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Volume 3 · Number 1 · March 2011
5 Editorial  ( PDF )
Maxillary osteonecrosis: new evidence regarding its etiopathogeny
Rev Osteoporos Metab Mineral 2011 3;1:5-6
Maxillary osteonecrosis (MON) is a disease which has appeared recently as a serious complication in patients suffering from neoplasms or other chronic diseases. MON has been associated with the use of powerful diphosphonates, for which reason many authors have named the disease secondary osteonecrosis of the mandible due to biphosphonates1-5.
This is a relatively new disease, which means that there is not yet unanimity on many of its aspects. For a start, there is no clear and universally accepted definition of MON. A panel of experts from the American Society of Bone and Mineral Research (ASBMR)2 recently recommended using the definition "an area of exposed bone which persists for more than 8 weeks in the absence of earlier irradiation and/or metastasis in the mandible". The American Academy of Mouth and Maxillofacial Surgeons published a similar definition: a patient may have MON if they comply with 3 requirements: 1) current or previous use of biphosphonates; 2) the presence exposed or necrotic bone for a minimum of 8 weeks; and 3) an absence of maxillary radiotherapy. At this point should insist that the correct name for the disease is maxillary necrosis and not necrosis of the mandible, given that there is frequently also affectation of the upper maxilla6....
Sosa Henríquez M1, Vicente Barrero M2, Bocanegra Pérez S2
1 Universidad de Las Palmas de Gran Canaria- Grupo de investigación en osteoporosis y metabolismo mineral
2 Hospital Universitario Insular - Servicio de Cirugía Maxilofacial - Las Palmas de Gran Canaria
9 Original Articles  ( PDF )
Changes in bone microarchitecture in rheumatoid arthritis. Study using microCT
Rev Osteoporos Metab Mineral 2011 3;1:9-16
Introduction: The objective of this study is to analyse the bone microarchitecture in rheumatoid arthritis (RA) in a series of biopsies of the iliac crest carried out previously in patients not having had earlier treatment with glucocorticoids, using microCT analysis.
Material and method: 14 bone specimens were obtained, taken from the iliac crest of patients with RA with no previous treatment with glucocorticoids. None of these patients was diagnosed with a disease or was taking medicines which could compromise bone mineral metabolism. A complete clinical history was taken, and a blood analysis carried out, including the rheumatoid factor. The specimens were embedded in methyl-methacrylate and studied with a microCT eXplorer Locus SP scanner. The acquisition parameters were: 80 kVp/80 ?A, thickness of aluminium filter:10-3 inches, FOV ? 2x2 cm, mode of acquisition of 360°, 720 views, 4 frame averages/view, exposure time 1.700 ms, voxel resolution: 28 ?m. A region of interest (ROI) was selected by means of interpolation, avoiding cortical bone. An automatic segmentation process (thresholding) was used to differentiate and segment the hematopoietic bone tissue. The microarchitectural parameters were generated automatically by computer using parallel-plate algorithms. The results were compared with 14 specimens from healthy controls of similar age and sex using Student’s tes...
García Miguel J1, Wright A3, Pérez-Edo L2, Blanch J2, Carbonell J2, Wehrli F3
1 Servicio de Reumatología - Hospital Universitari Sagrat Cor de Barcelona
2 Servicio de Reumatología - Hospital del Mar de Barcelona - IMAS
3 Laboratory for Structural NMR Imaging - University Hospital of Pennsylvania – Philadephia
Rheumatoid arthritis, Microarquitecture, Bone, Computed Tomography.
21 Original Articles  ( PDF )
Evaluation of the risedronate efficiency 75 mgs versus generic alendronate 70 mgs, in women with post-menopausal osteoporosis and previous vertebral fractures in Spain
Rev Osteoporos Metab Mineral 2011 3;1:21-29
Introduction: The objective is to assess the cost-effectiveness of risedronate 75 mg 2 consecutive days/month vs generic alendronate 70 mg weekly, during one year in 75 years old females with post-menopausal osteoporosis and previous vertebral fracture.
Methods: A cost-effectiveness analysis under Health National System perspective has been developed to assess clinical (hip fracture prevention and quality adjusted life years gained) and economic consequences (€ 2010) during 5 years following one year treatment with both alternatives. Drug effect has been considered during the one year of drug administration. Epidemiology data and unitary costs were derived from Spanish literature.
Results: In a cohort of 1.000 females, (75 years old) with post-menopausal osteoporosis and vertebral fractures, risedronate 75 mg vs alendronate avoid 10 hip fractures, with 9.983€/hip fracture avoided cost. Aditional QALY gained are 4 with an incremental cost of 99,83€. Incremental cost-effectiveness ratio (ICER) is 24.957€ per QALY gained with risedronate 75 mg vs generic alendronate 70 mg.
Conclusion: In the treatment of females with post-menopausal osteoporosis and previous vertebral fracture, risedronate 75 mg 2 consecutive days/month compared to generic alendronate 70 mg weekly is an efficient strategy in Spain.
Oyágüez Martín I1, Gómez Alonso C2, Marqués de Torres M3, García Coscolín T4, Betegón Nicolás L4, Casado Gómez MA1
1 Pharmacoeconomics & Outcomes Research Iberia - Madrid
2 Servicio de Metabolismo Óseo y Mineral - HUCA - Oviedo
3 Farmaceútico de Atención Primaria - Area Sanitaria Este de Málaga-Axarquia
4 Departamento Economía de la Salud - Sanofi-Aventis – Madrid
Osteroporosis, Risedronate, Alendronate, Costs.
31 Clinical Notes  ( PDF )
Preliminary study of osteoblasts in peripheral blood in the population of infants and adolescents*
Rev Osteoporos Metab Mineral 2011 3;1:31-34
The presence of osteoporosis in adult life is conditional on the adequate development and formation of bone during growth in infancy and adolescence and the successive loss which occurs throughout life. Knowledge regarding bone tissue cells and their precursors in stages of growth is scarce, given the difficulties in obtaining samples of this tissue. Recent studies suggest a method of obtaining osteoblast line cells from peripheral blood. The main objective of this work has been to quantify the osteoblast line cells in the peripheral blood of infants and adolescents, as well as noting any possible differences according to the stage of growth.
38 subjects were studied, 16 children (between 4 and 12 years of age) and 12 adolescents (aged between 12 and 18 years). Osteoblast precursor cells in peripheral blood were analysed using the flow cytometry technique. The preliminary results show higher levels of preosteoblastic cells in the youngest age group: 4.17% ± 0.92 vs 2.03% ± 0.48, p= 0.021. There is a negative correlation between the percentage of preosteoblastic cells and age r= -0.488 and weight r= -0.530, p< 0.05. In summary, this technique allows us to quantify preosteoblasts in peripheral blood, and we show that they have a higher percentage, the lower the age, during the period of infancy and adolescence.
Giner M1, Montoya MJ2, Vázquez MA2, Miranda M1, Pérez-Cano R1,2
1 Unidad de Osteoporosis - Servicio Medicina Interna - Hospital Universitario Virgen Macarena - Sevilla
2 Departamento de Medicina - Facultad de Medicina - Universidad de Sevilla
Osteoblasts, Peripheral blood, Infants, Adolescents.
35 Reviews  ( PDF )
Treatment of Paget’s disease of bone
Rev Osteoporos Metab Mineral 2011 3;1:35-40

Paget’s disease of bone (PDB) is a chronic and focussed skeletal disorder, whose cause is unknown. The disease is located in the osteoclasts, which increase in number, size and activity. Bone turnover accelerates, with an increase in bone resorption, followed by excessive and disorganised formation. The result is bone which is not laminar (plexiform bone) highly vascularised, increased in volume, less compact and more susceptible to fracture or deformation. It is usually diagnosed at over 60 years of age, being infrequent below 40 years of age. It slightly predominates in males. It is the most common metabolic bone disease after osteoporosis1.
It is considered to be a multifactorial disease with the involvement of environmental and genetic factors.
Its main clinical manifestations are bone deformity and pain. During its evolution various complications may appear, the most frequent being degenerative arthropathy in its vicinity, neurological changes due to compression, fractures, cardiac pathology, disorders of the metabolism and of bone remodelling.
The diagnosis is based on clinical manifestations, raised levels of biochemical markers for bone remodelling (essentially, alkaline phosphatase – AP) and radiology.
There is no curative treatment, but the anti-resorptives, especially the diphosphonates, are efficacious in controlling th...
García Arias M1, Torrijos Eslava A2
1 Médico Residente de 4º año - Servicio Reumatología - H. U. La Paz - Madrid
2 Reumatólogo - Responsable de la Unidad Metabólica Ósea - Servicio de Reumatología - H. U. La Paz – Madrid

