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Osteoporosis: HELP
Articles from Madison
Based on 85 articles published since 2008
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These are the 85 published articles about Osteoporosis that originated from Madison during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. 2017

Buckley, Lenore / Guyatt, Gordon / Fink, Howard A / Cannon, Michael / Grossman, Jennifer / Hansen, Karen E / Humphrey, Mary Beth / Lane, Nancy E / Magrey, Marina / Miller, Marc / Morrison, Lake / Rao, Madhumathi / Robinson, Angela Byun / Saha, Sumona / Wolver, Susan / Bannuru, Raveendhara R / Vaysbrot, Elizaveta / Osani, Mikala / Turgunbaev, Marat / Miller, Amy S / McAlindon, Timothy. ·Yale University, New Haven, Connecticut. · McMaster University, Hamilton, Ontario, Canada. · Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, Minnesota. · Arthritis Consultants of Tidewater, Virginia Beach, Virginia. · University of California, Los Angeles. · University of Wisconsin, Madison. · Oklahoma University Health Sciences Center, Oklahoma City. · University of California Davis, Sacramento. · Case Western Reserve University, MetroHealth System, Cleveland, Ohio. · Rheumatology Associates, Portland, Maine. · Duke University Medical Center, Durham, North Carolina. · Tufts Medical Center, Boston, Massachusetts. · Rainbow Babies and Children's Hospital, Cleveland, Ohio. · Virginia Commonwealth University, Richmond. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Rheumatol · Pubmed #28585373.

ABSTRACT: OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. RESULTS: Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

2 Guideline Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance. 2016

Lewiecki, E Michael / Binkley, Neil / Morgan, Sarah L / Shuhart, Christopher R / Camargos, Bruno Muzzi / Carey, John J / Gordon, Catherine M / Jankowski, Lawrence G / Lee, Joon-Kiong / Leslie, William D / Anonymous7130862. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com. · Osteoporosis Clinical Center and Research Program, University of Wisconsin, Madison, WI, USA. · Division of Clinical Immunology and Rheumatology, Department of Medicine, UAB Osteoporosis Prevention and Treatment Clinic, University of Alabama at Birmingham, Birmingham, AL, USA. · Swedish Medical Group, Seattle, WA, USA. · Rede Mater Dei de Saúde - Densimater, Belo Horizonte, Brazil. · Galway University Hospitals, National University of Ireland, Galway, Ireland. · Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. · Illinois Bone and Joint Institute, LLC., Morton Grove, IL, USA. · JK Lee Orthopaedics & Traumatology, Petaling Jaya, Malaysia. · University of Manitoba, Winnipeg, Manitoba, Canada. ·J Clin Densitom · Pubmed #27020004.

ABSTRACT: Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.

3 Editorial Response to the American College of Physicians Osteoporosis Guideline, 2017 Update. 2017

Caplan, Liron / Hansen, Karen E / Saag, Kenneth G. ·University of Colorado Denver School of Medicine and Denver Veterans Affairs Medical Center, Denver, Colorado. · University of Wisconsin School of Medicine & Public Health, Madison. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28881479.

ABSTRACT: -- No abstract --

4 Editorial What we don't know about osteoporosis. 2016

Lewiecki, E M / Binkley, N. ·New Mexico Clinical Research & Osteoporosis Center, 300 Oak Street NE, Albuquerque, NM, 87106, USA. mlewiecki@gmail.com. · University of Wisconsin Osteoporosis Clinical Center and Research Program, Madison, WI, USA. ·J Endocrinol Invest · Pubmed #26902997.

ABSTRACT: -- No abstract --

5 Review Non-human primates as a model for aging. 2018

Colman, Ricki J. ·Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Madison, WI 53705, USA; Wisconsin National Primate Research Center, University of Wisconsin, 1220 Capitol Court, Madison, WI 53715, USA. Electronic address: rcolman@primate.wisc.edu. ·Biochim Biophys Acta Mol Basis Dis · Pubmed #28729086.

