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R M Joakimsen

Publications and source records attributed to R M Joakimsen.

15 recordsLinked to original sources
PubMed2005

Features of the metabolic syndrome and the risk of non-vertebral fractures: the Tromsø study.

INTRODUCTION: We wanted to examine whether the features of the metabolic syndrome carried an increased risk of non-vertebral fracture. METHODS: This is a population-based, 6-year follow-up of 27,159 subjects from the municipality of Tromsø, followed from 1994 until 2001. Age range was 25-98 years. Non-fasting serum levels of high-density lipoprotein (HDL), triglycerides and glucose, blood pressure (BP), weight and height were measured at baseline. All non-vertebral fractures were registered by computerised search in radiographic archives. RESULTS: A total of 1,249 non-vertebral fractures were registered. Increasing number of metabolic syndrome features was associated with significantly reduced fracture risk in both men and women, p= 0.004 and p<0.0001, respectively. High BP was protective against fracture in men [relative risk (RR) 0.89; 95% confidence interval (CI) 0.8-0.99)] while increased body mass index (BMI) was protective in women (RR 0.91; 95% CI 0.84-0.98). Increasing non-fasting serum levels of HDL increased fracture risk in women (RR 1.12; 95% CI 1.05-1.21). BMI modified the effect of HDL in men. Accordingly, high HDL increased fracture risk in men with high BMI (RR 1.51; 95% CI 1.2-1.9). CONCLUSIONS: Increasing burden of metabolic syndrome features protects against non-vertebral fractures. Reduced non-vertebral fracture risk was associated with high BP in men and increased body mass in women. Lower non-fasting serum levels of HDL protect against fractures in women and obese men.

Adult↗
PubMed2005

Longitudinal changes in forearm bone mineral density in women and men aged 25-44 years: the Tromsø study: a population-based study.

The aim of this study was to describe and compare bone mineral density (BMD) development in Norwegian women and men aged 25-44 years in a population-based, longitudinal study. BMD was measured twice at distal and ultradistal forearm sites by single x-ray absorptiometry in 258 women and 147 men (mean follow-up time, 6.4 (standard deviation, 0.6) years). At the distal site, a small annual gain of approximately 0.1% became a small loss beginning at age 34 years in men and age 36 years in women. At the ultradistal site, BMD change was predicted by age in women only, and bone loss started at age 38 years. A high degree of tracking of BMD measurements was observed for both sexes and both sites, r > 0.93. Depending on total BMD change, participants were grouped into "losers", "nonlosers", and "gainers", and more than 6% lost more than the smallest detectable amount of BMD: > or =3.46% at the distal site and > or =5.14% at the ultradistal site. In both sexes, bone mineral content (grams) decreased, whereas area (centimeters squared) increased significantly in "losers" compared with "gainers". This finding might represent physiologic compensation preserving bone strength. No cohort effects were observed when 1994 and 2001 measures from similar age groups were compared.

Absorptiometry, Photon↗
PubMed2004

Long-term mental distress, bone mineral density and non-vertebral fractures. The Tromsø Study.

The purpose of this study was to examine, prospectively, the risk of non-vertebral fractures and low bone mineral density in a population-based cohort with respect to indicators of subjective mental distress. In 1979-1980 all males born 1925-1959 and all females born 1930-1959 living in Tromsø were invited (21,441; response rate, 78%). The same individuals were invited to the subsequent studies in 1986-1987 and 1994-1995 (74% attended the first two, and 71% attended all three surveys). Non-vertebral fractures were registered by linkage to the hospital X-ray register for the period 1988-1995, and forearm bone mineral density (BMD) was available in a subsample of 4,690 who had attended three times. Questions about mental distress (depression, insomnia and coping problems) were repeated three times and analyzed as cumulated exposure. Women who reported being depressed at two time points had an adjusted odds ratio (OR) =2.5 (95% confidence interval [CI] 1.3-4.9) for sustaining a non-vertebral fracture and OR=3.1 (95% CI 1.3-7.2) for sustaining an osteoporotic fracture, compared with those without depression on any occasion. The corresponding odds ratios for those with coping problems at two time points were slightly higher, whereas sleeping problems seem only to be weakly associated with non-vertebral fractures. The pattern of associations and the magnitude of OR estimates were mainly the same in women younger than 50 years and those 50 years and older. Women using nerve medicine and reporting depression twice had an odds ratio of 4.4 (95% CI 1.1-17.7) for sustaining a non-vertebral fracture, and those using nerve medicine and reporting coping problems twice had a corresponding OR 4.7 (95% CI 1.2-18.4). Among men no significant associations were found for either fracture type. No association was found between mean BMD and number of times reporting depression, insomnia or coping problems, in women or men. Long-term mental distress is associated with risk of all non-vertebral fractures and osteoporotic fractures in middle-aged women, but not in men. Mental distress itself seems to be more important than the use of nerve medicine.

