Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hip fractures are common and devastating events. The apolipoprotein E*4 (APOE) allele, associated with Alzheimer's disease, has also been associated with osteoporosis in hemodialysis patients. We prospectively studied 1750 women, age >/=65 years, who underwent measurements of hip and calcaneal bone mineral density (BMD), were typed for APOE and followed for approximately 7.0 years for the occurrence of fractures and falls. Women with at least one APOE*4 allele had an increased risk of hip fracture, relative hazard (RH) (95% confidence interval) = 1.90 (1.05-3.41) and wrist fracture, RH = 1.67 (1.01-2.77) compared with women without APOE*4, even after adjusting for age, cognitive function, falling, and BMD. The effect of APOE*4 on hip fracture was greatest among women with additional (>/=3) other risk factors. Women with an APOE*4 allele were also likely to report a maternal history of fracture. The average number of falls per year did not differ by APOE*4: 0.46 for APOE*4 women and 0.41 for women without an APOE*4 allele. Women with an APOE*4 allele experienced greater weight loss which contributed to faster rates of bone loss. We conclude that women with the APOE*4 polymorphism are at substantially increased risk of hip and wrist fracture that is not explained by bone density, impaired cognitive function, or falling. Possible alternate explanations include an effect of APOE on vitamin K, bone turnover, or weight loss. The APOE polymorphism may be a candidate gene for hip fractures among community dwelling nondemented women.
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PMID:Apolipoprotein E polymorphism: A new genetic marker of hip fracture risk--The Study of Osteoporotic Fractures. 1040 18

Hip fracture incidence rates are predicted to increase dramatically in the first half of the 21st century, especially in Asia, Latin America, Africa, and the Middle East. These increased rates will result primarily from the effects of public health efforts to improve nutrition and infectious-disease control, both of which contribute to improved longevity of populations. An example of a rapid increase in hip fracture incidence rates has been reported in Hong Kong. Findings of studies there suggest that environmental changes, ie, westernization, urbanization, or both, are strongly related with declines in bone mineral density and increases in fractures. Hip fracture incidence rates in Western nations are typically increasing at much more modest rates than those in Hong Kong and other Asian nations. Epidemiologic investigations have identified multiple risk factors, including exposures earlier in life to adverse factors that are considered to contribute to the development of osteoporosis in both Western and Asian nations. The major risk factors are inadequate nutrition, limited physical activity, and low lifetime estrogen exposure. A dietary shift toward a more plant-based diet in Western nations may be beneficial to bone health, but is not likely to counter the adverse effects of limited physical activity and low estrogen exposure.
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PMID:Plant-based diets and bone health: nutritional implications. 1047 28

Nearly 1.5 million American men age 65 and older have osteoporosis, and another 3.5 million are at risk. Hip fractures in older men have a higher mortality than in women and represent a growing medical problem. Glucocorticoid treatment, hypogonadism, and excessive alcohol consumption are important secondary etiologies for loss of bone mass in men. Detection of hypogonadism may be difficult, and testosterone replacement is indicated for only a well-defined subset of patients. Because of a lack of data on pathogenesis, risk factors, and therapeutic interventions in men, treatment decisions are usually based on extrapolation from studies in women. None of the medications approved by the FDA for the treatment of osteoporosis in postmenopausal women has been approved for use in older men, but physicians are prescribing bisphosphonates and calcitonin.
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PMID:Osteoporosis in older men: discovering when and how to treat it. 1049 25

Dual X-ray absorptiometry (DXA) is considered a gold standard for bone measurements in the assessment of osteoporosis. Other techniques such as quantitative ultrasound (QUS) are promising to detect patients with osteoporosis-related fractures and to predict fracture risk. In this cross-sectional retrospective study, we analyzed the behavior of QUS and DXA measurements alone and in combination with regard to the presence of fractures in 320 women, 147 with nontraumatic fractures. Speed of sound (SOS), broadband ultrasound attenuation (BUA), and a third parameter derived from SOS and BUA called stiffness were measured at the calcaneus using an Achilles device (Lunar, Madison, WI). Lumbar (BMDL) and hip (BMDH( bone mineral density were measured by DXA (Hologic QDR 1000, Waltham, MA). Mean SOS, BUA, stiffness, and BMDL and BMDH were significantly lower in women with fractures compared with women without fractures. Logistic regression adjusted for age identified stiffness as the parameter most strongly associated with the presence of fracture: its sensitivity was 54% and specificity 70%. Hip BMD was second, with a sensitivity of 54% and a specificity of 69%. Combining QUS and DXA measurements did not improve the specificity nor the sensitivity. There was no difference in the odds ratios with regard to the technique that was chosen for bone assessment. In conclusion, these results suggest that low QUS measurements are associated with the presence of fractures in a way similar to DXA. In our study, the combination of QUS and DXA did not improve the discrimination of women with fractures.
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PMID:Evaluation of quantitative ultrasound and dual X-Ray absorptiometry measurements in women with and without fractures. 1049 71

