RECTAL SALMON CALCITONIN FOR POSTMENOPAUSAL OSTEOPOROSIS.K.Overcaard. M.A.Hansen, C.Christiansen. K.Overgaard). Department of (Intr. by Clinical Chemistry, Clostrup Hospital, University of Copenhagen, Glostrup, Denmark. We examined the effect of a l-year treatment with rectal salmon calcitonin (sCT) on bone and calcium metabolism in 36 elderly women with a moderate degree of osteoporosis. The treatment period was preceded by an observation period of one year. Twenty-five women fulfilled the a-year period. During the observation period a significant bone loss of 1.5% was seen in the forearm (~~0.01) whereas the spinal bone mass was virtually unchanged. After institution of treatment with rectal sCT 100 IU and calcium 500 mg daily, the bone loss was prevented in the forearm and a sianificant increase of about 2% was seen in the suine a (PCO.01). The net effect of. treatment reveal& positive outcome in both bone chmpartments: +1.86% (SE 0.75) in the forearm (p-zO.05). +2.88% (SE 1.03) in the seine (~~0.01). Furthermore, the women, who had lost m&e tdan 3% during tne observation period, had a net positive effect in the forearm of 2.1% (SEMf0.56) during treatment. This was significantly different from the response in the wom~fwith_oalb$oneloss less tha;pi; ;:;h ISEM20.4) . . . mean resoonse Correspondingly, the parameters of bone t&no& (se&m alkaline phoephataae, plasma bone Gla protein, and fasting urinary hydroxyproline/creatinine) revealed no changes during the observation period but significant declines of LO-258 during sCT treatment (p
IS HERITABILITY A RISK FACTOR FOR POSTMENOPAUSAL OSTEOPOROSIS? M.A.Hansen. K.Overoaard. C.Christiansen. (Intr. by M.A.Hansen). Department of Clinical Chemistry, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. We investigated heritability as a risk factor for the development of osteoporosis in two randomly selected populations of postmenopausal women and their premenopausal daughters. We determined the fadnilial resemblance in bone mass at three sites; the distal forearm, lumbar spine and proximal femur, premenopausally and prospectively with increasing maternal postmenopausal age. We also examined the bone mass of daughters in relation to mothers with and without ost?ooorotic fractures. Peak bone mass- among premenopausal siblings was significantly zorrelateciatall sites (r=O.30 to ;=0.42, pco.oo1). The same levels of resemblance were found between. postmenopausal mothers and premenopausal daughters, although the relation of the forearm tended to decline when the maternal menopausal age was about 21 years. There was no significant difference in bone mass at any skeletal site between daughters of women with either peripheral or spinal fractures. and dauohters I ~~~ of ~~ women withoit fracturei. We also examined familial resemblance with four K;;:;;ica;n;arkers of bone turn;;;; (fasting urinary hydroxyproline, corrected for creatinine, serum alkaline phosphatase, and plasma Bone Gla protei?). A scnerallv sianificant resemblance were seenin premenopausal _ sibiings (rmo.25 to 0.39, hydroxyproline = NS), but not between premenopausal daughters and pustmenopausal mothers. Neither were filial biochemical ma:.kers of bone turnover related to the maternal rate cf postmenopausal hone loss over 12 years, or fracture starus. We co-elude that peak bone mass is nereditary in the distal forearm, lumbar spine and proximal femur but the mother/daughter resemblance only explnlns about 16% of the variability ir. daughters bone o.ass. Furthermore, daughters of wxnen with osteoparotic fractures are not substantially at an increased risk of having a low peak bone mass when compared to the daughters of women without fractures.
314 ASSESSMENT OF SKELETAL STATUS IN OSTEOPOROSIS: ASSOCIATION OF ULTRASOUND, SINGLE X-RAY ABSORPTIOMETRY.WEIGHT, AND AGE C-C, Gliier. M. Vahlensieck. K. Enee ke. . G. Fau kne . H. , Sienant Osteoporosis Research Group,‘DepErtment od Raiiologt, University of California. San Francisco, USA This study was carried out to assess the associations of Broadband Ultrasound Attenuation (BUA) measurements of the calcaneus with bone mineral density, weight and age. 42 female subjects (age 20 to 75, mean 49.9) covering a wide range of calcrneal bone mineral density (-298 to .724 dcm2; mean ,485 p&m?) and weight (100 to 232 Ibs; mean 146 Ibs) were recruited. Duplicate BUA measurements were obtained on a Walker Sonix UBA 575 and Single X-ray Absorptiometry (SXA) was measured on an Osteo OsteoAnalyzer. Uni- and multivariate regression analysis was performed todetermine the association of BUA, SXA, weight and age. Reproducibility of BUA was 1.76 dB/MHz or 2.12%. Regression of BUA vs. SXA was r=.77 (pcO.Ol), SEE=l0.36 dB/MHz, and CV=13.17%; BUA vs. agle yielded r=.64 (p
315 A QUESTIONNAIRE TO ASSESS QUALITY OF LIFE IN WOMEN WITH VERTEBRAL FRACTURES DUE TO OSTEOPOROSIS. J Clifton. DJ Cook. JD Adachi. Cl-1 Guyntt. E Juniper. St. Joseph’s Nospital, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada. The use of existing non-specific back pain questionnaires in wonlen with osteoporotic vertebral fractures may be invalid and rewlt in an inability of the questionnaire to detect change over time. We therefore developed a questionnaire for clinical trials that esnmines disease-related functional status in post-menopausal women with vertebral fractures due to osteoporosis. We used the methotlologic framework for developing instruments evaluating quality uf life. Females with osteoporotic vertebral fractures and back pain, health workers and the literature were used to generate potential items for the questionnaire. In the item reduction phase, we retained only those items endorsed as the most important or frequent by a sample of 100 women from the population of interest. The queslionn:lirc pretesting resulted in minor modifications. The Osteoporosis Quality of Life Questionnaire (OQLQ) inch&h 30 items grouped into five domains: symptoms, emotions, physical function, activities of daily living and leisure/social activities. All response options are presented using seven point scales, ranging from “extremely important” to “not at all important”. Osteoporosis is a common condition causing considemhle clisahili:~ and suffering, especially in patients with back pain the to vcrlchral This disease-specfic health-related qunli~y of lift fractures. instrument will be useful to future zlinicians anti rcscarchfrs ill osteoporosis.