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Osteoporosis: HELP
Articles by Elaine M. Dennison
Based on 44 articles published since 2008
||||

Between 2008 and 2019, E. Dennison wrote the following 44 articles about Osteoporosis.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Bisphosphonate drug holidays: we reap what we sow. 2016

Silverman, S L / Adachi, J D / Dennison, E / Anonymous1891055. ·David Geffen School of Medicine, University of California, Los Angeles; Division of Rheumatology, Cedars-Sinai Medical Center; and OMC Clinical Research Center, 8641 Wilshire Blvd, suite 301, Beverly Hills, CA, 90211, USA. stuarts@bhillsra.com. · St Joseph's Healthcare, McMaster University, Hamilton, ON, Canada. · MRC Life course Epidemiology Unit Southampton University and Victoria University of Wellington, Wellington, New Zealand. ·Osteoporos Int · Pubmed #26667246.

ABSTRACT: -- No abstract --

2 Editorial Where now with NICE? 2011

Dennison, E M / Cooper, C. · ·Osteoporos Int · Pubmed #21279505.

ABSTRACT: -- No abstract --

3 Review Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 2018

Bruyère, Olivier / Cooper, Cyrus / Al-Daghri, Nasser M / Dennison, Elaine M / Rizzoli, René / Reginster, Jean-Yves. ·Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. jyreginster@ulg.ac.be. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. jyreginster@ulg.ac.be. ·Aging Clin Exp Res · Pubmed #29177637.

ABSTRACT: Osteoarthritis (OA) is a progressive joint disease, that occurs frequently in the aging population and is a major cause of disability worldwide. Both glucosamine and chondroitin are biologically active molecules that are substrates for proteoglycan, an essential component of the cartilage matrix. Evidence supports the use of glucosamine and chondroitin as symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) with impact on OA symptoms and disease-modifying effects in the long term. Glucosamine and chondroitin are administered in exogenous form as a sulfate salt and multiple formulations of these agents are available, both as prescription-grade products and nutritional supplements. However, while all preparations may claim to deliver a therapeutic level of glucosamine or chondroitin not all are supported by clinical evidence. Only patented crystalline glucosamine sulfate (pCGS) is shown to deliver consistently high glucosamine bioavailability and plasma concentration in humans, which corresponds to demonstrated clinical efficacy. Similarly, clinical evidence supports only the pharmaceutical-grade chondroitin sulfate. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) advocates, through careful consideration of the evidence base, that judicious choice of glucosamine and chondroitin formulation is essential to maximize clinical benefit, patient adherence and satisfaction with treatment. In future, the ESCEO recommends that complex molecules with biological activity such as pCGS may be treated as "biosimilars" akin to the European Medicines Agency guidance on biological medicinal products. It seems likely that for all other complex molecules classed as SYSADOAs, the recommendation to use only formulations clearly supported by the evidence-base should apply.

4 Review Novel advances in the treatment of osteoporosis. 2016

Chan, Christopher K Y / Mason, Alice / Cooper, Cyrus / Dennison, Elaine. ·University Hospital Southampton NHS Foundation Trust, Rheumatology Department, Southampton General Hospital, Southampton, SO16 6YD, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. ·Br Med Bull · Pubmed #27558130.

