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© 1973 Oxford University Press

other

Mineralization of the Bone in an Insured Population: Correlation with Reported Fractures and Other Measures of Osteoporosis

NAOMI F. GOLDSMITH1, and JAMES O. JOHNSTON2

12Kaiser Foundation Research Institute and Department of Orthopedics, Kaiser-Permanente Medical Center Oakland California 94611, U. S. A.

Requests for reprints may be addressed to Dr. Goldsmith, 280. West McArthur Boulevard, Oakland, California 94611.

A total of 3,515 persons of three skin colors, who appeared for multiphasic screening, were examined for bone mineral at the distal radius and questioned about fractures. Two-thirds were tested for hearing acuity; a subsample of approximately 950 was tested for aortic calcification and vertebral osteoporosis. Information on income and occupation was available for the entire multiphasic population.

The fracture histories of 57 subjects in their fifties were tested for validity. Of 58 reported fractures, 18 were confirmed, 14 in the most recent score of years; records were not coextensive or were missing in 37 cases. Three instances of over-reporting and five of under-reporting were noted.

Bone mineral at the distal radius decreased with age, markedly in women after 45 years, and in men after 65 years. At the same time women reported higher fracture rates, and in both sexes there were increased ratios of aortic calcification, vertebral osteoporosis, and hearing loss. In all groups, low concentrations of bone mineral were associated with high fracture rates. Osteopenic persons, the 15 per cent of the population with the lowest bone mineral, contributed 27 per cent of the total fractures. In older white women, osteopenia was significantly associated with aortic calcification and vertebral osteoporosis. Hearing deficit, however, was associated with high concentration of mineral in all men of all ages.

The osteopenic population, regardless of sex, age, or skin color, was considered to be "preporotic", that is, to have low mineral at the distal radius, and to be at risk of an excess of fractures, vertebral osetoporosis, and aortic calcification.


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