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

More than a fifth of all females suffer from the risk to develop spinal osteoporosis. Hip fractures occur about 50,000 times per year in Federative Republic of Germany, about 1/3 in males and 2/3 in females. Estrogen deficiency is a risk factor of major importance for females; both sexes gain risk because of nutritional calcium deficiency and reduced mobility. Estrogen replacement therapy was proven to reduce the risk in females; and calcium supply reduces risk in both sexes. Therapy of developed spinal osteoporosis includes fluorides, calcium, vitamin D and calcitonin. No drug therapy has been developed so far for patients with senile osteoporosis and hip fractures.
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PMID:[Osteoporosis as a cause of pathological fractures]. 220 Nov 37

Hip fractures are common in the elderly, affecting 1 in 4 women by the age of 90 years and 1 in 8 men. These fractures have caused an "epidemic" during the last 20 years because the age specific rate for such fractures has doubled, and there has been a significant increase in the size of the elderly population in Europe. Hip fracture patients occupy a quarter of all orthopedic beds, the treatment is costly and the rehabilitation slow. Fifteen percent die in hospital; 33% are dead by one year. Of survivors only 2/3 return to their own home. There is now a move to prevent such fractures. Hip fractures arise in the elderly for two reasons: deteriorating bone stock and increasing falls. Hip fracture prevention needs to address both issues, but most work has looked at bone stock. Predictions of hip fracture risk even if based on bone density are poor, so preventive measures need to target the whole population. Bone density rises to a peak at 35 to 40 years in both sexes; men have a higher bone density at all times than women. Thereafter there is a steady loss of 1-2% per year. Women have 10 years of accelerated loss after the menopause. Hip fracture prevention starts by ensuring that peak bone mass is reached. This is under genetic influence but may be maximized by adequate dietary calcium and physical activity in adolescence. Smoking, alcohol and steroid use reduce bone density and their use should be moderated. In women amenorrhea reduces bone density. For women, estrogen may stop menopausal loss and maintain bone density for at least 15 years and in retrospective studies can reduce the fracture risk by 50%. Calcitonin may be an alternative. Five years beyond the menopause primary or secondary prevention may be started. Estrogen is still the best therapy but may be less popular because of the return of menstrual periods. Calcitonin or oral calcium supplements may also be of benefit. Drugs in combination may be more effective than alone. Over age 70, when calcium absorption diminishes, vitamin D, calcium and calcitonin may be effective. For men, treatment options are calcium, calcitonin or, later on, vitamin D. The role of exercise in bone density protection is unclear but should be encouraged for general health reasons. Bisphosphonates are new drugs that may be useful. Falls become increasingly common in the elderly such that up to 80% of all 80-year-olds may sustain at least one fall per year.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The epidemiology of hip fractures and methods of prevention. 805 45

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

Osteoporosis is a public health scourge that is usually eminently preventable. Some risk factors, such as low calcium intake, vitamin D deficiency, and physical inactivity, are amenable to early interventions that will help maximize peak bone density. Other risk factors subject to modification are cigarette smoking and excessive consumption of protein, caffeine, and alcohol. Hip fractures are the most serious outcome of osteoporosis, with enormous personal and public health consequences. The ongoing Study of Osteoporotic Fractures has identified additional independent predictors of hip fracture risk, including maternal hip fracture, absence of significant weight gain since age 25, height, hyperthyroidism, use of long-acting benzodiazepines or anticonvulsants, spending < 4 hours a day on one's feet, inability to rise from a chair without using one's arms, poor visual depth perception and contrast sensitivity, and tachycardia. In an individual perimenopausal woman, the risk of osteoporotic fracture and the urgency of estrogen replacement therapy can be best estimated on the basis of bone mineral density, as measured by dual-energy x-ray absorptiometry, coupled with the presence or absence of existing fractures and clinical risk factors evident from the history and physical examination. Estrogen, calcitonin, and bisphosphonates have all been proved effective in retarding postmenopausal bone loss and therefore reducing the risk of fracture. The use of sodium fluoride is more controversial, although a recent study has suggested a possible role for slow-release fluoride combined with high-dose calcium supplementation.
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PMID:Osteoporosis: prevention, diagnosis, and management. 921 58

Osteoporosis is a common entity, especially among elderly Caucasian women. Osteoporosis leads to hip fracture in many persons, putting them at risk for death and marked handicap. Hip fracture shows a steady increase in incidence after age 60 years, and most of the victims are over age 75 years. Screening studies predict hip fracture up to 8 years before fracture. Estrogen therapy, to be effective, should be initiated between the ages of 50 and 60 years, 25 to 15 years before the most likely age of fracture. Guidelines describing for whom the physician targets estrogen therapy, which is not without risks, are sketchy or nonexistent. The patient should also be educated as a young adult about risk factor modification for osteoporosis, including increasing exercise, ceasing smoking, and minimizing coffee and alcohol use.
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PMID:Twenty-five Years Before the Fall: Preventing Osteoporotic Hip Fracture. 2457 56