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PubMed1993

Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis.

Since magnesium regulates calcium transport, and magnesium replacement in magnesium-deficient postmenopausal patients resulted in unexpected improvement in documented osteoporosis, we investigated the effect of magnesium treatment on trabecular bone density in postmenopausal osteoporosis. Thirty-one postmenopausal patients (mean age +/- SD = 57.6 +/- 10.6 years), consecutively admitted to the Back Rehabilitation Unit with musculoskeletal pain of non-malignant origin and bone density values of < or = 1.19 g/cm3 (measured by Compton Bone Densitometer), received two to six tablets daily of 125 mg each of magnesium hydroxide (Magnesium Magma USP/; 'Mazor', Israel) for 6 months and two tablets for another 18 months in a 2 year, open, controlled therapeutic trial. Twenty-three symptom-free postmenopausal women (mean +/- SD = 61.2 +/- 6.2 years) whose bone density was concurrently assessed at the same laboratory and who were found to have osteoporosis but refused treatment, served as controls. No new fractures occurred. Twenty-two patients (71 per cent) responded by a 1-8 per cent rise of bone density. The mean bone density of all treated patients increased significantly after 1 year (P < 0.02) and remained unchanged after 2 years (P > 0.05). The mean bone density of the responders increased significantly both after one year (P < 0.001) and after 2 years (P < 0.02), while in untreated controls, the mean bone density decreased significantly (P < 0.001). The disparity between the initial mean bone density and bone density after one year in all osteoporotic patients and in the responders differed significantly from that of the controls (both P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Density↗
PubMed1990

Bone density in eumenorrheic female college athletes.

Information is limited on the effect of exercise on bone density in young eumenorrheic athletes. We studied 12 Caucasian intercollegiate volleyball players (V), nine basketball players (B), ten swimmers (S), and 13 non-athletes (N) with bone density measurements by photon absorptiometry of their calcaneus and lumbar spine (L2-L4). The effect of athletic status on bone density was analyzed by multivariate analysis of covariance, with height and weight as covariates. The bone densities reported below are mean +/- SE, adjusted for the covariates; units = g.cm-2, P less than 0.005. The swimmers had a significantly lower mean density in the lumbar spine than all other groups; the non-athletes' mean density was also lower than that of volleyball players (V = 1.31 +/- 0.03, B = 1.26 +/- 0.04, N = 1.18 +/- 0.03, S = 1.05 +/- 0.03). The volleyball and basketball players' mean calcaneal densities were greater than those of the swimmers and non-athletes (V = 0.530 +/- 0.017, B = 0.564 +/- 0.023, N = 0.438 +/- 0.018, S = 0.375 +/- 0.019). The higher bone densities for athletes in vertical weight-bearing activities are consistent with some but not all published data. The swimmers' low bone density in the lumbar spine, less than published values for amenorrheic runners, was unexpected.

Absorptiometry, Photon↗
PubMed1990

A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women.

Background. The effectiveness of calcium in retarding bone loss in older postmenopausal women is unclear. Earlier work suggested that the women who were most likely to benefit from calcium supplementation were those with low calcium intakes. Methods. We undertook a double-blind, placebo-controlled, randomized trial to determine the effect of calcium on bone loss from the spine, femoral neck, and radius in 301 healthy postmenopausal women, half of whom had a calcium intake lower than 400 mg per day and half an intake of 400 to 650 mg per day. The women received placebo or either calcium carbonate or calcium citrate malate (500 mg of calcium per day) for two years. Results. In women who had undergone menopause five or fewer years earlier, bone loss from the spine was rapid and was not affected by supplementation with calcium. Among the women who had been postmenopausal for six years or more and who were given placebo, bone loss was less rapid in the group with the higher dietary calcium intake. In those with the lower calcium intake, calcium citrate malate prevented bone loss during the two years of the study; its effect was significantly different from that of placebo (P less than 0.05) at the femoral neck (mean change in bone density [+/- SE], 0.87 +/- 1.01 percent vs. -2.11 +/- 0.93 percent), radius (1.05 +/- 0.75 percent vs. -2.33 +/- 0.72 percent), and spine (-0.38 +/- 0.82 percent vs. -2.85 +/- 0.77 percent). Calcium carbonate maintained bone density at the femoral neck (mean change in bone density, 0.08 +/- 0.98 percent) and radius (0.24 +/- 0.70 percent) but not the spine (-2.54 +/- 0.85 percent). Among the women who had been postmenopausal for six years or more and who had the higher calcium intake, those in all three treatment groups maintained bone density at the hip and radius and lost bone from the spine. Conclusions. Healthy older postmenopausal women with a daily calcium intake of less than 400 mg can significantly reduce bone loss by increasing their calcium intake to 800 mg per day. At the dose we tested, supplementation with calcium citrate malate was more effective than supplementation with calcium carbonate.