Hip fractures are a health problem of paramount importance for the individual and society. They are associated with a sharp increase of the incidence of immobility, dependency, nursing home placement, and death. In Germany, more than 100,000 elderly suffer a hip fracture every year. 90% of fractures of the proximal femur result from a fall with an impact near the hip. The kinetic energy of a fall from standing height without successful protective reactions is far above the fracture threshold of a femur in a man aged 70 and older, regardless of osteoporosis and sex. Therefore, propensity to fall and mechanisms of falling are more important in the pathogenesis of hip fracture than bone mineral density alone. The combination of age-associated gait and balance disorders, which increase the probability of falls, and age-related decreasing strength of the femur is responsible for the high incidence of hip fractures. Besides the interventions to reduce the fall frequency it is possible to decrease the number of hip fractures by a passive protection of the trochanter. An energy-shunting protector (crash helmet-like, hip padding) has been developed by Lauritzen and Lund (safehip). The protector consists of two stiff shells, sewn into special undergarment. The shells disperse the impact away from the trochanter to soft tissue, and increase the area of contact. A controlled study among nursing home residents has demonstrated a relative risk of hip fracture of 0.44 (95% CC 0.21 to 0.94) in the intervention group, i.e., the protector has reduced the number of hip fractures by more than a half. No hip fracture has happened during use of the protector. Using the protector can improve self-confidence and diminish self-restraint of physical activity, which is not rarely caused by fear of falling. Further investigations of compliance are necessary.
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PMID:[Proximal femoral fractures in the elderly: pathogenesis, sequelae, interventions]. 1050 90

There is little population-based data concerning fracture rates in Australia. We ascertained all fractures occurring during 2 years in adults aged 35 years and over residing within a defined region (population 218 000), representative of the Australian population. The major strength of this study is the comprehensive ascertainment of fractures, which was ensured by regular searches of the only two radiologic providers in the Geelong Osteoporosis Study region. Nevertheless, vertebral fractures are likely to be underestimated since our ascertainment relied on a clinical indication for a medical imaging procedure. Among those aged 35-55 years, the fracture rate (persons per 10,000/year) in men was about double the rate in women (65 vs 35). The fracture rate was almost 7 times higher in women over 60 years versus women less than 55 years of age. In contrast, the fracture rate in men over 60 years was only 50% higher than in men less than 55 years of age (72 vs 104). Fracture rates in women and men were highest at the hip (28 and 10 respectively), spine (21 and 7), distal forearm (Colles') (18 and 4) and humerus (11 and 3), and were 3-4 times higher in women than men. These fractures accounted for 63% of all fractures in women and 32% in men. By contrast, the rate of lower leg and ankle fractures was less than 10 per 10,000 in both women and men and did not increase to the same extent with age. Hip fracture rates appear high, particularly among the older age strata, compared with retrospective ascertainment in other populations. In Australia, as in many other countries, there is an increasing longevity of the population. The number of women aged 90 years and over increased by 32% and the number of men of this age increased by 48% in the 5 years between the Australian national census of 1991 and 1996. Given stable fracture rates, the substantial health burden imposed by age-related fractures, particularly hip fractures, will continue to escalate in both women and men.
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PMID:Age- and gender-specific rate of fractures in Australia: a population-based study. 1052 17

