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S R Cummings

Publications and source records attributed to S R Cummings.

At least 19 recordsLinked to original sources
PubMed1997

Racial differences in bone density between young adult black and white subjects persist after adjustment for anthropometric, lifestyle, and biochemical differences.

This study tested whether racial differences in bone density can be explained by differences in bone metabolism and lifestyle. A cohort of 402 black and white men and women, ages 25-36 yr, was studied at the Kaiser Permanente Medical Care Program in Northern California, a prepaid health plan. Body composition (fat, lean, and bone mineral density) was measured using a Hologic-2000 dual-energy x-ray densitometer. Muscle strength, blood and urine chemistry values related to calcium metabolism, bone turnover, growth factors, and level of sex and adrenal hormones were also measured. Medical history, physical activity, and lifestyle were assessed. Statistical analyses using t- and chi-square tests and multiple regression were done to determine whether racial difference in bone density remained after adjustment for covariates. Bone density at all skeletal sites was statistically significantly greater in black than in white subjects; on average, adjustment for covariates reduced the percentage density differences by 42% for men and 34% for women. Adjusted bone density at various skeletal sites was 4.5-16.1% higher for black than for white men and was 1.2-7.3% higher for black than for white women. We concluded that racial differences in bone mineral density are not accounted for by clinical or biochemical variables measured in early adulthood.

Adult↗
PubMed1996

Hip fracture.

Explore the source record for details and available documents.

Accidental Falls↗
PubMed1996

Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group.

BACKGROUND: Previous studies have shown that alendronate can increase bone mineral density (BMD) and prevent radiographically defined (morphometric) vertebral fractures. The Fracture Intervention Trial aimed to investigate the effect of alendronate on the risk of morphometric as well as clinically evident fractures in postmenopausal women with low bone mass. METHODS: Women aged 55-81 with low femoral-neck BMD were enrolled in two study groups based on presence or absence of an existing vertebral fracture. Results for women with at least one vertebral fracture at baseline are reported here. 2027 women were randomly assigned placebo (1005) or alendronate (1022) and followed up for 36 months. The dose of alendronate (initially 5 mg daily) was increased (to 10 mg daily) at 24 months, with maintenance of the double blind. Lateral spine radiography was done at baseline and at 24 and 36 months. New vertebral fractures, the primary endpoint, were defined by morphometry as a decrease of 20% (and at least 4 mm) in at least one vertebral height between the baseline and latest follow-up radiograph. Non-spine clinical fractures were confirmed by radiographic reports. New symptomatic vertebral fractures were based on self-report and confirmed by radiography. FINDINGS: Follow-up radiographs were obtained for 1946 women (98% of surviving participants). 78 (8.0%) of women in the alendronate group had one or more new morphometric vertebral fractures compared with 145 (15.0%) in the placebo group (relative risk 0.53 [95% Cl 0.41-0.68]). For clinically apparent vertebral fractures, the corresponding numbers were 23 (2.3%) alendronate and 50 (5.0%) placebo (relative hazard 0.45 [0.27-0.72]). The risk of any clinical fracture, the main secondary endpoint, was lower in the alendronate than in the placebo group (139 [13.6%] vs 183 [18.2%]; relative hazard 0.72 [0.58-0.90]). The relative hazards for hip fracture and wrist fracture for alendronate versus placebo were 0.49 (0.23-0.99) and 0.52 (0.31-0.87). There was no significant difference between the groups in numbers of adverse experiences, including upper-gastrointestinal disorders. INTERPRETATION: We conclude that among women with low bone mass and existing vertebral fractures, alendronate is well tolerated and substantially reduces the frequency of morphometric and clinical vertebral fractures, as well as other clinical fractures.

Aged↗
PubMed1996

Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group.

