Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark.

Aim: To compare the number of patients diagnosed with osteoporosis and osteoporotic fractures in Denmark, with the number of subjects expected to have osteoporosis.

Subjects And Methods: From the National Hospital Discharge Register, records for all patients diagnosed with osteoporosis and/or with osteoporotic fractures between 1995 and 1999 were retrieved. Based on normal Danish values for BMD, the expected number of subjects aged 50 years or more with osteoporosis according to the WHO definition was calculated.

Relationship between cigarette smoking and Graves' ophthalmopathy.

Environmental triggers in the development of Graves' disease (GD) have been suggested from the very first description of the disease. Since 1987 a number of studies from various countries, have assessed the risk for Graves' ophthalmopathy (GO) associated with smoking, and found an odds-ratio of approximately 4 associated with smoking. Smokers have a higher risk for more advanced GO and a dose response relation is evident.

Two single nucleotide polymorphisms in the CYP17 and COMT Genes--relation to bone mass and longitudinal bone changes in postmenopausal women with or without hormone replacement therapy. The Danish Osteoporosis Prevention Study.

Sex steroids are important physiologic regulators of bone mass, and genes regulating sex steroid production and metabolism are obvious as candidate genes for osteoporosis susceptibility. We present data from a study of 1795 recent postmenopausal women, assigned to either hormone replacement therapy (HRT) or no treatment and followed for 5 years. The association between bone mass measurements and two single nucleotide polymorphisms, a T (A1) to C (A2) transition in the 5'-UTR of the cytochrome P450c17alpha (CYP17) gene and a G (Val) to A (Met) transition in exon 4 of the catechol- O-methyltransferase (COMT) gene, was evaluated.

Reduced bone mineral density and increased bone turnover in Prader-Willi syndrome compared with controls matched for sex and body mass index--a cross-sectional study.

Objectives: To study bone mineral status, body composition, and biochemical markers of bone turnover in Prader-Willi syndrome (PWS).

Study Design: Eight subjects with PWS (three males, five females; mean age, 24 years [range 16-41]) were included. Each subject was compared with an age-, sex- and body mass index-matched control randomly drawn from the background population.

Female premenopausal fracture risk is associated with gc phenotype.

Unlabelled: The phenotype of the vitamin D binding and macrophage activating protein, Gc, is a predictor of premenopausal bone fracture risk, possibly mediated through activation of osteoclasts. This was concluded from a study on 595 Danish perimenopausal women 45-58 years of age (30,040 person years).

Introduction: The multifunctional plasma protein Gc, also known as group-specific component, Gc globulin, or vitamin D binding protein (DBP), has two functions with relation to bone tissue: it is the major carrier protein of vitamin D in the circulation, and deglycosylation converts it into a very potent macrophage- and osteoclast-activating factor (Gc-MAF).

Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women.

Unlabelled: To study effects of statins on human bone, 82 postmenopausal women were randomized to 1-year treatment with simvastatin 40 mg/day or placebo. The study showed no effect of simvastatin on biochemical bone markers or on BMD at the hip or spine. Thus, our results do not support a general beneficial effect of simvastatin on bone.

No effect of vitamin A intake on bone mineral density and fracture risk in perimenopausal women.

In recent studies from Sweden and the United States, a high vitamin A intake has been associated with low bone mineral density (BMD) and increased fracture risk. In Sweden and the United States, food items such as milk and breakfast cereals are fortified with vitamin A, whereas in Denmark there is no mandatory fortification with vitamin A. In the present study, we investigated relations between vitamin A intake and BMD and fracture risk in a Danish population consuming mostly unfortified food items.

Parathyroid surgery is associated with a decreased risk of hip and upper arm fractures in primary hyperparathyroidism: a controlled cohort study.

Objectives: To study if parathyroid surgery reduced fracture risk in patients with primary hyperparathyroidism.

Design: Controlled cohort study.

Setting: All subjects diagnosed with primary hyperparathyroidism (ICD8 codes: 252.

Fracture risk associated with smoking: a meta-analysis.

Objectives: To assess fracture risk associated with smoking.

Design: Systematic review.

Data Sources: Cohort, case-control, and cross-sectional studies identified by searching PubMed and EMBASE, and by recursive screening of reference lists.

Fracture risk is decreased in acromegaly--a potential beneficial effect of growth hormone.

Growth hormone (GH) is an anabolic hormone that may increase bone density and thus decrease fracture risk. Patients with acromegaly have an excess of GH, and we therefore investigated whether fracture risk was decreased in patients with acromegaly. We identified 206 patients newly diagnosed with acromegaly between 1983 and 1996 who underwent pituitary surgery.

Patients with eating disorders. A high-risk group for fractures.

Purpose: To analyze fracture risk and bone mineral density in patients with eating disorders (anorexia nervosa, bulimia nervosa, and other eating disorders).

Design: Clinical overview.

Findings: Bone mineral density is decreased and fracture risk increased in patients with anorexia nervosa.

Effects of 5 years of hormonal replacement therapy on menopausal symptoms and blood pressure-a randomised controlled study.

Objectives: To study the effects of hormonal replacement on hot flushes, other symptoms linked to menopause, and blood pressure.

Methods: The study included 1006 early postmenopausal women aged 45-58 years, participating in the Danish Osteoporosis Prevention Study (DOPS) randomised to Hormonal replacement therapy (HRT) (n=502) or no HRT (n=504) in an open label trial. Symptom scores were recorded at baseline, after 6 month, 1, 2, and 5 years on a modified Greene scale (range 0-4 with 0 equalling no symptoms, and 4 maximal symptoms).

Corticosteroid use and risk of hip fracture: a population-based case-control study in Denmark.

Objective: To examine the association between cumulative CS dose and risk of hip fracture.

Design: Population-based case-control design.

Subjects And Methods: A total of 6660 subjects with hip fracture and 33,272 age-matched population controls were identified using the County Hospital Discharge Registry in North Jutland County, Denmark and the Danish Central Personal Registry, respectively.

Polymorphisms in the CYP19 and AR genes--relation to bone mass and longitudinal bone changes in postmenopausal women with or without hormone replacement therapy: The Danish Osteoporosis Prevention Study.

Polymorphisms in the androgen receptor ( AR) gene and genes encoding enzymes involved in synthesis of sex steroids (e.g., the CYP19 gene encoding aromatase) have recently received attention in osteoporosis research.

Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark.

A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use.

Cohort study on effects of parathyroid surgery on multiple outcomes in primary hyperparathyroidism.

Objectives: To assess the effects of surgery compared with conservative treatment (no surgery) for primary hyperparathyroidism.

Design: Cohort study.

Setting: Nationwide Danish cohort.

Hyperthyroidism, bone mineral, and fracture risk--a meta-analysis.

This study examined changes in bone mineral and fracture risk after treatment for hyperthyroidism in a meta-analysis. The PubMed and EMBASE were searched using the MESH terms "hyperthyroidism," "bone mineral density" (BMD), and "fracture," resulting in retrieval of 289 references. Twenty references describing BMD and five describing fracture risk were included in the meta-analysis.

Bone loss associated with gastrointestinal disease: prevalence and pathogenesis.

Decreased bone mineral density is a frequent finding in gastrointestinal disease. Factors contributing to this are (1) malabsorption of vitamin D, calcium and possibly vitamin K and other nutrients; (2) treatment with glucocorticoids; (3) inflammatory cytokines in inflammatory bowel disease; and (4) hypogonadism induced by gastrointestinal disease. A low bone mineral density has been reported in (1) patients who have undergone gastrectomy (27-44% with Z-scores of < -1); (2) pernicious anaemia; (3) coeliac disease (8-22% with Z-scores of < -2); (4) Crohn's disease (mean 32-38% with Z-scores of < -1); and (5) ulcerative colitis (mean 23-25% with Z-scores of < -1).

[Preventive drug therapy of depressions].

At least 5-10 per cent of the Danish population will during their lifetime experience more than one episode of major depression but only a minority of this group will receive the necessary and sufficient prophylactic treatment against their illness. Randomised controlled studies have shown that the majority of commonly used antidepressant drugs, new as well as old ones, possess prophylactic efficacy. Thus, treatment efficacy is not a major problem but the treatment efficiency in everyday clinical practice is unsatisfactory.

Increased fracture rates in Turner's syndrome: a nationwide questionnaire survey.

Background And Objectives: Reduced bone mineral content (BMC) and bone mineral density (BMD) have previously been reported in Turner's syndrome, although appropriate GH treatment and early induction of puberty seem to permit normal bone mass accumulation. Furthermore, an increased risk of fractures and osteoporosis have been reported in a registry study. The aim of the present study was to further characterize the risk of fractures in TS and to explore risk factors, in a historical follow-up survey based on a self-administered questionnaire.

Standardization of BMD T-Scores in the first five years after the menopause: do femoral neck-equivalent and older normative range T-Scores improve diagnostic agreement?

Calculating T-scores using an older reference population reduces inconsistency between measurement sites when osteoporosis is diagnosed in the elderly. The present analysis in a younger, early postmenopausal cohort examined 5-yr consistency of normalization by local and femoral neck-equivalent T-scores. NHANES (femur) and Hologic (spine and forearm) references were applied to baseline, 1-, 2-, 3-, and 5-yr scans in 925 untreated women in a national cohort study, and alternative local and neck-equivalent scores calculated.

Cardiovascular events before and after surgery for primary hyperparathyroidism.

Cardiovascular disease [atherosclerosis and subsequent myocardial infarction (MI)] has been associated with primary hyperparathyroidism. We aimed at studying cardiovascular events before and after surgery and mortality after surgery for primary hyperparathyroidism using a historical follow-up design. A total of 674 patients who underwent surgery at three Danish centers between January 1, 1979 and December 31, 1997 were compared with 2021 age- and gender-matched controls.

Fractures in patients with primary hyperparathyroidism: nationwide follow-up study of 1201 patients.

Parathyroid hormone (PTH) increases bone turnover and may thus increase fracture risk. As PTH secretion is increased in primary hyperparathyroidism, surgical cure may prevent fractures. We studied fracture risk before and after diagnosis in patients treated surgically and conservatively for primary hyperparathyroidism.