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  • 1
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    Online Resource
    Reply to: Indications of Increased Vertebral Fracture Risk in Patients With Type 2 Diabetes
    Wiley ; 2018
    In:  Journal of Bone and Mineral Research Vol. 33, No. 1 ( 2018-01), p. 183-183
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 33, No. 1 ( 2018-01), p. 183-183
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v33.1
    DOI: 10.1002/jbmr.3322
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 2
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    SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study
    Wiley ; 2016
    In:  Journal of Bone and Mineral Research Vol. 31, No. 12 ( 2016-12), p. 2123-2128
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 31, No. 12 ( 2016-12), p. 2123-2128
    Abstract: Accentuated kyphosis is associated with adverse health outcomes, including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4° to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high sex hormone–binding globulin (SHBG), are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We, therefore, hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross‐sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis. Participants included 1500 men aged 65 and older from the Osteoporotic Fractures in Men (MrOS) Study, in whom baseline measures of kyphosis and sex hormones were available. Modified Cobb angle of kyphosis, calculated from T4 through T12, was assessed from supine lateral spine radiographs. Serum total estradiol and total testosterone were measured by mass spectrometry, and bioavailable sex steroids were calculated from mass action equations. After adjustment for age and other confounding variables, no association was found between bioavailable estradiol or testosterone and Cobb angle, either when kyphosis was analyzed as a continuous variable or dichotomized into highest versus lower three quartiles. In linear regression models adjusted for age and clinic site, there was a significant association between SHBG and kyphosis (parameter estimate = 0.76 per SD increase, p  = 0.01). In the fully adjusted model, this association was weakened and of only borderline statistical significance (parameter estimate = 0.61 per SD, p  = 0.05). Logistic models demonstrated similar findings. Although associated with bone loss, we did not demonstrate that low bioavailable estradiol translates into worse kyphosis in older men. High SHBG is associated with bone loss and vertebral fractures. Our results suggest that high SHBG may also be a risk factor for hyperkyphosis. © 2016 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v31.12
    DOI: 10.1002/jbmr.2901
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 3
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    Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study
    Wiley ; 2018
    In:  Journal of Bone and Mineral Research Vol. 33, No. 9 ( 2018-09), p. 1622-1629
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 33, No. 9 ( 2018-09), p. 1622-1629
    Abstract: We proposed the term “dysmobility syndrome” (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height 2 〈 7.26 kg/m 2 , total body fat 〉 30%, spine or hip T ‐score ≤ –2.5, grip strength 〈 30 kg, gait speed 〈 1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8%) had DS and 635 (11%) experienced an MOF, including 274 (5%) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95% CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95% CI, 2.78 to 4.29) and FRAX calculated with BMD (per %) conferred an HR of 1.10 (95% CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan‐Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95% CI, 3.10 to 12.54) and hip (HR 7.73; 95% CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women. © 2018 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v33.9
    DOI: 10.1002/jbmr.3455
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 4
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    Online Resource
    Bone Density Loss Is Associated With Blood Cell Counts
    Wiley ; 2017
    In:  Journal of Bone and Mineral Research Vol. 32, No. 2 ( 2017-02), p. 212-220
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 32, No. 2 ( 2017-02), p. 212-220