ABSTRACT: There has been, and continues to be, a dramatic shift in the human population towards older ages necessitating biomedical research aimed at better understanding the basic biology of aging and age-related diseases and facilitating new and improved therapeutic options. As it is not practical to perform the breadth of this research in humans, animal models are necessary to recapitulate the complexity of the aging environment. The mouse model is most frequently chosen for these endeavors, however, they are frequently not the most appropriate model. Non-human primates, on the other hand, are more closely related to humans and recapitulate the human aging process and development of age-related diseases. Extensive aging research has been performed in the well-characterized rhesus macaque aging model. More recently, the common marmoset, a small non-human primate with a shorter lifespan, has been explored as a potential aging model. This model holds particular promise as an aging disease model in part due to the successful creation of transgenic marmosets. Limitations to the use of non-human primates in aging research exist but can be mitigated somewhat by the existence of available resources supported by the National Institutes of Health. This article is part of a Special Issue entitled: Animal models of aging - edited by "Houtkooper Riekelt".

6 Review 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. 2017

Buckley, Lenore / Guyatt, Gordon / Fink, Howard A / Cannon, Michael / Grossman, Jennifer / Hansen, Karen E / Humphrey, Mary Beth / Lane, Nancy E / Magrey, Marina / Miller, Marc / Morrison, Lake / Rao, Madhumathi / Byun Robinson, Angela / Saha, Sumona / Wolver, Susan / Bannuru, Raveendhara R / Vaysbrot, Elizaveta / Osani, Mikala / Turgunbaev, Marat / Miller, Amy S / McAlindon, Timothy. ·Yale University, New Haven, Connecticut. · McMaster University, Hamilton, Ontario, Canada. · Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, Minnesota. · Arthritis Consultants of Tidewater, Virginia Beach, Virginia. · University of California, Los Angeles. · University of Wisconsin, Madison. · Oklahoma University Health Sciences Center, Oklahoma City. · University of California Davis, Sacramento. · Case Western Reserve University, MetroHealth System, Cleveland, Ohio. · Rheumatology Associates, Portland, Maine. · Duke University Medical Center, Durham, North Carolina. · Tufts Medical Center, Boston, Massachusetts. · Rainbow Babies and Children's Hospital, Cleveland, Ohio. · Virginia Commonwealth University, Richmond. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Care Res (Hoboken) · Pubmed #28585410.

ABSTRACT: OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. RESULTS: Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

7 Review The Hybrid Mouse Diversity Panel: a resource for systems genetics analyses of metabolic and cardiovascular traits. 2016

Lusis, Aldons J / Seldin, Marcus M / Allayee, Hooman / Bennett, Brian J / Civelek, Mete / Davis, Richard C / Eskin, Eleazar / Farber, Charles R / Hui, Simon / Mehrabian, Margarete / Norheim, Frode / Pan, Calvin / Parks, Brian / Rau, Christoph D / Smith, Desmond J / Vallim, Thomas / Wang, Yibin / Wang, Jessica. ·Departments of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA Microbiology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA Human Genetics, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA jlusis@mednet.ucla.edu. · Departments of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA. · Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA. · Department of Genetics, University of North Carolina, Chapel Hill, NC. · Departments of Biomedical Engineering University of Virginia, Charlottesville, VA. · Departments of Computer Science, University of California-Los Angeles, Los Angeles, CA. · Public Health Sciences, University of Virginia, Charlottesville, VA. · Human Genetics, University of California-Los Angeles, Los Angeles, CA. · Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI. · Anesthesiology, University of California-Los Angeles, Los Angeles, CA. · Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA. ·J Lipid Res · Pubmed #27099397.

ABSTRACT: The Hybrid Mouse Diversity Panel (HMDP) is a collection of approximately 100 well-characterized inbred strains of mice that can be used to analyze the genetic and environmental factors underlying complex traits. While not nearly as powerful for mapping genetic loci contributing to the traits as human genome-wide association studies, it has some important advantages. First, environmental factors can be controlled. Second, relevant tissues are accessible for global molecular phenotyping. Finally, because inbred strains are renewable, results from separate studies can be integrated. Thus far, the HMDP has been studied for traits relevant to obesity, diabetes, atherosclerosis, osteoporosis, heart failure, immune regulation, fatty liver disease, and host-gut microbiota interactions. High-throughput technologies have been used to examine the genomes, epigenomes, transcriptomes, proteomes, metabolomes, and microbiomes of the mice under various environmental conditions. All of the published data are available and can be readily used to formulate hypotheses about genes, pathways and interactions.

