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)

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

Hip fracture consecutive to osteoporosis represents a major health problem in terms of both morbidity and financial burden for the community. Deficiency in nutritional elements appear to play a major role in the pathogenesis of osteoporosis and of fractures in elderly. Correction of an inadequate supply in both calcium and vitamin D can reduce bone loss and fracture incidence in elderly subjects. In addition, low protein intake could be particularly detrimental for the conservation of bone integrity with aging. Thus, in hospitalized elderly patients reduced protein intake is associated with lower femoral neck bone mineral density (BMD) and poor physical performance. Furthermore, state of malnutrition or undernutrition is often observed in elderly patients with hip fracture. In these patients, in who we detected very low femoral neck (BMD) at the level of the proximal femur, the self-selected intake of protein and energy was insufficient during their hospitalization. Interestingly, the clinical outcome after hip fracture was significantly improved by daily oral nutritional supplement normalizing the protein intake, documented as a reduction in both complication rate and median duration of hospital stay. Further studies showed that normalization of the protein intake, independently of that of energy, calcium and vitamin D, was responsible for this more favorable outcome, and could prevent further bone loss, at least at the level of weight-bearing cortical bone. In undernourished elderly subjects an increase in the protein intake, from low to normal, could be beneficial for bone integrity. This could act through an increase in the growth factor IGF-1 which has been found to decrease with aging.
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PMID:Proteins and bone health. 909 48