Administration, Oral↗
PubMed1993

The association of obesity and glucose and insulin concentrations with bone density in premenopausal and postmenopausal women.

Obese subjects have increased bone density relative to non-obese subjects, yet this relationship is not fully understood. We examined whether alterations in glucose or insulin concentrations might explain the effect of obesity on bone density in 317 women from the San Antonio Heart Study, a population-based study of diabetes. We measured fasting and 2-hour plasma glucose and fasting and 2-hour serum insulin levels. Bone density was assessed by a Hologic dual-photon absorptiometer. Lumbar spine and femoral neck density were positively correlated with body mass index (BMI). Femoral neck density also was positively correlated with fasting insulin level in younger women after adjustment for age (r = .214, P < .01). After further adjustment for BMI, femoral neck density was not significantly correlated with fasting insulin level (P = .08). The magnitude of the estimated femoral neck density difference for a 32.2-microU/mL decrease in fasting insulin level (the difference in insulin concentrations between nondiabetics and diabetics) was 0.13 g/cm2. Adjustment for glucose and insulin concentrations does not explain the association between bone density and obesity.

Adult↗
PubMed1999

Pregnancy-related back and pelvic pain and changes in bone density.

OBJECTIVE: To elucidate whether there is an association between pregnancy-related back and pelvic pain and changes in bone density. METHODS: In this prospective cohort study, bone density was measured in the distal and ultra-distal forearm at 12 and 35 weeks of pregnancy and at 5 months post partum. The location and degree of any back or pelvic pain was registered. The patients were classified into four subgroups on the basis of presence or absence of disabling pain in late pregnancy and presence or absence of pain at 5 months' follow-up. Forty-nine women participated. RESULTS: Bone density decreases during pregnancy and lactation. Trabecular bone is mainly lost during pregnancy and cortical bone during lactation. No association between back or pelvic pain during pregnancy and bone loss was found. Between 35 weeks of pregnancy and 5 months post partum, bone loss in all the women was estimated as 1.1% of cortical bone (p < 0.001) and 0.6% of trabecular bone (n.s.). During the same period five women with mild pain during pregnancy and pain at follow-up lost 3.9% of cortical bone (p=0.043) and 5.3% of trabecular bone (p=0.043). Although this bone loss was significant compared to the other subgroups, the small study size does not permit general conclusions to be drawn from this finding. CONCLUSION: The results indicate that bone density decreases during pregnancy and lactation. The decrease in bone density was not associated with back or pelvic pain during pregnancy. It remains unclear whether bone loss is associated with back and pelvic pain during lactation.

Absorptiometry, Photon↗
PubMed1990

Interaction of genetic and environmental influences on peak bone density.

Risk of osteoporotic fracture in later life relates to both age and menopause-related bone loss but also to peak bone density achieved in early adulthood. Several studies have shown that genetic influences make a major contribution to variance in adult bone density, but environmental factors such as dietary calcium and physical activity also contribute a large proportion of observed variance in bone density. Previous hypotheses have suggested that the effect of certain environmental factors, such as hormonal and dietary influences, may be permissive to development of peak bone mass. Consideration of the evidence for the interaction between environmental influences, such as physical activity and nutrition, and genotype leads us to propose that environmental factors interact to allow or prevent full expression of bone density genotype. This expansion of the 'threshold' hypothesis can include the effects of sex, physical activity and dietary calcium in a model that allows more systematic study of the determinants of peak bone density and thereby more rational intervention to augment bone density in early adulthood.

Bone Density↗
PubMed2002

Quantitative trait loci for bone density in mice: the genes determining total skeletal density and femur density show little overlap in F2 mice.