8 Review PTH receptor-1 signalling-mechanistic insights and therapeutic prospects. 2015

Cheloha, Ross W / Gellman, Samuel H / Vilardaga, Jean-Pierre / Gardella, Thomas J. ·Department of Chemistry, 1101 University Avenue, University of Wisconsin, Madison, WI 53706, USA. · Laboratory for GPCR Biology, Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA. · Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, Boston, MA 02114, USA. ·Nat Rev Endocrinol · Pubmed #26303600.

ABSTRACT: Parathyroid hormone/parathyroid hormone-related protein receptor (PTH/PTHrP type 1 receptor; commonly known as PTHR1) is a family B G-protein-coupled receptor (GPCR) that regulates skeletal development, bone turnover and mineral ion homeostasis. PTHR1 transduces stimuli from PTH and PTHrP into the interior of target cells to promote diverse biochemical responses. Evaluation of the signalling properties of structurally modified PTHR1 ligands has helped to elucidate determinants of receptor function and mechanisms of downstream cellular and physiological responses. Analysis of PTHR1 responses induced by structurally modified ligands suggests that PTHR1 can continue to signal through a G-protein-mediated pathway within endosomes. Such findings challenge the longstanding paradigm in GPCR biology that the receptor is transiently activated at the cell membrane, followed by rapid deactivation and receptor internalization. Evaluation of structurally modified PTHR1 ligands has further led to the identification of ligand analogues that differ from PTH or PTHrP in the type, strength and duration of responses induced at the receptor, cellular and organism levels. These modified ligands, and the biochemical principles revealed through their use, might facilitate an improved understanding of PTHR1 function in vivo and enable the treatment of disorders resulting from defects in PTHR1 signalling. This Review discusses current understanding of PTHR1 modes of action and how these findings might be applied in future therapeutic agents.

9 Review Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. 2015

Harvey, N C / Glüer, C C / Binkley, N / McCloskey, E V / Brandi, M-L / Cooper, C / Kendler, D / Lamy, O / Laslop, A / Camargos, B M / Reginster, J-Y / Rizzoli, R / Kanis, J A. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: nch@mrc.soton.ac.uk. · Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany. · Osteoporosis Clinical Research Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. · Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. · Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Department of Medicine, University of British Columbia, Vancouver, Canada. · Bone Unit, University Hospital, Lausanne, Switzerland. · Scientific Office, Austrian Agency for Health and Food Safety, Vienna, Austria. · Unidade de Densitometria Óssea, Densimater Rede Materdei de Saúde, Belo Horizonte, MG, Brazil. · Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium. · Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. Electronic address: w.j.pontefract@sheffield.ac.uk. ·Bone · Pubmed #25988660.

ABSTRACT: Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. In order for TBS to usefully add to bone mineral density (BMD) and clinical risk factors in osteoporosis risk stratification, it must be independently associated with fracture risk, readily obtainable, and ideally, present a risk which is amenable to osteoporosis treatment. This paper summarizes a review of the scientific literature performed by a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. Low TBS is consistently associated with an increase in both prevalent and incident fractures that is partly independent of both clinical risk factors and areal BMD (aBMD) at the lumbar spine and proximal femur. More recently, TBS has been shown to have predictive value for fracture independent of fracture probabilities using the FRAX® algorithm. Although TBS changes with osteoporosis treatment, the magnitude is less than that of aBMD of the spine, and it is not clear how change in TBS relates to fracture risk reduction. TBS may also have a role in the assessment of fracture risk in some causes of secondary osteoporosis (e.g., diabetes, hyperparathyroidism and glucocorticoid-induced osteoporosis). In conclusion, there is a role for TBS in fracture risk assessment in combination with both aBMD and FRAX.

10 Review Treatment of osteoporosis: current state of the art. 2015

Hamrick, Irene / Schrager, Sarina / Nye, Ann Marie. ·Department of Family Medicine, University of Wisconsin, Madison, Wisconsin, USA, ihamrick@gmail.com. ·Wien Med Wochenschr · Pubmed #25502850.

ABSTRACT: Osteoporosis can be treated with medications and lifestyle changes, including avoiding a sedentary lifestyle, alcohol, and smoking. We will identify medications that protect against hip fractures in addition to vertebral fractures, and explore new evidence of adverse effects and risks. Bisphosphonates are used as first-line treatment. We will discuss the latest osteoporosis medications, drug interactions, potential bone protective effects of other drug classes, and the evidence of exercise and kyphoplasty.

