- Email: [email protected]
Vitamin D deficiency is highly prevalent in patients attending a falls and osteoporosis clinic
Abstracts / Bone 47 (2010) S72–S241
mortality and one-to-five year mortality rate showed no significant difference among four groups (p > 0.05). Interestingly, the second hip fracture produced a highest hazard ratio (HR) of developing a mortality was 7.98 (95% confidence interval [CI], 2.2-28.8) which was significantly higher than others. Discussion: The actual survivorship of initial hip fracture patients with second hip or other subsequent fracture were not different from patients who have only one hip fracture. However, patients with second hip fracture who had the highest hazard ratio should obtain special focus with meticulous care. Disclosure of Interest: None declared Keywords: survival, second hip fracture, major long bone fracture of extremity, vertebral body fracture doi:10.1016/j.bone.2010.04.398
PP263 Vitamin D deficiency is highly prevalent in patients attending a falls and osteoporosis clinic J.G. Browne1,⁎, F.O Connell1, K. Fitzgerald1, M. Healy2, V. Crowley2, M.C. Casey1, J. Walsh1 1 Bone Health and Osteoporosis Unit, MIRA, St James's Hospital, Dublin 8, Ireland 2 Department of Biochemistry, St James's Hospital, Dublin 8, Ireland Vitamin D levels are often suboptimal in older patients. Adults with fragility fracture are more likely to have serum vitamin D (25 (OH)D) levels lower that those of control patients of similar age. Vitamin D deficiency may be associated with an increase in falls, muscular weakness, reduced bone mass and cognitive impairment. Vitamin D deficiency may be defined as a 25(OH)D level <50 nmol/ L1 and >80 nmol/L being suggested as an optimal serum 25(OH)D level. A minimal intake of 1000 IU vitamin D per day in all adults age 20 and older has been suggested2. The aim of this study was to retrospectively review patients referred to the Falls and Osteoporosis Service in St James Hospital between January 2008 and December 2009. We reviewed baseline vitamin D levels, bone markers, history of fracture, Vitamin D supplementation, age and reason for referral. 672 patients were reviewed with an average age of 67.86 (± 14.37) years and a baseline mean 25(OH)D level of 54.91 (± 28.22) nmol/L. Overall, 45.1% of patients had 25(OH)D <50 nmol/L, with a further 35.7% <80 nmol/L. Less than 56.5% of patients were on vitamin D supplementation, with a mean 25(OH)D of 66.28 (±28.36) nmol/L, with 72% of patients being < 80 nmol/L. Patients who were not taking vitamin D supplementation had a mean 25(OH)D level of 35.71 (±20.54) nmol/L. 92% of patients had a 25 (OH)D level < 80 nmol/L. Hip fracture patients (n = 191) had significantly lower 25(OH)D levels compared to the remaining patients (39.55 (±24.78) vs 59.13 (±32.21) nmol/L, p < 0.001). Vitamin D deficiency is highly prevalent in Irish patients with a fracture history or osteoporosis. Just over a half of patients were on vitamin D supplementation suggesting a lack of awareness of the problem. These patients did not achieve adequate vitamin D levels >80 nmol/L based on a recommendation of 800 IU/day. Patients with a history of fracture had significantly lower vitamin D levels when compared to those without any fracture. Vitamin D deficiency is a common finding in older adults with a history of fall or fracture in Ireland. References 1. Holick MF. High prevalence of vitamin D inadequacy an implications for health. Mayo Clin Pro 206;81:353-73. 2. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18-28.
