Osteoporosis: Chu LW

Chan SP, Chen JF, Chu LW, Van DP, Hosking D, Ip TP, Koh L, Kung A, Lai NS, Lau E, Lee JK, Leewattana R, Min YK, Nghia ND, Boonsong O, Park HM, Ringe J, Setyohadi B, Shin CS, Soontrapa S, Taechakraichana N, Tanjung F, Tobing D, Tsai KS, Woo J, Yang RS. · c/o Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China. · Public Health Nutr. · Pubmed #18647434 No free full text.

Abstract: BACKGROUND: Vitamin D is essential for Ca absorption, prevention of falls and fracture, and maintenance of muscle strength and balance. Lack of awareness of the importance of vitamin D in bone health is common in Asia. OBJECTIVE: To define key statements, objectives and actions for improving osteoporosis management and vitamin D inadequacy in Asia. RESULTS AND CONCLUSION: This declaration was jointly produced by specialists at the Asia Metaforum on the Role of Vitamin D and the Management of Osteoporosis, held in September 2006 in Hong Kong, to define actions to prevent vitamin D insufficiency in Asia. Although developed specifically for Asia, some or all of these statements may be applicable to other regions of the world.

Kung AW, Yeung SS, Chu LW. · Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, PRC. · Calcif Tissue Int. · Pubmed #11000341 No free full text.

Abstract: Osteoporosis is a growing health problem in Asian women and it is expected that half of the world's hip fractures will occur in Asia in 50 years' time. As the use of hormonal replacement therapy (HRT) is extremely low in postmenopausal Asian women, nonhormonal agents will be more acceptable for the treatment and prevention of osteoporosis. The efficacy, tolerability, and acceptability of alendronate, an amino-bisphosphonate, for Asian women was evaluated in 70 osteoporotic southern Chinese women in a prospective, randomized, double-blind study. The subjects were randomized to receive either alendronate 10 mg daily or placebo, plus calcium supplementation 500 mg daily. The baseline L 1-4 and hip bone mineral density (BMD) were similar between both groups. At the end of 1 year, there was an increase of 5.8% in the lumbar spine BMD and 3.4% at the total hip with alendronate treatment when compared with baseline values (P < 0.001). Alendronate treatment for 1 year resulted in significant improvement in BMD at all sites measured when compared with placebo. There was also marked reduction in serum alkaline phosphatase (ALP) and urinary n-telopeptide (NTx) in the alendronate group when compared with the placebo group (ALP 25% versus 2%, NTx 75% versus 14%, both P < 0.005). The changes in ALP and NTx at 6 and 12 months correlated with the change in BMD at all sites measured at 1 year (P all <0.05). Alendronate was well tolerated and accepted, although two cases of gastric ulcer were reported. We conclude that alendronate is an effective and well-accepted agent for the treatment of osteoporosis in Asian women.

Kung AW, Luk KD, Chu LW, Tang GW. · Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, China. · Osteoporos Int. · Pubmed #10663345 No free full text.

Abstract: Quantitative ultrasound (QUS) is emerging as a simple, inexpensive and noninvasive method for assessing bone quality and assessing fracture risk. We assessed the usefulness of a contact calcaneal ultrasonometer by studying normal premenopausal women (group I, n = 53), normal postmenopausal women (group II, n = 198), and osteoporotic women without (group III, n = 141) and with vertebral fractures (group IV, n = 53). The osteoporotic subjects had a T-score of the spine or hip neck bone mineral density (BMD) <-2.5 based on the local Chinese peak young mean values. When compared with postmenopausal controls, mean broadband ultrasound attenuation (BUA), speed of sound (SOS), and quantitative ultrasound index (QUI) were 26%, 2.1% and 25% lower in women with vertebral fractures (p all <0.005). The correlation coefficients between QUS parameters and BMD of the spine and hip ranged between 0.4 and 0.5. The ability of the QUS to discriminate between patients groups was determined based on the mean value of normal premenopausal women in group I. The mean T-score for women with fractures was -2.87 +/- 1.02 for BUA, -2.54 +/- 0.79 for SOS, -3.17 +/- 0.70 for QUI, -2.65 +/- 0.86 for L2-4 BMD and -2.53 +/- 0.66 for hip neck BMD. After adjustment for age and body mass index, the odds ratio of vertebral fracture was 1.71 (95% CI 1.2-2.6) for each 1 SD reduction in BUA, 2.72 (1.3-5.3) for SOS, 2.58 (1.4-4.6) for QUI, 2.33 (1.6-3.3) for L2-4 BMD, 2.09 (1. 37-3.20) for femoral neck BMD and 1.88 (1.34-2.92) for total hip BMD. The association between the QUS parameters and vertebral fracture risk persisted even adjustment for BMD. The area under the receiver operating characteristic curve for BUA for vertebral fracture was 0. 92, for SOS, QUI, L2-4 BMD and femoral neck BMD was 0.95, and for total hip was 0.91.