11 Review Osteoporosis diagnosis in men: the T-score controversy revisited. 2014

Binkley, Neil / Adler, Robert / Bilezikian, John P. ·University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA, nbinkley@wisc.edu. ·Curr Osteoporos Rep · Pubmed #25255867.

ABSTRACT: Osteoporosis becomes common with aging in both sexes, but is often ignored in men. The 2013 International Society for Clinical Densitometry consensus conference endorsed a Caucasian female referent database for T-score calculation in men. This recommendation has generated controversy and concern. Accumulating data indicate that at the same DXA-measured body mineral density (BMD) (g/cm(2)), men and women are at approximately the same fracture risk. With this point in mind, using the same database to derive the T-score in men and women is reasonable. As a result, a greater proportion of men who sustain a fragility fracture will have T-scores that are higher than they would if a male database were used; in fact, many men will fracture at T-scores that are "normal." This highlights the importance of diagnosing osteoporosis not just by T-score, but also by the presence of fragility fracture and/or by estimations of fracture risk as generated by tools such as the FRAX calculator. The practical consequences of this change in densitometric definition of osteoporosis in men should be monitored, including the proportion of men at risk identified and treated as well as defining the response to treatment in those assessed by this more comprehensive approach.

12 Review A systematic review and meta-analysis of glucocorticoid-induced osteoporosis in children. 2014

Hansen, Karen E / Kleker, Brian / Safdar, Nasia / Bartels, Christie M. ·Department of Medicine, Division of Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: keh@medicine.wisc.edu. · Department of Dermatology, Kaiser Permanente, La Mesa, CA. · Department of Medicine, Division of Infectious Disease, William S Middleton Veterans Hospital, Madison, WI; Department of Medicine, Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, WI. · Department of Medicine, Division of Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI. ·Semin Arthritis Rheum · Pubmed #24680381.

ABSTRACT: OBJECTIVE: To summarize the published effects of systemic glucocorticoid therapy on bone mineral density (BMD) and fractures in children. METHODS: We performed a systematic review and meta-analysis of existing literature, using Medline, CINAHL, and Cochrane databases to identify studies of BMD or fractures in children ≤18 years taking systemic glucocorticoid therapy. We excluded studies of inhaled glucocorticoids, chemotherapy, and organ transplantation. Two authors reviewed abstracts for inclusion, read full-text articles to extract data, and rated each study using the Downs-Black scale. RESULTS: A total of 16 studies met eligibility criteria, including 10 BMD (287 children) and six fracture (37,819 children) studies. Spine BMD was significantly lower (-0.18; 95% CI = -0.25; -0.10 g/cm(2)) in children taking glucocorticoid therapy, compared to age- and gender-matched healthy controls. Spine BMD was also lower (-0.14; 95% CI = -0.27; 0.00 g/cm(2)) in children taking glucocorticoids, compared to children with the same disease not taking glucocorticoids. Incident clinical fracture rates varied from 2% to 33%. Morphometric vertebral fracture incidence ranged from 6% to 10%, and prevalence was 29-45%. CONCLUSION: Published data suggest that children treated with glucocorticoid therapy have lower spine BMD compared to healthy children. Whether children receiving glucocorticoid therapy have lower spine BMD compared to children with milder disease not requiring such therapy is not certain. Clinical and morphometric vertebral fractures are common, although only one study assessed fracture rates in healthy controls. Additional well-designed, prospective studies are needed to evaluate the skeletal effects of glucocorticoid therapy in children.

13 Review Vitamin A and bone health: the balancing act. 2013

Tanumihardjo, Sherry A. ·Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA. Electronic address: sherry@nutrisci.wisc.edu. ·J Clin Densitom · Pubmed #24183637.

ABSTRACT: The role of vitamin A status as it relates to bone health is historical yet controversial. Population-based studies have linked high dietary intake of preformed vitamin A, which is obtained from animal-source foods, fortified foods, and some supplements, to greater risk of osteoporosis and hip fracture. In contrast, carotenoids, some of which are vitamin A precursors from plants, are associated with improved bone health. Carotenoids may be a biomarker that reflects a generally healthy lifestyle, which includes fruit and vegetable consumption. Current dietary recommendations to increase fruit and vegetable intake in the Dietary Guidelines for Americans will result in greater intakes of provitamin A carotenoids if consumers comply. This could lead to artificially high intakes of vitamin A in dietary analyses. However, multiple factors affect the bioconversion of provitamin A carotenoids to the active form of vitamin A. The human body will strive to maintain vitamin A balance by down-regulating provitamin A carotenoid bioconversion. If high preformed vitamin A intake is associated with poor bone health and provitamin A carotenoids are protective, future studies are needed to clarify the associations between total body stores of vitamin A, dietary intake of the pre- and pro-forms, and bone health throughout the life cycle.