ABSTRACT: INTRODUCTION: Osteoporosis is a significant public health issue affecting over half of women aged over 50. With an aging population, its importance is set to increase further over time. Prevention of fragility fractures avoids significant mortality and morbidity as well as saving significant direct and indirect costs to the economy. In this review, we discuss existing treatments to contextualize the treatment landscape, and demonstrate how our understanding of bone pathophysiology has led to novel therapies-in the form of combinations and altered durations of existing treatments, as well as newer drug therapies. SOURCES OF DATA: PubMed and Embase were searched for randomized controlled trials of new therapies for osteoporosis. These searches were supplemented with material presented in abstract form at international meetings. AREAS OF AGREEMENT: New drugs that appear promising in the treatment of osteoporosis include the cathepsin K inhibitor, monoclonal antibodies against sclerostin and parathyroid hormone-related protein analog. AREAS OF CONTROVERSY: Separate to the development of novel drug therapies is the issue of how best to use agents that are currently available to us; specifically which agent to choose, alone or in combination; duration of therapy; how best to identify patients at highest risk of fracture, and to ensure the highest possible adherence to medication. Many of these issues have been addressed in other excellent review papers, and will not be considered in detail here. GROWING POINTS: As with all new treatments, we await results of long-term use and experience in 'real life' patient populations. AREAS TIMELY FOR DEVELOPING RESEARCH: As alluded to above, data are urgently required regarding the optimal duration of therapy; use of combination therapy; ordering of therapies for best therapeutic effect. As stratified medicine becomes more strongly considered in all areas of therapy, its merits in osteoporosis as in other musculoskeletal conditions, is timely and valuable.

5 Review Recent advances in the pathogenesis and treatment of osteoporosis. 2016

Curtis, Elizabeth M / Moon, Rebecca J / Dennison, Elaine M / Harvey, Nicholas C / Cooper, Cyrus. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, and Paediatric Endocrinology, Southampton University Hospitals NHS Foundation Trust, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK, and NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK cc@mrc.soton.ac.uk. ·Clin Med (Lond) · Pubmed #27481382.

ABSTRACT: Over recent decades, the perception of osteoporosis has changed from that of an inevitable consequence of ageing, to that of a well characterised and treatable chronic non-communicable disease, with major impacts on individuals, healthcare systems and societies. Characterisation of its pathophysiology from the hierarchical structure of bone and the role of its cell population, development of effective strategies for the identification of those most appropriate for treatment, and an increasing armamentarium of efficacious pharmacological therapies, have underpinned this evolution. Despite this marked progress, individuals who experience a fragility fracture remain under-treated in many areas of the world, and there is substantial need for investment both in secondary and primary prevention globally. In this brief article, we give an overview of the pathogenesis of osteoporosis, and summarise current and future approaches to its assessment and -treatment.

6 Review Measuring the musculoskeletal aging phenotype. 2016

Dawson, Alice / Dennison, Elaine. ·MRC Lifecourse Epidemiology Unit, University of Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; Victoria University, Wellington, New Zealand. Electronic address: emd@mrc.soton.ac.uk. ·Maturitas · Pubmed #27131919.

ABSTRACT: The world is aging. The population aged over sixty years worldwide is predicted to rise from 841 million in 2013 to more than 2 billion by 2050. Musculoskeletal (MSK) disease is a significant burden on the aging population, contributing 7.5% of the disease burden in those aged over 60 years. MSK diseases have a pronounced effect on disability level and independence in old age, with a consequent significant public health burden and impact on quality of later life. As numbers of older individuals and their disease burden increase, it is important to examine MSK disease in older life in detail. The musculoskeletal aging phenotype comprises four often interwoven key elements - osteoporosis, osteoarthritis, sarcopenia and frailty - and this review will focus on these four themes. It is crucial that we are able to accurately measure each phenotype in order that we might identify those individuals at greatest risk of developing these conditions, and design trials of therapeutic agents that might impact their development. Accurate measurement of the musculoskeletal aging phenotype is necessary firstly to document the burden of each condition, and then to enable factors to be identified which may accelerate or retard their development or progression. In some areas of MSK disease, this work is more advanced (osteoporosis); in other areas (sarcopenia) the field is currently very rapidly evolving. We will explore the tools currently used to measure the musculoskeletal aging phenotype and how they compare, as well as highlight areas where more work is needed.

7 Review Recent advances in the pathogenesis and treatment of osteoporosis. 2015

Curtis, Elizabeth M / Moon, Rebecca J / Dennison, Elaine M / Harvey, Nicholas C / Cooper, Cyrus. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, and Paediatric Endocrinology, Southampton University Hospitals NHS Foundation Trust, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK, and NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK cc@mrc.soton.ac.uk. ·Clin Med (Lond) · Pubmed #26634690.

