Document Detail


Effects of treatment with fluoride on bone mineral density and fracture risk--a meta-analysis.
MedLine Citation:
PMID:  17701094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fluoride has fallen into discredit due to the absence of an anti-fracture effect. However, in this meta-analysis, a fracture reducing potential was seen at low fluoride doses [< or =20 mg fluoride equivalents (152 mg monofluorophosphate/44 mg sodium fluoride)]: OR = 0.3, 95% CI: 0.1-0.9 for vertebral and OR = 0.5, 95% CI: 0.3-0.8 for non-vertebral fractures. INTRODUCTION: Fluoride is incorporated into bone mineral and has an anabolic effect. However, the biomechanical competence of the newly formed bone may be reduced. METHODS: A systematic search of PubMed, Embase, and ISI web of science yielded 2,028 references. RESULTS: Twenty-five eligible studies were identified. Spine BMD increased 7.9%, 95% CI: 5.4-10.5%, and hip BMD 2.1%, 95% CI: 0.9-3.4%. A meta-regression showed increasing spine BMD with increasing treatment duration (5.04 +/- 2.16%/year of treatment). Overall there was no significant effect on the risk of vertebral (OR = 0.8, 95% CI: 0.5-1.5) or non-vertebral fracture (OR = 0.8, 95% CI: 0.5-1.4). With a daily dose of < or =20 mg fluoride equivalents (152 mg monofluorophosphate/44 mg sodium fluoride), there was a statistically significant reduction in vertebral (OR = 0.3, 95% CI: 0.1-0.9) and non-vertebral (OR = 0.5, 95% CI: 0.3-0.8) fracture risk. With a daily dose >20 mg fluoride equivalents, there was no significant reduction in vertebral (OR = 1.3, 95% CI: 0.8-2.0) and non-vertebral (OR = 1.5, 95% CI: 0.8-2.8) fracture risk. CONCLUSIONS: Fluoride treatment increases spine and hip BMD, depending on treatment duration. Overall there was no effect on hip or spine fracture risk. However, in subgroup analyses a low fluoride dose (< or =20 mg/day of fluoride equivalents) was associated with a significant reduction in fracture risk.
Authors:
P Vestergaard; N R Jorgensen; P Schwarz; L Mosekilde
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2007-08-15
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  19     ISSN:  0937-941X     ISO Abbreviation:  Osteoporos Int     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-07-18     Revised Date:  2010-05-10    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  257-68     Citation Subset:  IM    
Affiliation:
The Osteoporosis Clinic, Department of Endocrinology and Metabolism C, Aarhus University Hospital Aarhus Amtssygehus, Tage Hansens Gade 2, 8000 Aarhus C, Denmark. p-vest@post4.tele.dk
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MeSH Terms
Descriptor/Qualifier:
Bone Density / drug effects*
Fluorides / adverse effects,  therapeutic use*
Fractures, Bone / physiopathology,  prevention & control*
Hip Joint / physiology
Humans
Randomized Controlled Trials as Topic
Spinal Fractures / prevention & control
Spine / physiology
Chemical
Reg. No./Substance:
0/Fluorides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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