3-15-07 Update on vertebroplasty, vitamin D and testosterone
AJNR Am J Neuroradiol. 2007 Mar;28(3):563-6, Outcomes of patients receiving long-term corticosteroid therapy who undergo percutaneous vertebroplasty. Koch CA, Layton KF, Kallmes DF. PMID: 17353337. This article concludes that percutaneous vertebroplasty (PVP) is as effective and helpful for those who need PVP due to long-term corticosteroid therapy as those with vertebral compression fractures due to primary osteoporosis. Editor's comments: For a discussion of PVP and kyphoplasty see this article on the Men's Osteoporosis Website.
AJNR Am J Neuroradiol. 2007 Mar;28(3):555-60, Percutaneous Vertebroplasty Compared with Optimal Pain Medication Treatment: Short-Term Clinical Outcome of Patients with Subacute or Chronic Painful Osteoporotic Vertebral Compression Fractures. The VERTOS Study. Voormolen MH and others. PMID: 17353335. This studycompared the pain relief in patients who received either PVP or optimal pain medication (OPM) over a two-week period. After two weeks patients in the OPM group were given the option to have PVP if they desired. Since 14 of the 16 patients in the OPM group asked for PVP, it is obvious that the PVP had better results. The authors noted: “ Pain relief and improvement of mobility, function, and stature after PV is immediate and significantly better in the short term compared with OPM treatment.” Editor's comments: PVP is a surgical procedure which can afford considerable relief, however, it is not without risk. So be sure to get all the information you can about the procedure and your practitioner's experience providing PVP or kyphoplasty so you can make an informed judgment about the risks and rewards of the surgery.
Orv Hetil. 2007 Feb 18;148(7):319-25, Vitamin D forming effectiveness of ultraviolet radiation from sunlight in different months in Budapest, Hungary. Bakos J, Miko P. PMID: 17344152. This article confirms what is commonly believed about humans getting inadequate sunshine during the winter months if they live in the northern latitudes. This study was performed in Budapest, Hungary, at a latitude of 47, 30 N. The authors conclude that there is no way to get adequate vitamin D production from the skin's absorption of UV B ultraviolet rays at that latitude from November to March. Editor's comments: Vitamin D has been shown in multiple studies to be the more important factor in bone health when compared to calcium. This study shows that people in far northern or southern latitudes are not producing enough vitamin D from solar UV B skin exposure during the winter months and should be getting approximately 1,000 IU of vitamin D via supplements to offset this shortage. There is latitude information on world cities and for US and Canadian cities on the Net to see if your location puts you at risk for low vitamin D levels during the winter months.
Int J Impot Res. 2007 Mar-Apr;19(2):176-82. Epub 2006 Aug 31, Low testosterone levels are associated with coronary artery disease in male patients with angina. Rosano GM and others. PMID: 16943795. This study looked at men undergoing coronary angiography and compared their testosterone levels to matched controls. Both bioavailable testosterone and plasma estradiol levels were lower in the men with coronary artery disease (CAD) than in the controls. This conflicts with the historical belief that high androgen levels were associated with a higher risk for CAD. Editor's comments: The testosterone levels noted in these men didn't appear to be frank hypogonadism which would also be associated with low bone mineral density. But the authors only reported mean testosterone levels, so possibly some of the men were hypogonadal. Whatever the case, there would appear to be an added CAD risk association for hypogonadal men with osteopenia or osteoporosis. When first receiving the hypogonadal diagnosis, men may want to have some CAD testing done to rule that out too.