ABSTRACT: Over recent decades, the perception of osteoporosis has changed from that of an inevitable consequence of ageing, to that of a well characterised and treatable chronic non-communicable disease, with major impacts on individuals, healthcare systems and societies. Characterisation of its pathophysiology from the hierarchical structure of bone and the role of its cell population, development of effective strategies for the identification of those most appropriate for treatment, and an increasing armamentarium of efficacious pharmacological therapies, have underpinned this evolution. Despite this marked progress, individuals who experience a fragility fracture remain under-treated in many areas of the world, and there is substantial need for investment both in secondary and primary prevention globally. In this brief article, we give an overview of the pathogenesis of osteoporosis, and summarise current and future approaches to its assessment and treatment.

8 Review Osteoporosis and sarcopenia in older age. 2015

Edwards, M H / Dennison, E M / Aihie Sayer, A / Fielding, R / Cooper, C. ·MRC Lifecourse Epidemiology Unit, University of Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; Victoria University, Wellington, New Zealand. · Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford OX3 5UG, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton SO16 6YD, UK. Electronic address: cc@mrc.soton.ac.uk. ·Bone · Pubmed #25886902.

ABSTRACT: Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties include the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. This article is part of a Special Issue entitled "Muscle Bone Interactions".

9 Review Determinants of Muscle and Bone Aging. 2015

Curtis, Elizabeth / Litwic, Anna / Cooper, Cyrus / Dennison, Elaine. ·MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, England. ·J Cell Physiol · Pubmed #25820482.

ABSTRACT: Loss of bone and muscle with advancing age represent a huge threat to loss of independence in later life. Osteoporosis represents a major public health problem through its association with fragility fractures, primarily of the hip, spine and distal forearm. Sarcopenia, the age related loss of muscle mass and function, may add to fracture risk by increasing falls risk. In the context of muscle aging, it is important to remember that it is not just a decline in muscle mass which contributes to the deterioration of muscle function. Other factors underpinning muscle quality come into play, including muscle composition, aerobic capacity and metabolism, fatty infiltration, insulin resistance, fibrosis and neural activation. Genetic, developmental, endocrine and lifestyle factors, such as physical activity, smoking and poor diet have dual effects on both muscle and bone mass in later life and these will be reviewed here. Recent work has highlighted a possible role for the early environment. Inflammaging is an exciting emerging research field that is likely to prove relevant to future work, including interventions designed to retard to reverse bone and muscle loss with age.

10 Review Osteoporosis therapies in 2014. 2014

Litwic, A / Cooper, C / Dennison, E. ·MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital, Southampton, UK - emd@mrc.soton.ac.uk. ·Panminerva Med · Pubmed #25424461.

ABSTRACT: Osteoporosis is a systemic disorder characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. It has a significant impact on public health through the increased morbidity, mortality, and economic costs associated with fractures. Despite the severe medical and socioeconomic consequences of fragility fractures, relatively few adults with fractures are evaluated and/or treated for osteoporosis. In this review, we summarize the existing treatment options and promising new therapies for the prevention and treatment of osteoporosis.

11 Review Osteoporosis: a lifecourse approach. 2014

Harvey, Nicholas / Dennison, Elaine / Cooper, Cyrus. ·Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. ·J Bone Miner Res · Pubmed #24861883.

ABSTRACT: It is becoming increasingly apparent that the risk of developing osteoporosis is accrued throughout the entire lifecourse, even from as early as conception. Thus early growth is associated with bone mass at peak and in older age, and risk of hip fracture. Novel findings from mother-offspring cohorts have yielded greater understanding of relationships between patterns of intrauterine and postnatal growth in the context of later bone development. Study of biological samples from these populations has helped characterize potential mechanistic underpinnings, such as epigenetic processes. Global policy has recognized the importance of early growth and nutrition to the risk of developing adult chronic noncommunicable diseases such as osteoporosis; testing of pregnancy interventions aimed at optimizing offspring bone health is now underway. It is hoped that through such programs, novel public health strategies may be established with the ultimate goal of reducing the burden of osteoporotic fracture in older age.