S171
Disclosure of Interest: None declared Keywords: falls clinic, prevalence, vitamin D deficiency doi:10.1016/j.bone.2010.04.399
PP264 Glucocorticoids induce bone loss at the mandible B. Bouvard⁎, M. Audran, E. Legrand, D. Chappard INSERM, U922-LHEA, Faculty of Medicine Angers, Angers, France Glucocorticoid (GC) treatment is the main cause of secondary osteoporosis. At the mandible, alveolar bone has a high remodeling level. There are some controversies about the relationships between alveolar bone loss and bone loss at the appendicular skeleton (long bones, vertebrae). Sex steroid deprivation induced by ovariectomy or orchidectomy in the rat also induces a decreased bone mass at the mandible. The effects of GCs on alveolar bone have been seldom explored. 5-month-old male Swiss-Webster mice were randomized into two groups. Pellets releasing 5 mg/kg/day prednisolone, or placebo, were subcutaneously implanted for 28 days. After euthanasia, the right tibia and the right hemimandible of each mouse were analyzed by microcomputed tomography (Skyscan). 3D modeling and analysis reconstruction of each ibia and hemimandible were obtained and measured. At the mandible, a sagittal section was done through the pulp chamber of the first molar and a two dimensional slice was obtained. It was used to measure the thickness of alveolar bone which consists of a thin slab between the incisor and the molar roots and connected with the alveolar processes. 3D modeling and analysis reconstruction of each tibia were performed to analyze histomorphometric parameters at the secondary spongiosa (BV/TV, Tb.Th, Tb.N, Tb.Sp). At day 28, BV/TV and Tb.Th of the tibias were reduced (p < 0.05) in the prednisolone-treated animals compared to the placebo group. Thickness of the alveolar bone slab was also significantly decreased in the glucocorticoid group. Although the amount of alveolar bone is considerably reduced in the mouse, this study show that GCs can induce an alveolar bone loss in long term treated animals.
Image/Graph: Disclosure of Interest: None declared Keywords: alveolar bone, glucocorticoids, microCT doi:10.1016/j.bone.2010.04.400
PP265 Osteoporosis and fall in elderly subjects with parkinson disease F. D'Amico1,⁎, P. Crescenti1, G. Gaglio1, A. Granata1, R. Natoli1, T. Pipicella1, E. Russo1, A. Grippa1 1 Department of Geriatrics, Hospital of Patti, Messina, Italy Objective: This study investigated the relationship between osteoporosis and fall in elderly subjects affected by Parkinson Disease (PD).
mortality and one-to-five year mortality rate showed no significant difference among four groups (p > 0.05). Interestingly, the second hip fracture produced a highest hazard ratio (HR) of developing a mortality was 7.98 (95% confidence interval [CI], 2.2-28.8) which was significantly higher than others. Discussion: The actual survivorship of initial hip fracture patients with second hip or other subsequent fracture were not different from patients who have only one hip fracture. However, patients with second hip fracture who had the highest hazard ratio should obtain special focus with meticulous care. Disclosure of Interest: None declared Keywords: survival, second hip fracture, major long bone fracture of extremity, vertebral body fracture doi:10.1016/j.bone.2010.04.398
PP263 Vitamin D deficiency is highly prevalent in patients attending a falls and osteoporosis clinic J.G. Browne1,⁎, F.O Connell1, K. Fitzgerald1, M. Healy2, V. Crowley2, M.C. Casey1, J. Walsh1 1 Bone Health and Osteoporosis Unit, MIRA, St James's Hospital, Dublin 8, Ireland 2 Department of Biochemistry, St James's Hospital, Dublin 8, Ireland Vitamin D levels are often suboptimal in older patients. Adults with fragility fracture are more likely to have serum vitamin D (25 (OH)D) levels lower that those of control patients of similar age. Vitamin D deficiency may be associated with an increase in falls, muscular weakness, reduced bone mass and cognitive impairment. Vitamin D deficiency may be defined as a 25(OH)D level <50 nmol/ L1 and >80 nmol/L being suggested as an optimal serum 25(OH)D level. A minimal intake of 1000 IU vitamin D per day in all adults age 20 and older has been suggested2. The aim of this study was to retrospectively review patients referred to the Falls and Osteoporosis Service in St James Hospital between January 2008 and December 2009. We reviewed baseline vitamin D levels, bone markers, history of fracture, Vitamin D supplementation, age and reason for referral. 