Absorptiometry, Photon↗
PubMed2001

[Vertebral fractures--a big health problem for elderly women?].

BACKGROUND: The term osteoporosis often conjures up an image of deformed spines,--small stooping ladies burdened with back pain. Most modern medication against osteoporosis has documented effect first and foremost against vertebral fractures. However, are vertebral fractures a public health issue, and are they frequent and serious enough to warrant aggressive and expensive preventive measures? MATERIAL AND METHODS: Through search in Medline with the terms "osteoporosis", "vertebral fracture*" and "vertebral deformities", we identified and reviewed a total of 222 scientific articles on vertebral fractures. RESULTS: Incident vertebral deformities entail temporary complaints, and the consequences of prevalent deformities are minute unless there are several deformities. Less than 8% of back pain among the elderly can be attributed to vertebral deformities. A large double-blind, randomised clinical trial demonstrates that treatment that halves the risk of new vertebral deformities barely affects the occurrence of back pain or disability. INTERPRETATION: Even if some patients' suffering is attributable to vertebral deformities, we conclude that vertebral deformities represent a minor public health problem. As a consequence, studies exploring predictors of painful vertebral fractures are warranted; furthermore, more documentation on prevention of non-vertebral fractures is needed.

Aged↗
PubMed2001

The Tromsø study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register?

In order to compare different methods of fracture registration, we sought all nonvertebral fractures suffered during 8 years (1988-95) among 21,441 persons invited to a survey in 1979/80. We registered a total of 54 hip fracture cases through three separate sources (self-report, computer linkage to the local radiographic archives, discharge register), whereas forearm fractures (a total of 291 cases) were registered through two separate sources (self-report, computer linkage to the radiographic archives). The registration of fractures at other sites (a total of 1321 cases) were from one source (computer linkage to the local radiographic archives), and we have compared three ways of obtaining data from this single source (no ascertainment, ascertainment of records coded as fracture, ascertainment of all records). Ninety-three percent of all hip fractures and 97% of all wrist fractures in the entire study population were found by computer linkage to the radiographic archives, whereas the discharge register detected 87% of all the hip fractures. Computer linkage with ascertainment gave no overreporting of fractures. Among the 11,626 persons who answered a follow-up questionnaire in 1994/95, 97% (CI 84-100%) of all hip fractures and 72% (CI 66-78%) of all wrist fractures were self-reported. We conclude that a computerized search of radiographic archives is a viable method of fracture registration.

Adult↗
PubMed2001

The Tromsø Study: a population-based study on the variation in bone formation markers with age, gender, anthropometry and season in both men and women.