Bone mineral density variation is a highly heritable trait and is the best predictor of skeletal fragility. Total skeletal density was determined by PIXIMUS, and femur density was determined by pQCT. The data were analyzed for quantitative trait loci (QTL) to determine if bone density at a specific skeletal site (femur) would identify new gene loci or the same gene loci as total body (PIXIMUS). In order to show concordance and differences in QTL for total body bone density versus femur bone density, we performed a genome-wide scan from 633 (MRL x SJL) F2 mice. The bone mineral density (BMD) data from pQCT were used to identify nine QTL on chromosomes 1, 3, 4, 9, 12, 17, and 18, while nine QTL on chromosomes 1, 2, 4, 9, 11, 14, and 15 were identified by PIXIMUSdata, accounting for 32.5% and 30.4% variation in F2 mice, respectively. QTL on chromosomes 1, 2, 3, 9, 11, 12, 14, 15, 17, and 18 are unique to our study, as they have never been described before. Chromosome 1 (D1Mit33 and D1Mit362) had similar QTL between pQCT and PIXIMUS. Several QTL were identified for both femur and total body BMD but only two QTL were common for both of these phenotypes. This suggests that genes regulating bone density differ depending on the skeletal site analyzed.

Animals↗
PubMed1989

Determinants of bone density among athletes engaged in weight-bearing and non-weight-bearing activity.

To identify the factors associated with greater bone density among athletic individuals, we recruited three distinct groups of young male subjects. Twenty were nationally ranked water polo players, 19 were engaged in weight-training programs, and 20 subjects comprised a nonexercising comparison group. All participants had measurements of spinal trabecular and integral bone density by quantitative computed tomography as well as a determination of hip bone density by dual photon absorptiometry. A series of potential predictor variables included maximal O2 uptake, back strength, leg strength, total kilocalories expended per day, body mass index, paraspinous muscle cross-sectional area, percent body fat, daily calcium intake, and age. We found no significant differences for any of the bone density measures between the two groups of athletic subjects, whereas bone density was generally significantly lower among the nonexercisers compared with either exercise group. Correlation analysis found only weak and somewhat inconsistent relationships when each of the subgroups was examined separately; however, when all subjects were assessed collectively, many more correlations reached significance. Paraspinous muscular area was found to be most robust in this regard, being significantly correlated with all three bone density measures (r = 0.33-0.55). By using step-wise regression analysis in each subgroup, we observed a consistent significant contribution (R2 = 0.18-0.44) of paraspinous muscle area to the variability in bone density at the spine and the hip. When the data of all three subgroups were pooled, regression analysis reconfirmed the importance of the muscle parameter (R2 = 0.06-0.27) to bone density variation, but more importantly it showed that differentiation based on exercise status was most significant (R2 = 0.18-0.22).

Adolescent↗
PubMed2006

[Assessment of bone density in children and adolescents by quantitative CT of one lumbar vertebra only].

AIM: The aim of this study was to determine whether measuring the trabecular bone density in one lumbar vertebra (L) instead of three has an effect on the assessment of bone density in children. MATERIALS AND METHODS: Bone density was measured in 70 patients (38 male, 32 female), ages 1 to 22 years (mean age 12.4, median 13 years) using a Somatom Balance Scanner (Siemens). The trabecular bone density was measured (1-cm slice, 80 kV, 81 mAs) in L1 through L3. RESULTS: The mean bone density in the lumbar vertebrae was 139.9 mg/ml calcium-hydroxylapatite per ml bone in L1, 133.9 in L2, and 131.7 in L3, and the mean of all three vertebrae was 135.2 mg/ml. Measurements in L1 were 4.7 mg/ml (standard deviation [SD] 4.7 mg/ml) above the mean value of the three upper lumbar vertebrae. The density in L2 was 1.3 mg/ml below the mean (SD 3.1 mg/ml). On average, L3 was 3.5 mg/ml below the mean (SD 4.6 mg/ml). This minor systematic deviation in the measurement values for the individual vertebrae from the mean value was so low that there was no statistical evidence for a deviation from an ideal regression line. CONCLUSIONS: When using an adequate technique, especially accurate analysis of the topogram (scout view) and the tomogram, measurement of the bone density of one lumbar vertebra provides satisfactory information regarding the trabecular bone density in children, but the values differ in the three upper lumbar vertebrae. The bone density of L2 is close to the mean of the upper three vertebrae. In the case of pathologic values or a pathologic trabecular pattern, three vertebrae should be measured.

Absorptiometry, Photon↗
PubMed1996

A review of residual ridge resorption and bone density.