    Abstract: Hematopoiesis depends on a supportive microenvironment. Preclinical studies in mice have demonstrated that osteoblasts influence the development of blood cells, particularly erythrocytes, B lymphocytes, and neutrophils. However, it is unknown whether osteoblast numbers or function impact blood cell counts in humans. We tested the hypothesis that men with low BMD or greater BMD loss have decreased circulating erythrocytes and lymphocytes and increased myeloid cells. We performed a cross‐sectional analysis and prospective analysis in the Osteoporotic Fractures in Men (MrOS) study, a multisite longitudinal cohort study. A total of 2571 community‐dwelling men (≥65 years) who were able to walk without assistance, did not have a hip replacement or fracture, and had complete blood counts (CBCs) at the third study visit were analyzed. Multivariable (MV)‐adjusted logistic regression estimated odds of white blood cell (WBC) subtypes (highest and lowest quintile versus middle), and anemia (clinically defined) associated with BMD by DXA scan (at visit 3), annualized percent BMD change (baseline to visit 3), and high BMD loss ( 〉 0.5%/year, from baseline to visit 3) at the femoral neck (FN) and total hip (TH). MV‐adjusted models included age, BMI, cancer history, smoking status, alcohol intake, corticosteroid use, self‐reported health, thiazide use, and physical activity. At visit 3 greater TH BMD loss (per 1 SD) was associated with increased odds of anemia, high neutrophils, and low lymphocytes. Annualized BMD loss of 〉 0.5% was associated with increased odds of anemia, high neutrophils, and low lymphocytes. Similar results were observed for FN BMD regarding anemia and lymphocytes. We conclude that community‐dwelling older men with declining hip BMD over about 7 years had increased risks of anemia, lower lymphocyte count, and higher neutrophil count, consistent with preclinical studies. Bone health and hematopoiesis may have greater interdependency than previously recognized. © 2016 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v32.2
    DOI: 10.1002/jbmr.3000
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2017
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  • 5
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    Online Resource
    Identification of Hip BMD Loss and Fracture Risk Markers Through Population‐Based Serum Proteomics
    Wiley ; 2017
    In:  Journal of Bone and Mineral Research Vol. 32, No. 7 ( 2017-07), p. 1559-1567
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 32, No. 7 ( 2017-07), p. 1559-1567
    Abstract: Serum proteomics analysis may lead to the discovery of novel osteoporosis biomarkers. The Osteoporotic Fractures in Men (MrOS) study comprises men ≥65 years old in the US who have had repeated BMD measures and have been followed for incident fracture. High‐throughput quantitative proteomic analysis was performed on baseline fasting serum samples from non‐Hispanic white men using a multidimensional approach coupling liquid chromatography, ion‐mobility separation, and mass spectrometry (LC‐IMS‐MS). We followed the participants for a mean of 4.6 years for changes in femoral neck bone mineral density (BMD) and for incident hip fracture. Change in BMD was determined from mixed effects regression models taking age and weight into account. Participants were categorized into three groups: BMD maintenance (no decline; estimated change ≥0 g/cm 2 , n  = 453); expected loss (estimated change 0 to 1 SD below the estimated mean change, –0.034 g/cm 2 for femoral neck, n  = 1184); and accelerated loss (estimated change ≥1 SD below mean change, n  = 237). Differential abundance values of 3946 peptides were summarized by meta‐analysis to determine differential abundance of each of 339 corresponding proteins for accelerated BMD loss versus maintenance. Using this meta‐analytic standardized fold change at cutoffs of ≥1.1 or ≤0.9 ( p   〈  0.10), 20 proteins were associated with accelerated BMD loss. Associations of those 20 proteins with incident hip fracture were tested using Cox proportional hazards models with age and BMI adjustment in 2473 men. Five proteins were associated with incident hip fracture (HR between 1.29 and 1.41 per SD increase in estimated protein abundance). Some proteins have been previously associated with fracture risk (eg, CD14 and SHBG), whereas others have roles in cellular senescence and aging (B2MG and TIMP1) and complement activation and innate immunity (CO7, CO9, CFAD). These findings may inform development of biomarkers for future research in bone biology and fracture prediction. © 2017 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v32.7
    DOI: 10.1002/jbmr.3125
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2017
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  • 6
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    Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture : VITAMIN D ASSOCIATIONS WITH SKELETAL OUTCOMES