12 Review Prenatal calcium and vitamin D intake, and bone mass in later life. 2014

Curtis, Elizabeth M / Moon, Rebecca J / Dennison, Elaine M / Harvey, Nicholas C. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. ·Curr Osteoporos Rep · Pubmed #24740166.

ABSTRACT: The aging population will result in an increasing burden of osteoporotic fractures, necessitating the identification of novel strategies for prevention. There is increasing recognition that factors in utero may influence bone mineral accrual, and, thus, osteoporosis risk. The role of calcium and vitamin D has received much attention in recent years, and in this review, we will survey available studies relating maternal calcium and vitamin D status during pregnancy to offspring bone development. The evidence base supporting a positive influence on intrauterine skeletal growth appears somewhat stronger for maternal 25(OH)-vitamin D concentration than for calcium intake, and the available data point toward the need for high-quality randomized controlled trials in order to inform public health policy. It is only with such a rigorous approach that it will be possible to delineate the optimal strategy for vitamin D supplementation in pregnancy in relation to offspring bone health.

13 Review Programming of osteoporosis and impact on osteoporosis risk. 2013

Dennison, Elaine M / Harvey, Nicholas C / Cooper, Cyrus. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, S016 6YD, UK. emd@mrc.soton.ac.uk ·Clin Obstet Gynecol · Pubmed #23787708.

ABSTRACT: Osteoporosis is a skeletal disorder characterized by reduced bone quantity and quality and an increased susceptibility to fracture, and seems to be one of many chronic conditions that might be influenced by events early in life. Specifically, there is growing evidence of an interaction between the genome and the environment in the expression of the disease.

14 Review Epigenetic influences in the developmental origins of osteoporosis. 2012

Holroyd, C / Harvey, N / Dennison, E / Cooper, C. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. ·Osteoporos Int · Pubmed #21656266.

ABSTRACT: Osteoporosis is a major public health problem due to consequent fragility fractures; data from the UK suggest that up to 50% of women and 20% men aged 50 years will have an osteoporosis-related fracture in their remaining lifetime. Skeletal size and density increase from early embryogenesis through intrauterine, infant, childhood and adult life to reach a peak in the third to fourth decade. The peak bone mass achieved is a strong predictor of later osteoporosis risk. Epidemiological studies have demonstrated a positive relationship between early growth and later bone mass, both at peak and in later life, and also with reduced risk of hip fracture. Mother-offspring cohorts have allowed the elucidation of some of the specific factors in early life, such as maternal body build, lifestyle and 25(OH)-vitamin D status, which might be important. Most recently, the phenomenon of developmental plasticity, whereby a single genotype may give rise to different phenotypes depending on the prevailing environment, and the science of epigenetics have presented novel molecular mechanisms which may underlie previous observations. This review will give an overview of these latter developments in the context of the burden of osteoporosis and the wider data supporting the link between the early environment and bone health in later life.

15 Review Osteoporosis in 2010: building bones and (safely) preventing breaks. 2011

Dennison, Elaine / Cooper, Cyrus. ·MRC Life Course Epidemiology Unit, University of Southampton, Southampton SO166YD, UK. ·Nat Rev Rheumatol · Pubmed #21289613.

ABSTRACT: -- No abstract --

16 Review Does birthweight predict bone mass in adulthood? A systematic review and meta-analysis. 2011

Baird, J / Kurshid, M A / Kim, M / Harvey, N / Dennison, E / Cooper, C. ·MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK. jb@mrc.soton.ac.uk ·Osteoporos Int · Pubmed #20683711.