Background information on how biological factors influence the level of bone turnover markers is crucial in order to make proper use of these measurements. In the present study, which is part of the fourth survey of a general population in Tromsø, Norway, we evaluated the variation in the bone formation markers bone alkaline phosphatase (S-BAP) and osteocalcin (S-OC) in 528 men and 605 women, age 25-74 years. In the Tromsø Study in 1994/5, the whole population above 25 years was initially invited and 7948 individuals attended an extended examination (76.4% of the invited population). The present study population is a random sample of these attendees. The variation with age, gender, height, weight, body mass index and season, and with menopausal status in women, was examined. In men there was a decrease in S-OC up to the age of 56 years with little further change, while S-BAP showed no change with age. Among women, variation in bone markers was mainly observed to change with menopause, with a 41% and 21% increase in the mean level of S-BAP and S-OC, respectively. There was a negative trend in S-OC with body mass index in both men and women. A seasonal change of 20% in the level of both bone markers in men and of S-BAP in postmenopausal women was observed in this region at a far northern latitude. We conclude that, of the factors examined, season and menopausal status must be taken into account when measuring these bone formation markers.

Adult↗
PubMed2000

The Tromsø study: determinants of precision in bone densitometry.

Studies of precision determinants in bone densitometry are scarce. A total of 111 subjects recruited from the population-based multipurpose Tromsø Study (Norway), 27-75 years of age, had repeated forearm bone single X-ray absorptiometry (SXA) measurements. Measurement conditions were systematically varied in series up to eight scans. Median coefficients of variation (CV) for two scans performed 1 week apart, by two different operators were 0.79% and 0.98% at distal and ultradistal sites, respectively. The CV distribution was skewed: 5% of the subjects had individual CVs above 2.2% (distal) and 3.4% (ultradistal). Age (P = 0.0097) and repositioning were important determinants of precision. The SXA bone mineral density (BMD)-measurement method is sufficiently precise to establish BMD level. The minimal individual percentage BMD change that can be detected with 95% certainty was 2% and 3% at distal and ultradistal sites, respectively. Detection of BMD changes less than this should rely on multiple repeat measurements at each point in time.

Absorptiometry, Photon↗
PubMed1998

The Tromsø Study: body height, body mass index and fractures.

Tall persons suffer more hip fractures than shorter persons, and high body mass index is associated with fewer hip and forearm fractures. We have studied the association between body height, body mass index and all non-vertebral fractures in a large, prospective, population-based study. The middle-aged population of Tromsø, Norway, was invited to surveys in 1979/80, 1986/87 and 1994/95 (The Tromsø Study). Of 16,676 invited to the first two surveys, 12,270 attended both times (74%). Height and weight were measured without shoes at the surveys, and all non-vertebral fractures in the period 1988-1995 were registered (922 persons with fractures) and verified by radiography. The risk of a low-energy fracture was found to be positively associated with increasing body height and with decreasing body mass index. Furthermore, men who had gained weight had a lower risk of hip fractures, and women who had gained weight had a lower risk of fractures in the lower extremities. High body height is thus a risk factor for fractures, and 1 in 4 low-energy fractures among women today might be ascribed to the increase in average stature since the turn of the century. Low body mass index is associated with a higher risk of fractures, but the association is probably too weak to have any clinical relevance in this age category.

Adult↗
PubMed1998

The Tromsø Study: physical activity and the incidence of fractures in a middle-aged population.

We have studied the relation of occupational and recreational physical activity to fractures at different locations. All men born between 1925 and 1959 and all women born between 1930 and 1959 in the city of Tromsø were invited to participate in surveys in 1979-1980 and 1986-1987 (The Tromsø Study). Of 16,676 invited persons, 12,270 (73.6%) attended both surveys. All nonvertebral fractures (n = 1435) sustained from 1988 to 1995 were registered in the only hospital in the area. Average age in the middle of the follow-up period (December 31, 1991) was 47.3 years among men and 4501 years among women, ranging from 32 to 66 years. Fracture incidence increased with age at all locations among women, but it decreased with or was independent of age among men. Low-energetic fractures constituted 74.4% of all fractures among women and 55.2% among men. When stratifying by fracture location, the most physically active persons among those 45 years or older suffered fewer fractures in the weight-bearing skeleton (relative risk [RR] 0.6, confidence interval [CI] 0.4-0.9, age-adjusted), but not in the non-weight-bearing skeleton (RR 1.0, CI 0.7-1.2, age-adjusted) compared with sedentary persons. The relative-risk of a low-energetic fracture in the weight-bearing skeleton among the most physically active middle-aged was 0.3 (CI 0.1-0.7) among men and 0.9 (CI 0.4-1.8) among women compared with the sedentary when adjusted for age, body mass index, body height, tobacco smoking, and alcohol and milk consumption. It seems that the beneficial effect on the skeleton of weight-bearing activity is reflected also in the incidence of fractures at different sites.