    Wiley ; 2015
    In:  Journal of Bone and Mineral Research Vol. 30, No. 8 ( 2015-08), p. 1403-1413
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 30, No. 8 ( 2015-08), p. 1403-1413
    Type of Medium: Online Resource
    ISSN: 0884-0431
    URL: Article
    DOI: 10.1002/jbmr.2487
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2015
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  • 7
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    Volumetric Bone Mineral Density and Failure Load of Distal Limbs Predict Incident Clinical Fracture Independent of FRAX and Clinical Risk Factors Among Older Men
    Wiley ; 2018
    In:  Journal of Bone and Mineral Research Vol. 33, No. 7 ( 2018-07), p. 1302-1311
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 33, No. 7 ( 2018-07), p. 1302-1311
    Abstract: Our objective was to determine the associations of peripheral bone strength and microarchitecture with incident clinical and major osteoporotic fracture among older men after adjusting for major clinical risk factors. We used a prospective cohort study design with data from 1794 men (mean age 84.4 years) in the Osteoporotic Fractures in Men (MrOS) study. Eligible men attended the year 14 visit, had high‐resolution peripheral quantitative computed tomography (HR‐pQCT) scans of the distal radius and distal or diaphyseal tibia, DXA measured BMD, and were followed for mean 1.7 years for incident fracture. Failure load was estimated using finite element analysis. We used Cox proportional hazards models with standardized HR‐pQCT parameters as exposure variables. Primary outcome was clinical fracture ( n  = 108). Covariates included either Fracture Risk Assessment Tool (FRAX) major osteoporotic fracture probability calculated with BMD (FRAX‐BMD), or individual clinical risk factors (CRF) including age, total hip BMD, race, falls, and prevalent fracture after age 50 years. Lower failure load was associated with higher risk of incident clinical fracture and incident major osteoporotic fracture. For clinical fracture with FRAX‐BMD adjustment, the associations ranged from hazard ratio (HR) 1.58 (95% CI, 1.25 to 2.01) to 2.06 (95% CI, 1.60 to 2.66) per SD lower failure load at the diaphyseal tibia and distal radius. These associations were attenuated after adjustment for individual CRFs, but remained significant at the distal sites. Associations of volumetric BMD with these outcomes were similar to those for failure load. At the distal radius, lower trabecular BMD, number, and thickness, and lower cortical BMD, thickness, and area were all associated with higher risk of clinical fracture, but cortical porosity was not. Among community‐dwelling older men, HR‐pQCT measures including failure load, volumetric BMD, and microstructure parameters at peripheral sites (particularly distal radius) are robust independent predictors of clinical and major osteoporotic fracture. © 2018 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v33.7
    DOI: 10.1002/jbmr.3433
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 8
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    Online Resource
    Bone Loss at the Hip and Subsequent Mortality in Older Men: The Osteoporotic Fractures in Men (MrOS) Study
    Wiley ; 2017
    In:  JBMR Plus Vol. 1, No. 1 ( 2017-08), p. 31-35
    Details
    In: JBMR Plus, Wiley, Vol. 1, No. 1 ( 2017-08), p. 31-35
    Abstract: Low bone mineral density (BMD) is associated with increased mortality risk, yet the impact of BMD loss on mortality is relatively unknown. We hypothesized that greater BMD loss is associated with increased mortality risk in older men. Change in femoral neck BMD was assessed in 4400 Osteoporotic Fractures in Men (MrOS) study participants with two to three repeat dual‐energy X‐ray absorptiometry scans over an average of 4.6 ± 0.4 (mean ± SD) years. Change in femoral neck BMD was estimated using mixed effects models; men were grouped into three categories of BMD change: maintenance ( n  = 1087; change ≥ 0 g/cm 2 ); expected loss ( n  = 2768; change between 0 g/cm 2 and 〈 1 SD below mean change [ 〉 –0.034 g/cm 2 ]); and accelerated loss ( n  = 545; change 1 SD below mean change or worse [≤–0.034 g/cm 2 ]). Multivariate proportional hazards models adjusted for potential confounders estimated the risk of all‐cause mortality over 8.1 ± 2.8 years following visit 2. Mortality was centrally adjudicated by physician review of death certificates. At visit 1, mean age was 72.9 ± 5.5 years. Men who maintained BMD were less likely to die during the subsequent follow‐up period (33.7%) than