1
|
Muttanahally KS, Yadav S, Freilich MA, Tadinada A. Does the outcome of graft materials at dental implant sites differ between patients with normal and compromised bone health? J ORAL IMPLANTOL 2024:500000. [PMID: 38624039 DOI: 10.1563/aaid-joi-d-23-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To assess the outcome of bone graft material at alveolar bone augmentation sites combined with dental implants in postmenopausal women with compromised bone health by evaluating cone beam computed tomography (CBCT) scans at multiple time points. MATERIALS AND METHODS CBCT scans were analyzed on 55 postmenopausal women with compromised bone health status to determine the fate of alveolar bone augmentation. CBCT scans were taken immediately after surgery and 9 and 24 months post-operatively. The patient's medication regimens and durations were recorded, and the pixel intensity value (PIV) was measured and standardized using scoring criteria and visual assessment. Statistical analyses included two-sample t-tests for continuous variables and Fisher's exact tests for categorical variables. RESULTS Among the normal patients, 73% received a grade 2 visual score, and 27% received a grade 1 visual score. After 24 months, 45% of patients received a grade 2 score, and 27% received a grade 3 score. In the osteoporotic group receiving medication, 77% of participants received a grade 1 visual score at the 9-month postoperative evaluation, while 23% received a grade 2 score. At the 24-month assessment, 55% of patients received a grade 1 score, 41% received a grade 2 score, and only 5% received a grade 3 score. Notably, although the graft material did not remodel into native bone, it was a scaffold for implants in controlled osteoporotic patients. CONCLUSION The study's results show that the pixel intensity values of particulate graft materials are similar across the three different time points, suggesting that the graft material's pixel intensity value remains constant in postmenopausal women with osteoporosis. The study's limitations include a small sample size and a restricted 24-month follow-up period. This limited time frame may need to capture long-term changes or variations in graft materials adequately. FUTURE DIRECTIONS Future research should include a larger sample size and have a longer follow-up duration to provide a more comprehensive understanding of the change in graft materials between patients with normal and compromised bone health.
Collapse
Affiliation(s)
- Kavya Shankar Muttanahally
- Assistant Professor, Oral and Maxillofacial Radiology Department of Growth and Development UNMC College of Dentistry, Lincoln, NE- 68583-0740
| | - Sumit Yadav
- Chair, Department of Growth and Development UNMC College of Dentistry, Lincoln, NE- 68583-0740
| | - Martin A Freilich
- Professor, Prosthodontics, UConn School of Dental Medicine 263 Farmington Avenue Farmington, CT 06030-1615
| | - Aditya Tadinada
- Associate Dean of Graduate Research, UConn School of Dental Medicine 263 Farmington Avenue Farmington, CT 06030-1615
| |
Collapse
|
2
|
Lu M, Tang Y, Geng X, Gu C, Zhao Y, Chen X. MRI-based vertebral bone quality score in cervical ossification of the posterior longitudinal ligament: a comparison with cervical spondylotic myelopathy using propensity score matching. Spine J 2024:S1529-9430(24)00082-2. [PMID: 38447872 DOI: 10.1016/j.spinee.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Bone mineral density plays a key role in the assessment of operative instrumentation complications and clinical outcomes. The MRI-based vertebral bone quality (VBQ) score has been introduced as a novel marker of bone quality. However, few studies have investigated the relationship between VBQ score and patients associated with cervical ossification of the posterior longitudinal ligament (OPLL). PURPOSE The aims of the study were (1) to reveal bone mineral density between cervical OPLL and cervical spondylotic myelopathy (CSM) group by VBQ score, (2) to compare the VBQ score of cervical OPLL between male and female group, (3) to explore the relationship between segmental VBQ scores associated with OPLL. STUDY DESIGN Retrospective cohort study. PATIENT SAMPLE Consecutive series of 425 patients at a single academic institution. OUTCOME MEASURES MRI based measurements of C2-C7 VBQ scores. METHODS Preoperative non-contrast T1-weighted MRIs of the cervical spine was used to measure the VBQ score. The VBQ score was defined as the mean value of the signal intensity of the vertebrae divided by that of the cerebrospinal fluid (CSF) space at the cisterna magna. Patients with cervical OPLL and CSM were matched based on age, sex, body mass index (BMI), comorbidity, medication history, diet habit, smoking, alcohol consumption via propensity score matching (PSM). Normality of each VBQ score was tested by the Shapiro-Wilk test. Wilcoxon's rank-sum test was used to compare matched cohorts. Kruskal-Wallis test was performed to compare the VBQ scores between segments. Multivariate logistic regression analysis was used to evaluate factors associated with the development of cervical OPLL. RESULTS A total of 425 patients were assessed. For final analysis, 135 paired patients were compared between the cervical OPLL and CSM groups, and 22 paired patients were compared between male and female group associated with cervical OPLL. There were no statistically significant differences in age, sex, BMI, comorbidity, medication history, diet habit, smoking, alcohol between the matched cohorts. OPLL group was associated with lower VBQ score compared with CSM group at C3, while there were no differences in VBQ score for the other levels between the two groups. There were no differences between male and female group associated with OPLL in C2-C7 VBQ scores. VBQ scores of cervical OPLL are variable between segments, with significantly lower scores at C6, C7 compared with C1-C5. Multivariate logistic regression analysis showed that BMI was correlated with the development of OPLL (regression coefficient, 0.162; 95% confidence interval, 0.010-0.037). Additional risk factors included hypertension, calcium supple history and smoking. CONCLUSIONS This study demonstrates that cervical OPLL is associated with lower VBQ score at C3, with no differences for the other levels when compared with CSM derived from measurements on MRI. No differences were found between male and female group associated with OPLL in C2-C7 VBQ scores. Cervical OPLL were found to have smaller VBQ score at C6, C7 compared with C1-C5. Our findings provide new insight for bone density assessment in cervical OPLL patient.
Collapse
Affiliation(s)
- Minming Lu
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China
| | - Yifan Tang
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China
| | - Xiangwu Geng
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China
| | - Changjiang Gu
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China
| | - Yin Zhao
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China
| | - Xiongsheng Chen
- Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University (Second Military Medical University) Shanghai 200003, P. R. China..
| |
Collapse
|
3
|
Agaronnik ND, Giberson-Chen C, Bono CM. Using advanced imaging to measure bone density, compression fracture risk, and risk for construct failure after spine surgery. Spine J 2024:S1529-9430(24)00103-7. [PMID: 38437918 DOI: 10.1016/j.spinee.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/22/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
Low bone mineral density (BMD) can predispose to vertebral body compression fractures and postoperative instrumentation failure. DEXA is considered the gold standard for measurement of BMD, however it is not obtained for all spine surgery patients preoperatively. There is a growing body of evidence suggesting that more routinely acquired spine imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) can be opportunistically used to measure BMD. Here we review available studies that assess the validity of opportunistic screening with CT-derived Hounsfield Units (HU) and MRI-derived vertebral vone quality (VBQ) to measure BMD of the spine as well the utility of these measures in predicting post-operative outcomes. Additionally, we provide screening thresholds based on HU and VBQ for prediction of osteopenia/ osteoporosis and post-operative outcomes such as cage subsidence, screw loosening, proximal junctional kyphosis, and implant failure.
Collapse
Affiliation(s)
| | - Carew Giberson-Chen
- Harvard Combined Orthopaedic Residency Program, 55 Fruit Street, Yawkey Building, Suite 3A, Boston, MA 02114
| | - Christopher M Bono
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115; Harvard Combined Orthopaedic Residency Program, 55 Fruit Street, Yawkey Building, Suite 3A, Boston, MA 02114; Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Yawkey Building, Suite 3A, Boston, MA 02114.
| |
Collapse
|
4
|
Maschhoff CW, Oquendo Y, Michaud JB, Carey D, Jamero C, Bishop JA, Jin C, DeBaun M, Gardner MJ. 3D Topographical Scanning for the Detection of Osteoporosis. J Frailty Sarcopenia Falls 2024; 9:4-9. [PMID: 38444543 PMCID: PMC10910256 DOI: 10.22540/jfsf-09-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 03/07/2024] Open
Abstract
Objectives Osteoporosis is associated with greater risk of fracture, which can lead to increased morbidity and mortality. DEXA scans are often inaccessible for patients, leaving many cases of osteoporosis undetected. A portable 3D topographical scan offers an easily accessible and inexpensive potential adjunct screening tool. We hypothesized that 3D scanning of arm and calf circumference and volume would correlate with DEXA T-scores. Methods 96 female patients were enrolled. Patients were consented and completed a topographical scan of bilateral arms and lower legs with a mobile 3D scanner for arm and calf circumference and volume in clinic. Patient charts were then retrospectively reviewed for DEXA T-scores. Results Forearm DEXA T-score was positively correlated with arm circumference (r = 0.49, p<0.01), arm volume (r=0.62, p<0.01), and calf volume (r=0.47, p<0.01). Femoral neck DEXA T-score was positively correlated with calf circumference (r=0.36, p<0.01) and calf volume (r=0.36, p<0.01). Conclusions Our results showed significant correlations between DEXA T-scores and topographical measurements from mobile device acquired 3D scans, although these were in the "moderate" range. Mobile device-based 3D scanning may hold promise as an adjunct screening tool for osteoporosis when DEXA scanning is not available or feasible for patients, although further studies are needed to elucidate the full potential of its clinical utility. At a minimum, identifying a patient as high risk may promote earlier diagnostic DEXA scanning.
Collapse
Affiliation(s)
- Clayton W. Maschhoff
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Yousi Oquendo
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - John B. Michaud
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - David Carey
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Christopher Jamero
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Julius A. Bishop
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Christopher Jin
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Malcolm DeBaun
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Michael J. Gardner
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| |
Collapse
|
5
|
Hassan AB, Tayem YI, Sadat-Ali M, Almarabheh AJ, Alawadhi A, Butt AJ, Jahrami H, Saleh J, Matar ME, Shaikh M, Hasan SK, Karashi AR. The estimated prevalence of osteoporosis in Bahrain: a multi-centered-based study. BMC Musculoskelet Disord 2024; 25:9. [PMID: 38167308 PMCID: PMC10759480 DOI: 10.1186/s12891-023-07145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES the primary aim of this study was to examine the prevalence and risk factors of low bone mineral density in Bahrain. METHODS this was a retrospective study, which targeted a cohort of 4822 Bahraini subjects (mean age 59.36 years: 93% females). Demographic data and results of lumbar and femur DEXA scan for the targeted sample, over the period 2016-2018, were retrieved from four hospitals. RESULTS The prevalence of low BMD was 62.3% (46.4% had osteopenia and 15.9% had osteoporosis). The highest rate of osteopenia was detected at the age group younger than 44 years. However, with increasing age, the rate of osteopenia declined, whereas osteoporosis increased (P < 0.001). Females were found to be at higher risk of developing both osteopenia (45.8%) and osteoporosis (18.1%) compared to males (39% and 12.4%, respectively) (P < 0.001). Postmenopausal women exhibited higher rates of low BMD (42.4% osteopenia, 22.3% osteoporosis) compared to elderly men (30.9% osteopenia, 9% osteoporosis). CONCLUSIONS We reported high prevalence of osteopenia and osteoporosis in Bahrain. Low BMD was more common in females, especially in postmenopausal women. Highest prevalence of osteopenia happened at young age. Therefore, we advocate screening at younger age than previously recommended.
Collapse
Affiliation(s)
- Adla Bakri Hassan
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
- King Abdullah Medical City, Manama, Kingdom of Bahrain.
| | - Yasin I Tayem
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Mir Sadat-Ali
- King Abdullah Medical City, Manama, Kingdom of Bahrain
| | - Amer J Almarabheh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | | | - Ahsan J Butt
- King Hamad University Hospital, Manama, Kingdom of Bahrain
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- Psychiatric Hospital, Government Hospitals, Manama, Kingdom of Bahrain
| | - Jamal Saleh
- Orthocare, Orthopaedic Centre, Manama, Kingdom of Bahrain
| | - Mai E Matar
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- King Abdullah Medical City, Manama, Kingdom of Bahrain
| | - Mansoor Shaikh
- Orthocare, Orthopaedic Centre, Manama, Kingdom of Bahrain
| | - Salman K Hasan
- King Hamad University Hospital, Manama, Kingdom of Bahrain
| | - Ali R Karashi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- Salmaniya Medical Complex, Government Hospitals, Manama, Kingdom of Bahrain
| |
Collapse
|
6
|
Ghalenavi E, Mirfeizi Z, Hashemzadeh K, Sahebari M, Joker MH. Diagnostic Value of Radiographic Singh Index Compared to Dual-Energy X-Ray Absorptiometry Scan in Diagnosing Osteoporosis: A Systematic Review. Arch Bone Jt Surg 2024; 12:1-11. [PMID: 38318309 PMCID: PMC10838578 DOI: 10.22038/abjs.2023.70632.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/29/2023] [Indexed: 02/07/2024]
Abstract
Objectives Since various medications can control the rate of fractures and subsequent complications of osteoporosis, the early detection of the disease is crucial. This systematic study aimed to compare the diagnostic accuracy of Singh index (SI) with dual-energy X-ray absorptiometry (DEXA) as a benchmark standard for diagnosing osteoporosis. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were utilized in the current study. A detailed search was carried out using PubMed and Scopus from inception to 30 May 2022. Examining quality of the studies was performed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results A total of 22 studies were included. In general, 50% of the studies considered SI a poor screening tool for detecting osteoporosis due to a negligible inter-observer agreement between SI and DEXA or a poor correlation of SI with the bone mineral density (BMD) category or DEXA T-score. A moderate inter-observer agreement was reported for SI in 5 (55.6%) studies. Among the studies assessing the sensitivity and specificity of SI compared to DEXA (n=13), six studies estimated a low sensitivity for SI. Conclusion While there is supporting evidence indicating the potential usefulness of SI for predicting femoral neck fractures in individuals with suspected osteoporosis, numerous studies challenge its reliability and diagnostic value as a screening tool for identifying femoral neck osteoporosis. Further primary studies are required to verify the effectiveness of the SI index in identifying populations at risk of osteoporosis.
