Impact of Adolescent Pregnancy on Bone Density in Underprivileged Pre-Menopausal Indian Women

Reference Data for Lunar iDXA for the Assessment of Bone Health in Indian Children and Youth: A Cross-Sectional Study

OBJECTIVE

Dual energy x-ray absorptiometry (DXA) is the commonest bone densitometry technique in children. As no pediatric reference database for Indian children using a narrow fan beam densitometer is available, the aim of the study was to provide sex- and age-specific reference percentile curves for the assessment of bone health using the Lunar iDXA in 1-19-year-old Indian children.

METHODS

A cross-sectional study was carried out between November 2017 and July 2022 involving 1247 (607 girls) healthy children from Pune, India. The bone mineral content [BMC (g)], bone area [BA (cm2)], and bone mineral density [BMD (g/cm2)] were measured using the GE-Lunar iDXA narrow-angle fan beam scanner. Reference percentile curves were generated for total body BMC (TBBMC), total body BA (TBBA), lumbar spine bone mineral apparent density [BMAD (g/cm3)], and left femoral neck BMAD. Additionally, we provided percentile curves for TBBA relative to height, TBBMC relative to TBBA, lean body mass (LBM) relative to height, and TBBMC relative to LBM.

RESULTS

Mean (SD) bone parameters were expressed by age groups for boys and girls separately. The average annual age-related increase in TBBMD, lumbar spine BMD, and femoral neck BMD was 6.3, 7.2, and 4.5%, respectively, across different age groups. The median TBBA and TBBMC for height were higher in boys than girls by 14.7 and 24.9%, respectively. Similarly, the median TBBMC for LBM was 36.8% higher in boys as compared to girls.

CONCLUSION

The study reports reference curves for DXA parameters (narrow fan beam) for Indian children and youth.

A Comparative Study of Bone-Health and Associated Factors in Healthy Indian Adolescents and Young Women

Introduction

Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health.

Methods

This cross-sectional case-control study was performed on 110 apparently healthy unmarried, nonpregnant, nonlactating, postmenarchal adolescent girls and young women aged 11 to 24 years residing in urban slums with the same number of age-matched controls from NS areas. Anthropometric, dietary, physical-activity and bone-health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography-DXA and pQCT-respectively) were evaluated using standard protocols. A P value of < 0.05 was considered statistically significant.

Results

Slum girls were significantly shorter and lighter and had lower dietary intakes of calcium and protein after adjusting for total daily calorie intake than NS girls (P < 0.05). Areal bone-mineral density (BMD) at lumber spine (0.940 ± 0.13 vs1.042 ± 0.15 g/cm2), femur and total body (less-head), bone-mineral apparent density adjusted for volume at the lumbar spine (0.295 ± 0.04 vs 0.319 ± 0.04 g/cm3) and height-adjusted bone density at femur (0.862 ± 0.011 vs 0.905 ± 0.011 g/cm2) were significantly lower in slum dwelling participants as compared to their NS counterparts (P < 0.05). After adjusting for confounders like sunlight exposure, anthropometric parameters and dietary calcium intake, area of dwelling was still a significant factor for the difference in BMD.

Conclusions

The potential determinants of poor bone density and geometry in girls and young women residing in slums include residential location, dietary habits, and physical activity levels. Despite adjustments for confounding factors, differences in bone health between those in slum and nonslum areas suggest adaptations developed over generations of deprivation in these individuals, necessitating urgent intervention.

Analysis of CBCT Bone Density Using the Hounsfield Scale

Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol.