Skip to main content
Erschienen in: Osteoporosis International 12/2005

01.12.2005 | Original Article

Exposure to CB-153 and p,p’-DDE and bone mineral density and bone metabolism markers in middle-aged and elderly men and women

verfasst von: Ewa Wallin, Lars Rylander, Bo A. G. Jönssson, Thomas Lundh, Anders Isaksson, Lars Hagmar

Erschienen in: Osteoporosis International | Ausgabe 12/2005

Einloggen, um Zugang zu erhalten

Abstract

The incidence of osteoporotic fractures is rising in western societies, partly due to unknown reasons. Persistent organochlorine compounds (POC) have in animal studies impaired the normal bone metabolism and resulted in increased bone fragility, which might have health implications for POC-exposed human populations. The aim of the present study was to assess whether a high dietary intake of POC through fatty fish from the Baltic may result in decreased bone mineral density (BMD) or disturbances in biochemical markers of bone metabolism. From a study base of fishermen and fishermen’s wives from the Swedish east coast who are considerably more POC-exposed than the general Swedish population, 196 men (median age 59 years) and 184 women (median age 62 years) participated in an examination of their forearm BMD, using dual energy x-ray absorptiometry (DXA). Further, POC exposure was assessed by analysis of lipid-adjusted serum levels of 2,2’,4,4’,5,5’-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p’-DDE). Cadmium in urine (U-Cd) was also analyzed. Biochemical markers in serum of osteoblastic (osteocalcin) and osteoclastic (CrossLaps) functions were measured. Adjustment for potential confounders was made by employing multiple regression analyses. Univariate analyses showed significant negative associations between CB-153 concentrations and BMD, but after adjustment for age and body mass index, these associations did not remain. None of the POC exposure variables were associated with CrossLaps or osteocalcin. There were no significant associations between U-Cd and BMD or any of the biochemical biomarkers. In conclusion, the results did not provide any support for the hypothesis that the current exposure levels to POC constitute a hazard for impaired bone metabolism in the general Swedish population.
Literatur
1.
Zurück zum Zitat Lind PM, Eriksen EF, Sahlin L et al. (1999) Effects of the antiestrogenic environment pollutant 3,3’,4,4’,5-pentachlorobiphenyl (PCB#126) in rat bone and uterus: diverging effects in ovariectomized and intact animals. Toxicol Appl Pharmacol 154:236-244CrossRefPubMed Lind PM, Eriksen EF, Sahlin L et al. (1999) Effects of the antiestrogenic environment pollutant 3,3’,4,4’,5-pentachlorobiphenyl (PCB#126) in rat bone and uterus: diverging effects in ovariectomized and intact animals. Toxicol Appl Pharmacol 154:236-244CrossRefPubMed
2.
Zurück zum Zitat Lind PM, Larsson S, Oxlund H et al. (2000) Change of bone tissue composition and impaired bone strength in rats exposed to 3,3’,4,4’,5-pentachlorobiphenyl (PCB-126). Toxicology 150:41–51CrossRefPubMed Lind PM, Larsson S, Oxlund H et al. (2000) Change of bone tissue composition and impaired bone strength in rats exposed to 3,3’,4,4’,5-pentachlorobiphenyl (PCB-126). Toxicology 150:41–51CrossRefPubMed
3.
Zurück zum Zitat Jamsa T, Viluksela M, Tuomisto JT et al. (2001) Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on bone in two rat strains with different aryl hydrocarbon receptor structures. J Bone Miner Res 16:1812-1820PubMed Jamsa T, Viluksela M, Tuomisto JT et al. (2001) Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on bone in two rat strains with different aryl hydrocarbon receptor structures. J Bone Miner Res 16:1812-1820PubMed
4.
Zurück zum Zitat Miettinen HM, Pulkkinen P, Jämsä T et al. (2003) In utero and lactational TCDD exposure affects rat bone development. Organohalogen Compounds 64:274–277 Miettinen HM, Pulkkinen P, Jämsä T et al. (2003) In utero and lactational TCDD exposure affects rat bone development. Organohalogen Compounds 64:274–277
5.