Collapse
Affiliation(s)
- Elham Ghalenavi
- Mashhad Medical School, Mashhad University of Medical Science, Mashhad, Iran
| | - Zahra Mirfeizi
- Rheumatic Disease Research Center, Mashhad University of Medical Science Mashhad, Iran
| | - Kamila Hashemzadeh
- Rheumatic Disease Research Center, Mashhad University of Medical Science Mashhad, Iran
| | - Maryam Sahebari
- Rheumatic Disease Research Center, Mashhad University of Medical Science Mashhad, Iran
| | - Mohammad Hassan Joker
- Rheumatic Disease Research Center, Mashhad University of Medical Science Mashhad, Iran
| |
Collapse
|
7
|
Selvam S, K S. Assessment of Bone Health Using Dual-Energy X-Ray Absorptiometry ( DEXA) And Its Association with Dietary Intakes, Serum Vitamin D Levels, and Anthropometric Measures in Healthy Urban Preschool Children. Indian J Pediatr 2023; 90:1191-1197. [PMID: 36350501 DOI: 10.1007/s12098-022-04364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To generate reference data for bone mineral content (BMC) and bone mineral density (BMD) measures among apparently healthy children aged 4-5 y and to study the relationship of BMC and BMD with age, sex, anthropometric measures, dietary intakes, and serum vitamin D levels. METHODS This cross-sectional study was conducted among 219 urban preschool children, aged 4.0-5.11 y. Bone health (BMC and BMD) was measured using dual energy X-ray absorptiometry (DEXA). Anthropometric parameters were measured using standard methodology. The 24-h dietary recall method was used to assess the dietary intake of the children. Serum vitamin D levels were assessed using the ELISA kit method. Percentiles for BMC and BMD for each age and sex were constructed using the lambda-mu-sigma (LMS) method. RESULTS The mean BMD and BMC among children was 0.75 ± 0.04 g/cm2 and 544.9 ± 87.6 g, respectively, and were significantly different by age and sex category. The BMC and BMD values of boys and girls increased with age, with boys having significantly higher values. A significant positive correlation was observed for BMC and BMD with anthropometric measures and dietary intake of calcium, phosphorous, protein, zinc, and B vitamins. CONCLUSION This study developed smoothed percentile curves for BMC and BMD in preschool children, which could be used as reference values for children from India.
Collapse
Affiliation(s)
- Sumithra Selvam
- Division of Epidemiology, Biostatistics and Population Health, St John's Research Institute, Koramangala, Bangalore, Karnataka, 560034, India.
| | - Srinivasan K
- Division of Epidemiology, Biostatistics and Population Health, St John's Research Institute, Koramangala, Bangalore, Karnataka, 560034, India
- Department of Psychiatry and Division of Mental Health & Neurosciences, St. John's Medical College & Hospital, St John's National Academy of Health Sciences, Koramangala, Bangalore, Karnataka, India
| |
Collapse
|
8
|
Burton H, Bodansky D, Silver N, Yao J, Horwitz M. Assessing Bone Mineral Density Using Radiographs of the Hand: A Multicenter Validation. J Hand Surg Am 2023; 48:1210-1216. [PMID: 37737801 DOI: 10.1016/j.jhsa.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Osteoporosis and fragility fractures incur substantial costs to quality of life and global health care systems. The current gold standard for quantifying bone density is dual-energy X-ray absorptiometry. Our hypothesis is that bone density can be accurately predicted with a simpler method using plain radiographs of the hand. METHODS This retrospective cohort study was undertaken in two centers in the United Kingdom, where the second metacarpal cortical percentage (2MCP) scores were calculated from radiographs. This study included patients who had sustained a distal radius fracture between 2020 and 2022 and had received both a posteroanterior radiograph of the hand and a dual-energy X-ray absorptiometry scan within 12 months of their radiograph and fracture. The Pearson correlation coefficient was calculated to determine the correlation between 2MCP scores and t-scores of the femoral neck on dual-energy X-ray absorptiometry scans. RESULTS Of the 188 patients, the 2MCP score significantly correlated with bone density t-scores of the femoral neck. A 2MCP score <50% demonstrated 100% sensitivity and 100% specificity for differentiating osteoporotic from normal subjects, whereas a 2MCP score <60% demonstrated 94.4% sensitivity and 83.0% specificity in differentiating osteopenic from normal subjects. CONCLUSIONS These data confirm that the likelihood of osteoporosis being present can be determined via the 2MCP score. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic I.
Collapse
Affiliation(s)
- Harry Burton
- Department of Hand and Wrist Surgery, Chelsea and Westminster Hospital, London, United Kingdom
| | - David Bodansky
- Department of Hand and Wrist Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Natan Silver
- Department of Hand and Wrist Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Jeffrey Yao
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA
| | - Maxim Horwitz
- Department of Hand and Wrist Surgery, Chelsea and Westminster Hospital, London, United Kingdom
| |
Collapse
|
9
|
Sangondimath G, Sen RK, T. FR. DEXA and Imaging in Osteoporosis. Indian J Orthop 2023; 57:82-93. [PMID: 38107793 PMCID: PMC10721776 DOI: 10.1007/s43465-023-01059-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/11/2023] [Indexed: 12/19/2023]
Abstract
Background Reduced bone density and increased fragility are hallmarks of osteoporosis, making the disease a major public health concern. The disease necessitates early diagnosis and appropriate therapy depend on an accurate evaluation of bone health. Essential tools for assessing osteoporosis include dual-energy X-ray absorptiometry (DEXA) and other imaging modalities. Methods This chapter focuses on dual-energy X-ray absorptiometry (DEXA) and other imaging methods as essential tools for assessment of osteoporosis. The chapter also explores complementary imaging modalities that help overcome limitation of DEXA by providing insights into the microarchitecture and bone quality. Results T-scores, used to categorise bone health, are determined by DEXA by comparing bone mineral density to age-matched standards. Bone mineral density (BMD) is the most common indicator of bone health; nevertheless, DEXA may misclassify bone health owing to reasons other than BMD. These constraints may be overcome with the use of complementary imaging methods, which provide information on the microarchitecture and quality of bone. The evaluation of bone structure is aided by high-resolution peripheral quantitative computed tomography (HR-pQCT), which produces precise 3D images of the trabecular and cortical bone compartments. Independent of traditional methods of gauging fracture risk, quantitative ultrasonography (QUS) uses an analysis of the characteristics of sound waves to determine bone health. Diagnostic precision is improved by magnetic resonance imaging (MRI) due to its ability to view bone marrow and trabecular structure without the use of ionising radiation. Discussion New methods, such as the trabecular bone score (TBS), examine bone texture and provide more data on the likelihood of fracture than conventional DEXA. By modelling bone strength using imaging data, finite element analysis (FEA) provides a biomechanical viewpoint on breakage probability. These combined methods boost diagnostic accuracy and pave the way for individualised treatment plans. Imaging helps with therapy monitoring as well as diagnosis. By monitoring bone density and structure over time, therapy effectiveness or course corrections may be quickly identified. The availability of sophisticated imaging techniques and the standardisation of procedures provide obstacles not withstanding their advantages. Ongoing work is being done to solve these issues and standardise and disseminate these methods in a variety of contexts. Conclusion The evaluation of osteoporosis is significantly aided by DEXA and other imaging methods. While DEXA is still the gold standard for diagnosing osteoporosis, other imaging techniques may shed light on bone health in greater detail. These methods improve fracture risk prediction and treatment assessment by providing information on bone architecture, quality, and strength. Integration of several imaging modalities shows potential for bettering osteoporosis therapy and patient outcomes as the field develops.
Collapse
Affiliation(s)
- Gururaj Sangondimath
- Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
| | - Ramesh Kumar Sen
- Department of Orthopedics, Max Super Speciality Hospital, Mohali, 160055 India
| | - Fazal Rehman T.
- Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
| |
Collapse
|
10
|
Avanti M, Martin A, Columbres RC, Mozaffar T, Kimonis V. Effects of enzyme replacement therapy on bone density in late onset Pompe disease. Mol Genet Metab 2023; 140:107644. [PMID: 37515933 DOI: 10.1016/j.ymgme.2023.107644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/31/2023]
Abstract
Pompe disease is an autosomal recessive disorder caused by a deficiency of α-glucosidase, resulting in the accumulation of glycogen in smooth, cardiac, and skeletal muscles, leading to skeletal muscle dysfunction, proximal muscle weakness, and early respiratory insufficiency. Although many patients exhibit decreased bone mineral density (BMD) and increased fractures, there is currently no official protocol for surveillance and management of osteoporosis and osteopenia in late onset Pompe disease (LOPD). Enzyme replacement therapy (ERT) has therapeutic effects on muscle function; however, very few studies report on the effect of ERT on bone mineralization in LOPD patients. Our study included 15 Pompe patients from 25 to 76 years of age on ERT for variable durations. Progressive impact of ERT on BMD of the hips and spine, and the frequency of osteopenia or osteoporosis was studied using DEXA scanning, and correlations were made with age of initiation of ERT, duration of ERT and six-minute walk test. We found a significant positive correlation between the age of ERT initiation and age of the subject, with increases in the Z-scores for the femur and lumbar region. Females had a significantly higher risk for developing osteoporosis compared to males. These results highlight the significance of ERT on reducing progression of osteoporosis in LOPD patients.
Collapse
Affiliation(s)
- Mahima Avanti
- Division of Genetics, Department of Pediatrics, University of California - Irvine, Orange, CA 92697, United States of America
| | - Angela Martin
- Division of Genetics, Department of Pediatrics, University of California - Irvine, Orange, CA 92697, United States of America
| | - Rod Carlo Columbres
- Division of Genetics, Department of Pediatrics, University of California - Irvine, Orange, CA 92697, United States of America
| | - Tahseen Mozaffar
- Division of Neuromuscular Diseases, Department of Neurology, University of California- Irvine, 200 S. Manchester Ave., Suite 206, Orange, CA, United States of America
| | - Virginia Kimonis
- Division of Genetics, Department of Pediatrics, University of California - Irvine, Orange, CA 92697, United States of America; Division of Neuromuscular Diseases, Department of Neurology, University of California- Irvine, 200 S. Manchester Ave., Suite 206, Orange, CA, United States of America; Department of Pathology, University of California - Irvine, Orange, CA 92697, United States of America.
| |
Collapse
|
11
|
Shahrour E. A promising strategy for the diagnosis, treatment, and prevention of osteoporosis (EMS strategy). Osteoporos Int 2023; 34:1821-1822. [PMID: 37646825 DOI: 10.1007/s00198-023-06876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Eiman Shahrour
- Department of Biochemistry and Microbiology, Faculty of Pharmacy, Tishreen University, Ministry of Higher Education, Lattakia, Syria.
| |
Collapse
|
12
|
Kramer AM, Martins JB, de Oliveira PC, Lehnen AM, Waclawovsky G. High-intensity interval training is not superior to continuous aerobic training in reducing body fat: A systematic review and meta-analysis of randomized clinical trials. J Exerc Sci Fit 2023; 21:385-394. [PMID: 37927356 PMCID: PMC10624584 DOI: 10.1016/j.jesf.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 09/10/2023] [Accepted: 09/16/2023] [Indexed: 11/07/2023] Open
Abstract
Background/Objective Guidelines on obesity management reinforce regular exercise to reduce body fat. Exercise modalities, including high-intensity interval training (HIIT), appear to produce a similar effect to continuous aerobic training (CAT) on body fat. However, they have not addressed the chronic effect of HIIT vs. CAT on body fat assessed by dual energy X-ray absorptiometry (DEXA). Thus, we compared the effectiveness of CAT vs. HIIT protocols on body fat (absolute or relative) (%BF) and abdominal visceral fat reduction, assessed by DEXA, in adults with overweight and obesity. Methods We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) including both female or male adults with excess body weight. We performed searches in the databases MEDLINE (PubMed), EMBASE, Scopus, LILACS, Web of Science and Cochrane. Results In our analysis (11 RCTs), we found no greater benefit on %BF of HIIT vs. CAT (MD -0.55%, 95% CI -1.42 to 0.31; p = 0.209). As for abdominal visceral fat, no training modality was superior (SMD: -0.05, 95% CI -0.29 to 0.19; p = 0.997). Regarding secondary outcomes (body weight, BMI, VO2 max, glycemic and lipid profiles), HIIT shows greater benefit than CAT in increasing VO2 max and fasting blood glucose and reducing total cholesterol. Conclusion HIIT is not superior to CAT in reducing %BF or abdominal visceral fat in individuals characterized by excess weight. However, HIIT showed beneficial effects on cardiorespiratory fitness, total cholesterol and fasting blood glucose when compared to CAT.
