Publications (20)65.24 Total impact
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Article: Bone mass, bone markers and prevalence of fractures in adults with osteogenesis imperfecta.
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ABSTRACT: Still little is known about the manifestations of osteogenesis imperfecta (OI) in adults. We therefore initiated this study of bone mass, bone turnover and prevalence of fractures in a large cohort of adult patients. We found a surprising low prevalence (10%) of osteoporosis. These patients, however, expressed the most severe disease. To characterize bone mineral density, bone turnover, calcium metabolism and prevalence of fractures in a large cohort of adults with osteogenesis imperfecta. One hundred fifty-four patients with adult OI participated and 90 (age range 25-83) provided dual X-ray absorptiometry (DXA) measurements. According to Sillence classification criteria, 68 persons were classified as OI type I, 9 as type III, 11 type IV and 2 were unclassified. Fracture numbers were based on self-reporting. Biochemical markers of bone turnover were measured and bone mineral density (BMD) of the spine, femoral neck and total body were determined by DXA. Only 10% of adults with OI exhibited osteoporotic T scores (T ≤ -2.5) but compared to patients with normal T scores this subgroup had a threefold higher fracture risk (22 vs. 69). s-PTH, s-Ca and 25[OH] vitamin D were all normal. Bone markers did not display major deviations from normal, but patients with OI type III displayed higher resorption marker levels than type I and IV. Multivariate regression analysis showed that only gender and total body BMD were significant determinants of fracture susceptibility, and the differences for total body BMC, BMD and Z scores were significant between the OI subtypes. In adult OI, DXA measurements only identified few patients as osteoporotic. These patients, however, exhibited a much higher fracture propensity. Due to deformities, low body height and pre-existing fractures, DXA assessment is complicated in this disease, and further studies are needed to work out how to minimize the impact of these confounders.Archives of Osteoporosis 12/2011; 6(1-2):31-8. -
Article: A population-based study of demographical variables and ability to perform activities of daily living in adults with osteogenesis imperfecta.
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ABSTRACT: To describe demographical variables, and to study functional ability to perform activities of daily life in adults with osteogenesis imperfecta (OI). Population-based study. Ninety-seven patients aged 25 years and older, 41 men and 56 women, were included. For the demographical variables, comparison was made to a matched control-group (475 persons) from the Norwegian general population. Structured interviews concerning social conditions, employment and educational issues and clinical examination were performed. The Sunnaas Activities of Daily Living (ADL) Index was used to assess the ability to perform ADL. The prevalence of clinical manifestations according to Sillence was in accordance with other studies. Demographical variables showed that most adults with OI are married and have children. They had a higher educational level than the control group, but the employment rate was significantly lower. However, the rate of employed men was similar in both groups. Adult persons with OI achieved a high score when tested for ADL. Adults with OI are well educated compared with the general population, and most of them are employed. High scores when tested for ADL indicate that most of them are able to live their lives independently, even though there are some differences according to the severity of the disorder.Disability and Rehabilitation 01/2010; 32(7):579-87. · 1.50 Impact Factor -
Article: Vitamin D deficiency, secondary hyperparathyroidism and bone mineral density in Pakistani and Norwegians living in Oslo, Norway / Vitamin D-mangel, sekundær hyperparathyroidisme og bentetthet hos pakistanere og nordmenn bosatt i Oslo