Adult↗
PubMed1997

Physical activity and predisposition for hip fractures: a review.

Studies on the association between physical activity and hip fractures are reviewed. All the studies, which comprise four follow-up studies, one nested case-control study and 17 case-control studies, suggest a protective effect of physical activity with regard to hip fractures. The association is strong and consistent with physical activity in leisure, weaker with respect to physical activity at work. The association is present for physical activity from childhood to adult age, and it is consistent in study populations from the USA, Australia, Asia and Northern and Southern Europe, in spite of very different hip fractures incidences in these populations. The magnitude of the association is difficult to assess because of varying criteria for exposure, but to be among the physically active seems to reduce the risk of later hip fracture by up to 50%. It seems that even daily chores, such as climbing stairs and walking, protect against hip fracture.

Accidental Falls↗
PubMed1996

[Osteoporosis. Knowledge and attitudes of the Norwegian population].

In March 1994, a random sample of 1,514 Norwegians aged 16-79 years were interviewed about their knowledge of osteoporosis and their attitudes towards prevention of this disease. About 85% answered correctly that osteoporosis can be prevented, but only 57% knew that it cannot be cured. Women had better knowledge of osteoporosis than men had. Two thirds of the women were positive to the use of long-term hormone replacement therapy to prevent osteoporosis. The majority of women aged 60 years or more preferred walking to other physical activities to prevent the disease. Although the data demonstrated fairly good general knowledge of osteoporosis in the population, the oldest women, those at the highest risk of developing the disease, knew less about osteoporosis than the younger women did.

Adolescent↗
PubMed1996

What do Norwegian women and men know about osteoporosis?

A survey of a random sample of 1514 Norwegian women and men aged 16-79 years was undertaken to investigate knowledge of osteoporosis and attitudes towards methods for preventing this disease. The interviews were carried out by Central Bureau of Statistics of Norway as part of their monthly national poll using a structured questionnaire. Women knew more about osteoporosis than did men (p < 0.001). In both men and women increased knowledge of osteoporosis was correlated to a high level of education. Furthermore it was clearly demonstrated that knowing someone with osteoporosis or suffering from it oneself increased the knowledge of osteoporosis significantly in both women and men. Multiple regression analysis confirmed the univariate analyses, and education was the strongest predictive factor for knowledge. To a hypothetical question as many as two-thirds of the women answered that they would use long-term hormone replacement therapy (HRT) to prevent osteoporosis on the recommendation of their general practitioner. Their attitudes towards the use of estrogen therapy did not show any significant relation to age, but their reluctance towards HRT increased with education (p < 0.001). When asked a question about their preferences regarding the use of physical activity as a means to prevent osteoporosis, older women preferred walking (p < 0.001), whereas younger women wanted more organized athletic activity (p < 0.001). The data demonstrated that there was a high degree of general knowledge of osteoporosis and its consequences in the general population.

Adolescent↗
PubMed1994

[Rheumatic fever--does it exist in Norway today?].

During the last 30 years, acute rheumatic fever has been a curiosity in Norway, and only five cases have been reported to MSIS (National Notification System for Infectious Diseases, Norway) in the 1990s. Even so, during the period 1990 to 1992 99 patients were discharged from Norwegian hospitals with the diagnosis acute rheumatic fever. Could the increase in the number of group A-streptococci in the last years have led to a corresponding increase in the incidence of acute rheumatic fever? If so, could such an increase have escaped our attention? We present an updated review of acute rheumatic fever and the case of a young soldier.

Acute Disease↗