Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Multicenter Project for Research in Osteoporosis.

The effect of femoral bone mineral density (BMD) and several parameters of femoral neck geometry (hip axis length, neck-shaft angle and mean femoral neck width) on hip fracture risk in a Spanish population was assessed in a cross-sectional study. All parameters were determined by dual-energy X-ray absorptiometry. There were 411 patients (116 men, 295 women; aged 60-90 years) with hip fractures in whom measurements were taken in the contralateral hip. Controls were 545 persons (235 men, 310 women; aged 60-90 years) who participated in a previous study on BMD in a healthy Spanish population. Femoral neck BMD was significantly lower, and neck-shaft angle and mean femoral neck width significantly higher, in fracture cases than in controls. The logistic regression analysis adjusted by age, height and weight showed that a decrease of 1 standard deviation (SD) in femoral neck BMD was associated with an odds ratio of hip fracture of 4.52 [95% confidence interval (CI) 2.93 to 6.96] in men and 4.45 (95% CI 3.11 to 6.36) in women; an increase of 1 SD in neck-shaft angle of 2.45 (95% CI 1.73 to 3.45) in men and 3.48 (95% CI 2.61 to 4.65) in women; and an increase of 1 SD in mean femoral neck width of 2.15 (95% CI 1.55 to 2.98) in men and 2.40 (95% CI 1.79 to 3.22) in women. The use of a combination of femoral BMD and geometric parameters of the femoral neck except for hip axis length may improve hip fracture risk prediction allowing a better therapeutic strategy for hip fracture prevention.

Is there an extrathyroidal source of calcitonin during pregnancy?

Calcitonin (CT) and ionic calcium (Ca++) were measured in paired serum samples from the umbilical artery and vein of 47 normal term babies (28 females and 19 males). In the whole group, we found higher CT levels in the vein than in the artery (P less than 0.01). Considered by sex, significant CT (P less than 0.01) and Ca++ (P less than 0.05) gradients existed only in the female group. CT and Ca++ were also measured in serum samples from a group of 26 normal babies (16 females and 10 males) at 2 days of life and in a group of 25 normal babies (12 females and 13 males) at 30 days of life. At 2 day we found a significant increase of CT (P less than 0.001) (females P less than 0.001 and males P less than 0.05), and a significant decrease of Ca++ (P less than 0.001) (females P less than 0.001 and males P less than 0.001), in umbilical artery blood levels at 30 days. Our data show more CT coming from the placenta to the foetus than vice versa, more evident in the females, suggesting an extrathyroidal source of CT, which may be the human placenta. The increase of CT at 2 days, opposing the release of calcium from bone, may contribute in part to the decrease in Ca++ levels observed at that time.

Treatment of hyperlipoproteinemia, types II and IV, with pirifibrate: one hundred observations.

A new drug, pirifibrate, was investigated in a multicenter study of 100 patients with type IIa, IIb, or IV hyperlipoproteinemia (HLP). After one month of dieting, patients completed six months of treatment with a dose of 1,500 mg/day of pirifibrate. An average fall of about 20% in plasma cholesterol was observed in type IIa and IIb HLP, and more than 50% in the triglycerides in type IIb and IV HLP. Both reductions were statistically significant (P less than 0.00005). Increases in the alpha-lipoproteins were observed in the three types of HLP. The pre-beta-lipoproteins showed a statistically significant fall in type IIb and IV HLP. Variations observed in beta-lipoproteins were significant only in some controls with type IV, HLP, who had low basal levels.