OBJECTIVE: To test the hypothesis that bone mineral density (BMD) is associated with the risk of developing breast cancer in older women. DESIGN: Prospective cohort study with mean (SD) follow-up of 3.2 (1.6) years. SETTING: Four clinical centers, one each located in the following areas: Baltimore, Md; Minneapolis, Minn; Portland, Ore; and the Monongahela Valley in Pennsylvania. PARTICIPANTS: A total of 6854 nonblack women who were 65 years of age or older and enrolled in the Study of Osteoporotic Fractures. MEASUREMENTS: Radius and calcaneus BMD by single photon absorptiometry at baseline; hip and spine BMD by dual-energy x-ray absorptiometry 2 years later. MAIN OUTCOME MEASURE: Breast cancer confirmed by medical record review. RESULTS: A total of 97 women developed breast cancer. In the multivariate model, adjusting for age, the degree of obesity, and other important covariates, the risk of breast cancer was about 30% to 50% higher per 1 SD increase in BMD (relative risk, distal radius BMD=1.50; 95% confidence interval, 1.16-1.95). The age-adjusted incidence rate of breast cancer per 1000 person-years among women in the lowest quartile of distal radius BMD was 2.46, compared with 5.99 among women with the highest BMD. Women with BMD above the 25th percentile were at 2.0 to 2.5 times increased risk of breast cancer compared with women below the 25th percentile. Results were consistent across all BMD sites. CONCLUSIONS: Bone mineral density predicts the risk of breast cancer in older women. The magnitude of the association is similar to that observed between BMD and all fractures. Our findings suggest a link between 2 of the most common conditions affecting a woman's health. Identifying a common denominator for these conditions should substantially improve our understanding of their etiology and prevention.

Absorptiometry, Photon↗
PubMed1996

Very low rates of hip fracture in Beijing, People's Republic of China the Beijing Osteoporosis Project.

One third of the world's hip fractures are said to occur in Asia, mostly in China. However, there have as yet been no validated studies of hip fracture rates in China. The authors estimated the incidence of hip fractures in Beijing, People's Republic of China, and took several steps to validate the estimates. All 76 Beijing hospitals reported all 1988-1992 admissions that had been coded as 820 (hip fracture) or 821 (other femoral fracture) according to the International Classification of Diseases, Ninth Revision. The authors then compared a random sample of the reports with original medical records, and discovered that 70% of intertrochanteric hip fractures had been miscoded as "other femoral fractures." The authors retrained all hospital staffs to provide corrected reports. Revised reports missed only 13% of the hip fracture cases recorded in operating room logs of 11 randomly selected hospitals. To validate hospital-based estimates of hip fracture rates, the authors interviewed a random sample of 2,113 Beijing women aged 50 years or more (97% response rate); all but 4% of past fractures and all seven hip fractures had been treated in hospitals. Finally, the authors surveyed the 27 hospitals in the counties surrounding Beijing. No Beijing residents had been treated for hip fracture outside of the city. Based on the 1990 China census, age-standardized rates of hip fracture (per 100,000) in Beijing-87 for women, 97 for men-were much lower than those seen in Hong Kong in 1985 (353 for women, 181 for men) or in US Caucasians (510-559 for women, 174-207 for men). From 1988 to 1992, the rates in Beijing increased 34% in women and 33% in men. The authors conclude that hip fracture rates in Beijing are among the lowest in the world but may be rising rapidly.

Adult↗
PubMed1996

Association of estrogen replacement therapy with the risk of osteoarthritis of the hip in elderly white women. Study of Osteoporotic Fractures Research Group.

OBJECTIVE: To determine whether postmenopausal estrogen replacement therapy is associated with a reduced risk of radiographic findings of osteoarthritis (OA) of the hip. DESIGN: Cross-sectional study. SUBJECTS: White women (N = 4366; age, > or = 65 years) who were participants in a cohort study of osteoporotic fractures. MEASUREMENTS AND METHODS: Radiographs of the pelvis that were obtained in all subjects were assessed for radiographic features of OA of the hip on a summary scale of 0 (none) to 4 (severe OA). Postmenopausal estrogen use was assessed by interview. The association of current and past oral estrogen use with OA of the hip was analyzed by using logistic regression, adjusting for potential confounding variables (eg, indicators of osteoporosis and correlates of estrogen use). RESULTS: Five hundred thirty-nine women (12.3%) had mild or greater radiographic findings of OA of the hip in at least 1 hip, and 214 women (4.9%) had moderate to severe findings; 17% and 24% of the women were current and past users of oral estrogen, respectively. Women who were currently using oral estrogen had a significantly reduced risk of any OA of the hip (adjusted odds ratio [OR], 0.62; 95% confidence interval [CI], 0.49-0.86) and moderate to severe manifestation of disease (OR, 0.54; 95% CI, 0.33-0.88). Current users who had taken estrogen for 10 years or longer had a greater reduction in the risk of any OA of the hip (OR, 0.57; 95% CI, 0.40-0.82) compared with that of users for less than 10 years (OR, 0.75; 95% CI, 0.47-1.24). Current estrogen use for 10 years or longer was associated with a nonsignificant trend for a reduced risk of moderate to severe symptomatic disease (OR, 0.59; 95% CI, 0.28-1.29). CONCLUSION: Postmenopausal estrogen replacement therapy may protect against OA of the hip in elderly white women.