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ABSTRACT: We studied the prevalence of vitamin D deficiency and bone mineral density in Norwegian born and Pakistani born men and women living in Oslo. We measured 25-hydroxyvitamin D, iPTH and ionized calcium in serum and bone mineral density (BMD) at the forearm with single energy X-ray absorptiometry. 1386 persons born in Norway and 177 persons born in Pakistan participated. Among the Pakistani born 9% of the men and 21% of women were seriously vitamin D deficient (25(OH)D 2 (95% CI: 0.007–0.033) higher in Pakistani men than in Norwegian men. We also found 5-8% higher bone mineral density in Pakistani men and women when we controlled for different skeletal size. While BMD was lower in Norwegian women with, compared to Norwegian women without, secondary hyperparathyroidsm (–0.027 g/cm2, p = 0.019), there was no difference in BMD between Pakistani women with and without secondary hyperparathyroidsmVi har sett på prevalens av vitamin D-mangel og bentetthet hos norskfødte og pakistanskfødte menn og kvinner i den populasjonsbaserte Helseundersøkelsen i Oslo 2000-2001. Det ble målt 25-hydroksyvitamin D, iPTH og ionisert kalsium i serum, og benmineraltetthet (BMD) ble målt i underarmen. Totalt deltok 1386 personer født i Norge og 177 personer født i Pakistan i aldersgruppen 30-75 år. Blant pakistanske menn og kvinner hadde henholdsvis 8% og 10% tilfredsstillende vitamin D-status (25(OH)D ! 50 nmol/l), mens 9% og 21% hadde alvorlig vitamin D-mangel (25(OH)D 2 (95% CI: 0,007–0,033) høyere BMD hos pakistanske menn enn hos norske menn. Tilsvarende fant vi opptil 5-8% høyere bentetthet hos pakistanere enn nordmenn når vi korrigerte for ulik skjelettstørrelse i de to gruppene. Videre fant vi en positiv sammenheng mellom 25(OH)D og BMD hos norske kvinner (r = 0,11, p = 0,019) og norske menn (r = 0,16, p = 0,002). En svakere sammenheng ble funnet hos pakistanske menn, mens vi ikke fant noen assosiasjon hos pakistanske kvinner. Tilsvarende hadde de norske kvinnene med sekundær hyperparatyreoidisme lavere BMD enn norske kvinner uten sekundær hyperparatyreoidisme (–0,027 g/cm2, p = 0,019). Samme tendens ble også observert for både pakistanske og norske menn, men ikke for pakistanske kvinner.Norsk Epidemiologi. 01/2009; -
Article: Intervensjonsstudien "Forebyggelse av lårhalsbrudd". Metode og praktisk gjennomføring
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ABSTRACT: Bakgrunn 3 kan forebygge brudd blant sykehjemsbeboere. Her beskrivesmetoden og den praktiske gjennomføringen av studien.Metode mg vitamin D daglig som 5 ml tran og kontrollgruppa fikk 5 ml tran der vitamin D var fjernet. Endepunktenevar lårhalsbrudd og alle ikke-vertebrale brudd. Et enkelt studieopplegg ble vektlagt. På bakgrunnav styrkeberegningen var målsetningen å inkludere ca. 2000 deltakere.Resultater Konklusjon The intervention study”Prevention of hip fractures”. Nor J Epidemiol 2000; 10 (1): 79-85. Background 3 can prevent suchfractures. Here we present the method and the implementation of the study.Method mg vitamin D daily in 5 ml cod liver oil for 2 years and the control group received 5 ml cod liver oilwithout vitamin D. The endpoints were hip fractures and all non-vertebral fractures. It was consideredimportant to use a trial that the nursing homes would find easy to implement. According to power calculationthe aim was to include about 2000 participants.Results Conclusion : The participation was lower than expected as recruiting nursing homes and nursing homeresidents posed considerable difficulty. However, the great majority of the ward staff at the participatingwards did not find the intervention demanding. A total of 1144 was included in the study.: A total of 1144 residents from 51 nursing homes (of 106 invited) in Oslo, Lier and Bergen participated.The participation rate at the individual nursing home varied from 3 to 57%. The participants were85 years old and 3/4 were women. Mean calcium intake from cheese and milk was 450 mg/day, more than40% used a vitamin D supplement while only 3% used a calcium supplement. 1/3 of the participants completedthe 2 years intervention, about 1/3 finished the intervention before 2 years because of death and 1/3finished before 2 years of other causes. The great majority of the wards did not find the interventiondemanding.: A randomised, double-blinded, controlled trial in nursing homes. The intervention group received10 : Vitamin D deficiency is a potential important risk factor for osteoporotic fractures. We havecarried out a trial in nursing homes residents to study if supplementation with vitamin D ENGLISH SUMMARY: Deltakelsen var lavere enn forventet idet det var betydelige vansker med å rekruttere sykehjemsbeboeretil studien, men de avdelinger som deltok fant gjennomføringen av studien lite arbeidskrevende.Totalt ble 1144 inkludert i studien.Kvaavik E, Meyer HE, Smedshaug GB, Falch JA, Tverdal A, Pedersen JI. : I alt 1144 beboere ved 51 sykehjem (av 106 forespurte) i Oslo, Lier og Bergen deltok. Deltakelsenved de enkelte sykehjem varierte fra 3 til 57% av beboerne. Deltakerne var i gjennomsnitt 85 år og3/4 var kvinner. Kalsiuminntak fra ost og melk var i gjennomsnitt 450 mg/dag, 40% brukte vitamin Dtilskudddaglig mens 3% brukte kalsiumtilskudd. 