Hip fracture among the elderly is a large and growing public health issue. Presently, all therapies approved for treatment and prevention of osteoporosis involve pharmacological agents that act systemically. In this study, we evaluated the feasibility of preventing osteoporotic hip fractures with local, rather than systemic, therapy. Our hypothesis is that local therapy to increase bone density may be as effective as systemic therapy in reducing fracture risk. Thus, the goal of this investigation was to use finite element analyses to study the effect of a localized increase in bone density on the strength of an osteopenic, human femur. Finite element predictions of the failure load were made after increasing the bone density within small regions in the proximal femur. The outcome variable from these analyses was the predicted load required to break a femur in a simulated fall to the side with impact on the greater trochanter. Increasing the density by 25% relative to baseline values in a small region (0.86 cm3) of the femoral neck increased the predicted failure load by 6.2%. The same density increase in a much larger region (4.92 cm3) increased the failure load by 15%. Inclusion of more than one region of increased density provided little additional benefit. In comparison, when the density of the entire femur was increased by 5% relative to baseline values, the predicted failure load increased by 5.4%. These findings suggest that agents capable of inducing increased bone density in small regions of the proximal femur have the potential to reduce the risk of hip fracture.
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PMID:Effect of local density changes on the failure load of the proximal femur. 1081 38

Hip fracture due to osteoporosis (OP) and hip osteoarthritis (OA) are both important causes of locomotor morbidity in the elderly population. In osteoporosis, bone mass gradually decreases until the skeleton is too fragile to support the body and a fracture occurs, typically in the femur, wrist, or spine. In osteoarthritis, there is a proliferation of bone, leading to a stiffening of the tissue. Current clinical methods for assessment of bone changes in these disorders largely depend on assessing bone mineral density. However, this does not provide any information about bone structure which is considered to be an equally important factor in assessing bone quality. This paper presents a novel approach for computer analysis of trabecular (or cancellous) bone structure. The technique uses a Fourier transform to generate a "spectral fingerprint" of an image. Principal components analysis is then applied to identify key features from the Fourier transform and this information passed to a neural network for classification. Testing this on a series of 100 histological sections of trabecular bone from patients with OP and OA and a normal group correctly classified over 90% of the OP group with an overall accuracy of 77%-84%. Such high success rates on a small group suggest that this may provide a simple, but powerful, method for identifying alterations in bone structure.
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PMID:Analysis of trabecular bone structure using Fourier transforms and neural networks. 1071 79

Hip arthroplasty is a common surgical intervention in our hospital practice, involving high perioperative risk related to patients age and multiple concomitant diseases. Hemodynamic complications described vary from slight hypotension during surgery to heart failure and sudden death, particularly if the operation involves a cemented femoral component. Because of the type of patients undergoing such operations (elderly patients, with osteoporosis and scarce cardiopulmonary reserve), the unclear origin of complications and the lack of consensus on what constitutes adequate monitoring during surgery, hip arthroplasty is problematic for the specialists involved. We report on five deaths during cemented hip arthroplasty; after reviewing the case history and autopsy report of one, we believe the events leading to death were triggered by massive pulmonary embolism.
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PMID:[Heart arrest in cemented hip arthroplasty]. 1073 88

This study compared the effects of oral alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women. Women at least 5 yr postmenopause (n = 299) were randomized to either 10 mg alendronate, matching alendronate placebo, or open-label intranasal calcitonin 200 IU daily for 12 months. Hip and spine bone mineral density (BMD) and markers of bone turnover were measured, and safety and tolerability were assessed. Alendronate produced greater increases in BMD than calcitonin at 12 months at the lumbar spine (5.16% vs. 1.18%; P < 0.001), trochanter (4.73% vs. 0.47%; P < 0.001), and femoral neck (2.78% vs. 0.58%; P < 0.001). Changes in BMD with calcitonin were greater than with placebo at the femoral neck, but were not different from placebo at either the trochanter or lumbar spine. Greater decreases in bone turnover were seen with alendronate than with calcitonin (serum bone-specific alkaline phosphatase, 43% vs. 9%, P < 0.001; urinary N-telopeptide, 62% vs. 11%, P < 0.001). Similar percentages of patients in each group reported an adverse experience during the study. We conclude that, in postmenopausal women with osteoporosis, 12 months of therapy with alendronate produced significantly greater increases in BMD of the hip and spine and greater decreases in bone turnover than intranasal calcitonin.
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PMID:Comparison of alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women. 1084 52


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