Residual ridge resorption is a common and often incapacitating problem, particularly for persons with edentulous mandibles. Several studies suggest a correlation between ridge resorption and osteoporosis. Recent radiologic studies indicate that the mineral density of the cortex and the bone mass in the mandible are correlated with skeletal bone density. Most resorption occurs in the alveolar process, whereas the basal portion remains relatively intact. On the other hand, radiologic measurements of bone density primarily yield information after the basal portion, where the bone mass of the mandible is greatest and functional stresses of mastication may affect bone density. Ironically, radiologic measurements may not accurately indicate the effect of osteoporosis on alveolar resorption. Apparently, excessive occlusal force can also produce extensive atrophy without systemic impact. Not until muscular function decreases does real osteoporosis develop in edentulous jaws. Not only does the volume of the ridge decrease, but also the density of the basal portion decreases as a result of diminished function. This article reviews the literature on residual ridge resorption and components that may affect the rate of resorption.

Aged↗
PubMed1996

Bone density and shape as determinants of bone strength in IGF-I and/or pamidronate-treated ovariectomized rats.

Areal bone mineral density (BMD) is a major determinant of bone strength and thereby of fracture risk. Other factors including trabecular microarchitecture and bone dimensions also contribute to bone strength. To investigate the relative importance for bone strength of BMD and bone dimensions, the relations between strength and the latter variables were evaluated under different experimental conditions in ovariectomized rats. Bone strength was assessed in compression and bending with measurement of BMD by dual-energy X-ray absorptiometry. Interventions were designed to increase trabecular BMD in rats with estrogen deficiency-induced bone loss (OVX) by treatment with pamidronate, an inhibitor of bone resorption, or to modify bone dimensions, particularly diameter, by administration of the growth factor IGF-I. In OVX rats, pamidronate treatment increased BMD with a commensurate increase in bone strength at the level of lumbar vertebrae and femoral neck (r = 0.789, p < 0.0001 and r = 0.535, p < 0.001, respectively). IGF-I increased the external diameter of midshaft tibia and femoral neck, which also correlated with bone strength (r = 0.678,p < 0.0001 and r = 0.507,p < 0.0002, respectively). Thus, both bone dimensions and BMD contributed to the determination of bone strength. In conclusion, adult rats with estrogen deficiency-induced bone loss represent a useful experimental model for investigating bone strength and its determinants such as BMD and external bone dimensions.

Absorptiometry, Photon↗
PubMed1992

Peripheral bone density in women with untreated multinodular goitre.

OBJECTIVES: We wished to determine whether women with multinodular goitre and spontaneous subclinical hyperthyroidism have decreased bone density. DESIGN AND SUBJECTS: Bone density was measured at the distal and proximal forearm. Data were expressed as Z-scores relative to the mean values out of 125 control subjects matched for age and menopause. The Z-scores of 23 women with subclinical hyperthyroid goitre (TSH < 0.1 mU/l and normal values for FT4 and total T3) and of 54 women with euthyroid goitre were compared. MEASUREMENTS: Bone density was measured by single photon absorptiometry. TSH was measured by IRMA, FT4 by RIA. RESULTS: Relative to the euthyroid goitre subjects the mean +/- SEM Z-scores of both the distal and proximal forearm density were lower (-0.69 +/- 0.17 vs -0.1 +/- 0.18, P < 0.05 and -0.5 +/- 0.18 vs 0.07 +/- 0.18, P < 0.05, respectively). Median (range) FT4 in the subclinical hyperthyroid goitre subjects was significantly higher than euthyroid goitre subjects (15.6 (11-23.2) pmol/l vs 11.9 (8.3-18.3) pmol/l, P < 0.001) although still within the normal range. FT4 correlated inversely with Z-scores of both distal and proximal forearm bone density in the subjects with subclinical hyperthyroidism (r = -0.42, P < 0.05 and r = -0.43, P < 0.05, respectively), but not in the euthyroid goitre subjects. CONCLUSION: These findings indicate that women with untreated multinodular goitre and subclinical hyperthyroidism have reduced bone density in the forearm.

Adult↗
PubMed1996

The relative importance of vertebral bone density and disc degeneration in spinal flexibility and interbody implant performance. An in vitro study.