Zurück zum Zitat Cripps DJ, Peters HA, Gocmen A et al (1984) Porphyria turcica due to hexachlorobenzene: a 20 to 30 year follow-up study on 204 patients. Br J Dermatol 111:413-422PubMed Cripps DJ, Peters HA, Gocmen A et al (1984) Porphyria turcica due to hexachlorobenzene: a 20 to 30 year follow-up study on 204 patients. Br J Dermatol 111:413-422PubMed
6.
Zurück zum Zitat Miller RW (1985) Congenital PCB poisoning: a reevaluation. Environ Health Perspect 60:211–214PubMed Miller RW (1985) Congenital PCB poisoning: a reevaluation. Environ Health Perspect 60:211–214PubMed
7.
Zurück zum Zitat Turner RT, Riggs BL, Spelsberg TC (1994) Skeletal effects of estrogen. Endocrin Rev 15:275–296CrossRef Turner RT, Riggs BL, Spelsberg TC (1994) Skeletal effects of estrogen. Endocrin Rev 15:275–296CrossRef
8.
Zurück zum Zitat Slemenda CW, Longcope C, Zhou L et al. (1997) Sex steroids and bone mass in older men. J Clin Invest 100:1755–1759PubMed Slemenda CW, Longcope C, Zhou L et al. (1997) Sex steroids and bone mass in older men. J Clin Invest 100:1755–1759PubMed
9.
Zurück zum Zitat Bonefeld-Jorgensen EC, Andersen HR, Rasmussen TH et al. ( 2001) Effect of highly bioaccumulated polychlorinated biphenyl congeners on estrogen and androgen receptor activity. Toxicology 158:141–153CrossRefPubMed Bonefeld-Jorgensen EC, Andersen HR, Rasmussen TH et al. ( 2001) Effect of highly bioaccumulated polychlorinated biphenyl congeners on estrogen and androgen receptor activity. Toxicology 158:141–153CrossRefPubMed
10.
Zurück zum Zitat Danzo BJ (1997) Environmental xenobiotics may disrupt normal endocrine function by interfering with the binding of physiological ligands to steroid receptors and binding proteins. Environ Health Perspect 105:294–301PubMed Danzo BJ (1997) Environmental xenobiotics may disrupt normal endocrine function by interfering with the binding of physiological ligands to steroid receptors and binding proteins. Environ Health Perspect 105:294–301PubMed
11.
Zurück zum Zitat Kelce WR, Stone CR, Laws SC et al. (1995) Persistent DDT metabolite p,p’-DDE is a potent androgen receptor antagonist. 375:581–585 Kelce WR, Stone CR, Laws SC et al. (1995) Persistent DDT metabolite p,p’-DDE is a potent androgen receptor antagonist. 375:581–585
12.
Zurück zum Zitat Sohoni P, Sumpter JP (1998) Several environmental oestrogens are also anti-androgens. J Endocrinol 158:327–339CrossRefPubMed Sohoni P, Sumpter JP (1998) Several environmental oestrogens are also anti-androgens. J Endocrinol 158:327–339CrossRefPubMed
13.
Zurück zum Zitat Safe S, Wormke M (2003) Inhibitory aryl hydrocarbon receptor-estrogen receptor alpha cross-talk and mechanisms of action. Chem Res Toxicol 16:807–816PubMed Safe S, Wormke M (2003) Inhibitory aryl hydrocarbon receptor-estrogen receptor alpha cross-talk and mechanisms of action. Chem Res Toxicol 16:807–816PubMed
14.
Zurück zum Zitat Woodhouse AJ, Cooke GM (2004) Suppression of aromatase activity in vitro by PCBs 28 and 105 and Aroclor 1221. Toxicol Lett 152:91–100CrossRefPubMed Woodhouse AJ, Cooke GM (2004) Suppression of aromatase activity in vitro by PCBs 28 and 105 and Aroclor 1221. Toxicol Lett 152:91–100CrossRefPubMed
15.
