BMD, but a significantly lower increase in standardized value with age than distal radius (cortical site) BMD. At other BMD sites we did not find any significant differences compared with QUS regarding changes with age. The measurements obtained by QUS, DXA and SXA, respectively, were divided into quartiles. Of all subjects in the lowest quartile for QUS measurements, only 34–50% were also in the lowest quartiles for DXA and SXA measurements. In conclusion, QUS measurements of the calcaneus in children show similar results as for adult regarding the correlation with DXA and SXA; they also have a significant correlation with anthropometric data. QUS did not identify the same individuals with low bone mass as the X-ray techniques. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the bone mineral densities (BMD) of female junior and senior football (soccer) players with different training regimens and histories, female former football players, and their respective controls. Active junior (age 13-17 years, n=62) and senior (age 18-28 years, n=34) players, representing three teams with different levels of performance and training, were compared reciprocally and with matched controls ( n=90). Former players (age 34-84 years, n=25) who had ended their careers on average 9.7 years previously and their matched controls ( n=57) were also studied. Body composition and total body, lumbar spine and proximal femur BMD were measured with dual-energy X-ray absorptiometry. Former players and their controls were asked in a questionnaire to specify their current level of physical activity. In a control for differences in age, weight and body mass index, football players had significantly greater BMD than controls at all sites measured. This difference appeared to be site-specific, with greater differences in BMD at the proximal femur sites (10.5-11.1%) than at the lumbar spine (4.8%) or for the total body (3.5%). Further, differences were greater for senior than for junior players. However, no BMD differences were found between teams representing different levels of performance and training. Female former football players had retained their proximal femur and total-body BMD advantage over controls. In conclusion, training in female football, which is an impact-loading activity, has a site-specific, positive effect on bone formation that is not increased over a certain level of physical activity. The BMD advantage attained appears to be preserved to some extent after the termination of the athlete's active career, which may have a positive effect on future fracture risk. [ABSTRACT FROM AUTHOR]

Altogether 426 women had their forearm bone mineral content (BMC) measured with single photon absorptiometry (SPA): one group in the early 1970s, another about 18 years later. Both groups represented purportedly healthy subjects. A third group of 328 women, measured at the same time as the second group, was from the same population but chosen by random selection (the population-based group). In the two sets of non-population-based women there was a small percentage reduction in the cortical forearm bone mass in the recent measurement as compared with the earlier measurement. This was significant only in women below 70 years of age. The forearm BMC, both cortical and trabecular, was less in all age groups of women randomly selected from the same population as the healthy control sample. This difference emphasizes the importance of selecting normative data from a population-based sample. [ABSTRACT FROM AUTHOR]

Thirty-six women aged 60, 70 or 80 years who had fractured one of their distal radii (Colles' fracture) 0 to 35 (median 10) years earlier were examined in this population-based study. Single photon measurements (SPA) were performed on both arms 1 cm and 6 cm proximal to the styloid process of the ulna. All women were questioned about earlier wrist fractures and which, if any, side had been affected. Information about the type and site of the fracture was also gathered from the hospital records. The bone mineral content (BMC) was found to be increased by almost 20% in the once-fractured radius at the distal measuring site (1 cm) when compared with the unaffected side. This difference did not seem to diminish with time. At the proximal measuring site there was no difference between the once-fractured and the non-fractured side. There was a progressive loss of bone mineral in the once-fractured arm during the first years after the fracture however. This appeared to be reversed after about 10 years to a relative gain, even though the correlation was weak. Six of the 36 women could not remember which side had been fractured and five could not remember having had such a fracture at all. Determination of osteoporosis by measuring forearm BMC with single photon densitometry is therefore of limited value in some women of the oldest age groups. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to determine the predictive ability of a single bone mineral density (BMD) measurement on a 25-year perspective. A group of 1076 women (age 20–78 years) had had their forearm BMD measured from 1970 to 1975. In those women that were still alive at the end of 1994 (n = 410), all fragility fractures (distal end of the radius, proximal end of the humerus, hip, and vertebra) that had occurred after the BMD measurement and that were roentgen verified were recorded, after a follow-up time of 20–25 years. Altogether, 213 fractures occurred in the cohort. In the age group ≥40–70 (at time of BMD measurement) the relative risk (RR) associated with a 1 SD decrease of forearm BMD was 1.66 (CI 1.13–2.46) for a hip fracture (n = 43), 1.79 (CI 1.22–2.62) for a vertebral fracture (n = 63), and 1.33 (CI 1.20–1.73) for all fractures. In the age group 30–50, a fracture of the distal end of the radius after 20 years could be predicted; RR 1.90 (CI 1.02–3.55). These are slightly lower predictive values compared with previous studies of the same population with follow-up times of 11 and 13 years, especially with regard to hip fractures. However, the present study demonstrates that a single BMD measurement at the forearm has a predictive ability for fragility fractures—including hip fractures—on a 25-year perspective. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to evaluate the bone turnover by using bone metabolic markers in relation to previous fracture history and independent of bone mass. Patients and controls were recruited from a population-based study of 193 women, all living in the same city and aged 60, 70, and 80 years. The bone mineral content (BMC) was measured bilaterally in the distal forearm by single-photon absorptiometry (SPA). At the same time, serum samples were obtained for biochemical analysis. Of the 193 women, we identified 26 with at least one major fracture during the past few years. Each of these 26 women with a certified recent previous fracture was individually matched with a woman from the same study group of equal BMC and age but without a fracture history. In the two groups, the serum samples were analyzed for osteocalcin, C-terminal procollagen peptide (P1CP), alkaline phosphatase, bone-specific alkaline phosphatase, calcium, phosphate, and albumin. The serum concentration of osteocalcin was 20% lower in the women with a previous fracture than in the controls (P = 0.03). The other markers of bone formation gave similar values in the two groups. There was a significant correlation between the osteocalcin and P1CP concentrations (P = 0.001). Our findings indicate that the susceptibility to fractures independent of factors such as age and BMC may be related to a decreased bone turnover. [ABSTRACT FROM AUTHOR]