men who had accelerated BMD loss (60.6%) ( p   〈  0.001). Compared to men who had maintained BMD, those who had accelerated BMD loss had a 44% greater risk of mortality in multivariate‐adjusted models (HR, 1.44; 95% CI, 1.23 to 1.68). Compared to men who had maintained BMD, there was no significant difference in mortality risk for men with expected loss of BMD (36.9% died) (multivariate HR, 1.00; 95% CI, 0.89 to 1.13). Further adjustment for visit 1 or visit 2 BMD measurement did not substantially alter these associations. Results for total hip BMD were similar. In conclusion, accelerated loss of BMD at the hip is a risk factor for mortality in men that is not explained by comorbidity burden, concurrent change in weight, or physical activity. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 2473-4039 , 2473-4039
    URL: Issue
    URL: Article
    DOI: 10.1002/jbm4.v1.1
    DOI: 10.1002/jbm4.10006
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2905710-3
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  • 9
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    Online Resource
    Association of change in muscle mass assessed by D 3 ‐creatine dilution with changes in grip strength and walking speed
    Wiley ; 2020
    In:  Journal of Cachexia, Sarcopenia and Muscle Vol. 11, No. 1 ( 2020-02), p. 55-61
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 11, No. 1 ( 2020-02), p. 55-61
    Abstract: Muscle mass declines with age. However, common assessments used to quantify muscle mass are indirect. The D 3 ‐creatine (D 3 Cr) dilution method is a direct assessment of muscle mass; however, longitudinal changes have not been examined in relation to changes in other measures of muscle mass, strength, and performance. Methods A convenience sample of 40 men from the Osteoporotic Fractures in Men Study (mean age = 83.3 years, standard deviation = 3.9) underwent repeat assessment of D 3 Cr muscle mass, dual‐energy X‐ray absorptiometry (DXA) lean mass, grip strength, and walking speed at two time points approximately 1.6 years apart (2014–2016). One‐sample t ‐tests and Pearson correlations were used to examine changes in DXA total body lean mass, DXA appendicular lean mass/height 2 , DXA appendicular lean mass/weight, D 3 Cr muscle mass, D 3 Cr muscle mass/weight, grip strength, walking speed, and weight. Results D 3 ‐creatine muscle mass, D 3 Cr muscle mass/weight, grip strength, and walking speed all significantly declined (all P 〈 0.01). The change in DXA measures of lean mass was moderately correlated with changes in D 3 Cr muscle mass. There was no significant correlation between the change in DXA measures of lean mass and change in walking speed (all P 〉 0.05). The change in D 3 Cr muscle mass/weight was moderately correlated with change in walking speed ( r = 0.33, P 〈 .05). The change in grip strength was weakly correlated with the change in DXA measures of lean mass and D 3 Cr muscle mass ( r = 0.19–0.32). Conclusions The results of our study provide new insights regarding the decline in muscle strength and D 3 Cr muscle mass. The D 3 Cr method may be a feasible tool to measure declines in muscle mass over time.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    URL: Article
    DOI: 10.1002/jcsm.v11.1
    DOI: 10.1002/jcsm.12494
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2586864-0
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  • 10
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    Online Resource
    Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS)
    Wiley ; 2016
    In:  Journal of Bone and Mineral Research Vol. 31, No. 10 ( 2016-10), p. 1810-1819
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 31, No. 10 ( 2016-10), p. 1810-1819
    Abstract: Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow‐up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson's disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson's disease. The incidence rate of hip fracture per 1000 person‐years (PY) was greatest in men with FNBMD T ‐scores 〈 –2.5 (white women reference database) who also had 4+ risk factors, 33.4. Men age ≥80 years with 3+ major comorbidities experienced hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age 〈 70 years with zero comorbidities. Older men with low FNBMD, multiple risk factors, and multimorbidity have a high risk of hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification. © 2016 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v31.10
    DOI: 10.1002/jbmr.2836
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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