Course of bone mass during and after hormonal replacement therapy with and without addition of nandrolone decanoate

A total of 33 women with postmenopausal osteoporosis were matched pairwise by age, years since menopause, and body mass index and randomized to receive either cyclic estrogen-progestagen replacement treatment (group 1) or the same treatment plus nandrolone decanoate (ND; group 2). Both groups were treated during 3 years and subsequently followed for another year off treatment. A year after cessation of the treatment the distal forearm bone mineral content in group 2 was significantly higher than that in group 1. Bone mass measurements in the axial skeleton already showed a significant difference in favor of group 2 after 3 years treatment, which persisted during the year off treatment. The decline in lumbar bone mineral mass and density in the 1 year off treatment was similar in both groups. Correction for body mass did not change these results. Bone turnover parameters did not show significant differences between the two groups after cessation of treatment. A higher muscle mass, induced by ND, could partly explain the differences between the groups since even 1 year after treatment was stopped an increased serum creatinine level was still observed in group 2

Trabecular rod buckling index in thoraco-lumbar vertebral bone

Published in Clinical Anatomy, 2005; 19 (1):12-18 at www.interscience.wiley.comThe need for improved mechanistic understanding of cancellous bone failure is at the core of important clinical problems such as osteoporosis, as well as basic biological issues such as bone formation and adaptation. Three-dimensional (3D) anaglyphs were produced from 15 T12 and L1 vertebral bodies, which encompass the adult life span in both sexes. The anaglyphs were viewed with red-green stereo glasses, using an image analyzer, and trabecular thickness and trabecular length were measured. From biomechanical principles, the strength of individual trabeculae can be estimated from measurement of trabecular rod thickness and trabecular rod length as the load to buckling index. The distribution of the load to buckling index was best described by a log normal curve. Trabecular rod thickness, trabecular rod length, and load to buckling index for males were consistently greater than for females. With aging, trabecular rod thickness, and the load to buckling index decrease for males while trabecular rod length increases for females. In this study, the load to buckling index for thoraco-lumbar vertebral trabecular rods potentially quantifies a greater risk of vertebral fracture for females. Decreased trabecular rod thickness or increased trabecular rod length result in the strength of trabeculae shifting closer to a putative fracture threshold. The corollary being that there is a reduced safety margin for resistance to mechanical loads for the vertebral bodies. The 3D anaglyph technique for measuring trabecular dimensions provides an accurate and precise methodology by which these morphological studies can be undertaken.Peter Sutton-Smith, Ian H. Parkinson, Andrew M.J. Linn, Simone A. Kooke and Nicola L. Fazzalar