Collapse
Affiliation(s)
- Ana Marenco Kramer
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | - Jocelito Bijoldo Martins
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | | | - Alexandre Machado Lehnen
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | - Gustavo Waclawovsky
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| |
Collapse
|
13
|
Courtois EC, Ohnmeiss DD, Guyer RD. Assessing lumbar vertebral bone quality: a methodological evaluation of CT and MRI as alternatives to traditional DEXA. Eur Spine J 2023; 32:3176-3182. [PMID: 37439864 DOI: 10.1007/s00586-023-07855-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 04/20/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE The purpose of this study was to investigate the impact of various methods on the assessment of vertebral bone quality. METHODS A consecutive series of 427 candidates for lumbar disc replacement with lumbar DEXA and MRI and/or CT scans were included. Two measurement techniques were used on CTs-a sagittal and axial. From axial images, the upper, mid, and lower portions of each vertebral body were measured. Four MRI vertebral bone quality (VBQ) calculations were generated using separate equations. RESULTS All CT measures were highly correlated with each other, regardless of measurement or calculation method (range 0.925-0.995). Sagittal measurements were highly correlated with axial (r = 0.928, p < 0.001). CT values were correlated with DEXA (range 0.446-0.534). There was no benefit to measuring multiple axial images of each vertebral body vs. just midbody (r = 0.441 and 0.455, respectively). No MRI VBQ values were highly correlated with DEXA (r = - 0.103, p = 0.045). In receiver operating curve analysis, the area under the curve ranged from 0.539 to 0.558, indicating poor ability of VBQ to identify osteoporosis/osteopenia. CONCLUSION CT produced values more closely related to DEXA, while MRI was less reliable for osteoporosis/osteopenia screening. On CT, there was no benefit to making multiple measurements for each vertebral body to calculate a composite. Measuring sagittal CT images produced values similar to axial and required less time. While assessing bone quality from existing images rather than getting an additional DEXA scan is appealing, the methods of measuring these images needs standardization to maximize their utility.
Collapse
Affiliation(s)
| | - Donna D Ohnmeiss
- Texas Back Institute Research Foundation, 6020 W Parker Rd #200, Plano, TX, 75093, USA.
| | - Richard D Guyer
- Center for Disc Replacement at Texas Back Institute, Plano, TX, USA
| |
Collapse
|
14
|
Banks KP, Farrell MB, Gunther RS, McWhorter NE, Byerly DW, Peacock JG. Improving DXA Quality by Avoiding Common Technical and Diagnostic Pitfalls: Part 1. J Nucl Med Technol 2023; 51:167-175. [PMID: 36195442 DOI: 10.2967/jnmt.122.264885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Dual-energy x-ray absorptiometry (DXA) is an accurate means to assess bone mineral density, determine the risk of a fragility fracture, and monitor response to therapy. Despite its seemingly straightforward nature-the review of 2-to-3 nondiagnostic images and a few automatically generated numbers-the proper performance and interpretation of DXA can often be complex. It is complex because it is highly dependent on many factors, such as image acquisition, processing, analysis, and subsequent examination interpretation. Each step is subject to potential errors, artifacts, and diagnostic pitfalls; hence, meticulous attention must be paid to the technique by both the technologist and the interpreting physician to provide high-quality results and, in turn, maximize the examination's clinical utility. This article is part 1 of a 2-part series. Part 1 will begin with a review of bone physiology and osteoporosis etiology, followed by a discussion of the principles underlying DXA and the technical procedure. Part 2 will focus on DXA interpretation and discuss scanning pitfalls and clues to recognizing issues and improving scan quality.
Collapse
Affiliation(s)
- Kevin P Banks
- Department of Radiology, Brooke Army Medical Center, San Antonio, Texas
- Department of Radiology, Uniformed Services University, Bethesda, Maryland; and
| | | | - Rutger S Gunther
- Department of Radiology, Brooke Army Medical Center, San Antonio, Texas
| | - Nathan E McWhorter
- Department of Radiology, Brooke Army Medical Center, San Antonio, Texas
- Department of Radiology, Uniformed Services University, Bethesda, Maryland; and
| | - Doug W Byerly
- Department of Radiology, Brooke Army Medical Center, San Antonio, Texas
- Department of Radiology, Uniformed Services University, Bethesda, Maryland; and
| | - Justin G Peacock
- Department of Radiology, Brooke Army Medical Center, San Antonio, Texas
- Department of Radiology, Uniformed Services University, Bethesda, Maryland; and
| |
Collapse
|
15
|
de Ritter R, Stehouwer CDA. Further investigation of the association between diabetes status and body composition and whether this association is moderated by sex. Reply to Mai Y [letter]. Diabetologia 2023; 66:1750-1751. [PMID: 37391626 DOI: 10.1007/s00125-023-05959-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
16
|
Fiedler B, Patel V, Lygrisse KA, Kelly ME, Turcotte JJ, MacDonald J, Schwarzkopf R. The effect of reduced bone mineral density on elective total hip arthroplasty outcomes. Arch Orthop Trauma Surg 2023; 143:5993-5999. [PMID: 36920526 DOI: 10.1007/s00402-023-04830-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Reduced bone mineral density (BMD) and disruption of normal bony architecture are the characteristics of osteopenia and osteoporosis and in patients undergoing total hip arthroplasty (THA) may cause failure of trabecular ingrowth. The purpose of this study is to evaluate the impact of reduced BMD on outcomes following primary elective THA. METHODS A retrospective chart review of 650 elective THAs with a DEXA scan in their electronic health record (EHR) from 2011 to 2020 was conducted at an urban, academic center and a regional, health center. Patients were separated into three cohorts based on their t-score and the World Health Organizations definitions: normal (t-score ≥ - 1), osteopenia (t-score < - 1.0 and > - 2.5), and osteoporosis (t-score ≤ - 2.5). Demographic and outcome data were assessed. Subsidence was assessed for patients with non-cemented THAs. Regression models were used to account for demographic differences. RESULTS 650 elective THAs, of which only 11 were cemented, were included in the study. Patients with osteopenia and osteoporosis were significantly older than those without (p = 0.002 and p < 0.0001, respectively) and had a lower BMI (p < 0.0001 and p < 0.0001, respectively). PFx was significantly greater in patients with osteoporosis when compared to those with normal BMD (6.5% vs. 1.0%; p = 0.04). No such difference was found between osteoporotic and osteopenic patients. The revision rate was significantly higher for osteoporotic patients than osteopenic patients (7.5% vs. 1.5%; p = 0.04). No such difference was found between the other comparison groups. CONCLUSION Patients with osteoporosis were older with reduced BMI and had increased PFx after non-cemented elective THA. Understanding this can help surgeons formulate an appropriate preoperative plan for the treatment of patients with osteoporotic bone undergoing elective THA.
Collapse
Affiliation(s)
- Benjamin Fiedler
- Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY, 10003, USA
| | - Vaidehi Patel
- Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY, 10003, USA
| | - Katherine A Lygrisse
- Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY, 10003, USA
| | - McKayla E Kelly
- Adult Reconstructive Division, Anne Arundel Medical Center, Annapolis, MD, USA
| | - Justin J Turcotte
- Adult Reconstructive Division, Anne Arundel Medical Center, Annapolis, MD, USA
| | - James MacDonald
- Adult Reconstructive Division, Anne Arundel Medical Center, Annapolis, MD, USA
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY, 10003, USA.
| |
Collapse
|
17
|
Dandache C, Confavreux CB, Gavoille A, Massy E, Chambard L, Rambaud J, Geye M, Brevet M, Girard N, Subtil F, Pialat JB. Peripheral but not axial muscle mass is associated with early mortality in bone metastatic lung cancer patients at diagnosis. Joint Bone Spine 2023; 90:105613. [PMID: 37442335 DOI: 10.1016/j.jbspin.2023.105613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/22/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES Identification of sarcopenia is a key issue in oncology. Several methods may be used to evaluate muscle mass in patients. Routine cancer follow-up computed tomography (CT) provides axial muscle mass whereas whole-body densitometry (DEXA) measures appendicular lean mass (ALM). Up to now, no studies have assessed, in cancer patients, the correlation between CT and DEXA muscle mass indicators and compared their prognostic value. METHODS We included patients with synchronous bone metastases from lung adenocarcinoma at diagnosis. Diagnosis was confirmed by bone biopsy. Skeletal muscle area was determined semi-automatically on initial CT scan at the T7, T12, and L3 vertebral level using Osirix® software. The skeletal muscle index (SMI) was calculated as the ratio of muscle area to height squared. Standardised ALM/height squared data were obtained by DEXA assessment within a 30-day window of CT. RESULTS A total of 65 patients were included; 47 (72%) were male. Mean±SD age was 65±11.4years. DEXA was available for 46 patients. The performance status was good (<1) for 39 patients. SMI indicators were significantly correlated with each other (rho from 0.3 to 0.7) but moderately correlated with ALM (rho from 0.1 to 0.7). ALM had a good discriminatory ability on 6-month survival (AUC 0.87 [0.76; 0.97]). ALM was associated with early mortality (<6months) (HR=0.29, 95% CI [0.15; 0.57]; P<0.001) but not with later mortality (>6months). In contrast, no significant effect was found for SMI. CONCLUSIONS Peripheral muscle mass (standardized ALM by DEXA) but not axial muscle mass (SMI assessed by CT) was associated with early mortality (<6months) suggesting that cancer-induced muscle loss would affect differently appendicular muscles and axial muscles.
Collapse
Affiliation(s)
- Célia Dandache
- Département de Radiologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; Département de Radiologie, Hôpital Édouard-Herriot, Hospices Civils de Lyon, 69003 Lyon, France; Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; CREATIS, CNRS UMR 5220, Inserm 1206 Unit, Université Lyon 1, INSA Lyon, 69100 Villeurbanne, France
| | - Cyrille B Confavreux
- Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; Département de Rhumatologie, Centre Expert des Métastases Osseuses (CEMOS), Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; Inserm UMR1033, LYOS, Université de Lyon, 69003 Lyon, France.
| | - Antoine Gavoille
- Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; Service de Biostatistiques, Hospices Civils de Lyon, 69003 Lyon, France
| | - Emmanuel Massy
- Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; Département de Rhumatologie, Centre Expert des Métastases Osseuses (CEMOS), Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; Inserm UMR1033, LYOS, Université de Lyon, 69003 Lyon, France
| | - Lauriane Chambard
- Département de Rhumatologie, Centre Expert des Métastases Osseuses (CEMOS), Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Julien Rambaud
- Département de Radiologie, Hôpital Édouard-Herriot, Hospices Civils de Lyon, 69003 Lyon, France; Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; CREATIS, CNRS UMR 5220, Inserm 1206 Unit, Université Lyon 1, INSA Lyon, 69100 Villeurbanne, France
| | - Madiane Geye
- Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; Département de Rhumatologie, Centre Expert des Métastases Osseuses (CEMOS), Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marie Brevet
- Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; Département d'Anatomopathologie, Groupement Hospitalier Est, Hospices Civils de Lyon, 69003 Lyon, France
| | - Nicolas Girard
- Institut du Thorax Curie-Montsouris, Institut Curie, 75014 Paris, France
| | - Fabien Subtil
- CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, 69100 Villeurbanne, France; Service de Biostatistiques, Hospices Civils de Lyon, 69003 Lyon, France
| | - Jean-Baptiste Pialat
- Département de Radiologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; Université Claude-Bernard Lyon 1, Université de Lyon, 69100 Lyon, France; CREATIS, CNRS UMR 5220, Inserm 1206 Unit, Université Lyon 1, INSA Lyon, 69100 Villeurbanne, France
| |
Collapse
|
18
|
Seo J, Kim H, Min J, Kim Y, Jeon IH, D'Lima D, Koh KH. Development of in vitro osteoporosis model in minipig proximal humerus and femur: validation in histological and biomechanical study. J Orthop Surg Res 2023; 18:615. [PMID: 37608307 PMCID: PMC10463625 DOI: 10.1186/s13018-023-04102-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/14/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The minipig has been used for research in various fields of medicine, even in orthopedics. Though previous studies have already suggested other methods to create osteoporotic bone, those methods had some disadvantages for taking time and efforts. Therefore, we aimed to generate osteoporotic proximal humerus and proximal femur of minipig using EDTA solution and validate their properties through dual energy X-ray absorptiometry (DEXA), micro-CT study, histological and biomechanical ways. METHODS Six minipigs were used. Out of a total of 12 proximal humerus (PH) and 12 proximal femurs (PF), 6 PH and 6 PF were used as the decalcified group and the opposite side as the non-decalcified group. In vitro decalcification with Ca-chelating agents (0.5 M EDTA solution, pH 7.4) was used. Area BMD (aBMD) was measured using DEXA, Volumetric BMD (vBMD), and microstructure were measured using micro-CT. Universal testing machine was used to measure ultimate load to failure (ULTF). Each group was compared using two types of suture anchors (all-suture anchor, ASA, and conventional screw type anchor, CA). RESULTS There was a significant difference in aBMD and cortical thickness (aBMD: decalcified, 0.433 ± 0.073 g/cm2, undecalcified, 0.962 ± 0.123 g/cm2, p < 0.001; cortical thickness: decalcified, 0.33 ± 0.34 mm, undecalcified, 1.61 ± 0.45 mm, p < 0.001). In the case of ASA, the ULTF was significantly lower in the decalcified group (decalcified: 176.6 ± 74.2 N, non-decalcified: 307.7 ± 116.5 N, p = 0.003). In the case of CA, there was no significant difference (decalcified: 265.1 ± 96.0 N, undecalcified: 289.4 ± 114.5 N, p = 0.578). CONCLUSION We demonstrated that decalcification with EDTA solution significantly decreased aBMD, vBMD, and cortical thickness. Decalcified minipig bone using EDTA resulted in similar biomechanical properties as osteoporotic human bone with respect to anchor pull-out.
Collapse
Affiliation(s)
- Jeonghyeon Seo
- Department of Orthopedic Surgery, Areumcheil Hospital, Seoul, Republic of Korea
| | - Hyojune Kim
- Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Joongkee Min
- Asan Medical Center, Convergence Medicine Research Center, Computerized Tomography Core, Seoul, Republic of Korea
| | - Yongwoo Kim
- Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - In-Ho Jeon
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Darry D'Lima
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, Scripps Health, San Diego, CA, USA
| | - Kyoung Hwan Koh
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA.
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, Scripps Health, San Diego, CA, USA.
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil Songpa-Gu, Seoul, 05505, Republic of Korea.
| |
Collapse
|
19
|
de Ritter R, Sep SJS, van Greevenbroek MMJ, Kusters YHAM, Vos RC, Bots ML, Kooi ME, Dagnelie PC, Eussen SJPM, Schram MT, Koster A, Brouwers MCG, van der Sangen NMR, Peters SAE, van der Kallen CJH, Stehouwer CDA. Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study. Diabetologia 2023; 66:861-872. [PMID: 36805778 PMCID: PMC10036428 DOI: 10.1007/s00125-023-05880-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 02/23/2023]
Abstract
AIMS/HYPOTHESIS Obesity is a major risk factor for type 2 diabetes. However, body composition differs between women and men. In this study we investigate the association between diabetes status and body composition and whether this association is moderated by sex. METHODS In a population-based cohort study (n=7639; age 40-75 years, 50% women, 25% type 2 diabetes), we estimated the sex-specific associations, and differences therein, of prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes (reference: normal glucose metabolism [NGM]) with dual-energy x-ray absorptiometry (DEXA)- and MRI-derived measures of body composition and with hip circumference. Sex differences were analysed using adjusted regression models with interaction terms of sex-by-diabetes status. RESULTS Compared with their NGM counterparts, both women and men with prediabetes and type 2 diabetes had more fat and lean mass and a greater hip circumference. The differences in subcutaneous adipose tissue, hip circumference and total and peripheral lean mass between type 2 diabetes and NGM were greater in women than men (women minus men [W-M] mean difference [95% CI]: 15.0 cm2 [1.5, 28.5], 3.2 cm [2.2, 4.1], 690 g [8, 1372] and 443 g [142, 744], respectively). The difference in visceral adipose tissue between type 2 diabetes and NGM was greater in men than women (W-M mean difference [95% CI]: -14.8 cm2 [-26.4, -3.1]). There was no sex difference in the percentage of liver fat between type 2 diabetes and NGM. The differences in measures of body composition between prediabetes and NGM were generally in the same direction, but were not significantly different between women and men. CONCLUSIONS/INTERPRETATION This study indicates that there are sex differences in body composition associated with type 2 diabetes. The pathophysiological significance of these sex-associated differences requires further study.
Collapse
Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Leiden University Medical Center, Department of Public Health and Primary Care/LUMC-Campus, The Hague, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Martijn C G Brouwers
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | | | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
20
|
Mina T, Yew YW, Ng HK, Sadhu N, Wansaicheong G, Dalan R, Low DYW, Lam BCC, Riboli E, Lee ES, Ngeow J, Elliott P, Griva K, Loh M, Lee J, Chambers J. Adiposity impacts cognitive function in Asian populations: an epidemiological and Mendelian Randomization study. Lancet Reg Health West Pac 2023; 33:100710. [PMID: 36851942 PMCID: PMC9957736 DOI: 10.1016/j.lanwpc.2023.100710] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/15/2023]
Abstract
Background Obesity and related metabolic disturbances including diabetes, hypertension and hyperlipidemia predict future cognitive decline. Asia has a high prevalence of both obesity and metabolic disease, potentially amplifying the future burden of dementia in the region. We aimed to investigate the impact of adiposity and metabolic risk on cognitive function in Asian populations, using an epidemiological analysis and a two-sample Mendelian Randomization (MR) study. Methods The Health for Life in Singapore (HELIOS) Study is a population-based cohort of South-East-Asian men and women in Singapore, aged 30-84 years. We analyzed 8769 participants with metabolic and cognitive data collected between 2018 and 2021. Whole-body fat mass was quantified with Dual X-Ray Absorptiometry (DEXA). Cognition was assessed using a computerized cognitive battery. An index of general cognition ' g ' was derived through factor analysis. We tested the relationship of fat mass indices and metabolic measures with ' g ' using regression approaches. We then performed inverse-variance-weighted MR of adiposity and metabolic risk factors on ' g ', using summary statistics for genome-wide association studies of BMI, visceral adipose tissue (VAT), waist-hip-ratio (WHR), blood pressure, HDL cholesterol, triglycerides, fasting glucose, HbA1c, and general cognition. Findings Participants were 58.9% female, and aged 51.4 (11.3) years. In univariate analysis, all 29 adiposity and metabolic measures assessed were associated with ' g ' at P < 0.05. In multivariable analyses, reduced ' g ' was consistently associated with increased visceral fat mass index and lower HDL cholesterol (P < 0.001), but not with blood pressure, triglycerides, or glycemic indices. The reduction in ' g ' associated with 1SD higher visceral fat, or 1SD lower HDL cholesterol, was equivalent to a 0.7 and 0.9-year increase in chronological age respectively (P < 0.001). Inverse variance MR analyses showed that reduced ' g ' is associated with genetically determined elevation of VAT, BMI and WHR (all P < 0.001). In contrast, MR did not support a causal role for blood pressure, lipid, or glycemic indices on cognition. Interpretation We show an independent relationship between adiposity and cognition in a multi-ethnic Asian population. MR analyses suggest that both visceral adiposity and raised BMI are likely to be causally linked to cognition. Our findings have important implications for preservation of cognitive health, including further motivation for action to reverse the rising burden of obesity in the Asia-Pacific region. Funding The Nanyang Technological University-the Lee Kong Chian School of Medicine, National Healthcare Group, National Medical Research Council, Ministry of Education, Singapore.
Collapse
Affiliation(s)
- Theresia Mina
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Yik Weng Yew
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,National Skin Centre, Research Division, 1 Mandalay Rd, 308205, Singapore
| | - Hong Kiat Ng
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Nilanjana Sadhu
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Gervais Wansaicheong
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Diagnostic Radiology, Tan Tock Seng Hospital (TTSH), 11 Jalan Tan Tock Seng, 308433, Singapore
| | - Rinkoo Dalan
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Endocrinology, TTSH, Singapore
| | - Dorrain Yan Wen Low
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Benjamin Chih Chiang Lam
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Khoo Teck Puat Hospital, Integrated Care for Obesity & Diabetes, 90 Yishun Central, 768828, Singapore
| | - Elio Riboli
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Eng Sing Lee
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Clinical Research Unit, National Healthcare Group Polyclinic, 3 Fusionopolis Link, Nexus@one-north, #05-10, 138543, Singapore
| | - Joanne Ngeow
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Division of Medical Oncology, National Cancer Centre, 11 Hospital Drive, 169610, Singapore
| | - Paul Elliott
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Konstadina Griva
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Marie Loh
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,National Skin Centre, Research Division, 1 Mandalay Rd, 308205, Singapore
| | - Jimmy Lee
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Research Division, Institute of Mental Health, 539747, Singapore
| | - John Chambers
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
| |
Collapse
|
21
|
Michel B, Augat P, Berninger MT, Keppler L, Simon G, von Rüden C, Birkenmaier C, Schipp R, Becker J. Influence of different CCD angles on osseointegration and radiological changes after total hip arthroplasty of a triple wedge shape cementless femoral stem: a prospective cohort study. Int Orthop 2023:10.1007/s00264-023-05776-z. [PMID: 36973427 DOI: 10.1007/s00264-023-05776-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the osseointegration and radiological outcomes in patients after total hip arthroplasty, hypothesizing different load patterns with one cementless stem design and different CCD angles (CLS Spotorno femoral stem 125° vs 135°). METHODS All cases of degenerative hip osteoarthritis fulfilling strict inclusion criteria were treated with cementless hip arthroplasty between 2008 and 2017. Ninety-two out of one hundred six cases were clinically and radiologically examined three and 12 months after implantation. Two groups with each 46 patients were rendered prospectively and compared in clinical (Harris Hip Score) and radiological outcome. RESULTS At final follow-up, no significant difference regarding Harris Hip Score was detected between the two groups (mean 99.2 ± 3.7 vs. 99.3 ± 2.5; p = 0.73). Cortical hypertrophy was found in none of the patients. Stress shielding was seen in a total of 52 hips (n = 27 vs. n = 25; 57% of the 92 hips). No significant difference regarding stress shielding was detected when comparing both groups (p = 0.67). Significant bone density loss was detected in Gruen zone one and two in the 125° group. The 135° group showed significant radiolucency in Gruen zone seven. No overall radiological loosening or subsidence of the femoral component was observed. CONCLUSION According to our results, the use of a femoral component with a 125° CCD angle versus a 135° CCD did not result in a different osseointegration and load transfer with a clinically relevant significance.
Collapse
Affiliation(s)
- Björn Michel
- Klinikum Garmisch-Partenkirchen, Endogap, Joint Replacement Institute, Auenstraße 6, 82467, Garmisch-Partenkirchen, Germany
| | - Peter Augat
- Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria
- Institute for Biomechanics, BG Unfallklinik Murnau, Murnau, Germany
| | - Markus T Berninger
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Keppler
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| | - Gerhard Simon
- Klinikum Garmisch-Partenkirchen, Department of Radiology & Nuclear Medicine, Auenstraße 6, 82467, Garmisch-Partenkirchen, Germany
| | - Christian von Rüden
- Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| | - Christof Birkenmaier
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich, Ludwig-Maximilians Universität Munich, Munich, Germany
- Artemed Klinikum München Süd, Am Isarkanal 30, 81379, Munich, Germany
| | - Rolf Schipp
- Klinikum Garmisch-Partenkirchen, Endogap, Joint Replacement Institute, Auenstraße 6, 82467, Garmisch-Partenkirchen, Germany
| | - Johannes Becker
- Klinikum Garmisch-Partenkirchen, Endogap, Joint Replacement Institute, Auenstraße 6, 82467, Garmisch-Partenkirchen, Germany.
- Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria.
- Institute for Biomechanics, BG Unfallklinik Murnau, Murnau, Germany.
| |
Collapse
|
22
|
Ng PTT, Straker L, Tucker K, Izatt MT, Claus A. Advancing Use of DEXA Scans to Quantitatively and Qualitatively Evaluate Lateral Spinal Curves, for Preliminary Identification of Adolescent Idiopathic Scoliosis. Calcif Tissue Int 2023; 112:656-665. [PMID: 36907926 DOI: 10.1007/s00223-023-01075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
Dual-energy X-ray absorptiometry (DEXA) scan is an emerging screening method for identifying likely adolescent idiopathic scoliosis (AIS). Using DEXA in an unbiased population sample (the Raine Study), we aimed to report the inter-rater reliability and minimal detectable change (MDC95) for scoliosis curve angle measurement, identify likely AIS prevalence, and the concordance between reported AIS diagnosis and DEXA-identified likely AIS. Scoliosis curve angles were measured using the modified Ferguson method on DEXA scans (n = 1238) at age 20 years. For curve angle inter-rater reliability, two examiners measured angles (6-40°) on 41 scans. Likely, AIS was determined with quantitative and qualitative criteria (modified Ferguson angles ≥ 10° and expert review of spinal curves).The inter-rater reliability for scoliosis curve angle measurement was good-excellent (ICC: 0.82; 95% CI: 0.71-0.89; p < 0.001), and MDC95 was 6.2°. The prevalence of likely AIS was 2.1% (26/1238). Diagnosis of AIS was reported despite little or no scoliosis curve (< 3.8°) for 20 participants (1.6%), and diagnosis of AIS was not reported despite scoliosis curve ≥ 10° for 11 participants (0.9%). Results support the use of modified Ferguson method to measure scoliosis curve angles on DEXA. There is potential utility for using a combination of quantitative measurement and qualitative criteria to evaluate DEXA images, to identify likely AIS for reporting prevalence. Without formal school screening, the analysis of DEXA in this population sample suggested that relying on current health professional diagnosis alone could result in 2.5% of this cohort being at risk of false positive diagnosis or delay in necessary management due to non-diagnosis of AIS.