STUDY DESIGN: An in vitro biomechanical investigation in the human lumbar spine focuses on the functional significance of vertebral bone density and intervertebral disc degenerations. OBJECTIVE: To determine that interrelationship between vertebral bone density and intervertebral disc degeneration, their effect on normal spine motion, and their significance in the biotechnical performance of interbody fixation techniques. SUMMARY OF BACKGROUND DATA: A relationship between vertebral bone density and intervertebral disc degeneration has been suggested, but a definitive relationship has not been established. The effect of vertebral bone density and intervertebral disc degeneration on interbody stabilization remains unknown despite the rapidly increasing use of this surgical method for patients with chronic low back pain. METHODS: The vertebral bone density and intervertebral disc degeneration of 72 functional spinal units were determined using dual energy x-ray absorptiometry scans and macroscopic grading, respectively. A three-dimensional flexibility test was performed on 24 functional spinal units in the intact and stabilised conditions. The compressive behavior of the bone-implant interface was evaluated in 48 functional spinal units. RESULTS: The vertebral bone density in moderately degenerated disc was significantly lower than at all other levels of intervertebral disc degeneration. Increasing intervertebral disc degeneration resulted in more axial rotation and less lateral bending. In flexion-extension and lateral bending, better vertebral bone resulted in significantly better stabilization. This trend was observed also in axial compression in which higher failure loads were observed with greater bone densities. CONCLUSION: The authors conclude a significant relationship exists between bone density and disc degeneration, bone density is a highly important factor in the performance of interbody stabilization, and disc degeneration, is of moderate importance in signal motion.

Biomechanical Phenomena↗
PubMed1983

A new method of measuring bone density in the lower tibia of normal and postinjury limbs. A quantitative and comparative study.

In osteoporosis, a pathologic state of diminution of bone mass, radiography is the most widely used diagnostic method, but it is only descriptive and mainly depicts changes in the compacta. Based on the Compton photon-scattering phenomenon, a noninvasive yet quantitative measuring method for analyzing bone density was developed. The values of repeated measurements taken at identical locations did not vary by more than 2%. Using this technique, bone density of the lower tibia was measured in 39 men and 36 women; 14 had been affected by an injury to a knee or calf and immobilized five to eight years prior to this investigation. The measured values demonstrated an impressive equality between the tibiae of each individual and between the two sexes up to 50 years of age. However, these values correlated poorly with the bone density of the distal radius. In women older than 50 years of age, bone density decreased. Bone density was also low in all postinjury limbs. When compared with radiographic and bone mineral content (BMC) measurements of the same limb at the same location, the bone density measurements were useful and reduced the range of uncertainty of diagnosing osteoporosis by radiography only. Little or no correlation was found between bone density values and BMC measurements. The Compton scattering technique may become a precise and sensitive method for the clinical diagnosis of postinjury osteoporosis and quantitation of the long-term effects of limb injuries.

Adolescent↗
PubMed1996

Radial cortical and trabecular bone densities of men and women standardized with the European Forearm Phantom.

We previously showed that it is possible to cross-calibrate peripheral bone densitometers using the European Spine Phantom (ESP). We have now performed a multinational study of cross-calibrated radius bone density based on normal subjects of both sexes in eight European centers. Six centers were equipped with machines made by Scanco or Stratec for determining distal radial trabecular bone density by quantitative computed tomography (QCT) and two were equipped with Lunar SP2 single photon absorptiometry (SPA) equipment for measuring midshaft cortical bone density. Subjects recruited ranged from 20 to over 80 years of age. Over one hundred and fifteen men were studied by QCT and a different cohort of 104 men were studied with SPA; the equivalent figures for women were 235 and 123. Reference ranges were derived for bone density against age for each of the four groups, and their applicability is discussed in relation to between-center differences in the results obtained. There were insignificant differences (P > 0.05 with Bonferroni correction) between centers in the values obtained by QCT in the different populations. However, there were considerably larger and highly statistically significant differences between midshaft cortical bone density values of about 10% of overall means between subjects from eastern Finland and central Belgium (P < 0.001), with higher Finnish values. Women had considerably lower radial trabecular bone density values than men at all ages, a result that differentiates the radius from the spine. This sex difference widened after menopause. These results have important implications for understanding the contribution of bone density to the differential risk of Colles' fracture in the two sexes and suggest that further work is needed to establish young normal reference ranges for radial bone density in Europe.

Absorptiometry, Photon↗
PubMed1999

The effect of calcium citrate on bone density in the early and mid-postmenopausal period: a randomized placebo-controlled study.