1/3 av deltakerne fullførte intervensjonen, ca. 1/3 avsluttetfør 2 år pga. død og 1/3 avsluttet før 2 år av andre årsaker. De fleste avdelingslederne fant det litearbeidskrevende å gjennomføre intervensjonen.: En randomisert, dobbelt blindet, kontrollert studie på sykehjem. Intervensjonsgruppa fikk i 2 år10 : Vitamin D-mangel er en potensielt viktig risikofaktor for osteoporotiske brudd. Vi har gjennomførten studie for å teste om vitamin D SAMMENDRAGNorsk Epidemiologi. 01/2009; -
Article: Weight change over three decades and the risk of osteoporosis in men: the Norwegian Epidemiological Osteoporosis Studies (NOREPOS).
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ABSTRACT: The purpose of this study was to assess the effect of weight in middle-aged men and subsequent weight change on the risk of osteoporosis three decades later. The authors utilized data from 1,476 Norwegian men participating in two health screenings in Oslo (1972-1973 and 2000-2001) and Tromsø (1974-1975 and 2001). Height and weight were measured at baseline and follow-up. Total hip bone mineral density (BMD) was assessed at follow-up by dual energy x-ray absorptiometry. Baseline body mass index (BMI) was positively related to BMD three decades later. Subsequent weight change was also strongly related to BMD, and the proportion of persons with osteoporosis decreased from 15.1% among those who lost >or=10% of their body weight to 0.6% among those who gained >or=10% of their body weight. Excluding participants with medical conditions did not change the association between weight change and BMD. Taking both BMI and weight change into account, the prevalence of osteoporosis in the lowest quarter of baseline BMI was 31% (95% confidence interval: 24, 37) in persons losing >or=5% of their weight and 4% (95% confidence interval: 1, 7) in persons gaining >or=5% of their weight. In this cohort of middle-aged men, low baseline BMI and weight loss during the following three decades were both strongly and negatively related to total hip BMD.American journal of epidemiology 07/2008; 168(4):454-60. · 5.59 Impact Factor -
Article: Pakistanis living in Oslo have lower serum 1,25-dihydroxyvitamin D levels but higher serum ionized calcium levels compared with ethnic Norwegians. The Oslo Health Study.
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ABSTRACT: Persons of Pakistani origin living in Oslo have a much higher prevalence of vitamin D deficiency and secondary hyperparathyroidism but similar bone mineral density compared with ethnic Norwegians. Our objective was to investigate whether Pakistani immigrants living in Oslo have an altered vitamin D metabolism by means of compensatory higher serum levels of 1,25-dihydroxyvitamin D (s-1,25(OH)2D) compared with ethnic Norwegians; and whether serum levels of ionized calcium (s-Ca2+) differ between Pakistanis and Norwegians. In a cross-sectional, population-based study venous serum samples were drawn from 94 Pakistani men and 67 Pakistani women aged 30-60 years, and 290 Norwegian men and 270 Norwegian women aged 45-60 years; in total 721 subjects. Pakistanis had lower s-1,25(OH)2D compared with Norwegians (p < 0.001). Age- and gender adjusted mean (95% CI) levels were 93 (86, 99) pmol/l in Pakistanis and 123 (120, 126) pmol/l in Norwegians, p < 0.001. The difference persisted after controlling for body mass index. There was a positive relation between serum 25-hydroxyvitamin D (s-25(OH)D) and s-1,25(OH)2D in both groups. S-Ca2+ was higher in Pakistanis; age-adjusted mean (95% CI) levels were 1.28 (1.27, 1.28) mmol/l in Pakistanis and 1.26 (1.26, 1.26) mmol/l in Norwegians, p < 0.001. In both groups, s-Ca2+ was inversely correlated to serum intact parathyroid hormone levels (s-iPTH). For any s-iPTH, s-Ca2+ was higher in Pakistanis, also when controlling for age. Community-dwelling Pakistanis in Oslo with low vitamin D status and secondary hyperparathyroidism have lower s-1,25(OH)2D compared with ethnic Norwegians. However, the Pakistanis have higher s-Ca2+. The cause of the higher s-Ca2+ in Pakistanis in spite of their higher iPTH remains unclear.BMC Endocrine Disorders 02/2007; 7:9. · 2.16 Impact Factor -
Article: The Oslo Health Study: Is bone mineral density higher in affluent areas?
