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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On account of the unusually rapid aging of the population, osteoporosis became the most important health problem for the elderly in Japan. There are approximately 10,000,000 patients with osteoporosis in Japan and almost 1,000,000 patients are in bedridden state. Hip fracture is the second most frequent cause for the bedridden state. Ministry of Health and Welfare funded several projects to assess the current status of osteoporosis and to prevent osteoporotic fracture. Japan osteoporosis Foundation founded in 1991 concentrations its effort on public education and research support on osteoporosis.
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PMID:[Anti-osteoporotic programs in Japan]. 796 96

Hip fractures lead to excess deaths and substantial disability. Most are related both to falls and to osteoporosis, which affects one in four post-menopausal white women, but a lesser number of men or women of other races. Consequently, about half of the 1.66 million hip fractures worldwide in 1990 occurred in Europe and North America. Even within these regions, however, there is substantial variation in hip fracture incidence rates, which suggests the existence of important environmental factors that could be manipulated to reduce hip fracture occurrence. This is important because in the United States alone, a quarter of a million hip fractures annually cost over $8 billion, mostly for acute medical care and nursing home services. Future costs will be even greater because populations are ageing rapidly around the world and because hip fracture incidence rates are rising in some regions. The number of elderly is increasing most rapidly in Asia, Latin America, the Middle East, and Africa, and these regions will account for over 70% of the 6.26 million hip fractures expected in the year 2050. Because fracture treatment is expensive, and rehabilitation not always successful, effective prophylaxis offers the only hope of alleviating the enormous social burden of hip fractures.
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PMID:Hip fractures: a worldwide problem today and tomorrow. 811 May 12

Hip fracture is one of the most severe consequences of osteoporosis affecting aged women. However, abnormalities of bone turnover responsible for bone loss in this condition have not been clearly defined. To further evaluate the bone metabolic status of women sustaining hip fracture, we have prospectively measured serum osteocalcin as a marker of bone formation and urinary excretion of pyridinoline (Pyr) and deoxypyridinoline (D-pyr) cross-links as markers of bone collagen degradation in 174 independently living women (80 +/- 8 years) within a few hours after a hip fracture. Comparison was made with 77 age-matched controls (80 +/- 5 years) and 17 premenopausal women (39 +/- 3 years). In addition 15 of the patients were followed with daily measurements during the first postoperative week. At the time of admission osteocalcin was 20% lower in the fractured women compared to the elderly controls (7.6 +/- 3.8 vs. 9.5 +/- 4.5 ng/ml, P = 0.001). Pyr and D-pyr were 36% and 40% higher, respectively (P = 0.0001), than in elderly controls and 85% and 76% higher than in premenopausal controls (P = 0.0001). Serum osteocalcin did not correlate with the cortisol level measured at the same time (r = 0.03, ns), nor with serum albumin and creatinine. Serum osteocalcin remained unchanged within 18 hours after fracture, whereafter it progressively decreased until the third postoperative day. No correlation was noted between the excretion of pyridinoline cross-links and the time elapsed from fracture.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impairment of bone turnover in elderly women with hip fracture. 824 67

There is little published information on the epidemiology of fracture in Australia. We have therefore carried out a population-based retrospective study of fracture in an Australian population covering 1,073 subjects, 60 per cent of the eligible population over the age of 65 resident in Busselton in the southwest of Western Australia. They completed a questionnaire on the number of fractures, the skeletal site and the degree of trauma that caused the fracture. In this population, 39 per cent had sustained a total of 620 fractures, and 22 per cent of women and 6 per cent of men had sustained osteoporotic fractures. Hip and spine fractures accounted for only 9 per cent of osteoporotic fractures in females whereas wrist fractures accounted for 27 per cent, other upper limb fractures for 19 per cent and other lower limb fractures for 11 per cent. These results suggest that emphasis on spinal and hip fractures as the only manifestations of osteoporosis is inappropriate.
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PMID:Fracture prevalence in an Australian population. 839 4

Hip fractures among the elderly are a significant and rapidly growing public health problem. The prevailing view is that most hip fractures are the consequence of age-related bone loss or osteoporosis. However, because over 90% of hip fractures are the result of falls, we have undertaken a falls surveillance study to determine if factors related to the mechanics of falling are associated with increased risk of hip fracture. Case subjects with hip fracture and control subjects without hip fracture were sampled from falls recorded at the Hebrew Rehabilitation Center for Aged, a chronic care facility. Fall information was obtained by interview of the subject and witnesses if the fall was witnessed. Data were analyzed by multiple logistic regression. Increased risk of hip fracture from a fall was associated with impacting on the hip or side of the leg and potential energy associated with the fall. Quetelet, or body mass index, was inversely related to fracture risk. The adjusted odds ratio of hip fracture for a fall involving impact on the hip region was 21.7 (95% confidence interval, 8.2-58). The potential energy associated with these falls was an order of magnitude greater than the average energy required to fracture elderly, cadaveric, proximal femurs in earlier in vitro experiments. We conclude, therefore, that a fall from standing height should no longer be considered minimal trauma but rather trauma of sufficient magnitude to pose a high risk of hip fracture if impact occurs on the hip and if energy-absorbing processes are inadequate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact near the hip dominates fracture risk in elderly nursing home residents who fall. 801 74