Collapse
Affiliation(s)
- P T T Ng
- Laboratory for Motor Control and Pain Research, School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane, QLD, Australia.
- Physiotherapy Department, KK Women's and Children's Hospital, Singapore, Singapore.
| | - L Straker
- School of Allied Health, Curtin University, Bentley, Perth, WA, Australia
| | - K Tucker
- Laboratory for Motor Control and Pain Research, School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane, QLD, Australia
| | - M T Izatt
- Biomechanics and Spine Research Group, Queensland University of Technology at the Centre for Children's Health Research, South Brisbane, Brisbane, QLD, Australia
| | - A Claus
- School of Health & Rehabilitation Sciences, The University of Queensland, St. Lucia, Brisbane, QLD, Australia
- Tess Cramond Pain and Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, Australia
| |
Collapse
|
23
|
Ismail RIH, Awad HA, Saber M, Shehata BM. Bone mineral content for preterm neonates treated with caffeine using dual energy X-ray absorptiometry: An observational study. J Neonatal Perinatal Med 2023; 16:129-135. [PMID: 36872800 DOI: 10.3233/npm-221172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND Prematurity is associated with lots of comorbidities. Premature neonates also have lower bone mineral content (BMC) compared to term neonates. Apnea of prematurity is a common complication and caffeine citrate is widely used for its prevention and treatment. Caffeine also affects creatinine clearance, urine flow rate and releases calcium from its storage sites. OBJECTIVES The primary objective was to assess BMC in preterm neonates treated with caffeine using dual energy X-ray absorptiometry (DEXA). Secondary objectives were to determine whether caffeine therapy is associated with increased incidence of nephrocalcinosis or bone fracture. METHODS Prospective observational study on 42 preterm neonates, 34 weeks' gestation or less; 22 of them received intravenous caffeine (caffeine group) and 20 did not (control group). Serum levels of calcium, phosphorus, alkaline phosphatase, magnesium, sodium, potassium, and creatinine, abdominal ultrasonography, and DEXA scan were done for all included neonates. RESULTS BMC showed significant lower levels in the caffeine compared to control group (p = 0.017). Additionally, BMC was significantly lower in neonates who received caffeine for more than 14 days compared to those who received it for 14 days or less(p = 0.04). BMC showed significant positive correlation to birth weight, gestational age, serum P and significant negative correlation to serum ALP. Caffeine therapy duration was negatively correlated to BMC (r = -0.370, p = 0.000) and positively correlated to serum ALP levels (r = 0.667, p = 0.001). None of the neonates had nephrocalcinosis. CONCLUSIONS Caffeine administration for more than 14 days in preterm neonates may be associated with lower BMC but not nephrocalcinosis or bone fracture.
Collapse
Affiliation(s)
- R I H Ismail
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - H A Awad
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M Saber
- Ministry of Health, Cairo, Egypt
| | - B M Shehata
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
24
|
Ballas ER, Nguyen VT, Wolin EA. Femoral Neck Fracture with Avascular Necrosis. J Nucl Med Technol 2023; 51:78-79. [PMID: 36041873 DOI: 10.2967/jnmt.122.264354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
Hip fractures are common in the aging population, with complications such as avascular necrosis. We describe a case of an 85-y-old woman with early avascular necrosis as a complication from femoral neck fracture discovered on routine bone densitometry screening.
Collapse
Affiliation(s)
- Elissa R Ballas
- David Grant USAF Medical Center, Travis Air Force Base, California; and
| | - Vincent T Nguyen
- David Grant USAF Medical Center, Travis Air Force Base, California; and
| | - Ely A Wolin
- David Grant USAF Medical Center, Travis Air Force Base, California; and.,Uniformed Services University, Bethesda, Maryland
| |
Collapse
|
25
|
Katebi L, Rabbani A, Sayarifard F, Mehdizadeh M, Sayarifard A, Sotoudeh A, Abbasi F, Rostami P. Determination of Bone Density by DEXA Method Based on Bone Age and its Comparison with Chronological Age in Chronic Patients. Mediterr J Rheumatol 2023; 34:44-52. [PMID: 37223593 PMCID: PMC10201103 DOI: 10.31138/mjr.34.1.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 05/25/2023] Open
Abstract
Background and Objective Given the growing awareness about the important role of children's age in building bone for a person's life, physicians need to assess bone health in high-risk children for bone density disorders more than before to optimize their bones' density and prevent osteoporosis in future. The aim of this study was to evaluate bone density based on chronological and bone age. Materials and Methods In this cross-sectional study, 80 Patients who have been referred for bone density to the Osteoporosis Centre of the Children's Medical Centre over a one-year period (spring 98 to spring 99) were studied. Bone density was performed for all patients by using DEXA method. Results The z-score mean chronological age for the lumbar spine was -0.8± 1.85 years and bone age was -0.58±1.64 years. The z-score mean chronological age for femoral bone was -1.6±1.02 years and bone age was -1.32± 1.4 years. Conclusion Results showed that in all patients, the difference in the mean Z score of chronological age and bone age of the spine between patients was not significant but for femur was significant. Also, use of corticosteroids leads to significant difference between the two age groups' z-score in femur and spine.
Collapse
Affiliation(s)
- Leyla Katebi
- Department of Pediatrics, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Ali Rabbani
- Department of Pediatrics, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sayarifard
- Department of Pediatrics, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Mehdizadeh
- Department of Radiology, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Azadeh Sayarifard
- Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Arya Sotoudeh
- Department of Pediatrics, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Farzaneh Abbasi
- Department of Pediatrics, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Parastoo Rostami
- Department of Pediatrics, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
| |
Collapse
|
26
|
Nunes CLDC, Vilela RSR, Schultz EB, Hannas MI, Chizzotti ML. Assessing dual-energy X-ray absorptiometry prediction of intramuscular fat content in beef longissimus steaks. Meat Sci 2023; 197:109076. [PMID: 36535231 DOI: 10.1016/j.meatsci.2022.109076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
This study assessed the capability of dual-energy X-ray absorptiometry (DEXA) to predict intramuscular fat (IMF) content of beef longissimus steaks against chemical IMF as the gold standard. DEXA performance of fat% prediction was assessed using a leave-one-out cross validation method among Angus and Nellore steaks, which generated a chemical fat% range of 14.05-36.82% and 2.46-7.84%, respectively, and using pooled data. There was a significant positive association between DEXA predicted fat and chemical fat content. However, higher precision was found for pooled data (R2 = 0.95, RMSECV = 1.95) and Angus (R2 = 0.75, RMSECV = 2.39) than Nellore (R2 = 0.15, RMSECV = 1.22) group. Accuracy also had the same response with average slope values close to 1 for pooled data and Angus and a lower value (0.42) for Nellore group. DEXA precisely predicts IMF content across a wide range of fat content. However, its precision and accuracy of prediction within low-fat content samples are lower than in high-fat content.
Collapse
Affiliation(s)
| | | | - Erica Beatriz Schultz
- Department of Animal Science, Universidade Federal de Viçosa, 36570-900 Viçosa, MG, Brazil
| | - Melissa Izabel Hannas
- Department of Animal Science, Universidade Federal de Viçosa, 36570-900 Viçosa, MG, Brazil
| | - Mario Luiz Chizzotti
- Department of Animal Science, Universidade Federal de Viçosa, 36570-900 Viçosa, MG, Brazil
| |
Collapse
|
27
|
Malik AT, Gordon A, Awan H, Khan SN, Goyal KS. Declining Trend in Anti-osteoporotic Treatment, Despite a Rise in DEXA Screening Following "Sentinel" Distal Radius Fractures. Hand (N Y) 2023:15589447231153176. [PMID: 36788744 DOI: 10.1177/15589447231153176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE To understand national trends and costs associated with the utilization of anti-osteoporotic medication and DEXA screening within the year following a sentinel/primary distal radius fracture. METHODS The 2008-2015Q1 Humana Administrative Claims database was queried to identify patients aged ≥50 years, with a "sentinel" occurrence of a primary closed distal radius fracture. Linear regression models were used to report and assess for significant trends in utilization of anti-osteoporotic medication and DEXA screenings within the year following the fracture. Multivariate logistic regression analyses were used to assess for factors associated with receiving or not receiving anti-osteoporotic medication. RESULTS A total of 14 526 sentinel distal radius fractures were included in the study. Only 7.2% (n = 1046) of patients received anti-osteoporosis medication in the year following the distal radius fracture. Treatment with medication for osteoporosis declined from 8.2% in 2008 to 5.9% in 2015, whereas the rate of DEXA screening increased from 14.8% in 2008 to 23.6% in 2015. The most common prescribed treatment was alendronate sodium (n = 835; 79.8%-$49/patient). Factors associated with increased odds of receiving anti-osteoporotic medication were age 70 to 79 years (odds ratio [OR], 1.45; P = .014), age 80 to 89 years (OR, 1.66; P = .001), Asian (OR, 2.95; P = .002) or Hispanic (OR, 1.77; P = .006) ethnicity, belonging to South (OR, 1.19; P = .029) or West (OR, 1.37; P = .010), and having an Elixhauser Comorbidity Index score of 3 (OR, 2.14; P = .024) or > 3 (OR, 2.05; P = .022). CONCLUSIONS Despite a rising utilization of DEXA screening following "sentinel" distal radius fractures, the proportion of individuals who receive anti-osteoporotic treatment is decreasing over time.
Collapse
Affiliation(s)
| | - Adam Gordon
- The Ohio State University Wexner Medical Center, Columbus, USA
| | - Hisham Awan
- The Ohio State University Wexner Medical Center, Columbus, USA
| | - Safdar N Khan
- The Ohio State University Wexner Medical Center, Columbus, USA
| | - Kanu S Goyal
- The Ohio State University Wexner Medical Center, Columbus, USA
| |
Collapse
|
28
|
Bigach SD, Kolevar MP, Moore RD, Adavi P, Rimnac CM, Kraay MJ. Dual-Energy X-Ray Absorptiometry ( DEXA) Evaluation of the Bone Remodeling Effects of a Low-Modulus Composite Hip Stem After 2 Decades of Follow-Up. HSS J 2023; 19:69-76. [PMID: 36776510 PMCID: PMC9837405 DOI: 10.1177/15563316221108182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/06/2022] [Indexed: 02/14/2023]
Abstract
Background: The Epoch FullCoat Hip Stem (Zimmer) was an isoelastic composite femoral stem developed to address stem stiffness concerns. Purpose: We sought to evaluate the long-term bone mineral density (BMD) of a cohort of patients who underwent total hip arthroplasty (THA) using the Epoch isoelastic stem and having more than 2-decade follow-up. Methods: We conducted a retrospective chart review of all patients who were study subjects at our institution in a multicenter prospective trial for the Food and Drug Administration of the Epoch implant in the mid-1990s. Through this, we identified 16 patients who had dual-energy X-ray absorptiometry (DEXA) scans, with which we could determine BMD preoperatively and at 3 points postoperatively. Of these, 5 agreed to participate in the study (the others were deceased, unable or declined to participate, or were lost to follow-up) with mean follow-up of 22 years. These participants underwent clinical and radiographic evaluation consisting of a Harris hip score, anteroposterior (AP) pelvis and AP and lateral hip X-rays, and DEXA evaluation of both hips. BMD in the 7 Gruen zones at last follow-up was compared with immediate postoperative and 2-year follow-up. Results: At last follow-up, all stems were well-fixed with signs of extensive osteointegration. In proximal Gruen zones 1 and 7, patients underwent a decrease in BMD with more modest losses in Gruen zone 1. All patients demonstrated an increase in BMD in zones 2 through 6 at latest follow-up, except for 1 patient in Gruen zone 6. BMD changes were not limited to the first 2 years of follow-up. Conclusion: This small follow-up cohort study found excellent long-term clinical results, no plain radiographic signs of notable stress shielding, and general maintenance of BMD at a follow-up of over 20 years for this isoelastic stem. Long-term bone remodeling after implantation of the isoelastic stem resulted in increased BMD in Gruen zones 2 through 6, suggesting that composite implant designs may still have a role in THA.
Collapse
Affiliation(s)
- Stephen D. Bigach
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Matthew P. Kolevar
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Rebecca D. Moore
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA
| | - Pranav Adavi
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA
| | - Clare M. Rimnac
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Matthew J. Kraay
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
29
|
Zaidi Q, MacNeille R, Ramos O, Wycliffe N, Danisa O, İnceoğlu S, Cheng W. Predicting Pedicle Screw Pullout and Fatigue Performance: Comparing Lateral Dual-Energy X-Ray Absorptiometry, Anterior to Posterior Dual-Energy X-Ray Absorptiometry, and Computed Tomography Hounsfield Units. Int J Spine Surg 2023; 17:43-50. [PMID: 36805550 PMCID: PMC10025856 DOI: 10.14444/8356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND As the prevalence and associated health care costs of osteoporosis continue to rise in our aging population, there is a growing need to continue to identify methods to predict spine construct integrity accurately and cost-effectively. Dual-energy x-ray absorptiometry (DEXA) in both anterior to posterior (AP) and lateral planes, as well as computed tomography (CT) Hounsfield units (HU), have all been investigated as potential preoperative predictive tools. The purpose of this study is to determine which of the 3 bone density analysis modalities has the highest potential for predicting pedicle screw biomechanics. METHODS Lumbar spine specimens (L2, L3, and L4) from 6 fresh frozen cadavers were used for testing. AP-DEXA, lateral-DEXA, and CT images were obtained. Biomechanical testing of pedicle screws in each vertebrae was then performed including pullout strength and fatigue testing. Statistical analysis was performed. RESULTS Pullout strength was best predicted by CT HU, followed by AP-DEXA, then lateral-DEXA (R 2 = 0.78, 0.70, and 0.40, respectively). Fatigue testing showed a significant correlation of relative rotation between HU value and AP-DEXA bone mineral density (R 2 = 0.54 and R 2 = 0.72, respectively), and there was a significant correlation between relative translation and HU value (R 2 = 0.43). There was a poor correlation between relative rotation and lateral-DEXA (R 2 = 0.13) as well as a poor correlation between relative translation and both AP- and lateral-DEXA (R 2 = 0.35 and R 2 = 0.02). CONCLUSIONS CT is the only modality with a statistically significant correlation to all biomechanical parameters measured (pullout strength, relative angular rotation, and relative translation). AP-DEXA also predicts the biomechanical measures of screw pullout and relative angular rotation and is superior to lateral-DEXA. CT may provide an incremental benefit in assessing fatigue strength, but this should be weighed against the disadvantages of cost and radiation. CLINICAL RELEVANCE The results of this study can help to inform clinicians on different bone density analyses and their implications on pedicle screw failure.
Collapse
Affiliation(s)
- Qasim Zaidi
- Loma Linda University Medical Center, Loma Linda, CA, USA
| | | | - Omar Ramos
- Loma Linda University Medical Center, Loma Linda, CA, USA
| | | | - Olumide Danisa
- Loma Linda University Medical Center, Loma Linda, CA, USA
| | | | - Wayne Cheng
- Loma Linda University Medical Center, Loma Linda, CA, USA
| |
Collapse
|
30
|
Ghazzawi HA, Amawi AT, Alduraidi H, Juweid M, Alhawari HH, Al-Abbadi MA, Alabbadi AM, AlNemer LSS. The Preventable Effect of Taekwondo Sport among Cadets and Junior' Bone Mineral Density: DEXA Assessment. Children (Basel) 2023; 10:children10010170. [PMID: 36670720 PMCID: PMC9856767 DOI: 10.3390/children10010170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. The current study aimed to investigate the impact of rapid weight loss on BMD among cadets and juniors TKD athletes. A descriptive case series study design was conducted and collected from 28 males and females aged 12-17 years old, with mean age 14.4 ± 1.7. Dual-energy X-ray absorptiometry (DEXA) was used for both BMD and body composition assessment, and laboratory tests were also performed for the total calcium (Ca), TSH, free T4 (FT4), and 25-OH-vitamin D. Results showed normal levels of Ca (82.1%), TSH (96.4%), and FT4 (96.4%), whilst 85.7% had vitamin D deficiency. DEXA results showed that within male athletes, juniors had a wider range of BMD than cadets, while within females, results did not vary, with no statistical difference between both males and females. Our results suggested that children and adolescents' BMD was positively related to TKD sport regardless of the abnormal weight loss strategies used, as evidenced by laboratory results. Children and adolescents should be conscious and practice TKD sport adopting healthy weight loss behaviors.
Collapse
Affiliation(s)
- Hadeel Ali Ghazzawi
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan
- Correspondence: (H.A.G.); (M.J.)
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt 19328, Jordan
| | - Hamza Alduraidi
- Community Health Nursing Department, School of Nursing, The University of Jordan, Amman 11942, Jordan
| | - Malik Juweid
- Department of Radiology and Nuclear Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Correspondence: (H.A.G.); (M.J.)
| | - Hussam H. Alhawari
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Mousa A. Al-Abbadi
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Ali M. Alabbadi
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Lana Salah Subhi AlNemer
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan
| |
Collapse
|
31
|
Deshpande N, Hadi MS, Lillard JC, Passias PG, Linzey JR, Saadeh YS, LaBagnara M, Park P. Alternatives to DEXA for the assessment of bone density: a systematic review of the literature and future recommendations. J Neurosurg Spine 2023; 38:436-445. [PMID: 36609369 DOI: 10.3171/2022.11.spine22875] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/18/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Osteoporosis has significant implications in spine fusion surgery, for which reduced spinal bone mineral density (BMD) can result in complications and poorer outcomes. Currently, dual-energy x-ray absorptiometry (DEXA) is the gold standard for radiographic diagnosis of osteoporosis, although DEXA accuracy may be limited by the presence of degenerative spinal pathology. In recent years, there has been an evolving interest in using alternative imaging, including CT and MRI, to assess BMD. In this systematic review of the literature, the authors assessed the use and effectiveness of MRI, opportunistic CT (oCT), and quantitative CT (qCT) to measure BMD. METHODS In accordance with the PRISMA guidelines, the authors conducted a systematic search for articles posted on PubMed between the years 2000 and 2022 by using the keywords "opportunistic CT, quantitative CT, MRI" AND "bone density" AND "spine." Inclusion criteria consisted of articles written in English that reported studies pertaining to human or cadaveric subjects, and studies including a measure of spinal BMD. Articles not related to spinal BMD, osteoporosis, or spinal surgery or reports of studies that did not include the use of spinal MRI or CT were excluded. Key study outcomes were extracted from included articles, and qualitative analysis was subsequently performed. RESULTS The literature search yielded 302 articles. Forty-two articles reported studies that met the final inclusion criteria. Eighteen studies utilized MRI protocols to correlate spinal BMD with vertebral bone quality scores, M-scores, and quantitative perfusion markers. Eight studies correlated oCT with spinal BMD, and 16 studies correlated qCT with spinal BMD. With oCT and qCT imaging, there was consensus that Hounsfield unit (HU) values > 160 demonstrated significant reduction in risk of osteoporosis, whereas HU values < 110 were significantly correlated with osteoporosis. CONCLUSIONS Osteoporosis is increasingly recognized as a significant risk factor for complications after spinal fusion surgery. Consequently, preoperative assessment of BMD is a critical factor to consider in planning surgical treatment. Although DEXA has been the gold standard for BMD measurement, other imaging modalities, including MRI, oCT, and qCT, appear to be viable alternatives and may offer cost and time savings.
Collapse
Affiliation(s)
- Nachiket Deshpande
- 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Moustafa S Hadi
- 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Jock C Lillard
- 2Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee; and
| | - Peter G Passias
- 3Department of Orthopedic Surgery, Langone Orthopedic Hospital, New York, New York
| | - Joseph R Linzey
- 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Yamaan S Saadeh
- 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Michael LaBagnara
- 2Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee; and
| | - Paul Park
- 2Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee; and
| |
Collapse
|
32
|
Khatiwada S, Agarwal S, Kandasamy D, Kumar R, Jyotsna VP, Tandon N. Prevalence and Predictors of Osteoporosis/BMD Below Expected Range for Age in Pheochromocytoma/Paraganglioma and BMD, TBS Change Post-Operatively: A Prospective Cohort Study. Indian J Endocrinol Metab 2023; 27:87-90. [PMID: 37215262 PMCID: PMC10198189 DOI: 10.4103/ijem.ijem_322_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/30/2022] [Accepted: 01/06/2023] [Indexed: 03/05/2023] Open
Abstract
Context Pheochromocytomas/paragangliomas (PPGLs) have recently been shown to be associated with lower bone mineral density (BMD) and trabecular bone score as compared to healthy controls suggesting low bone mineral concentration and disrupted bone microarchitecture. There is paucity of data on prevalence and clinical predictors of low BMD/osteoporosis in PPGL from India and the extent of change in BMD post-operatively. Aims This study aimed to find prevalence of low BMD/osteoporosis and trabecular bone score (TBS)-adjusted FRAX score in subjects with PPGL and to see the post-operative change in BMD and TBS at follow-up. Material and Methods 32 consecutively diagnosed adult cases with PPGL were enrolled. Although the provisional diagnosis of PPGL was made based on imaging consistent with PPGL supported by biochemical evidence of catecholamine excess, its confirmation was made histopathologically before final analysis. Results We found significantly low average BMD T-score/Z-score at spine, hip or wrist. Osteoporosis was evident in 87.5% of subjects (nine of 11 post-menopausal women or men >50 years of age) and BMD below the expected range for age in 42.9% of subjects (nine of 21 pre-menopausal women or men <50 years of age) by International Society for Clinical Densitometry criteria. Conclusions 87% of older subjects with PPGL had osteoporosis while 43% of younger subjects had BMD below expected range for age (Z-score ≤-2.0), more at lumbar spine than at hip. Decreased body weight was associated with osteoporosis in older or Z-score ≤-2.0 in younger subjects. There was no significant change in BMD and TBS scores at a median of four months post-operatively.
Collapse
Affiliation(s)
- Saurav Khatiwada
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| | | | | | | | - Viveka P Jyotsna
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| |
Collapse
|
33
|
Al Shammaa A, Al-Thani A, Al-Kaabi M, Al-Saeed K, Alanazi M, Shi Z. Serum Magnesium is Inversely Associated with Body Composition and Metabolic Syndrome. Diabetes Metab Syndr Obes 2023; 16:95-104. [PMID: 36760601 PMCID: PMC9844104 DOI: 10.2147/dmso.s391369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Magnesium is vital to maintain normal physiological functions. We aimed to identify the association between serum magnesium and different measures of body adiposity among Qatari adults. We hypothesized that the association was mediated by depression and sleep duration. PATIENTS AND METHODS The study included 1000 adults aged 20 years and above who attended the Qatar Biobank Study (QBB) between 2012 and 2019. Body adiposity was assessed using dual-energy X-ray absorptiometry (DEXA). Serum magnesium concentration was measured. Sub-optimal magnesium was defined as magnesium concentration less than 0.85 mmol/L. The association was examined using linear regression. RESULTS The mean age of the participants (n=1000) was 35.8 (SD 10.3) years. More than half of the participants had sub-optimal magnesium concentrations (60.2% in men and 52.3% in women). Serum magnesium was inversely associated with different types of fat mass. In the fully adjusted model, per 1 SD increment of serum magnesium had standardized regression coefficients of -0.09 (p 0.005) for total fat mass, -0.08 (p 0.008) for trunk fat, -0.09 (p 0.003) for gynoid fat and -0.08 (p 0.008) for android fat. There was no gender difference in the association. The inverse association between serum magnesium and fat mass was significant in those with sleep duration ≥7 hours but not in those <7 hours. Depressive symptom and sleep did not mediate the association between serum magnesium and fat mass. Serum magnesium was inversely associated with metabolic syndrome (per 1 SD increment had an odds ratio (OR) of 0.70 (95% CI 0.57-0.85)). CONCLUSION There was an inverse association between serum magnesium and fat mass, especially among those with an adequate sleep duration and without chronic conditions including diabetes, hypertension and depression.
Collapse
Affiliation(s)
- AlMaha Al Shammaa
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Amna Al-Thani
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maryam Al-Kaabi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Kaltham Al-Saeed
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maria Alanazi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Correspondence: Zumin Shi, Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar, Tel +974 4403 6034, Fax +974 4403 4801, Email
| |
Collapse
|
34
|
Ibad HA, Mammen JS, Simonsick EM, Kwoh CK, Guermazi A, Demehri S. Higher thyroid hormone has a negative association with lower limb lean body mass in euthyroid older adults: Analysis from the Baltimore Longitudinal study of aging. Front Aging 2023; 4:1150645. [PMID: 37114095 PMCID: PMC10126399 DOI: 10.3389/fragi.2023.1150645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023]
Abstract
Background: Hyperthyroidism is associated with lower lean body mass, as a result of catabolic actions of thyroid hormone. Therefore, higher thyroid hormone levels could be a factor in the development of sarcopenia and age associated functional decline. The relationship between thyroid hormone and muscle mass in ambulatory, euthyroid older adults is not known. Method: We used mixed-effects models to estimate the cross-sectional relationships (accounting for inter-person variability) between thyroid axis hormone measures and lower limb composition or sarcopenia at visits in the Baltimore Longitudinal Study of Aging (BLSA) at which DEXA scans were available and both thyrotropin (TSH) and free thyroxine (FT4) were in the reference range. Analyses were adjusted for levothyroxine use, age, race, sex, BMI, smoking, alcohol intake, cholesterol, and systolic blood pressure. Results: 1442 euthyroid participants (median age 68, 50% female, and 69% white) contributed to 5306 visits from 2003 to 2019. FT4 was negatively associated with lower limb lean mass (beta: 88.49; 95% Confidence Interval (CI): 122.78, -54.20; p < 0.001) and positively associated with sarcopenia (OR: 1.11%, 95% CI: 1.01, 1.22) in the whole cohort. Additionally, higher FT4 was associated with lower leg lean mass (beta: 66.79; 95% CI: 102.24, -31.33; p < 0.001) and sarcopenia (OR:1.09%, 95% CI:1.01, 1.18) in older adults, but not in younger adults alone. Conclusion: In euthyroid older adults, higher FT4 is associated with lower leg lean mass and higher odds of sarcopenia. Understanding the relationship between thyroid hormone and sarcopenia is needed to improve clinical decision-making and avoid functional decline from excess thyroid hormone use in older adults.