Aged↗
PubMed1996

Mortality following fractures in older women. The study of osteoporotic fractures.

BACKGROUND: Most investigators have hypothesized that the increase in mortality following osteoporotic fractures reflects poor underlying health status in addition to the acute effects of the fracture. METHODS: We observed 9704 ambulatory women aged 65 years or older enrolled in the Study of Osteoporotic Fractures. We obtained reports of fractures and deaths every 4 months and reviewed death certificates and hospital discharge summaries. Multivariable proportional hazards models were used to determine the association between fractures and age-adjusted mortality. RESULTS: During a mean follow-up of 5.9 years, 1737 women had nonspine fractures, with a postfracture mortality rate of 3 per 100 woman-years, compared with 1.8 per 100 woman-years in those who did not have fractures (P < .001). After adjusting for other factors associated with mortality, women (n = 361) with fractures of the hip or pelvis had a 2.4-fold (95% confidence interval, 1.7-3.3) increase in mortality. However, only 9 (14%) of the 64 deaths that occurred after hip or pelvic fractures were caused or hastened by the fracture. By contrast, 11 (17%) of these deaths seemed to have been a result of chronic conditions that has contributed to the hip or pelvic fracture, and 44 (69%) of the deaths were not clearly related to the fracture. CONCLUSIONS: Mortality is increased following several types of fractures in older women. Most of the increase following hip and pelvic fractures is due to underlying conditions and probably would not be affected by reductions in the incidence of these fractures.

Aged↗
PubMed1996

Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group.

The assessment of radiographs for vertebral fractures is important in the clinical evaluation of patients with suspected osteoporosis, in the epidemiological evaluation of elderly populations, and in clinical trials of osteotrophic drugs. The purpose of this study is to compare visual semiquantitative (SQ) approaches and quantitative morphometric approaches for assessing prevalent and incident vertebral fractures in postmenopausal osteoporosis. We analyzed lateral thoracolumbar spine radiographs (baseline and approximately 3.5 year follow-up) of 503 women (age > or = 65) randomly selected from the Study of Osteoporotic Fractures (SOF) population. SQ assessment by an experienced radiologist graded vertebral fractures from 0 (normal) to 3 (severe). Incident fractures by SQ were defined as an increase of > or = 1 grade on follow-up radiographs. Trained research assistants visually triaged women as normal, uncertain, or probably fractured and visually flagged vertebrae with moderate/severe (grade > or = 2) prevalent fractures or with any (grade > or = 1 change) incident fracture. The radiographs were also digitized by research assistants, and quantitative morphometry (QM) was used to classify vertebral deformities at several cut-offs based on standard deviation (SD) reductions in height ratios from normal means, e.g., QM > or = 3 SD. Incident fractures by QM were defined as a decrease in height of more than 15% (QM15) on follow-up radiographs. Finally, a combination of these methods was used to detect moderate/severe prevalent fractures and any grade of incident fractures. In the overall analysis, the prevalence of fractures varied from 14 to 33% and the incidence from 5 to 10% by woman, depending upon the method and cut-off criteria. In the detailed analysis, considering visually triaged uncertain as abnormal, triage by research assistants detected 97.0% (163/168) of women with SQ grade > or = 1 fractures and 100% (70/70) with SQ grade > or = 2 fractures. Visual flagging by research assistants detected 88.5% (108/122) of SQ > or = 2 prevalent fractures (kappa score, kappa = 0.82) and 85.2% (52/61) of SQ incident fractures (kappa = 0.79). QM > or = 3 SD detected 37.9% (141/372) of SQ > or = 1 prevalent fractures (kappa = 0.51) and 79.5% (97/122) of SQ > or = 2 prevalent fractures (kappa = 0.68), plus 18 vertebrae without SQ fractures. QM 15 detected 59% (36/61) of SQ incident fractures (kappa = 0.70), plus five vertebrae without SQ incident fractures. The combination assessment detected 92% (112/122) of SQ > or = 2 prevalent fractures (kappa = 0.76) and 84% (51/61) of SQ incident fractures (kappa = 0.91). The precision errors of QM vertebral height measurements (baseline versus follow-up) ranged from 2.71 to 2.92%. Nevertheless, excluding the 5719 vertebrae that were clearly normal by morphometry, i.e., within 2 SD of the normal means at both baseline and follow-up, two-thirds (358/556) of the remaining vertebrae changed classification by at least 1 SD category. Visual triage and visual flagging by research assistants appear to be highly effective methods for vertebral fracture assessment in osteoporosis, potentially reducing the number of false-positive and false-negative fractures detected by QM, at least relative to SQ by the radiologists. There is higher concordance among the visual approaches studied than between the visual SQ and quantitative morphometric approaches, with QM having limited ability to detect mild fractures but good ability to detect moderate/severe fractures, as classified by SQ. Use of a combination of sensitive qualitative and quantitative criteria, with adjudication by an experienced radiologist, is feasible and draws upon the relative strengths of each of the methods. Quantitative morphometry should not be performed in isolation, particularly when applying highly sensitive morphometric criteria at low threshold levels, without visual assessment to confirm the detected prevalent or incident vertebral defor

Aged↗
PubMed1996

Treatable and untreatable risk factors for hip fracture.

Treatable risk factors for hip fracture, such as impaired visual acuity or low bone mass, are useful guides to interventions that can substantially reduce an individual's risk of hip fracture. Programs to treat risk factors in populations will have a limited impact on the rates of hip fracture if prevalence of the risk factor is relatively low or the intervention reaches and changes the risk factors of a limited proportion of the population. Even untreatable risk factors, such as a maternal history of a hip fracture, can be useful in making treatment decisions, because they identify women who are likely to derive more benefit from drugs that maintain or increase bone mass.

Aged↗
PubMed1996

Osteoporosis: association of recent fractures with quantitative US findings.

PURPOSE: To study the association of quantitative ultrasound (US) parameters and bone mineral density (BMD) in patients with and patients without recent fractures. MATERIALS AND METHODS: The authors studied 4,698 women (69 years or older) who had sustained 1,363 new fractures, including 106 hip fractures, during the 7 years prior to the study. Broadband ultrasound attenuation (BUA) and other velocity parameters were measured by means of quantitative US of the calcaneus. BMD was measured at the spine, hip, and calcaneus. RESULTS: The standardized age-adjusted odds ratio for all fractures was 1.5 (95% confidence interval [CI] = 1.4, 1.7) for BUA and up to 1.6 (95% CI = 1.5, 1.7) for BMD. For hip fractures, the odds ratio was 1.9 (95% CI = 1.5, 2.4) for BUA and up to 2.6 (95% CI = 2.0,3.4) for BMD. Sensitivity and specificity with BUA, velocity parameters, and BMD were comparable. Results of multivariate analysis showed that both BUA and BMD were independently associated with fractures and that combined measurements improved sensitivity and specificity. CONCLUSION: Quantitative US parameters are strongly associated with risk of fracture and partly independent of BMD. This simple, low-cost, portable, and radiation-free approach may complement bone densitometry in assessing risk of osteoporotic fracture.

Aged↗
PubMed1996

Treatment thresholds for preventive therapy: a simplified example of therapy for prevention of hip fractures.

Physicians intuitively understand that preventive treatments may be worthwhile for patients at very high risk of a disease, but not for those with a very low risk. Somewhere in between lies a probability of the disease, called the "treatment threshold" above which prevention is worthwhile and below which it is not. This essay presents an approach to clinical decision-making based on methods developed for bedside decision analysis. Using a hypothetical example of a treatment to prevent hip fracture, this model demonstrates that the treatment threshold (the probability of fracture above which prevention is cost-effective) decreases as 1) the effectiveness of the treatment increases, 2) the cost of the drug decreases, 3) the cost of physician visits and tests to monitor treatment decreases, 4) the value placed on the fracture (medical costs, death, disability) increases. When sufficient data becomes available, estimates of treatment threshold can be combined with estimates of an individual's risk of fracture to aid clinical decision-making about prevention of fractures.

Cost-Benefit Analysis↗
PubMed1995

Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group.

BACKGROUND: Many risk factors for hip fractures have been suggested but have not been evaluated in a comprehensive prospective study. METHODS: We assessed potential risk factors, including bone mass, in 9516 white women 65 years of age or older who had had no previous hip fracture. We then followed these women at 4-month intervals for an average of 4.1 years to determine the frequency of hip fracture. All reports of hip fractures were validated by review of x-ray films. RESULTS: During the follow-up period, 192 women had first hip fractures not due to motor vehicle accidents. In multivariable age-adjusted analyses, a maternal history of hip fracture doubled the risk of hip fracture (relative risk, 2.0; 95 percent confidence interval, 1.4 to 2.9), and the increase in risk remained significant after adjustment for bone density. Women who had gained weight since the age of 25 had a lower risk. The risk was higher among women who had previous fractures of any type after the age of 50, were tall at the age of 25, rated their own health as fair or poor, had previous hyperthyroidism, had been treated with long-acting benzodiazepines or anticonvulsant drugs, ingested greater amounts of caffeine, or spent four hours a day or less on their feet. Examination findings associated with an increased risk included the inability to rise from a chair without using one's arms, poor depth perception, poor contrast sensitivity, and tachycardia at rest. Low calcaneal bone density was also an independent risk factor. The incidence of hip fracture ranged from 1.1 (95 percent confidence interval, 0.5 to 1.6) per 1,000 woman-years among women with no more than two risk factors and normal calcaneal bone density for their age to 27 (95 percent confidence interval, 20 to 34) per 1,000 woman-years among those with five or more risk factors and bone density in the lowest third for their age. CONCLUSIONS: Women with multiple risk factors and low bone density have an especially high risk of hip fracture. Maintaining body weight, walking for exercise, avoiding long-acting benzodiazepines, minimizing caffeine intake, and treating impaired visual function are among the steps that may decrease the risk.

Aged↗
PubMed1995

Bone mass measurements and risk of fracture in Caucasian women: a review of findings from prospective studies.

Prospective studies have shown that bone mass, measured by any method and at any site, is inversely related to a woman's risk of fracture. Most types of fractures are more frequent in women with low bone mass. Bone mineral density measured in the proximal femur appears to have a stronger relationship to risk of hip fracture than bone density measured in other sites. On the other hand, measurement of bone mass in the spine does not appear to be substantially superior to measurements of bone mass in other sites. Even after age 80, bone mass measurements have a strong predictive value for most types of fracture. A woman's lifetime risk of hip fracture can be estimated from bone mass measurements made in the perimenopausal period. Although an individual's level of bone mass may vary from site to site, the incremental value of measuring bone mass in more than one site is not certain. Bone mass measurements, perhaps in combination with other risk factors for fracture, help define individuals with a high risk of fracture who stand to benefit most from efforts to prevent fractures.

Absorptiometry, Photon↗
PubMed1995

Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group.

BACKGROUND: Muscle strength declines with advancing age; the causes of this are uncertain. In women, strength begins to decline around the time of menopause, suggesting that hormonal changes might influence strength. To determine the effect of postmenopausal estrogen use on muscle strength, neuromuscular function, and the risk of falling, we examined 9704 participants aged 65 years or more enrolled in the Study of Osteoporotic Fractures. METHODS: We measured hip abductor, triceps extensor, and hand-grip muscle strength, balance, gait speed, and self-reported functional disability. Falls during the first year of follow-up were determined from postcards that participants mailed every 4 months indicating whether they had fallen in the previous 4 months (> 99% complete follow-up). RESULTS: After adjusting for age, medications, medical history, and personal habits, current estrogen users did not differ in a clinically meaningful way from those who had never used estrogen on tests of hip abductor strength (mean difference, 0.15 kg; 95% confidence interval, -0.05 to 0.34 kg), triceps extensor strength (0.005 kg; -0.17 to 0.18 kg), or grip strength (0.30 kg; 0.00 to 0.59 kg). Gait speed, time to stand five times from a chair, balance, self-reported disability, and incidence of falls (odds ratio, 1.12; 95% confidence interval, 0.87 to 1.44) also did not differ between current users and never users. In addition, current users were similar to past users on all measures. CONCLUSION: We found no evidence that postmenopausal estrogen use has beneficial effects on muscle strength or neuromuscular function or that it reduces the risk of falling.

Accidental Falls↗
PubMed1995

Estrogen replacement therapy and fractures in older women. Study of Osteoporotic Fractures Research Group.