Zurück zum Zitat Fukuzawa NH, Ohsako S, Nagano R et al. (2003) Effects of 3,3’,4,4’,5-pentachlorobiphenyl, a coplanar polychlorinated biphenyl congener, on cultured neonatal mouse testis. Toxicol In Vitro 17:259–269PubMed Fukuzawa NH, Ohsako S, Nagano R et al. (2003) Effects of 3,3’,4,4’,5-pentachlorobiphenyl, a coplanar polychlorinated biphenyl congener, on cultured neonatal mouse testis. Toxicol In Vitro 17:259–269PubMed
16.
Zurück zum Zitat Sonnenschein C, Soto AM (1998) An updated review of environmental estrogen and androgen mimics and antagonists. J Steroid Biochem Mol Biol 65:143–150CrossRefPubMed Sonnenschein C, Soto AM (1998) An updated review of environmental estrogen and androgen mimics and antagonists. J Steroid Biochem Mol Biol 65:143–150CrossRefPubMed
17.
Zurück zum Zitat Gray LE (1998) Xenoendocrine disrupters: laboratory studies on male reproductive effects. Toxicol Lett 102–103:331–335 Gray LE (1998) Xenoendocrine disrupters: laboratory studies on male reproductive effects. Toxicol Lett 102–103:331–335
18.
Zurück zum Zitat Daston GP, Cook JC, Kavlock RJ (2003) Uncertainties for endocrine disrupters: our view on progress. Toxicol Sci 74:245–252CrossRefPubMed Daston GP, Cook JC, Kavlock RJ (2003) Uncertainties for endocrine disrupters: our view on progress. Toxicol Sci 74:245–252CrossRefPubMed
19.
Zurück zum Zitat Kester MH, Bulduk S, Tibboel D, et al. (2000) Potent inhibition of estrogen sulfotransferase by hydroxylated PCB metabolites: a novel pathway explaining the estrogenic activity of PCBs. Endocrinology 141:1897–1900CrossRefPubMed Kester MH, Bulduk S, Tibboel D, et al. (2000) Potent inhibition of estrogen sulfotransferase by hydroxylated PCB metabolites: a novel pathway explaining the estrogenic activity of PCBs. Endocrinology 141:1897–1900CrossRefPubMed
20.
Zurück zum Zitat Kester MH, Bulduk S, van Toor H, et al. (2002) Potent inhibition of estrogen sulfotransferase by hydroxylated metabolites of polyhalogenated aromatic hydrocarbons reveals alternative mechanism for estrogenic activity of endocrine disrupters. J Clin Endocrinol Metab 87:1142–1150CrossRefPubMed Kester MH, Bulduk S, van Toor H, et al. (2002) Potent inhibition of estrogen sulfotransferase by hydroxylated metabolites of polyhalogenated aromatic hydrocarbons reveals alternative mechanism for estrogenic activity of endocrine disrupters. J Clin Endocrinol Metab 87:1142–1150CrossRefPubMed
21.
Zurück zum Zitat Gore AC, Wu TJ, Oung T, et al. (2002) A novel mechanism for endocrine-disrupting effects of polychlorinated biphenyls: direct effects on gonadotropin-releasing hormone neurons. J Neuroend 14:814–823CrossRef Gore AC, Wu TJ, Oung T, et al. (2002) A novel mechanism for endocrine-disrupting effects of polychlorinated biphenyls: direct effects on gonadotropin-releasing hormone neurons. J Neuroend 14:814–823CrossRef
22.
Zurück zum Zitat Birnbaum LS, Cummings AM (2002) Dioxins and endometriosis: a plausible hypothesis. Environ Health Perspect 110:15–21PubMed Birnbaum LS, Cummings AM (2002) Dioxins and endometriosis: a plausible hypothesis. Environ Health Perspect 110:15–21PubMed
23.
Zurück zum Zitat Matsumura F (2003) On the significance of the role of cellular stress response reactions in the toxic actions of dioxin. Biochemical Pharmacology 66:527–540CrossRefPubMed Matsumura F (2003) On the significance of the role of cellular stress response reactions in the toxic actions of dioxin. Biochemical Pharmacology 66:527–540CrossRefPubMed
24.