ABSTRACT: SUMMARY: This systematic review and meta-analysis assessed the strength and magnitude of the association between birthweight and adult bone mass. Higher birthweight was associated with higher bone mineral content of the spine and hip in adult men and women at ages between 18 and 80 years across a range of settings. INTRODUCTION: The aim of this review was to assess the strength and magnitude of the association between early size and adult bone mass. METHODS: Systematic review and meta-analysis of studies that assessed the association between birthweight or weight at 1 year, and bone mineral content (BMC) or bone mineral density (BMD) in adulthood. RESULTS: Fourteen studies met inclusion criteria. Nine assessed the relationship between birthweight and lumbar spine BMC, most showing that higher birthweight was associated with greater adult BMC. Meta-analysis demonstrated that a 1 kg increase in birthweight was associated with a 1.49 g increase in lumbar spine BMC (95% CI 0.77-2.21). Birthweight was not associated with lumbar spine BMD in 11 studies. In six studies, considering the relationship between birthweight and hip BMC, most found that higher birthweight was associated with greater BMC. Meta-analysis demonstrated that a 1 kg increase in birthweight was associated with a 1.41 g increase in hip BMC (95% CI 0.91-1.91). Seven studies considered the relationship between birthweight and hip BMD and, in most, birthweight was not a significant predictor of hip BMD. Three studies assessing the relationship between weight at 1 year and adult bone mass all reported that higher weight at one was associated with greater BMC of the lumbar spine and hip. CONCLUSIONS: Higher birthweight is associated with greater BMC of the lumbar spine and hip in adulthood. The consistency of these associations, across a range of settings, provides compelling evidence for the intrauterine programming of skeletal development and tracking of skeletal size from infancy to adulthood.

17 Review Osteoporosis: impact on health and economics. 2010

Harvey, Nicholas / Dennison, Elaine / Cooper, Cyrus. ·The MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK. ·Nat Rev Rheumatol · Pubmed #20125177.

ABSTRACT: Osteoporosis is a major public health problem through associated fragility fractures. The most common sites of fracture are the hip, spine and wrist, and these have an enormous health and economic impact. All fractures result in some degree of morbidity, but fractures at the hip are associated with the worst outcomes. The worldwide direct and indirect annual costs of hip fracture in 1990 were estimated at US$34.8 billion, and are expected to increase substantially over the next 50 years. Fracture incidence varies between populations, and is set to increase over coming decades as the global population becomes more elderly. This effect will be particularly marked in the developing world, which is additionally assuming more-westernized lifestyles that predispose to increased fracture risk. Strategies to target those at high risk of fracture have been developed, but preventative measures at the public health level are also urgently needed to reduce the burden of this devastating disease.

18 Review Early life factors in the pathogenesis of osteoporosis. 2009

Winsloe, Chivon / Earl, Susie / Dennison, Elaine M / Cooper, Cyrus / Harvey, Nicholas C. ·Medical Research Council Epidemiology Resource Centre, University of Southampton, School of Medicine, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom. ·Curr Osteoporos Rep · Pubmed #19968918.

ABSTRACT: Osteoporosis is a major public health burden through associated fragility fractures. Bone mass, a composite of bone size and volumetric density, increases through early life and childhood to a peak in early adulthood. The peak bone mass attained is a strong predictor of future risk of osteoporosis. Evidence is accruing that environmental factors in utero and in early infancy may permanently modify the postnatal pattern of skeletal growth to peak and thus influence risk of osteoporosis in later life. This article describes the latest data in this exciting area of research, including novel epigenetic and translation work, which should help to elucidate the underlying mechanisms and give rise to potential public health interventions to reduce the burden of osteoporotic fracture in future generations.

19 Review Developmental origins of osteoporosis: the role of maternal nutrition. 2009

Cooper, Cyrus / Harvey, Nicholas / Cole, Zoe / Hanson, Mark / Dennison, Elaine. ·MRC Epidemiology Resource Centre and Centre for Developmental Origins of Health and Adult Disease, University of Southampton, Southampton General Hospital, Southampton, UK. cc@mrc.soton.ac.uk ·Adv Exp Med Biol · Pubmed #19536660.

ABSTRACT: Osteoporosis is a major cause of morbidity and mortality through its association with age-related fractures. Although most effort in fracture prevention has been directed at retarding the rate of age-related bone loss, and reducing the frequency and severity of trauma among elderly people, evidence is growing that peak bone mass is an important contributor to bone strength during later life. The normal patterns of skeletal growth have been well characterised in cross-sectional and longitudinal studies. It has been confirmed that boys have higher bone mineral content, but not volumetric bone density, than girls. Furthermore, there is a dissociation between the peak velocities for height gain and bone mineral accrual in both genders. Puberty is the period during which volumetric density appears to increase in both axial and appendicular sites. Many factors influence the accumulation of bone mineral during childhood and adolescence, including heredity, gender, diet, physical activity, endocrine status, and sporadic risk factors such as cigarette smoking. In addition to these modifiable factors during childhood, evidence has also accrued that fracture risk might be programmed during intrauterine life. Epidemiological studies have demonstrated a relationship between birthweight, weight in infancy, and adult bone mass. This appears to be mediated through modulation of the set-point for basal activity of pituitary-dependent endocrine systems such as the hypothalamic-pituitary-adrenal (HPA) and growth hormone/insulin-like growth factor-1 (GH/IGF-1) axes. Maternal smoking, diet (particularly vitamin D deficiency) and physical activity also appear to modulate bone mineral acquisition during intrauterine life; furthermore, both low birth size and poor childhood growth, are directly linked to the later risk of hip fracture. The optimisation of maternal nutrition and intrauterine growth should also be included within preventive strategies against osteoporotic fracture, albeit for future generations.

20 Review The impact of methods for estimating bone health and the global burden of bone disease. 2009

Cole, Zoë A / Dennison, Elaine M / Cooper, Cyrus. ·MRC Epidemiology Resource Centre, University of Southampton, UK. ·Salud Publica Mex · Pubmed #19287891.

ABSTRACT: Osteoporosis constitutes a major public health problem through its association with age related fractures. Fracture rates are generally higher in caucasian women than in other populations. Important determinants include estrogen deficiency in women, low body mass index, cigarette smoking, alcohol consumption, poor dietary calcium intake, physical inactivity, certain drugs and illnesses. Thus, modification of physical activity and dietary calcium/vitamin D nutrition should complement high risk approaches. In addition, the recently developed WHO algorithm for evaluation of 10-year absolute risk of fracture provides a means whereby various therapies can be targeted cost-effectively to those at risk. Risk factors, together with bone mineral density (BMD) and biochemical indices of bone turnover, can be utilised to derive absolute risks of fracture and cost-utility thresholds at which treatment is justified. These data will provide the basis for translation into coherent public health strategies aiming to prevent osteoporosis both in individuals and in the general population.

21 Review Developmental origins of osteoporotic fracture. 2009

Cooper, C / Westlake, S / Harvey, N / Dennison, E. ·MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD. cc@mrc.soton.ac.uk ·Adv Exp Med Biol · Pubmed #19227545.

ABSTRACT: -- No abstract --

22 Review Epidemiology of osteoporosis. 2008

Holroyd, Christopher / Cooper, Cyrus / Dennison, Elaine. ·MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK. ·Best Pract Res Clin Endocrinol Metab · Pubmed #19028351.

ABSTRACT: Osteoporosis represents a major public health problem through its association with fragility fractures. All osteoporotic fractures increase patient morbidity; however, fractures of the hip and vertebrae are also linked with significant mortality. The public health burden of osteoporotic fracture is likely to rise in future generations, due in part to an increase in life expectancy. Understanding the epidemiology of this disease is therefore essential in trying to develop strategies to help reduce this load. This chapter will review the epidemiology of osteoporosis, including the relationship between low bone mass and fracture. It will review the epidemiology of fractures, concentrating on the sites where the majority of age-related fractures occur. Finally it will discuss new developments in the assessment of fracture risk.

23 Review Update on the treatment of post-menopausal osteoporosis. 2008

Cole, Zoë / Dennison, Elaine / Cooper, Cyrus. ·MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. ·Br Med Bull · Pubmed #18477578.

ABSTRACT: BACKGROUND: Osteoporosis has a huge impact on public health, through the increased morbidity, mortality and economic costs associated with resultant fractures. The goal is to evaluate and identify those that are at risk of osteoporotic fracture in order to start preventative and therapeutic measures to reduce their risk of fracture. SOURCES OF DATA: This article reviews the data from randomized controlled trials for the current therapeutic agents available in the UK. It also reviews new trial data for promising osteoporosis therapies, in particular Denosumab, a monoclonal antibody against RANK ligand. AREAS OF AGREEMENT: Bisphosphonates are the current recommended first-line treatments for patients with osteoporosis. AREAS OF CONTROVERSY/GROWING POINTS: There are a number of patients where bisphosphonates are contraindicated. Under these circumstances, it is important that clinicians have access to alternative treatments. The long-awaited National Institute for Health and Clinical Excellence (NICE) technology appraisals for both primary and secondary prevention and the clinical guidelines will clarify this. Treatment decisions should be based on risk factors and pharmaceutical intervention given to those with the highest risks. AREAS TIMELY FOR DEVELOPING RESEARCH: Future studies are required to look at these agents in combination to see whether anti-fracture efficacy can be improved.

24 Review Osteoporosis epidemiology update. 2008

Cole, Zoe A / Dennison, Elaine M / Cooper, Cyrus. ·Medical Research Council Epidemiology Resource Centre, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom. zac@mrc.soton.ac.uk ·Curr Rheumatol Rep · Pubmed #18460262.

ABSTRACT: Osteoporosis remains a major public health problem through its association with fragility fractures. Despite the availability of preventative therapeutic agents, the incidence and its associated costs continue to rise globally. Understanding osteoporosis epidemiology is essential to developing strategies to reduce the burden of osteoporotic fracture in the population. This article reviews the epidemiology of osteoporosis globally, highlighting recent advances. It describes the burden of common osteoporotic fractures, the associated morbidity and mortality, the clustering of fractures in individuals, and the identification of at-risk groups. It also highlights the development of new algorithms to identify individuals at high risk of fracture, enabling the implementation of appropriate treatment strategies.

25 Review Growth and bone development. 2008

Cooper, Cyrus / Harvey, Nicholas / Javaid, Kassim / Hanson, Mark / Dennison, Elaine. ·MRC Epidemiology Resource Centre and Centre for Developmental Origins of Health and Adult Disease, University of Southampton, Southampton General Hospital, Southampton, UK. cc@mrc.soton.ac.uk ·Nestle Nutr Workshop Ser Pediatr Program · Pubmed #18196944.

ABSTRACT: Osteoporosis is a major cause of morbidity and mortality through its association with age-related fractures. Although most effort in fracture prevention has been directed at retarding the rate of age-related bone loss, and reducing the frequency and severity of trauma among elderly people, evidence is growing that peak bone mass is an important contributor to bone strength during later life. The normal patterns of skeletal growth have been well characterized in cross-sectional and longitudinal studies. It has been confirmed that boys have higher bone mineral content, but not volumetric bone density, than girls. Furthermore, there is a dissociation between the peak velocities for height gain and bone mineral accrual, in both genders. Puberty is the period during which volumetric density appears to increase in both axial and appendicular sites. Many factors influence the accumulation of bone mineral during childhood and adolescence, including heredity, gender, diet, physical activity, endocrine status, and sporadic risk factors such as cigarette smoking. In addition to these modifiable factors during childhood, evidence has also accrued that fracture risk might be programmed during intrauterine life. Epidemiological studies have demonstrated a relationship between birthweight, weight in infancy, and adult bone mass. This appears to be mediated through modulation of the set-point for basal activity of pituitary-dependent endocrine systems such as the hypothalamicpituitary-adrenal and growth hormone/insulin-like growth factor-1 axes. Maternal smoking, diet (particularly vitamin D deficiency), and physical activity also appear to modulate bone mineral acquisition during intrauterine life; furthermore, both low birth size and poor childhood growth are directly linked to the later risk of hip fracture. The optimization of maternal nutrition and intrauterine growth should also be included within preventive strategies against osteoporotic fracture, albeit for future generations.

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