Collapse
Affiliation(s)
- Hamza Ahmed Ibad
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jennifer S. Mammen
- The Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Jennifer S. Mammen,
| | | | - C. Kent Kwoh
- Division of Rheumatology, The University of Arizona, Tucson, AZ, United States
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - Shadpour Demehri
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| |
Collapse
|
35
|
Sharma P, Al-Dadah O. Clinical efficacy of bisphosphonates and monoclonal antibodies on bone mineral density following skeletal fractures. J Clin Orthop Trauma 2022; 34:102022. [PMID: 36161063 PMCID: PMC9494278 DOI: 10.1016/j.jcot.2022.102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 10/31/2022] Open
Abstract
Background Bisphosphonates and monoclonal antibodies are drugs primarily developed to inhibit osteoclast-mediated bone resorption and are used to treat an array of skeletal pathologies. Their use is aimed at increasing bone health and therefore reducing fracture risks. The aim of this study was to evaluate the effectiveness of bone protection therapy on improving bone mineral density (BMD) in patients following a fracture. Methods Inclusion criteria consisted of patients who sustained a skeletal fracture and were subsequently commenced on bone protection therapy. Dual-energy X-ray Absorptiometry (DEXA) scans were performed at baseline and following a consented period of drug therapy. Bone health data included T-Scores, Z-Scores, FRAX Major, FRAX Hip and BMD. The clinical effectiveness of four bisphosphonates (alendronate, risedronate, pamidronate and zoledronate) and one monoclonal antibody (denosumab) were evaluated. Results A total of 100 patients were included in the study. Overall, bone protection therapy significantly improved Z-score Hip, Z-score Spine, T-score Spine and BMD Spine (p < 0.05). There was a marked difference between drug therapies. Denosumab and zoledronate were associated with the greatest treatment effect size. Alendronate only improved Z-score Spine and Z-score Hip (p < 0.05). Pamidronate and risedronate did not demonstrate any statistically significant improvement across any DEXA parameter. Conclusion Overall, bisphosphonates/monoclonal antibodies confer beneficial effects on bone health as measured by DEXA scans in patients following skeletal fractures. However, the magnitude of improvement varies among the commonly used drugs. Alendronate, zoledronate and denosumab were associated with greatest therapeutic benefit. Bone protection therapy did not improve fracture risk of patients (FRAX scores).
Collapse
Affiliation(s)
- Priya Sharma
- Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL, United Kingdom
| | - Oday Al-Dadah
- Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL, United Kingdom
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, United Kingdom
| |
Collapse
|
36
|
Aynaszyan S, Devia LG, Udoeyo IF, Badve SA, DelSole EM. Patient physiology influences the MRI-based vertebral bone quality score. Spine J 2022; 22:1866-1874. [PMID: 35724811 DOI: 10.1016/j.spinee.2022.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/31/2022] [Accepted: 06/11/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Osteoporosis is a critical issue affecting postmenopausal women and the aging population. A novel magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score has been proposed as a method to identify poor bone quality and predict fragility fractures. The diagnostic accuracy of this tool is not well understood. PURPOSE To examine the ability of VBQ to predict osteoporosis and osteopenia, its correlation with dual-energy x-ray absorptiometry (DEXA), and the influence of patient-specific factors upon the score. STUDY DESIGN Retrospective cohort study. PATIENT SAMPLE Patients over the age of 18 with a DEXA scan and noncontrast, T1-weighted MRI of the lumbar spine completed within a 2-year period. OUTCOME MEASURES Area-under-curve (AUC) values of the VBQ score predicting osteopenia and osteoporosis when controlling for patient characteristics. METHODS Patients with noncontrast, T1-weighted MRIs of the lumbar spine and DEXA scans completed within a 2-year time frame were retrospectively reviewed. Patient demographics and medical risk factors for osteoporosis were identified and compared. VBQ scores were measured by two trained researchers and interrater reliability was calculated. Patients were separated into three groups defined by lowest DEXA T-score: Healthy Bone, Osteopenia, and Osteoporosis. analysis of variance, Kruskal-Wallis test, chi-square, t tests, Mann-Whitney U tests, and multivariate linear regression were performed to examine the relationship between patient characteristics, DEXA t-scores, and VBQ scores. Receiver operating characteristic analysis and AUC values were generated for the prediction of osteopenia and osteoporosis. RESULTS A total of 156 patients were included for analysis. Sufficient inter-rater reliability was determined for VBQ measures (intraclass correlation coefficient: 0.81). Most patients were female (83%), postmenopausal (81%), and had hyperlipidemia (64%). Patients with hyperlipidemia and healthy bone density by DEXA had elevated baseline VBQ scores (p<.001) reflective of values seen in osteopenia and osteoporosis. The AUC of the VBQ score predicting osteopenia and osteoporosis changed to be more concordant with DEXA results after controlling for hyperlipidemia (AUC=0.72, 0.70 vs. AUC=0.88, 0.89; p<.001). Sub-analysis of hyperlipidemia subtypes revealed that elevated high-density lipoprotein is associated with elevated VBQ scores. CONCLUSIONS Hyperlipidemia increased the MRI-based VBQ score in our healthy bone population. The high signal intensities resembled values seen in osteopenia and osteoporosis, suggesting that physiologic variables which impact bone composition may influence the VBQ score. Specifically, elevated high-density lipoprotein may contribute to this. The microarchitectural changes and the clinical implications of these factors need further exploration.
Collapse
Affiliation(s)
- Stephan Aynaszyan
- Geisinger Commonwealth School of Medicine, 525 Pine St., Scranton, PA 18510, USA
| | - Luis G Devia
- Geisinger Commonwealth School of Medicine, 525 Pine St., Scranton, PA 18510, USA
| | - Idorenyin F Udoeyo
- Department of Spine Surgery, Geisinger Musculoskeletal Institute, 3 W. Olive St., Scranton, PA 18508, USA
| | - Siddharth A Badve
- Department of Spine Surgery, Geisinger Musculoskeletal Institute, 3 W. Olive St., Scranton, PA 18508, USA
| | - Edward M DelSole
- Geisinger Commonwealth School of Medicine, 525 Pine St., Scranton, PA 18510, USA; Department of Spine Surgery, Geisinger Musculoskeletal Institute, 3 W. Olive St., Scranton, PA 18508, USA.
| |
Collapse
|
37
|
Uhlinova J, Kuudeberg A, Metsküla K, Lember M, Rosenberg M. Significant associations between bone mineral density and vascular calcification in patients with different stages of chronic kidney disease. BMC Nephrol 2022; 23:327. [PMID: 36199013 PMCID: PMC9533531 DOI: 10.1186/s12882-022-02955-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Chronic kidney disease—mineral and bone disorders (CKD-MBD) is characterised by generalised vascular calcification (VC) and impaired bone health. We aimed to investigate the relationship between VC and bone mineral density (BMD) in CKD patients. Methods We performed a cross-sectional study of patients with different stages of CKD. For assessment of VC of abdominal aorta lateral lumbar X-rays (Kauppila score), the ankle-brachial index (ABI) and echocardiography were used. Total body densitometry provided BMD. Results Ninety patients (41% male, median age 64 years (range 29–87)) were included, of whom 41.1% had a Kauppila score > 1. Evidence of peripheral VC as measured by ABI was detected in 23.3% of cases. Lesions of the heart valves were found in 46.7% of patients. There was a significant association between high ABI and lesions of the heart valves. In the multivariate regression model to analyse the independent determinants of abdominal aorta calcification (AAC) and ABI, the BMD of the femoral neck was identified as significant for both (p = 0.001, p = 0.001). The total spine BMD was found to be significant for AAC (p = 0.001), and the BMD of spine L1-L4 and the ribs were found to be significant for ABI (p = 0.01, p = 0.002 respectively). In factorial regression analysis, where BMD was independent determinant, valvular calcification was significant for BMD of femur, femoral neck and total BMD. Age and tALP were inversely correlated with the BMD of femur and femoral neck. Conclusions Our work highlighted clinically important relationships between VC and bone mineral density (BMD) in CKD patients. We detected inverse relationships between AAC, high ABI and BMD. Secondly, BMD at certain bone sites (femur, femoral neck) and total BMD were associated with important lesions of heart valves. Thirdly, a significant association between a high ABI and lesions of the heart valves. We believe that the results of our study will help in the planning of future research and in current clinical practice for the early diagnosis, further monitoring and management of CKD-MBD. Additionally, these results may have treatment implications on use of different CKD-MBD medications.
Collapse
Affiliation(s)
- Jana Uhlinova
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Puusepa str. 8, 50406, Tartu, Estonia. .,Department of Internal Medicine, Tartu University Hospital, Tartu, Estonia.
| | - Anne Kuudeberg
- Department of Anatomy, Institute of Pathological Anatomy and Forensic Medicine, University of Tartu, Tartu, Estonia
| | - Kaja Metsküla
- Department of Immunology, Institute of Biomedicine and Translation Medicine, University of Tartu, Tartu, Estonia
| | - Margus Lember
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Puusepa str. 8, 50406, Tartu, Estonia.,Department of Internal Medicine, Tartu University Hospital, Tartu, Estonia
| | - Mai Rosenberg
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Puusepa str. 8, 50406, Tartu, Estonia.,Department of Internal Medicine, Tartu University Hospital, Tartu, Estonia
| |
Collapse
|
38
|
Touban BM, Sayegh MJ, Galina J, Pavlesen S, Radwan T, Anders M. Computed Tomography Measured Psoas Cross Sectional Area Is Associated With Bone Mineral Density Measured by Dual Energy X-Ray Absorptiometry. J Clin Densitom 2022; 25:592-598. [PMID: 35606278 DOI: 10.1016/j.jocd.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Dual-energy X-ray absorptiometry (DEXA) is the gold standard for osteoporosis screening and diagnosis. However, abdominal conventional computed tomography (CT) scan is widely available and multiple studies validated its use as a screening tool for osteoporosis compared to DEXA. The aim of this study was to determine the reliability of measuring core muscle size at the L3-L4 intervertebral disk space and estimate the relationship between core muscle size and bone mineral density (BMD) measured by DEXA. Retrospective chart review was performed on patients who underwent a DEXA scan for osteoporosis and a conventional abdominal CT scan within one-year apart. Total cross-sectional area (CSA) and Hounsfield Unit (HU) density of core muscles (psoas, paraspinal, and abdominal wall muscles) were measured. The association between psoas, paraspinal, abdominal, and central muscle CSA and Bone Mineral density (BMD) at L3, L4, total Lumbar Spine (LS), and right (R) and left (L) hip was estimated in crude and adjusted for age and sex linear regression models. Sixty patients (37 females, 23 males) met the inclusion criteria. The average interval between DEXA and abdominal CT scans was 3.6 months (range 0.1-10.2). Psoas muscle density was significantly positively associated with R hip BMD in both crude and adjusted models (β = 20.2, p = 0.03; β = 18.5, p = 0.01). We found a significant positive linear association between psoas muscle CSA and HU density with BMD of LS, R, and L hip in both crude and adjusted models. The strongest significant positive linear association was observed between total abdominal CSA and R hip BMD in crude and age and sex adjusted (ß = 85.3, p = 0.01; ß = 63.9, p = 0.02, respectively). CT scans obtained for various clinical indications can provide valuable information regarding BMD. This is the first study investigating association between BMD with central muscle density and CSA, and it demonstrated their significant positive the association.
Collapse
Affiliation(s)
- Basel M Touban
- Department of Orthopaedics, Brooke Army Medical Center, F. Edward Hebert School of Medicine - Uniformed Services University JBSA-Fort Sam Houston, TX USA
| | - Michael J Sayegh
- Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell University, New Hyde Park, NY USA
| | - Jesse Galina
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA.
| | - Sonja Pavlesen
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
| | - Tariq Radwan
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
| | - Mark Anders
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
| |
Collapse
|
39
|
Aslan SG, Genç H. Sarcopenia in knee osteoarthritis: the association with clinical and sonographic findings, physical function, and nutrition. Ir J Med Sci 2022. [PMID: 36050588 DOI: 10.1007/s11845-022-03141-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purposes of this study were to examine to (1) the relation between OA and sarcopenia and to identify the most practical, easily accessible, and inexpensive method for investigating sarcopenia; (2) evaluation of sarcopenia risk factors in patients with OA. DESIGN One hundred two patients with clinical and radiological diagnosis of knee osteoarthritis and 33 healthy control subjects were included in the study and all subjects were evaluated for sarcopenia. Dual-X-ray absorptiometry (DEXA) is used to measure body composition parameters and muscle thickness measurements with ultrasonography for diagnosis of sarcopenia. RESULTS The mean age of the group with sarcopenia was statistically higher than the other two groups (p < 0.001). The weight, body mass index (BMI), waist circumference, upper-mid-arm circumference, thigh, and leg circumference of osteoarthritis (OA) patients with sarcopenia were statistically lower than those of non-sarcopenic and control group (p < 0.01, p < 0.001). Body composition parameter results showed that sarcopenic patients had statistically lower values as fat mass, lean body mass, and skeletal muscle index (p < 0.001, p = 0.001, p < 0.001, respectively) than those of non-sarcopenic and control group and fat mass index values (p = 0.012) are lower than the non-sarcopenic group. With respect to sarcopenia, the effect of adiponectin and leptin levels were not detected. It was determined that body composition values measured with DEXA, ultrasonographic measures, isokinetic muscle strength assessment, handgrip strength, and gait speed had predictive values for sarcopenia. CONCLUSIONS We found that patients with sarcopenic OA were older, weaker, undernourished, and restricted in their level of physical activity in the study. Among the methods of determining sarcopenia, ultrasound becomes prominent with its practical, cheap, and easily accessible features. We think that our results will increase the awareness of the presence of sarcopenia in OA patients.
