The Year in Osteoporosis Volume 2 by Kristina Akesson, Jonathan D. Adachi, Anthony D. Woolf

By Kristina Akesson, Jonathan D. Adachi, Anthony D. Woolf

For experts in rheumatology, orthopaedics, endocrinology, geriatrics, and women's future health.

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Environmental factors might be of greater clinical importance since it is possible to influence these. The search for risk factors in clinical cohorts is therefore always of great interest. In this rather large cohort there is good evidence that low vitamin B12 levels are associated with osteoporosis. This is an interesting finding. Its cause is, of course, not yet proven and the mechanism of action on bone cells is not known. However, if this finding should hold true in other investigations and vitamin B12 deficiency comes to be recognized as a major risk factor for osteoporotic fractures, this would be an important step forward because the deficiency is easy to investigate and to correct.

Patients with idiopathic osteoporosis also had lower bone formation parameters, including a 10% reduction in wall width, an 18% reduction in mineral apposition rate, and a 42% reduction in mineralized perimeter. The bone formation rate was 52% lower. All these measures indicate that bone resorption and formation are uncoupled in women with idiopathic osteoporosis. As in men with idiopathic osteoporosis, the disease is probably due to osteoblast dysfunction. Comment Idiopathic osteoporosis in younger individuals has been studied most in men.

Osteoporosis Int 2004; 15: 552–9. Promislow JH, Goodman-Gruen D, Slymen DJ, Barrett-Connor E. Retinol intake and bone mineral density in the elderly: the Rancho Bernardo study. J Bone Miner Res 2002: 17: 1349–58. van Staa TP, Leufkens HGM, Cooper C. The epidemiology of corticosteroid induced osteoporosis: a meta-analysis. Osteoporosis Int 2002; 13: 777–87. (C) Clinical Ch2 40 30/1/06 15:17 Page 40 I . E P I D E M I O L O G Y A N D PAT H O P H Y S I O L O G Y 16. Jones A, Fay JK, Burr M, Stone M, Hood K, Roberts G.

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