In order to explain the higher prevalence of fractures in urban compared with rural areas, 782 residents in the city of Malmö, Sweden and 486 inhabitants from the nearby rural municipality of Sjöbo were invited to participate in a sex- and age-matched cross-sectional study on life-style differences; 73 and 80% respectively responded. Responders answered a questionnaire on medical and social background and were interviewed on past and present physical activity. The men and women of the rural area were found to be significantly more active physically at work and during spare time. Housing was larger in the rural area. For women, these differences are decreasing in the younger age groups. Bone mass was found to be correlated to heavier work load for men. Other life-style variable such as dairy calcium intake, coffee drinking, estrogen medication, and morbidity, could not explain this difference. Higher prevalence of fractures in the city could therefore be explained by physically less active life-style. [ABSTRACT FROM AUTHOR]

This is a follow-up of a previous study on the predictive power of bone mineral measurements; two more observation years have been added. A group of women (n = 1076) had their forearm bone mineral content (BMC) measured from 1970-1976. All fractures that occurred in 1975-1987 (13 years) were recorded. Four hundred sixty-nine fragility fractures occurred during the collection period. Again, it was found that BMC at the distal end of the forearm is a good predictor of future fracture before the age of 70. The measurement at the proximal site (forearm shafts), however, in contrast to our previous study, has a capacity of predicting fracture also in the age group 70-80. BMC measurements were good predictors of vertebral crush fractures and trochanteric hip fracture but lesser predictors of fractures of the distal end of the forearm. In age groups 40-70, BMC was a stronger predictor of fracture than age, and the risk associated with a 1 SD decrease of BMC 6 was 3.2 for a hip fracture as compared with those without any fragility fracture, even when adjusted for age. In addition to BMC, low body weight was a fracture predictor. Body weight 5 kg below age-adjusted mean increased the risk of a trochanteric hip fracture by 30%. The data are used in hypothetical calculations of the effects of screening. [ABSTRACT FROM AUTHOR]

Fifteen years after their forearm bone mineral content was measured, 366 women were measured again with the same single photon technique. 96 of the women had sustained one or more fragility fractures during that period. The initial bone mineral content was less in those women who were to have fractures. The rate of loss over the years did not differ between fracture and non-fracture women--the initial bone mass was the better predictor. Peak bone mass in the women in this study occurred before the age of 40. [ABSTRACT FROM AUTHOR]

In 1,076 women who had been interviewed from 1970 to 1976 with regard to previous fracture and disease, all fragility fractures that occurred from 1975 to 1985 were recorded. Hip and vertebral fractures were good predictors of future fragility fractures but mainly in younger women (less than 70 years) and this was also the case for fracture of the distal end of the forearm in the age group 40-59. Later in life, falling tendency became the important predictor. [ABSTRACT FROM AUTHOR]

In 1,076 women the forearm bone mineral content (BMC) had been measured with single photon gamma absorptiometry (SPA) 10-16 years ago. The incidence of fractures incurred in the ensuing years (1975-1985) was recorded. The BMC had been significantly less in those women who were to have the types of fractures that are related to bone fragility but only in women measured during the first post- menopausal decades. From age 50-69, diminished BMC at the distal forearm site was associated with a threefold increase of relative risk whereas at the proximal site there was about a sixfold increase in relative risk. This association was not evident in the population over 70 years of age because of a high frequency of fractures (mostly of the spine) in subjects with relatively high BMC values. Body weight and grip strength were significantly lower in the fracture group over 70 years of age. [ABSTRACT FROM AUTHOR]

A placebo-controlled, double-blind study was carried out over 4 months to evaluate two doses of synthetic human calcitonin (0.25 and 0.125 mg) given s.c. three times per week. Enrolled were 60 women, aged 56-82 years, who had experienced a vertebral fracture due to low-energy trauma within the preceding year. During active treatment there was within the first month a dose-dependent decrease of the indices of bone resorption (fasting urinary calcium and hydroxyproline excretions), whereas only the higher dose and a treatment period of 4 months produced a reduction of bone formation (serum osteocalcin). The bone mineral content (BMC) of the nondominant forearm was unchanged. Treatment with calcitonin also had significant, dose-dependent, analgetic effects. The amelioration of pain was, in multivariate analyses, related to a reduction in parameters felt to be markers for bone resorption. In the placebo group there was a significant reduction of the BMC of the forearm but no changes of any of the biochemical markers for bone turnover and no improvement of pain. In conclusion, treatment with two low doses of calcitonin induced changes of the biochemical markers of bone turnover in a dose-dependent manner. The analgetic properties of calcitonin were also of salient clinical importance. The knowledge derived from this study could be adapted to the dosage schedule in long-term trials in osteoporosis. [ABSTRACT FROM AUTHOR]