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ABSTRACT: Based on previously reported differences in fracture incidence in the socioeconomic less affluent Oslo East compared to the more privileged West, our aim was to study bone mineral density (BMD) in the same socioeconomic areas in Oslo. We also wanted to study whether possible associations were explained by socio-demographic factors, level of education or lifestyle factors. Distal forearm BMD was measured in random samples of the participants in The Oslo Health Study by single energy x-ray absorptiometry (SXA). 578 men and 702 women born in Norway in the age-groups 40/45, 60 and 75 years were included in the analyses. Socioeconomic regions, based on a social index dividing Oslo in two regions - East and West, were used. Age-adjusted mean BMD in women living in the less affluent Eastern region was 0.405 g/cm2 and significantly lower than in West where BMD was 0.419 g/cm2. Similarly, the odds ratio of low BMD (Z-score </= -1) was 1.87 (95% CI: 1.22-2.87) in women in Oslo East compared to West. The same tendency, although not statistically significant, was also present in men. Multivariate analysis adjusted for education, marital status, body mass index, physical inactivity, use of alcohol and smoking, and in women also use of post-menopausal hormone therapy and early onset of menopause, did hardly change the association. Additional adjustments for employment status, disability pension and physical activity at work for those below the age of retirement, gave similar results. We found differences in BMD in women between different socioeconomic regions in Oslo that correspond to previously found differences in fracture rates. The association in men was not statistically significant. The differences were not explained by socio-demographic factors, level of education or lifestyle factors.International Journal for Equity in Health 01/2007; 6:19. · 1.71 Impact Factor -
Article: Biochemical markers of bone turnover and their relation to forearm bone mineral density in persons of Pakistani and Norwegian background living in Oslo, Norway: The Oslo Health Study.
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ABSTRACT: To evaluate whether Pakistanis have increased bone turnover compared with ethnic Norwegians due to their high prevalence of vitamin D deficiency and secondary hyperparathyroidism, and whether the relation between bone turnover and bone mineral density (BMD) differs between Pakistanis and ethnic Norwegians. A cross-sectional, population-based study conducted in the city of Oslo in 2000-2001. Random samples of 132 community-dwelling Pakistani men and women of ages 40, 45, and 59-60 years, and 580 community-dwelling Norwegian men and women of ages 45 and 59-60 years are included in this substudy. Venous serum samples were drawn for measurements of markers of the vitamin D endocrine system and the bone turnover markers osteocalcin (s-OC), bone alkaline phosphatase (s-bone ALP), and tartrate-resistant acid phosphatase (s-TRACP). BMD was measured at the forearm by single-energy X-ray absorptiometry. Pakistanis had higher s-bone ALP compared with Norwegians. Mean (95% CI) age-adjusted levels were 22.5 (21.0, 24.1) U/l in Pakistani men versus 19.3 (18.6, 20.1) U/l in Norwegian men, P < 0.0005, and 20.3 (18.4, 22.1) U/l in Pakistani women versus 16.7 (16.0, 17.4) U/l in Norwegian women, P = 0.001. There tended to be an inverse association between bone turnover and BMD in men and women of both ethnic groups, and it was strongest for s-bone ALP. Overall mean (95% CI) distal BMD decrease was -16 (-20, -11) mg/cm(2) per 1 s.d. increase in s-bone ALP (P < 0.0005) when adjusting for age, sex, and ethnicity. Except for somewhat higher s-bone ALP levels in Pakistanis, there were only minor ethnic differences in bone turnover, despite a strikingly different prevalence of secondary hyperparathyroidism. Bone turnover was inversely associated with forearm BMD in both ethnic groups.European Journal of Endocrinology 11/2006; 155(5):693-9. · 3.42 Impact Factor -
Article: Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry.