Eight patients (6 women and 2 men) with osteoporosis caused or aggravated by renal acidification defects are presented. Three of the female patients were premenopausal; the others were 9, 20 and 22 years postmenopausal, and two of them were on hormonal replacement therapy. Two patients had nephrolithiasis: one male with recurrent calcium phosphate stones and a left sided staghorn calculus, and one female with nephrocalcinosis due to medullary sponge kidney and hypercalciuria (patients No. 1 and 2, respectively, Table 1). In the remaining subjects, clinical suspicion was based on: a) Hip fracture in a 44-yr-old premenopausal female without any risk factor (No. 3, Table 2). b) Several vertebral compression fractures in a 45-yr-old male without hypogonadism or other predisposing factors (No. 7, Table 2). c) Lack of response to antiosteoporotic therapy in 3 women (patients No. 4, 6 and 8, Table 2). Serum bicarbonate levels and urine acidification capacity were studied in all patients. Three had low serum bicarbonate (two of whom showed high fractional excretion of bicarbonate), four had a distal defect, and one had a mixed form. Serum creatinine and potassium, and venous blood pH were normal in all cases, suggesting incomplete renal tubular acidosis. Bone mineral density in Z-score (means +/- s.e.m.) was - 1.75 +/- 0.08 in the lumbar spine (n = 8), and - 1.57 +/- 0.09 in the femoral neck (n = 4) [Tables 1 and 2; Figs 1 and 2]. Following one year treatment with oral sodium bicarbonate and potassium citrate, total skeletal calcium increased by 3-10% in five of the patients. Whereas the high prevalence of renal acidification defects among renal stone formers with or without hypercalciuria is well acknowledged, renal tubular acidosis is not included in the list of entities causing secondary osteoporosis. As shown in 6 patients of this series, incomplete RTA should be considered as another disease capable of causing osteoporosis or worsening involutional bone loss.
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PMID:[Renal acidification mechanism disorders in patients with osteoporosis]. 854 15

In the 50-year "modern" history of osteoporosis, there have been about 17 antifracture studies with sufficient attention to design to allow inference regarding efficacy. Antivertebral fracture efficacy has been reported with etidronate, estrogen patch, calcitonin, and 1,25-dihydroxyvitamin D. Two studies using fluoride were positive, and two were negative. Hip fractures have been neglected. One study showed efficacy of hip protectors, one showed efficacy of vitamin D and calcium in nursing home dwellers. The source of most hip fractures is the community. One community based antihip fracture efficacy study using annual injections of vitamin D was positive. There have been no antivertebral or antihip fracture studies in men, or in corticosteroid-related osteoporosis in men or women. Lack of independently repeated demonstration of efficacy, small fracture numbers, and data pooling in some of these (the best) studies leave great uncertainty. Estrogen and bisphosphonates appear to be the best options at this time. New data suggest that calcium supplementation is likely to reduce the rate of bone loss and perhaps reduce fracture rates. The challenge is to maintain and restore the constituents of bone mineral density (BMD), that is: to promote periosteal and endosteal bone formation; reduce endosteal bone resorption and cortical porosity; and increase trabecular thickness, number, and connectivity. There are many opportunities, for instance, intermittent parathyroid hormone (PTH) increases bone strength and, with estrogen, may increase connectivity. The anabolic effects of PTH may be partly mediated by IGF-1. IGF-1 increases periosteal, endosteal, and trabecular bone formation, cortical and trabecular width, and trabecular and endocortical connectivity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Present and future of osteoporosis therapy. 857 94

The epidemiologic patterns of vertebral and femoral fractures are sufficiently different to suggest that they represent distinct disorders (type I versus type II osteoporosis) although osteopenia is common in both. To determine whether differences in femoral geometry, one of the main determinants of bone quality, might contribute to the heterogeneity in osteoporotic fractures, we obtained dual energy X-ray absorptiometry scans on 210 women age 60 or older, including 105 type I fracture cases, 30 type II patients, and 75 controls. Hip axis length, measured on the scan printout, was significantly increased (p < 0.01) in hip fracture patients compared with women with postmenopausal osteoporosis, whereas femoral neck density (BMD) was equal in both groups. The best discrimination between both fracture types was obtained by a logistic regression model based on age and axis length. Adding BMD to the model did not improve the discriminative power (p = 0.67). These data provide further evidence that geometric characteristics may be implicated in hip fracture risk. Furthermore, these findings suggest that an increase in hip axis length may predispose osteopenic subjects to a femoral localization of fragility fractures, consistent with the postulated heterogeneity in the pathogenesis of osteoporotic fractures.
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PMID:Measurement of femoral geometry in type I and type II osteoporosis: differences in hip axis length consistent with heterogeneity in the pathogenesis of osteoporotic fractures. 861 71

Hip fractures in the elderly represent a global issue, associated with significant morbidity and mortality. Considering the magnitude of the problem, any substantial reduction in the hip fracture burden depends on prevention. In view of the complex pathogenesis of senile (type II) osteoporosis, preventive strategies should focus on the frequency of falling in the elderly as well as on the prevalence of compromised femoral integrity as a consequence of bone loss. Although many risk factors for senile osteoporosis are potentially preventible or reversible with targeted interventions, the beneficial effects of most strategies have not yet been adequately documented, indicating the need for additional long-term controlled studies.
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PMID:Strategies for the prevention of senile (type II) osteoporosis: an update. 864 30

We present a case of idiopathic transient osteoporosis of the hip in a 43 year-old male. The patient presented with pain in the hip and limb. Hip x ray showed osteoporosis and scintigraphy revealed a diffuse uptake in the femoral head. Magnetic resonance imaging showed decreased signal intensity on the T1 weighted images and increased signal intensity on T2 weighted images in the femoral head and neck. Blood tests were normal. Healing was achieved by restricting weight-bearing and administering calcitonin and calcium. Radiographic remineralization occurred simultaneously with clinical resolution.
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PMID:[Transient osteoporosis of the hip. Presentation of a case and literature review]. 866 58


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