Zurück zum Zitat Boyce WJ, Vessey MP (1985) Rising incidence of fracture of the proximal femur. Lancet 1:150-151CrossRefPubMed Boyce WJ, Vessey MP (1985) Rising incidence of fracture of the proximal femur. Lancet 1:150-151CrossRefPubMed
25.
Zurück zum Zitat Gullberg B, Duppe H, Nilsson B et al. (1993) Incidence of hip fractures in Malmo, Sweden (1950–1991). Bone (Suppl):s23–s29 Gullberg B, Duppe H, Nilsson B et al. (1993) Incidence of hip fractures in Malmo, Sweden (1950–1991). Bone (Suppl):s23–s29
26.
Zurück zum Zitat Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413PubMed Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413PubMed
27.
Zurück zum Zitat Ismail AA, Pye SR, Cockerill WC et al. (2002) Incidence of Limb Fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 13:565–571CrossRefPubMed Ismail AA, Pye SR, Cockerill WC et al. (2002) Incidence of Limb Fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 13:565–571CrossRefPubMed
28.
Zurück zum Zitat Lips P (1997) Epidemiology and predictors of fractures associated with osteoporosis. Am J Med 103:3–8CrossRefPubMed Lips P (1997) Epidemiology and predictors of fractures associated with osteoporosis. Am J Med 103:3–8CrossRefPubMed
29.
Zurück zum Zitat Kido T, Nogawa K, Yamada Y et al. (1989) Osteopenia in inhabitants with renal dysfunction induced by exposure to environmental cadmium. Int Arch Occup Environ Health 61:271–276CrossRefPubMed Kido T, Nogawa K, Yamada Y et al. (1989) Osteopenia in inhabitants with renal dysfunction induced by exposure to environmental cadmium. Int Arch Occup Environ Health 61:271–276CrossRefPubMed
30.
Zurück zum Zitat Kjellstrom T (1992) Mechanisms and epidemiology of bone effects of cadmium [review]. IARC Sci Publ 118:301–310PubMed Kjellstrom T (1992) Mechanisms and epidemiology of bone effects of cadmium [review]. IARC Sci Publ 118:301–310PubMed
31.
Zurück zum Zitat Jarup L, Alfven T, Persson B et al. (1998) Cadmium may be a risk factor for osteoporosis. Occup Environ Med 55:435–439PubMed Jarup L, Alfven T, Persson B et al. (1998) Cadmium may be a risk factor for osteoporosis. Occup Environ Med 55:435–439PubMed
32.
Zurück zum Zitat Staessen JA, Roels HA, Emlianov D et al. (1999) Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Lancet 353:1140–1144CrossRefPubMed Staessen JA, Roels HA, Emlianov D et al. (1999) Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Lancet 353:1140–1144CrossRefPubMed
33.
Zurück zum Zitat Alfven T, Elinder C-G, Carlsson MD et al. (2000) Low-level cadmium exposure and osteoporosis. J Bone Miner Res 15:1579–1586.PubMed Alfven T, Elinder C-G, Carlsson MD et al. (2000) Low-level cadmium exposure and osteoporosis. J Bone Miner Res 15:1579–1586.PubMed
34.
Zurück zum Zitat Glynn AW, Michaelsson K, Lind PM et al. (2000) Organochlorines and bone mineral density in Swedish men from the general population. Osteoporosis Int 11:1036–1042CrossRef Glynn AW, Michaelsson K, Lind PM et al. (2000) Organochlorines and bone mineral density in Swedish men from the general population. Osteoporosis Int 11:1036–1042CrossRef
35.
Zurück zum Zitat Beard J, Marshall S, Jong K et al. (2000) 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane and reduced bone mineral density. Arch Environ Health 55:177–180PubMed Beard J, Marshall S, Jong K et al. (2000) 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane and reduced bone mineral density. Arch Environ Health 55:177–180PubMed
36.
Zurück zum Zitat Bohannaon AD, Cooper GS, Wolff MS et al. (2000) Exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDT) in relation to bone mineral density and rate of bone loss in menopausal women. Arch Environ Health 55:386–391PubMed Bohannaon AD, Cooper GS, Wolff MS et al. (2000) Exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDT) in relation to bone mineral density and rate of bone loss in menopausal women. Arch Environ Health 55:386–391PubMed
37.