41 Reviews  ( PDF )
Dyslipidemia and bone metabolism. A common bond of the osteoporosis and the atherosclerosis?
Rev Osteoporos Metab Mineral 2011 3;1:41-50
The magnitude of the public health problem related to cardiovascular disease (CVD) and osteoporosis has been widely documented in the medical literature in the last decades, and common pathogenic links have been recently proposed. Dyslipidemia is one of the most important risk factors in the genesis and development of atherosclerosis, and therefore of CVD, which remains the leading cause of cardiovascular mortality in western countries. On the other hand, osteoporosis and its more serious consequence; fracture, represent a true epidemic nowadays. In this context, the relationship between dyslipidemia and bone metabolism has been addressed by several investigators, although results have been inconsistent. The purpose of this paper is to review the medical literature about the possible association between dyslipidemia and several aspects of bone metabolism....
Yezerska I, Hernández Hernández JL, Olmos Martínez JM, González Macías J
Unidad de Metabolismo Óseo - Servicio de Medicina Interna - Hospital Marqués de Valdecilla - Universidad de Cantabria – RETICEF
Dyslipidemia, Arteriosclerosis, Cardiovascular disease, Osteoporosis, Fracture, Bone mineral density, Bone turnover markers.
53 Special Documents  ( PDF )
Position document on the requirements and optimum levels of vitamin D
Rev Osteoporos Metab Mineral 2011 3;1:53-64

In the last few years there has been a notable interest in vitamin D, not only due to its crucial importance in bone mineral metabolism, but also for its effects outside the bone, which, every day, are becoming better known.
Similarly, the existence of low blood levels of vitamin D, lower than what is desirable, has been found in different populations, both healthy and sick, and there is a discussion as to what would be the optimum levels of vitamin D in the blood.
For all these reasons, the Spanish Society of Bone and Mineral Metabolism Research (Sociedad Española de Investigación Ósea y Metabolismo Mineral – SEIOMM), jointly with all the scientific societies involved in the study of bone metabolism, have produced this position document on the requirements and optimum levels of vitamin D.

Material and method

The content of this document was developed in the following stages:
a) Meeting of a group of experts in osteoporosis to discuss and agree the relevant clinical questions related to vitamin D (Table1).
b) Creation of a systematic review team, formed by two experts in bone mineral metabolism who carried out the search, a standardised review, critical analysis and tabulation of the articles which had been published in Spanish and English between January 2000 and May 2010. The search was carried out using the Me...
Gómez de Tejada Romero MJ1, Sosa Henríquez M2, Del Pino Montes J3, Jódar Gimeno E4, Quesada Gómez JM5, Cancelo Hidalgo MJ6, Díaz Curiel M7, Mesa Ramos M8, Muñoz Torres M9, Carpintero Benítez P10, Navarro Ceballos C11, Valdés y Llorca C12, Giner Ruíz V13, Blázquez Cabrera JA14, García Vadillo JA15, Martínez Rodríguez ME16, Peña Arrebola A16, Palacios Gil-Antuñano S17
Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM) y Sociedades afines
1 Secretaria de la SEIOMM y coordinadora general del proyecto - 2 Presidente de la SEIOMM - 3 Vice-Presidente de la SEIOMM - 4 Tesorero de la SEIOMM - 5 Experto en vitamina D de la SEIOMM - 6 Por la Asociación Española para el Estudio de la Menopausia (AEEM) - 7 Por la Fundación Hispana de Osteoporosis y Enfermedades Metabólicas Óseas (FHOEMO) - 8 Por la Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT-GEIOS) - 9 Por la Sociedad Española de Endocrinología y Nutrición (SEEN) - 10 Por la Sociedad Española de Fracturas Osteoporóticas (SEFRAOS) - 11 Por la Sociedad Española de Geriatría y Gerontología (SEGG) - 12 Por la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) - 13 Por la Sociedad Española de Medicina Familiar y Comunitaria (SEMFyC) - 14 Por la Sociedad Española de Medicina Interna (SEMI) - 15 Por la Sociedad Española de Reumatología (SER) - 16 Por la Sociedad Española de Rehabilitación y Medicina Física (SERMEF) - 17 Por la Sociedad Iberoamericana de Osteoporosis y Metabolismo Mineral (SIBOMM)
Revista de Osteoporosis y Metabolismo Mineral has recently been acepted for coverage in the Emerging Sources Citation Index, wich is the new edition of the Web of Science that was launched in november 2015. This means that any articles published in the journal will be indexed in the Web of Science at the time of publication.
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