672 patients were reviewed with an average age of 67.86 (± 14.37) years and a baseline mean 25(OH)D level of 54.91 (± 28.22) nmol/L. Overall, 45.1% of patients had 25(OH)D <50 nmol/L, with a further 35.7% <80 nmol/L. Less than 56.5% of patients were on vitamin D supplementation, with a mean 25(OH)D of 66.28 (±28.36) nmol/L, with 72% of patients being < 80 nmol/L. Patients who were not taking vitamin D supplementation had a mean 25(OH)D level of 35.71 (±20.54) nmol/L. 92% of patients had a 25 (OH)D level < 80 nmol/L. Hip fracture patients (n = 191) had significantly lower 25(OH)D levels compared to the remaining patients (39.55 (±24.78) vs 59.13 (±32.21) nmol/L, p < 0.001). Vitamin D deficiency is highly prevalent in Irish patients with a fracture history or osteoporosis. Just over a half of patients were on vitamin D supplementation suggesting a lack of awareness of the problem. These patients did not achieve adequate vitamin D levels >80 nmol/L based on a recommendation of 800 IU/day. Patients with a history of fracture had significantly lower vitamin D levels when compared to those without any fracture. Vitamin D deficiency is a common finding in older adults with a history of fall or fracture in Ireland. References 1. Holick MF. High prevalence of vitamin D inadequacy an implications for health. Mayo Clin Pro 206;81:353-73. 2. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18-28.
S171
Disclosure of Interest: None declared Keywords: falls clinic, prevalence, vitamin D deficiency doi:10.1016/j.bone.2010.04.399
PP264 Glucocorticoids induce bone loss at the mandible B. Bouvard⁎, M. Audran, E. Legrand, D. Chappard INSERM, U922-LHEA, Faculty of Medicine Angers, Angers, France Glucocorticoid (GC) treatment is the main cause of secondary osteoporosis. At the mandible, alveolar bone has a high remodeling level. There are some controversies about the relationships between alveolar bone loss and bone loss at the appendicular skeleton (long bones, vertebrae). Sex steroid deprivation induced by ovariectomy or orchidectomy in the rat also induces a decreased bone mass at the mandible. The effects of GCs on alveolar bone have been seldom explored. 5-month-old male Swiss-Webster mice were randomized into two groups. Pellets releasing 5 mg/kg/day prednisolone, or placebo, were subcutaneously implanted for 28 days. After euthanasia, the right tibia and the right hemimandible of each mouse were analyzed by microcomputed tomography (Skyscan). 3D modeling and analysis reconstruction of each ibia and hemimandible were obtained and measured. At the mandible, a sagittal section was done through the pulp chamber of the first molar and a two dimensional slice was obtained. It was used to measure the thickness of alveolar bone which consists of a thin slab between the incisor and the molar roots and connected with the alveolar processes. 3D modeling and analysis reconstruction of each tibia were performed to analyze histomorphometric parameters at the secondary spongiosa (BV/TV, Tb.Th, Tb.N, Tb.Sp). At day 28, BV/TV and Tb.Th of the tibias were reduced (p < 0.05) in the prednisolone-treated animals compared to the placebo group. Thickness of the alveolar bone slab was also significantly decreased in the glucocorticoid group. Although the amount of alveolar bone is considerably reduced in the mouse, this study show that GCs can induce an alveolar bone loss in long term treated animals.
Image/Graph: Disclosure of Interest: None declared Keywords: alveolar bone, glucocorticoids, microCT doi:10.1016/j.bone.2010.04.400
PP265 Osteoporosis and fall in elderly subjects with parkinson disease F. D'Amico1,⁎, P. Crescenti1, G. Gaglio1, A. Granata1, R. Natoli1, T. Pipicella1, E. Russo1, A. Grippa1 1 Department of Geriatrics, Hospital of Patti, Messina, Italy Objective: This study investigated the relationship between osteoporosis and fall in elderly subjects affected by Parkinson Disease (PD).