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ABSTRACT: The custom made Unique stem is designed to fit closely to the metaphyseal region of the femur in order to obtain maximum mechanical stability and optimal load transfer. Thirty-seven patients (38 hips) with non-inflammatory arthritis were randomized to the uncemented custom made Unique stem or the Elite Plus stem inserted with cement. The patients have been followed clinically as well as with radiostereometry (RSA) and Dual-energy X-ray Absorptiometry (DXA) for 2 years. After 2 years the RSA result showed minimal translation and rotation for the Unique stem while the Elite Plus rotated slightly (mean 1.05 degrees) into retroversion. Compared to previous studies the Elite Plus was as stable as the Charnley prosthesis. The DXA results showed a significantly higher proximal and total (10% for the Unique versus 5% for Elite) bone loss for the Unique stem compared to the Elite Plus. Thus the optimal proximal press-fit of the custom made stem did secure a stable fixation, but did not decrease the proximal bone loss.Journal of Orthopaedic Research 12/2005; 23(6):1280-5. · 2.81 Impact Factor -
Article: Bone mineral density in ethnic Norwegians and Pakistani immigrants living in Oslo--The Oslo Health Study.
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ABSTRACT: Bone mineral density (BMD, grams per square centimeter) is scarcely studied in immigrants from the Indian subcontinent. Pakistani immigrants in Oslo, Norway, have a very high prevalence of vitamin D deficiency. Thus, it is of great interest to compare BMD between Pakistani immigrants and ethnic Norwegians in Oslo. The comparison was done with and without adjustment for skeletal size, and we examined whether known risk factors explained possible differences in bone density between these two ethnic groups. BMD was measured at the distal and ultra-distal forearm site in a random sample of the participants in the Oslo Health Study by single energy X-ray absorptiometry (SXA). One hundred and seventy-three Pakistani-born subjects (71 women, 102 men) and 1,386 Norwegian-born subjects (675 women, 711 men) aged 30, 40, 45 and 59/60 years, living in Oslo, were included in the analysis. To account for variation in skeletal size, we computed height-adjusted BMD values, BMD/height (grams per cubic centimeter), and volumetric bone mineral apparent density (BMAD, grams per cubic centimeter). We found no differences in distal or ultra-distal forearm BMD between Pakistanis and Norwegians in either women or men. We found, however, higher values in Pakistani men when BMD was height-adjusted (2% higher in distal sites and 5% in ultra-distal sites). We also found higher bone mass values (both distal and ultra-distal) in Pakistani women and men than in their Norwegian counterparts when volumetric measures, such as BMD/height (7%-8% higher in women, 6%-7% in men) and BMAD (6% higher in women, 8% in men), were used. In a regression model that included ethnicity, anthropometry and lifestyle factors, BMD was higher in Pakistani men than in Norwegian men, but not in women. We conclude that Pakistanis living in Oslo have similar BMD to ethnic Norwegians, but they have higher volumetric bone mass values. When we adjusted for confounders we found higher BMD values in Pakistani men than in Norwegian men.Osteoporosis International 07/2005; 16(6):623-30. · 4.58 Impact Factor -
Article: Incidence of vertebral deformities in 255 female rheumatoid arthritis patients measured by morphometric X-ray absorptiometry.