Zurück zum Zitat Svensson BG, Nilsson A, Hansson M et al. (1991) Exposure to dioxins and dibenzofurans through the consumption of fish. N Engl J Med 324:8–12PubMed Svensson BG, Nilsson A, Hansson M et al. (1991) Exposure to dioxins and dibenzofurans through the consumption of fish. N Engl J Med 324:8–12PubMed
38.
Zurück zum Zitat Svensson BG, Nilsson A, Jonsson E et al. (1995) Fish consumption and exposure to persistent organochlorine compounds, mercury, selenium and methylamines among Swedish fishermen. Scand J Work Environ Health 21:96–105PubMed Svensson BG, Nilsson A, Jonsson E et al. (1995) Fish consumption and exposure to persistent organochlorine compounds, mercury, selenium and methylamines among Swedish fishermen. Scand J Work Environ Health 21:96–105PubMed
39.
Zurück zum Zitat Rylander L, Hagmar L (1995) Mortality and cancer incidence among women with a high consumption of fatty fish contaminated with persistent organochlorine compounds. Scand J Work Environ Health 21:419-426PubMed Rylander L, Hagmar L (1995) Mortality and cancer incidence among women with a high consumption of fatty fish contaminated with persistent organochlorine compounds. Scand J Work Environ Health 21:419-426PubMed
40.
Zurück zum Zitat Rylander L, Dyremark E, Strömberg U et al. (1997) The impact of age, lactation and dietary habits on PCB in plasma in Swedish women. Sci Total Environ 207:55–61CrossRefPubMed Rylander L, Dyremark E, Strömberg U et al. (1997) The impact of age, lactation and dietary habits on PCB in plasma in Swedish women. Sci Total Environ 207:55–61CrossRefPubMed
41.
Zurück zum Zitat Alveblom A-K, Rylander L, Johnell O et al. (2003) Incidence of hospitalized osteoporotic fractures in cohorts with high dietary intake of persistent organochlorine compounds. Int Arch Occup Environ Health 76:246-248PubMed Alveblom A-K, Rylander L, Johnell O et al. (2003) Incidence of hospitalized osteoporotic fractures in cohorts with high dietary intake of persistent organochlorine compounds. Int Arch Occup Environ Health 76:246-248PubMed
42.
Zurück zum Zitat Wallin E, Rylander L, Hagmar L (2004) Dietary exposure to persistent organochlorine compounds through fish consumption and incidence of osteoporotic fractures. Scand J Work Environ Health 20:30–35 Wallin E, Rylander L, Hagmar L (2004) Dietary exposure to persistent organochlorine compounds through fish consumption and incidence of osteoporotic fractures. Scand J Work Environ Health 20:30–35
43.
Zurück zum Zitat Grimvall E, Rylander L, Nilsson-Ehle P et al. (1997) Monitoring of polychlorinated biphenyls in human blood plasma with respect to age, lactation and fish consumption; methodology developments. Arch Environ Contam Toxicol 32:329-336CrossRefPubMed Grimvall E, Rylander L, Nilsson-Ehle P et al. (1997) Monitoring of polychlorinated biphenyls in human blood plasma with respect to age, lactation and fish consumption; methodology developments. Arch Environ Contam Toxicol 32:329-336CrossRefPubMed
44.
Zurück zum Zitat Glynn AW, Wolk A, Aune M et al. (2000) Serum concentrations of organochlorines in men: a search for markers of exposure. Sci Total Environ 263:197–208CrossRefPubMed Glynn AW, Wolk A, Aune M et al. (2000) Serum concentrations of organochlorines in men: a search for markers of exposure. Sci Total Environ 263:197–208CrossRefPubMed
45.
Zurück zum Zitat Gladen BC, Longnecker MP, Schecter AJ (1999) Correlations among polychlorinated biphenyls, dioxins, and furans in humans. Am J Ind Med 35:15–20CrossRefPubMed Gladen BC, Longnecker MP, Schecter AJ (1999) Correlations among polychlorinated biphenyls, dioxins, and furans in humans. Am J Ind Med 35:15–20CrossRefPubMed
46.