14 Review Clinical controversies in vitamin D: 25(OH)D measurement, target concentration, and supplementation. 2013

Binkley, Neil / Wiebe, Donald. ·Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: nbinkley@wisc.edu. ·J Clin Densitom · Pubmed #24183636.

ABSTRACT: Despite a plethora of recent research and systematic reviews of available data, controversy continues to surround the definition of optimal vitamin D status, the daily intake needed, and the potential adverse health consequences of "insufficiency." Efforts to standardize vitamin D measurement and improve understanding of the physiologic consequences of other vitamin D metabolites such as 3-epi and 24,25(OH)2D (and potentially other vitamin D compounds) are needed. Currently, measurement of circulating 25(OH)D is accepted as the approach to define an individual's vitamin D status. However, existing 25(OH)D assays may include other vitamin D metabolites such as the 3-epimer of 25(OH)D and 24,25(OH)2D. It seems unlikely that the controversy will soon be resolved.

15 Review Glucocorticoid-induced osteoporosis: an update on effects and management. 2013

Buehring, Bjoern / Viswanathan, Ravi / Binkley, Neil / Busse, William. ·University of Wisconsin Osteoporosis Research Program, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine & Public Health, Madison, Wis; GRECC, William S. Middleton Memorial Veterans Hospital, Madison, Wis. Electronic address: bbuehring@medicine.wisc.edu. ·J Allergy Clin Immunol · Pubmed #24176682.

ABSTRACT: Glucocorticoids remain a cornerstone of guideline-based management of persistent asthma and allergic diseases. Glucocorticoid-induced osteoporosis (GIO) is the most common iatrogenic cause of secondary osteoporosis and an issue of concern for physicians treating patients with inhaled or oral glucocorticoids either continuously or intermittently. Patients with GIO experience fragility fractures at better dual-energy x-ray absorptiometry T-scores than those with postmenopausal or age-related osteoporosis. This might be explained, at least in part, by the effects of glucocorticoids not only on osteoclasts but also on osteoblasts and osteocytes. Effective options to detect and manage GIO exist, and a management algorithm has been published by the American College of Rheumatology to provide treatment guidance for clinicians. This review will summarize GIO epidemiology and pathophysiology and assess the role of inhaled and oral glucocorticoids in asthmatic adults and children, with particular emphasis on the effect of such therapies on bone health. Lastly, we will review the American College of Rheumatology GIO guidelines and discuss diagnostic and therapeutic strategies to mitigate the risk of GIO and fragility fractures.

16 Review Myostatin--the holy grail for muscle, bone, and fat? 2013

Buehring, B / Binkley, N. ·Division of Geriatrics and Gerontology, University of Wisconsin Osteoporosis Clinical Research Program, UW Madison, 2870 University Ave, Suite 100, Madison, WI, 53705, USA, bbuehring@medicine.wisc.edu. ·Curr Osteoporos Rep · Pubmed #24072591.

ABSTRACT: Myostatin, a member of the transforming growth factor beta (TGF-β) superfamily, was first described in 1997. Since then, myostatin has gained growing attention because of the discovery that myostatin inhibition leads to muscle mass accrual. Myostatin not only plays a key role in muscle homeostasis, but also affects fat and bone. This review will focus on the impact of myostatin and its inhibition on muscle mass/function, adipose tissue and bone density/geometry in humans. Although existing data are sparse, myostatin inhibition leads to increased lean mass and 1 study found a decrease in fat mass and increase in bone formation. In addition, myostatin levels are increased in sarcopenia, cachexia and bed rest whereas they are increased after resistance training, suggesting physiological regulatory of myostatin. Increased myostatin levels have also been found in obesity and levels decrease after weight loss from caloric restriction. Knowledge on the relationship of myostatin with bone is largely based on animal data where elevated myostatin levels lead to decreased BMD and myostatin inhibition improved BMD. In summary, myostatin appears to be a key factor in the integrated physiology of muscle, fat, and bone. It is unclear whether myostatin directly affects fat and bone, or indirectly via muscle. Whether via direct or indirect effects, myostatin inhibition appears to increase muscle and bone mass and decrease fat tissue-a combination that truly appears to be a holy grail. However, at this time, human data for both efficacy and safety are extremely limited. Moreover, whether increased muscle mass also leads to improved function remains to be determined. Ultimately potential beneficial effects of myostatin inhibition will need to be determined based on hard outcomes such as falls and fractures.

17 Review What's in a name revisited: should osteoporosis and sarcopenia be considered components of "dysmobility syndrome?". 2013

Binkley, N / Krueger, D / Buehring, B. ·Osteoporosis Clinical Research Program, University of Wisconsin, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA, nbinkley@wisc.edu. ·Osteoporos Int · Pubmed #23903951.

ABSTRACT: Sarcopenia and osteoporosis are age-related declines in the quantity and quality of muscle and bone respectively, with shared pathogeneses and adverse health consequences. Both absolute and relative fat excess, i.e., obesity and sarcopenic obesity, contribute to disability, falls, and fractures. Rather than focusing on a single component, i.e., osteoporosis, sarcopenia, or obesity, we realized that an opportunity exists to combine clinical factors, thereby potentially allowing improved identification of older adults at risk for disability, falls, and fractures. Such a combination could be termed dysmobility syndrome, analogous to the approach taken with metabolic syndrome. An arbitrary score-based approach to dysmobility syndrome diagnosis is proposed and explored in a small cohort of older adults. Further evaluation of such an approach in large population-based and prospective studies seems warranted.

18 Review Long term consequences of the female athlete triad. 2013

Thein-Nissenbaum, Jill. ·Physical Therapy Program, School of Medicine and Public Health, University of Wisconsin-Madison, 5173 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706-1532, USA. thein@pt.wisc.edu ·Maturitas · Pubmed #23541905.

ABSTRACT: In the past 40 years, female sports participation, particularly at the high school level, has significantly increased. Physical activity in females has numerous positive benefits, including improved body image and overall health. Unfortunately, a select population of exercising females may experience symptoms related to the female athlete triad, which refers to the interrelatedness of energy availability, menstrual function, and bone mineral density. Clinically, these conditions can manifest as disordered eating behaviors, menstrual irregularity, and stress fractures. Triad symptoms are distributed along a spectrum between optimal health and disease; all of the components of the triad may not be affected simultaneously. The female athlete triad was first identified in 1992. Since that time, a vast amount of research related to the identification, management and prevention of this condition has been published. More recently, research related to the long term effects of triad components has come into light. Women who were diagnosed with female athlete triad syndrome as adolescents and young adults in the 1990s are now in their 30s and 40s; negative long term effects of the female athlete triad, such as low bone mineral density, are now starting to manifest. Women of all ages should be assessed for triad components during routine annual physical examinations; appropriate measures to treat any current triad components should be implemented. In addition, women in their 30s, 40s and early 50s should be screened for a history of the female athlete triad. Multidisciplinary management of these conditions is strongly recommended.

19 Review Balanced mineralization in the arterial system: possible role of osteoclastogenesis/osteoblastogenesis in abdominal aortic aneurysm and stenotic disease. 2012

Yamanouchi, Dai / Takei, Yuichiro / Komori, Kimihiro. ·Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. yamano@surgery.wisc.edu ·Circ J · Pubmed #23117745.

ABSTRACT: Arterial calcification is the result of the same highly organized processes as seen in bone, which rely on a delicate balance between osteoblasts and osteoclasts. Although previously understood as passive precipitation, evidence has accumulated to suggest that arterial calcification is the result of organized, regulated processes bearing many similarities to osteogenesis in bone, including the presence of subpopulations of arterial wall cells that retain osteoblastic lineage potential. These cells have the potential to form mineralized nodules and express osteoblast markers, including bone morphogenetic protein-2, osteocalcin, osteopontin, and alkaline phosphatase. By contrast, osteoclast-like cells mediate the catabolic process of mineral resorption. Recent data shows that cells positive for tartrate-resistant acid phosphatase, a major marker for osteoclasts, have been histologically identified in atherosclerotic lesions and are referred to as osteoclast-like cells. Evidence has accumulated to suggest that initial arterial calcification through passive precipitation of calcium phosphate initiates balanced mineralization regulated by osteoclast-like and osteoblast-like cells. Subsequently, various pathogenic conditions may trigger an imbalance between osteoblastogenesis and osteoclastogenesis, leading to either calcification in stenotic/occlusive disease or destruction of the extracellular matrix in aneurysmal disease. Further elucidation of these newly emerging concepts could lead to a novel therapeutic approach to arterial stenotic/occlusive disease and/or abdominal aortic aneurysm.

20 Review Female athlete triad syndrome in the high school athlete. 2011

Thein-Nissenbaum, Jill M / Carr, Kathleen E. ·University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. thein@pt.wisc.edu ·Phys Ther Sport · Pubmed #21802036.

ABSTRACT: Female sports participation at the high school level has significantly increased since the 1970s. Physical activity in females has numerous positive benefits, including improved body image and overall health. Unfortunately, a select population of exercising females may experience symptoms related to the "female athlete triad," which refers to the interrelationships among energy availability, menstrual function, and bone mineral density. Clinically, these conditions can manifest as disordered eating behaviors, menstrual irregularity, and stress fractures. Athletes with conditions related to the triad are distributed along a spectrum between optimal health and disease and may not experience all conditions simultaneously. Previous research related to the triad has primarily focused on collegiate and elite athletes. However, mounting evidence demonstrates that the triad is present in the high school population. High school athletes should be assessed for triad components at preparticipation physicals. In addition, parents, coaches, and health care professionals should be educated and informed about the female athlete triad syndrome. In the presence of triad symptoms, further evaluation and treatment by a multidisciplinary team is strongly recommended for the athlete.

21 Review Uncertainties in the prevention and treatment of glucocorticoid-induced osteoporosis. 2011

Hansen, Karen E / Wilson, H Alexander / Zapalowski, Carol / Fink, Howard A / Minisola, Salvatore / Adler, Robert A. ·University of Wisconsin Department of Medicine, Madison, WI, USA. keh@medicine.wisc.edu ·J Bone Miner Res · Pubmed #21721042.

ABSTRACT: Much knowledge has accrued since the 2001 American College of Rheumatology (ACR) guidelines were published to assist clinicians in the prevention and treatment of glucocorticoid-induced osteoporosis (GIO). Therefore, the ACR undertook a comprehensive effort to review the literature and update the GIO guidelines [Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken). 2010;62:1515-1526]. Herein, we review the new guidelines for JBMR readers, highlighting the changes introduced by the 2010 publication. We discuss several patient scenarios for which the new treatment guidelines do not apply, or for which our committee interprets existing literature differently and suggests an alternative approach.

22 Review The importance of stereochemistry on the actions of vitamin D. 2011

Chiellini, G / DeLuca, Hector F. ·Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706-1544, USA. ·Curr Top Med Chem · Pubmed #21291397.

ABSTRACT: The seco-steroid hormone 1α,25-dihydroxyvitamin D(3) [1α,25(OH)(2)D(3)] is the most potent natural metabolite of vitamin D(3) and regulates primarily calcium and phosphate homeostasis, but also as a regulator of specific differentiation and of the immune system. Most, if not all, of the biological actions of 1α,25(OH)(2)D(3) are mediated through its specific receptor, the vitamin D receptor (VDR), which is a member of the nuclear receptor superfamily acting as a ligand-dependent transcription factor with coactivators. 1α,25(OH)(2)D(3) has significant therapeutic potential in the treatment of osteoporosis, rickets, secondary hyperparathyroidism, psoriasis, and renal osteodystrophy. However, the use of 1α,25(OH)(2)D(3) itself is limited because it induces significant hypercalcemia. Vitamin D is a highly flexible molecule and a very large number of analogs have been synthesized by industry and academia in an attempt to provide beneficial therapeutic agents with low calcemic activity. Chemical modifications of every portion of the vitamin D(3) molecule (the A, C, and D rings, the 17β-aliphatic side chain, and the 5,6,7,8-diene moiety) have been reported, with the most of the interesting analogs resulting from a combination of several modifications. The three-dimensional structure of both rat and human VDR-LBD have provided significant information for our understanding of the structure-function relationship (SFR) of vitamin D and some synthetic analogs. In this review, we focus on the current understanding of the relationship between selected stereochemical modifications of key structural components (i.e. A-ring, CD-ring and Side-chain) of the 1α,25(OH)(2)D(3) molecule and their effect on biological potency and selectivity. Based on current information, suggestions for the structure-based design of therapeutically valuable vitamin D analogs will conclude the review.