OBJECTIVE: To determine the relation between estrogen replacement therapy and fractures. DESIGN: Prospective cohort study. SETTING: Four clinical centers in Baltimore County, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, Pennsylvania. PARTICIPANTS: 9704 ambulatory, nonblack women 65 years of age or older. MEASUREMENTS: Estrogen use, medical history, and anthropometric data were obtained by questionnaire, interview, and examination. Appendicular bone mass was measured by single-photon absorptiometry. Incident fractures were validated by radiographic report. RESULTS: After adjustment for potential confounders, current estrogen use was associated with a decrease in the risk for wrist fractures (relative risk [RR], 0.39; 95% CI, 0.24 to 0.64) and for all nonspinal fractures (RR, 0.66; CI, 0.54 to 0.80) when compared with no estrogen use. Results were similar for women using unopposed estrogen or estrogen plus progestin, for women younger or older than 75 years of age, and for current smokers or nonsmokers. The effect of estrogen remained after adjustment was made for appendicular bone mass. The relative risk for hip fracture tended to be lower among current users (RR, 0.60; CI, 0.36 to 1.02) than among never-users. Estrogen was most effective in preventing hip fracture among those older than 75 years. Current users who started estrogen within 5 years of menopause had a decreased risk for hip fractures (RR, 0.29; CI, 0.09 to 0.92), wrist fractures (RR, 0.29; CI, 0.13 to 0.68), and all nonspinal fractures (RR, 0.50; CI, 0.36 to 0.70) when compared with women who had never used estrogen. Previous use of estrogen for more than 10 years or use begun soon after menopause had no substantial effect on the risk for fractures. CONCLUSIONS: Current use of estrogen appears to decrease the risk for fracture in older women. These results suggest that for protection against fractures, estrogen should be initiated soon after menopause and continued indefinitely.

Age Factors↗
PubMed1995

Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group.

OBJECTIVE: To examine the cross-sectional association between radiographic features of hip osteoarthritis (OA) and bone mineral density (BMD) of the hip, spine, and appendicular skeleton among Caucasian women ages 65 and older who were participating in the Study of Osteoporotic Fractures. METHODS: Pelvis radiographs of 4,855 subjects were assessed for individual radiographic features of hip OA: osteophytes, joint space narrowing, subchondral sclerosis, cysts, and femoral head deformity. Hips were graded on a summary scale of 0 (no OA) to 4 (severe OA) based on the number of radiographic features present. Appendicular BMD was measured in all subjects, and hip and spine BMD in 84% of the group. We used linear regression to examine the association of BMD with hip OA, and to adjust for age, weight, and other determinants of bone mass. RESULTS: Three hundred fifty-one women (7.2%) had mild (grade 2) and 228 (4.7%) had moderate to severe (grade 3-4) radiographic evidence of hip OA. Women with grade 3-4 hip OA had a higher age-adjusted BMD at the femoral neck and Ward's triangle (9-10%; P < 0.0001), trochanter (4%; P < 0.01), lumbar spine (8%; P < 0.0001), and distal radius and calcaneus (5%; P < 0.0001 [for each comparison]) compared with those with grade 0-1 OA in the worse hip. Elevations in BMD were greatest in the femoral neck of hips with OA, in women with bilateral hip OA, and in women with hip osteophytes. These findings were essentially unchanged by adjustment for determinants of bone mass. CONCLUSION: Elderly Caucasian women with moderate to severe radiographic hip OA had higher BMD in the hip, spine, and appendicular skeleton than did women without hip OA. Our findings are consistent with a role of elevated BMD in the pathogenesis of hip OA.

Aged↗
PubMed1995

Rheumatoid arthritis and bone mineral density in elderly women. The Study of Osteoporotic Fractures Research Group.

Previous studies have suggested that women with rheumatoid arthritis (RA) have decreased bone mineral density (BMD) in both the appendicular and axial skeleton. The purpose of this investigation was to determine the association of RA and BMD from a community-based sample of ambulatory Caucasian women age 65 and over. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine and by single photon absorptiometry (SPA) at the distal radius and calcaneus. Study subjects included 120 postmenopausal women with RA who were further classified according to corticosteroid use, i.e., never users, current users, and ex-users, and 7966 age-similar controls. Elderly women with RA had a lower age-adjusted bone density of the distal radius, calcaneus, hip, and lumbar spine. Women with RA who were current users of steroids had the lowest BMD at both appendicular sites and at the hip, but those who never used steroids also had a significantly decreased BMD at all sites. The BMD of women with RA who had never used steroids remained significantly decreased at the distal radius, calcaneus, and hip after adjustment for age, BMD determinants, and functional outcomes of RA. Functional outcomes of RA largely accounted for the lower BMD of women who were currently using steroids. Women with RA have lower appendicular and axial bone mass that is not attributable to the use of steroids. Those currently taking steroids have even lower appendicular and axial bone mass that may reflect their poorer functional outcome and is likely to increase the risk of fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