Zurück zum Zitat Sjödin A, Hagmar L, Klasson-Wehler E et al. (2000) Influence of the consumption of fatty Baltic Sea fish on plasma levels of halogenated environmental contaminants in Latvian and Swedish men. Environ Health Perspect 108:1035–1041PubMed Sjödin A, Hagmar L, Klasson-Wehler E et al. (2000) Influence of the consumption of fatty Baltic Sea fish on plasma levels of halogenated environmental contaminants in Latvian and Swedish men. Environ Health Perspect 108:1035–1041PubMed
47.
Zurück zum Zitat Richthoff J, Rylander L, Jonsson BA et al. (2003) Serum levels of 2,2,4,4,5,5 -hexachlorobiphenyl (CB-153) in relation to markers of reproductive function in young males from the general Swedish population. Environ Health Perspect 111:409–413PubMed Richthoff J, Rylander L, Jonsson BA et al. (2003) Serum levels of 2,2,4,4,5,5 -hexachlorobiphenyl (CB-153) in relation to markers of reproductive function in young males from the general Swedish population. Environ Health Perspect 111:409–413PubMed
48.
Zurück zum Zitat Rignell-Hydbom A, Rylander R, Giwercman A et al. (2004) Exposure to CB-153 and p,p’-DDE and male reproductive function. Hum Reprod 19:2066–2075CrossRefPubMed Rignell-Hydbom A, Rylander R, Giwercman A et al. (2004) Exposure to CB-153 and p,p’-DDE and male reproductive function. Hum Reprod 19:2066–2075CrossRefPubMed
49.
Zurück zum Zitat Rylander L, Nilsson-Ehle P, Hagmar L (2005) A simplified precise method for adjusting serum levels of persistent organohalogen pollutants to total serum lipids. Chemosphere (7 July; Epub ahead of print) Rylander L, Nilsson-Ehle P, Hagmar L (2005) A simplified precise method for adjusting serum levels of persistent organohalogen pollutants to total serum lipids. Chemosphere (7 July; Epub ahead of print)
50.
Zurück zum Zitat Mazzachi BC, Peake MJ, Ehrhardt V (2000) Reference range and method comparison studies for enzymatic and Jaffe creatinine assays in plasma and serum and early morning urine. Clin Lab 46:53–55PubMed Mazzachi BC, Peake MJ, Ehrhardt V (2000) Reference range and method comparison studies for enzymatic and Jaffe creatinine assays in plasma and serum and early morning urine. Clin Lab 46:53–55PubMed
51.
Zurück zum Zitat Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed
52.
Zurück zum Zitat Wolff MS, Anderson HA (1999) Correspondence re: J. M. Schildkraut et al., Environmental contaminants and body fat distribution. Cancer Epidemiol Biomark Prev., 8:179–183. Cancer Epidemiol Biomark Prev 8:951–952 Wolff MS, Anderson HA (1999) Correspondence re: J. M. Schildkraut et al., Environmental contaminants and body fat distribution. Cancer Epidemiol Biomark Prev., 8:179–183. Cancer Epidemiol Biomark Prev 8:951–952
53.
Zurück zum Zitat Lind PM, Bergman A, Olsson M et al. (2003) BMD in male Baltic grey seal. Ambio 32:385–388PubMed Lind PM, Bergman A, Olsson M et al. (2003) BMD in male Baltic grey seal. Ambio 32:385–388PubMed
Metadaten
Titel
Exposure to CB-153 and p,p’-DDE and bone mineral density and bone metabolism markers in middle-aged and elderly men and women
verfasst von
Ewa Wallin
Lars Rylander
Bo A. G. Jönssson
Thomas Lundh
Anders Isaksson
Lars Hagmar
Publikationsdatum
01.12.2005
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 12/2005
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-005-2004-3

Weitere Artikel der Ausgabe 12/2005

Osteoporosis International 12/2005 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.