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ABSTRACT: To date, no studies have been published on incident deformities in patients with rheumatoid arthritis (RA). Morphometric X-ray absorptiometry (MXA) is an alternative to conventional X-rays for identifying vertebral deformities. The aim of the present study was to describe the incidence of vertebral deformities in 255 female RA patients measured by MXA, and the relationship between incident deformities and clinical and demographic variables. MXA is still under evaluation for its ability to identify deformities, so we explored four different cut-off thresholds including fixed percentage reduction and the principle of least significant change (LSC). MXA (T4-L4) and BMD (L2-L4 and total hip; Lunar Expert) were performed on 255 patients (mean age 54.3, range 29.2-70.8 years) at baseline and after a mean period of 2.3 years. MXA scans were analyzed pairwise by the same trained technician, and incident deformities calculated applying LSC with a 99.9% and 99.99% confidence limit, and a fixed reduction of 20% and 25% for anterior, middle or posterior heights. Long term precision (%CV) of height measurements for all vertebrae combined (T4-L4) were 4.8, 4.8 and 4.4, respectively. Frequency and distribution of incident deformities varied from 39 deformities in 33 patients (fixed 20% reduction) to 17 deformities in 15 patients (fixed 25% reduction), and quality control analyses revealed a high number of presumed false deformities. Incidence per 100 patient years varied from 2.9 to 6.7 deformities according to method, and was comparable to those obtained from intervention studies in corticosteroid-induced osteoporosis. Patients with incident deformities were significantly older, had lower BMD, higher disability and more often a previous non-vertebral fractures than those without incident deformities Incident deformities by MXA need further evaluation in secondary osteoporosis. It seems, however, that older patients with previous limb fractures and low BMD are especially prone to this complication.Osteoporosis International 02/2005; 16(1):35-42. · 4.58 Impact Factor -
Article: Vitamin D deficiency and secondary hyperparathyroidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway, The Oslo Health Study.
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ABSTRACT: We studied the prevalence of poor vitamin D status and the association with bone density in men and women born in Norway (quoted as Norwegians, n = 869) and Pakistan (quoted as Pakistanis, n = 177) in the population-based Oslo Health Study, 2000-2001. We measured 25-hydroxyvitamin D, iPTH and ionized calcium in serum and bone mineral density at the forearm site with single energy X-ray absorptiometry. Mean 25-hydroxyvitamin D was 74.8 +/- 23.7 nmol/l in the Norwegians and 25.0 +/- 13.6 nmol/l in the Pakistanis (P = 0.000). The prevalence of secondary hyperparathyroidism (iPTH > or = 8.5 pmol/l, 25-hydroxyvitamin D < 50 nmol/l and Ca2+ < or = 1.35 mmol/l) was four times higher in Pakistani compared to Norwegian women. Also in Pakistani men, serious vitamin D deficiency defined as secondary hyperparathyroidism was prevalent, and five times as frequent as in Norwegian men. However, whereas BMD was significantly lower in Norwegian women with, compared to Norwegian women without, secondary hyperparathyroidism, there was no difference in BMD between Pakistani women with and without secondary hyperparathyroidism. In conclusion, vitamin D deficiency was prevalent among Pakistani immigrants, and in great contrast to the vitamin D replete Norwegians. Serious vitamin D deficiency was interestingly not associated with reduced forearm bone density among Pakistani women.Bone 09/2004; 35(2):412-7. · 4.02 Impact Factor -
Article: [The patient as a supplier of knowledge].
Tidsskrift for den Norske laegeforening 03/2004; 124(4):513-4. -
Article: Vertebral deformities in rheumatoid arthritis: a comparison with population-based controls.