23 Review The role of cigarette smoking and statins in the development of postmenopausal osteoporosis: a pilot study utilizing the Marshfield Clinic Personalized Medicine Cohort. 2010

Giampietro, P F / McCarty, C / Mukesh, B / McKiernan, F / Wilson, D / Shuldiner, A / Liu, J / LeVasseur, J / Ivacic, L / Kitchner, T / Ghebranious, N. ·Marshfield Clinic, Department of Medical Genetic Services, 1000 North Oak Avenue, Marshfield, WI 54449, USA. pfgiampietro@pediatrics.wisc.edu ·Osteoporos Int · Pubmed #19506792.

ABSTRACT: SUMMARY: A cohort of postmenopausal osteoporotic females and controls with normal bone mineral density, the interleukin 6 (IL6) -634G > C (rs1800796) C allele of the promoter region showed association with osteoporosis. The lipoprotein receptor-related protein 5 (LRP5) gene showed association between C135242T C/T alleles and osteoporosis only in smokers, suggesting a role for environmental interaction. INTRODUCTION: A nested case-control study within a population-based cohort was undertaken to assess the relative impact of cigarette smoking, statin use, genetic polymorphisms, and one-way interaction of these factors on development of osteoporosis in postmenopausal women. METHODS: Genotyping of 14 single-nucleotide polymorphisms (SNPs) corresponding to vitamin D receptor gene, estrogen receptor 1, collagen type 1 alpha 1, IL6, transcription growth factor beta, apolipoprotein E, and LRP5 genes was performed in cases (n = 309) with osteoporosis and controls (n = 293) with normal bone mineral density drawn from a homogeneous Caucasian population. SNPs were chosen based on known functional consequences or prior evidence for association and genotyped using matrix-assisted laser desorption ionization time-of-flight technology. RESULTS: Cases differed from controls relative to body mass index, age, and smoking but not statin use. After adjusting for age, the IL6 -634G > C (rs1800796) allele showed association with osteoporosis (odds ratio (OR) for CC + CG = 2.51, p = 0.0047)), independent of statin use or smoking status. On stratification for smoking, association with LRP5 C135242T (rs545382) and osteoporosis emerged (OR 2.8 in smokers for CT alleles, p = 0.03)), suggestive of potential environmental interaction. CONCLUSION: Evidence suggested a role for genetic variation in IL6 and LRP5 in conferring risk for osteoporosis in Caucasian women, with the latter manifest only in smokers.

24 Review A perspective on male osteoporosis. 2009

Binkley, Neil. ·Osteoporosis Clinical Center and Research Program and Institute on Aging University of Wisconsin, Madison, WI, USA. nbinkley@wisc.edu ·Best Pract Res Clin Rheumatol · Pubmed #19945687.

ABSTRACT: Osteoporosis and fragility fracture become common with advancing age in men. The incidence of osteoporosis-related fracture is similar to myocardial infarction and exceeds that of lung and prostate carcinoma combined. These fractures cause substantial morbidity, and the mortality following hip fracture is greater in men than in women. A decline in sex steroids and glucocorticoid and alcohol use, among other factors, contribute to bone loss and fracture risk. Approaches to reduce fracture risk in men are very similar to that in women - recognising and addressing muscle weakness/falls risk and optimising nutrition, with emphasis on calcium and vitamin D and medications when appropriate. Despite the high prevalence, osteoporosis remains largely undiagnosed and undertreated. Hopefully, increased recognition of male osteoporosis by health-care providers and the men themselves, in combination with recent consensus recommendations for treatment based on fracture-risk estimation, will reduce the burden of fragility fracture in men.

25 Review DMPA's effect on bone mineral density: A particular concern for adolescents. 2009

Schrager, Sarina B. ·Department of Family Medicine, University of Wisconsin, 777 South Mills Street, Madison, WI 53715, USA. sbschrag@wisc.edu ·J Fam Pract · Pubmed #19442384.

ABSTRACT: Discuss the potential for decreased bone mineral density in using depot-medroxyprogesterone acetate (DMPA) with any woman who is thinking of it as a means of contraception. Recommend to women that they take 1300 mg of calcium and 400 IU of vitamin D when using DMPA. Consider prescribing estrogen replacement if DMPA is going to be used for more than 2 years.

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