This placebo-controlled randomized trial was conducted to ascertain the value of calcium citrate supplementation in averting bone loss in 63 postmenopausal women, 57 of whom were early postmenopausal (five years after menopause) and six of whom were mid-postmenopausal (five to ten years after menopause). Bone density data were available for 25 women who took 800 mg of calcium citrate daily and 31 women who received placebo for one to two years. The two groups were similar in baseline age, years postmenopause (3.3 in the calcium citrate group vs 2.7 in the placebo group), height, weight, calcium intake, and L2-L4 bone density. L2-L4 bone density did not change during calcium citrate treatment (+ 1.03% after two years), whereas it declined significantly by -2.38% after two years on placebo (P < .001). Femoral neck bone density did not change in either group. Radial shaft bone density did not change in the calcium citrate group (-0.02% after two years), but it declined significantly in the placebo group (-1.79% after one year and -3.03% after two years, P < .01). The difference in bone density of the L2-L4 vertebrae and radial shaft after two years of treatment was significant between the two groups. An analysis of covariance disclosed no significant effect of calcium citrate on L2-L4 bone density during the first three years after menopause, but a protective effect after three years. Although serum PTH did not change, serum and urinary calcium increased and serum calcitriol and urinary phosphorus decreased in the calcium citrate group, indicative of parathyroid suppression. Serum bone-specific alkaline phosphatase and osteocalcin, and urinary hydroxyproline and N-telopeptide decreased during some calcium citrate treatment periods, indicative of a reduction in bone turnover. Thus, calcium citrate supplementation (400 mg of calcium twice daily) averted bone loss and stabilized bone density in the spine, femoral neck, and radial shaft in women relatively soon after menopause. This bone-sparing action was probably due to the inhibition of bone resorption from parathyroid suppression.

Bone Density↗
PubMed1993

Lack of association between free testosterone and bone density separate from age in elderly males.

It is unclear what proportion of the variance in bone density in elderly males is accounted for by testosterone status. We studied 112 ambulatory, elderly volunteers (mean age 71.7 years) and determined free testosterone (FT), as well as bone density measurements by photon absorptiometry at multiple sites. Our studies of 35 of these subjects 4 years later included morning FT and dual energy X-ray absorptiometry. There were no significant correlations between FT and bone density at multiple scanning sites with the effects of age partialed out. We suspect that our inability to detect a significant effect of FT on bone density was related to the relative strength of other determinants of bone density, as well as to the fact that FT values are far more dynamic than bone density.

Absorptiometry, Photon↗
PubMed1997

Influence of inhaled corticosteroids and dietary intake on bone density and metabolism in patients with moderate to severe asthma.

OBJECTIVES: Compare the effect of high doses of inhaled corticosteroids on bone loss in subjects with moderate to severe asthma or mild asthma, and examine the influence of dietary intake on bone metabolism. DESIGN: A survey on the effects of corticotherapy and nutrition on bone density was conducted in 74 subjects currently being treated for asthma in the asthma clinic of Hôpital Laval (Sainte-Foy, Quebec, Canada). Fifty-eight subjects completed the study (attrition rate = 15%). MAIN OUTCOME MEASURES: In all subjects expiratory volumes were determined and urinary analysis was conducted for hydroxyproline, calcium, phosphorus, and cortisol levels. Osteocalcin, calcium, phosphorus, cortisol, alkaline phosphatase, and gamma-glutamyltransferase levels were measured in blood samples. Bone density of the lumbar spine was determined by means of dual-energy x-ray absorptiometry. Nutrition evaluation was based on a 3-day food diary analyzed using progiciel Nutri 91. The nutritional parameters examined were calcium; phosphorus; magnesium; zinc; vitamins A, C, and D; protein; total fiber; oxalates; energy; caffeine; and alcohol in relation to bone density. SUBJECTS: Thirty-one patients with moderate to severe asthma who had been taking more than 1,000 micrograms beclomethasone per day or the equivalent for more than 2 years and 27 patients with mild asthma who were taking less than 500 micrograms beclomethasone per day or the equivalent. STATISTICAL ANALYSES PERFORMED: Four-factor analysis of variance with hierarchized interactions of four levels, Duncan's test, Pearson correlation coefficients. RESULTS: Blood levels of osteocalcin and protein intake were lower in patients with moderate to severe asthma than in those with mild asthma (P < .05). Significant correlations (P < .02) were observed between bone density and calcium intake (r = .40), phosphorus intake (r = .35), protein intake (r = .30), and serum alkaline phosphatase level (r = -.30). Bone density was not significantly different between the two groups of patients with asthma. APPLICATIONS: A follow-up of patients with asthma who are taking inhaled corticosteroids is needed to assess bone density, osteocalcin levels, and dietary intakes of calcium. Verify if osteocalcin level decreases over time in patients with moderate to severe asthma, monitor possible modifications in bone density, and verify if the correlation between dietary calcium and bone density is maintained.

Absorptiometry, Photon↗