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ABSTRACT: Previous studies have shown an increased prevalence of osteoporosis in rheumatoid arthritis (RA), but the extent of osteoporotic fractures is not clarified. The aim of this study was to compare the prevalence of vertebral deformities in a representative, population-based cohort of female patients with RA with that in matched controls, and to examine the relationship between deformities and RA, bone mineral density (BMD), and corticosteroid use. Female patients (mean age, 63.0 years; range, 50.7-73.6 years) were recruited from a county register of patients with RA. Population controls were matched for age, sex, and residential area. Participants had thoracolumbar radiographs taken according to a standardized procedure, and BMD was measured at the hip and spine (L2-L4). The overall number of vertebral deformities was substantially higher in the RA group compared with controls (147 vs 51, applying the morphometric criteria), with a highly significant difference between patients and controls regarding the presence of multiple deformities measured morphometrically (11.2% vs 4.8%; odds ratio, 2.60; 95% confidence interval, 1.21-6.04) and moderate or severe deformities measured semiquantitatively (17.3% vs 10.0%; odds ratio, 2.00; 95% confidence interval, 1.11-3.74). In Poisson regression analysis, vertebral deformities were independently associated with RA, BMD, and long-term corticosteroid use. Vertebral deformities are markedly increased in patients with RA compared with controls, especially regarding severe and multiple deformities. A diagnosis of RA was associated with vertebral deformities independently of BMD and long-term corticosteroid use. These findings have important implications for prevention of established osteoporosis in RA.Archives of Internal Medicine 03/2004; 164(4):420-5. · 11.46 Impact Factor -
Article: [Increased cortisol levels, frostbite and effects on the muscles and skeleton during extreme polar conditions].
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ABSTRACT: We wanted to record physiological changes, injuries and illnesses during a long sledge expedition in North Canada. The expedition consisted of four men aged 41 to 50, and 16 polar dogs. Measurements of cortisol in saliva were performed before, during and after the expedition. Frostbites and other injuries were registered continuously. Body weight and muscle, fat and bone mass were measured by dual X-ray absorptiometry scanning, and strength and endurance of shoulders, knees and back were tested. The group encountered extreme frost (-30 to -42 degrees C day temperature), wind, unexpected amounts of pack ice, and poorly motivated dogs. The participants showed increased free cortisol levels during their stay on the ice, probably because of increased mental stress. Three got first degree and two second-degree frostbites, but the affected areas were normal on vascular examination five months later. All members increased their muscle mass, but muscle strength and endurance remained unchanged.Tidsskrift for den Norske laegeforening 01/2004; 123(24):3529-32. -
Article: Vertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density.
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ABSTRACT: To examine the occurrence of vertebral deformities in female patients with rheumatoid arthritis (RA), and the relationship between vertebral deformities and bone mineral density (BMD) and between vertebral deformities and clinical variables. Lateral radiographs of the spine were obtained in 229 female patients with RA (mean age 63.4 years, range 51.4-73.6 years) recruited from a county RA register. Vertebral deformities were measured semiquantitatively by an experienced radiologist. A clinical examination including core measurements of disease activity and severity was performed, and BMD was measured at the spine (L2-L4) and hip. According to the statistical analysis, 49 patients were considered to have relevant vertebral deformities. The occurrence of vertebral deformities was independently associated with age, long-term corticosteroid use, and previous nonvertebral fracture, as well as reduced BMD. Our results failed to show any independent relationship between vertebral deformities and the activity or severity of disease. Corticosteroid use is an important marker of established osteoporosis in patients with RA. Additionally, there seems to be a consistent relationship between BMD and vertebral deformities in this patient group.Arthritis & Rheumatism 07/2003; 49(3):355-60. · 7.87 Impact Factor -
Article: Bone loss in patients with rheumatoid arthritis: results from a population-based cohort of 366 patients followed up for two years.
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ABSTRACT: To evaluate the extent of and risk factors for bone loss in a population-based cohort of patients with rheumatoid arthritis (RA) receiving conventional health care. In a longitudinal study, clinical data were collected and bone mineral density (BMD) measurements were performed at baseline and after 2 years. Dual-energy x-ray absorptiometry was used for hip and spine BMD measurements. At baseline, patients received advice about lifestyle adjustments and calcium and vitamin D supplementation; during the followup period they were treated with antirheumatic and bone-sparing drugs, according to clinical judgment. After a mean +/- SD of 2.2 +/- 0.2 years, 366 (298 women, 68 men) of the 488 patients who were examined at baseline were reexamined. At that time, 47.9% were current users of corticosteroids and 37.0% were using antiresorptive drugs (hormone replacement therapy, bisphosphonates, or calcitonin). The mean BMD reduction was -0.64% in the femoral neck, -0.77% in the total hip, and -0.29% in the spine at L2-4. BMD was increased at all measurement sites in current users of antiresorptive drugs (0.16-1.64%) but was decreased in patients using calcium and vitamin D alone (-1.99% to -1.39%) and in patients not using any osteoporosis treatment (-1.20% to -0.43%). Current use of corticosteroids was independently associated with increased risk for BMD loss in the total hip (odds ratio [OR] 2.63, 95% confidence interval [95% CI] 1.38-5.00) and spine at L2-4 (OR 2.70, 95% CI 1.30-5.63), whereas current use of antiresorptive drugs was associated with decreased risk for bone loss in the total hip (OR 0.43, 95% CI 0.20-0.89). Results of this population-based, 2-year followup study indicate that adequate management of patients with RA, addressing both the rheumatic disease and osteoporosis, protects against bone loss.Arthritis & Rheumatism 08/2002; 46(7):1720-8. · 7.87 Impact Factor -
Article: Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial.
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ABSTRACT: Randomized controlled trials have shown that a combination of vitamin D and calcium can prevent fragility fractures in the elderly. Whether this effect is attributed to the combination of vitamin D and calcium or to one of these nutrients alone is not known. We studied if an intervention with 10 microg of vitamin D3 per day could prevent hip fracture and other osteoporotic fractures in a double-blinded randomized controlled trial. Residents from 51 nursing homes were allocated randomly to receive 5 ml of ordinary cod liver oil (n = 569) or 5 ml of cod liver oil where vitamin D was removed (n = 575). During the study period of 2 years, fractures and deaths were registered, and the principal analysis was performed on the intention-to-treat basis. Biochemical markers were measured at baseline and after 1 year in a subsample. Forty-seven persons in the control group and 50 persons in the vitamin D group suffered a hip fracture. The corresponding figures for all nonvertebral fractures were 76 persons (control group) and 69 persons (vitamin D group). There was no difference in the incidence of hip fracture (p = 0.66, log-rank test), or in the incidence of all nonvertebral fractures (p = 0.60, log-rank test) in the vitamin D group compared with the control group. Compared with the control group, persons in the vitamin D group increased their serum 25-hydroxyvitamin D concentration with 22 nmol/liter (p = 0.001). In conclusion, we found that an intervention with 10 microg of vitamin D3 alone produced no fracture-preventing effect in a nursing home population of frail elderly people.Journal of Bone and Mineral Research 05/2002; 17(4):709-15. · 6.37 Impact Factor -
Article: Vitamin D deficiency, secondary hyperparathyroidism and bone mineral density in Pakistani and Norwegians living in Oslo, Norway
Norsk Epidemiologi. -
Article: In vivo and in vitro comparison of densitometers in the NOREPOS study.
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ABSTRACT: The purpose of this study was to assess the agreement of in vivo hip scans on 3 densitometers (1 GE Lunar DPX-IQ and 2 GE Lunar Prodigy scanners) and to evaluate whether the European Spine Phantom (ESP) was able to reproduce the in vivo variability. Sixteen subjects had 3 repeated scans (with repositioning) on each densitometer, and the ESP was measured on each densitometer at least 40 times. Mean differences between hip scans on the Prodigy scanners were small and insignificant, and the in vivo results were not significantly different from the in vitro results. Bland and Altman plots showed no systematic differences between the Prodigy scanners over the range of bone mineral density (BMD). On the other hand, differences between Prodigy and DPX-IQ changed systematically over the range of BMD. The ESP did not fully reproduce the in vivo difference between Prodigy and DPX-IQ. In conclusion, the ESP is a valid substitute when assessing agreement between Prodigy scanners. However, when assessing agreement between different types of scanners, substitution of in vivo with in vitro measurements should be made with caution.Journal of Clinical Densitometry 11(2):276-82. · 1.29 Impact Factor
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Institutions
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2011
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Sunnaas Rehabilitation Hospital
Nesoddtangen, Akershus Fylke, Norway
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2003–2010
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University of Oslo
Oslo, Oslo, Norway
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2007
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Norwegian Institute of Public Health
Oslo, Oslo, Norway
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2002–2005
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Diakonhjemmet Hospital (Norway)
Oslo, Oslo, Norway
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