Collapse
|
40
|
Kalia M, Chaturvedi R, Rohilla R, Grover PK, Goel NK, Dalal M, Kaur R. Prevalence and predictors of low bone mineral density among adults aged 50 years and above in Chandigarh, India. J Family Med Prim Care 2022; 11:5231-5235. [PMID: 36505648 PMCID: PMC9731050 DOI: 10.4103/jfmpc.jfmpc_2179_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Osteoporosis, defined as skeletal disorder characterized by reduced bone density and strength, is prevalent in both developing and developed countries. Dual energy X-ray absorptiometry (DEXA) is an effective tool to diagnose low bone mineral density (BMD). Objective This study objective was to know the prevalence and predictors of low BMD in a community-based screening program among the adult population using DEXA scan. Methods In this community-based study conducted between January and June 2016, a population-based screening program was offered to both males and females of age 50 years and above. BMD was measured to derive T-scores and classify as normal, osteopenic, and osteoporotic individuals. Results A total of 455 subjects were enrolled where 62.4% proportion was women; 42.6% subjects were in the age group of 50 to 59 years. The prevalence of osteoporosis and osteopenia was 20.9% and 48.1%, respectively. Hypertension (23.7%) and diabetes (8.4%) were common comorbidities. Age and gender (female) were independent predictors of low BMD. Conclusion Osteoporosis/osteopenia is present in both genders with increasing trend with age advancement. Institution of timely screening will prevent the morbidity associated with fractures due to low BMD.
Collapse
Affiliation(s)
- Meenu Kalia
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Ruchi Chaturvedi
- Department of Community Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Ravi Rohilla
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Parneet K. Grover
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India,Address for correspondence: Dr. Parneet K. Grover, Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India. E-mail:
| | - Naveen K. Goel
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Manjesh Dalal
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Ravneet Kaur
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| |
Collapse
|
41
|
Lepionka T, Anyżewska A, Maculewicz E, Klos K, Lakomy R, Szarska E, Tomczak A, Gaździńska A, Skuza K, Bertrandt J. Assessment of the Body Composition and Bone Calcification of Students of Police Schools and Police Training Centers in Poland-A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:ijerph19127161. [PMID: 35742406 PMCID: PMC9222845 DOI: 10.3390/ijerph19127161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 02/01/2023]
Abstract
The 21st century is considered the age of malnutrition resulting in the unprecedented frequency of civilization diseases. Among these disorders, obesity is particularly distinguished and considered an epidemic-scale disease. For this reason, conducting studies on obesity and counteracting this phenomenon is essential. Research from recent years indicates a problem of excessive body weight among officers of uniformed services, who should be characterized by good health and fitness level due to the specificity of the work. As the problem of obesity affects every fourth Pole, research in uniformed services seems to be essential from health and national security perspectives. The presented study aimed to determine the elements of nutritional status in 289 students of Polish police schools and police training centers. Body composition was determined by bioelectrical impedance analysis, and bone calcification assessment was conducted by the DXA densitometric method. Based on BMI and body fat content, body weight disorders were found in 31.8% of all examined students. Densitometric test results showed changes in bone calcification of varying severity in 26.6% of the total number of respondents. The presence of obesity in students of police schools and training centers proves that the present nutrition model is energetically unbalanced, while the demonstrated disorders of bone calcification indicate an improper condition of mineral nutrition.
Collapse
Affiliation(s)
- Tomasz Lepionka
- Military Institute of Hygiene and Epidemiology, 4 Kozielska, 01-163 Warsaw, Poland; (K.K.); (R.L.); (E.S.); (K.S.)
- Correspondence: ; Tel.: +48-261519847
| | - Anna Anyżewska
- University of Economics and Human Sciences in Warsaw, Okopowa 59, 01-043 Warsaw, Poland;
| | - Ewelina Maculewicz
- Faculty of Physical Education, Józef Pilsudski University of Physical Education in Warsaw, 34 Marymoncka, 00-968 Warsaw, Poland;
| | - Krzysztof Klos
- Military Institute of Hygiene and Epidemiology, 4 Kozielska, 01-163 Warsaw, Poland; (K.K.); (R.L.); (E.S.); (K.S.)
| | - Roman Lakomy
- Military Institute of Hygiene and Epidemiology, 4 Kozielska, 01-163 Warsaw, Poland; (K.K.); (R.L.); (E.S.); (K.S.)
| | - Ewa Szarska
- Military Institute of Hygiene and Epidemiology, 4 Kozielska, 01-163 Warsaw, Poland; (K.K.); (R.L.); (E.S.); (K.S.)
| | | | - Agata Gaździńska
- Laboratory of Dietetics and Obesity Treatment, Department of Psychophysiological Measurements and Human Factor Research, Military Institute of Aviation Medicine, 54/56 Krasinskiego, 01-755 Warsaw, Poland;
| | - Katarzyna Skuza
- Military Institute of Hygiene and Epidemiology, 4 Kozielska, 01-163 Warsaw, Poland; (K.K.); (R.L.); (E.S.); (K.S.)
| | - Jerzy Bertrandt
- Faculty of Economic Sciences, John Paul II University of Applied Sciences in Biala Podlaska, Sidorska 95/97, 21-500 Biala Podlaska, Poland;
| |
Collapse
|
42
|
Abstract
PURPOSE OF REVIEW The purpose of this manuscript is to review the current diagnosis, management, and referral practices of patients with osteoporosis after a fragility fracture from the orthopedic surgeon's perspective. RECENT FINDINGS Effective treatments are available for osteoporosis that significantly decrease the risk of additional fractures. Despite recommendations for improved post-fragility fracture osteoporosis management, the rate of diagnosis and treatment is still unacceptably low. Patients sustaining a low-energy fracture should be evaluated for osteoporosis with discussion of beginning pharmacological treatment. Antiresorptive and anabolic agents are available treatment options. Fracture Liaison Services can help to coordinate the care of these patients and improve the rate of diagnosis and initiation of therapy. Dartmouth-Hitchcock is working to improve the bone health for our patients utilizing a multidisciplinary team-based approach. This process is intended to lead to increased recognition of osteoporosis within our institution and close the capture gap between hospital discharge and initiation of osteoporosis pharmacotherapy.
Collapse
Affiliation(s)
- Phillip Snodgrass
- Department of Orthopaedics, Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA.
| | - Anthony Zou
- Department of Orthopaedics, Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA
| | - Ugis Gruntmanis
- Department of Medicine, Division of Endocrinology, Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA
| | - Ida Leah Gitajn
- Department of Orthopaedics, Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA
| |
Collapse
|
43
|
Pinter ZW, Monsef JB, Salmons HI, Sebastian AS, Freedman BA, Currier BL, Elder BD, Nassr AN. Does Preoperative Bone Mineral Density Impact Fusion Success in Anterior Cervical Spine Surgery? A Prospective Cohort Study. World Neurosurg 2022:S1878-8750(22)00688-X. [PMID: 35605943 DOI: 10.1016/j.wneu.2022.05.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of this study was to identify risk factors for pseudarthrosis in patients undergoing anterior cervical discectomy and fusion (ACDF) with a focus on the role of bone mineral density (BMD) on arthrodesis. METHODS We retrospectively reviewed a prospectively collected database of patients undergoing 1- to 4-level ACDF for degenerative indications between 2012 and 2018 at a single institution. All patients were required to have undergone a preoperative dual-energy x-ray absorptiometry (DEXA) scan. Fusion status was assessed on computed tomography (CT) scans obtained 1 year postoperatively. Patients were divided into subgroups based on fusion status and compared on the basis of demographic, BMD, and surgical variables to determine risk factors for pseudarthrosis. RESULTS We identified 79 patients for inclusion in this study. Fusion was achieved in 65 patients (82%), while 14 patients (18%) developed pseudarthrosis. The pseudarthrosis subgroup demonstrated significantly lower BMD than their counterparts who achieved successful fusion in both mean hip (-1.4 ± 1.2 vs. -0.2 ± 1.2, respectively; P = 0.002) and spine T-scores (-0.8 ± 1.8 vs. 0.6 ± 1.9, respectively; P = 0.02). The pseudarthrosis group had a substantially higher proportion of patients with osteopenia (57.1% vs. 20.0%) and osteoporosis (21.5% vs. 6.2%; P < 0.001) than the fusion group. Multivariate analysis demonstrated osteopenia (odds ratio [OR] 8.76, P = 0.04), osteoporosis (OR 9.97, P = 0.03), and low BMD (OR 11.01, P = 0.002) to be associated with an increased likelihood of developing pseudarthrosis. CONCLUSIONS The results of this study suggest that both osteopenia and osteoporosis are associated with increased rates of pseudarthrosis in patients undergoing elective ACDF.
Collapse
|
44
|
Blanton CA, Barrott JJ, Kunz K, Bunde E, Streff HM, Sparks CA, Williams DW, Gabaldόn AM. The Impact of Hempseed Consumption on Bone Parameters and Body Composition in Growing Female C57BL/6 Mice. Int J Environ Res Public Health 2022; 19. [PMID: 35627377 DOI: 10.3390/ijerph19105839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
Optimizing peak bone mass is critical to healthy aging. Beyond the established roles of dietary minerals and protein on bone integrity, fatty acids and polyphenols modify bone structure. This study investigated the effect of a diet containing hempseeds (HS), which are rich in polyunsaturated fatty acids and polyphenols, on bone mineral density, bone cell populations and body composition. Groups (n = 8 each) of female C57BL/6 mice were fed one of three diets (15% HS by weight; 5% HS; 0% HS (control)) from age 5 to 30 weeks. In vivo whole-body composition and bone mineral density and content were measured every 4 weeks using dual-energy X-ray absorptiometry. Ex vivo humeri cell populations in the epiphyseal plate region were determined by sectioning the bone longitudinally, mounting the sections on slides and staining with tartrate-resistant acid phosphatase and alkaline phosphatase stain to identify osteoclasts and osteoblasts, respectively. Mixed models with repeated measures across experimental weeks showed that neither body weight nor body weight gain across weeks differed among groups yet mice fed the 15% HS diet consumed significantly more food and more kilocalories per g body weight gained than those fed the 5% HS and control diets (p < 0.0001). Across weeks, fat mass was significantly higher in the 5% HS versus the control group (p = 0.02). At the end point, whole-body bone mineral content was significantly higher in the control compared to the 5% HS group (p = 0.02). Humeri from both HS groups displayed significantly lower osteoblast densities compared to the control group (p < 0.0001). No relationship was seen between osteoblast density and body composition measurements. These data invite closer examination of bone cell activity and microarchitecture to determine the effect of habitual HS consumption on bone integrity.
Collapse
|
45
|
Hangge PT, Norain A, Butterfield RJ, Wasif N, Cronin PA, Stucky CCH. Parathyroidectomy in the elderly is beneficial and safe with similar improvements in postoperative bone mineral density. Am J Surg 2022; 224:147-152. [PMID: 35534296 DOI: 10.1016/j.amjsurg.2022.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/20/2022] [Accepted: 04/22/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study evaluated bone health outcomes of parathyroidectomy in elderly primary hyperparathyroidism (pHPT) patients. METHODS A retrospective review was performed of parathyroidectomy patients with pHPT at a single institution from 2010 to 2019. Bone mineral density (BMD) improvements at postoperative dual-energy X-ray absorptiometry (DEXA) scans were analyzed between groups aged ≥75 and < 75 years using 1:1 matching on preoperative BMD. RESULTS Patients ≥75 had BMD improvements through the second postoperative DEXA scans. While mean T-scores slightly improved in the ≥75 group during the study period, T-score improvement was more significant in the <75 group at first and third postoperative DEXA scans with +0.7 < 75 and +0.1 improvements ≥75 by the third DEXA (p = 0.026). Postoperative fragility fracture rates were similar in the ≥75 group, but significantly improved in patients <75 (10.4% preoperatively to 1.4% postoperatively, p = 0.020). Both cohorts had low complication rates with recurrent laryngeal nerve injury and permanent hypocalcemia of <1% (p = 0.316). CONCLUSIONS Postoperative BMD improvement was similar between the two cohorts with no difference in complication rates suggesting parathyroidectomy is safe and effective in the elderly.
Collapse
Affiliation(s)
- Patrick T Hangge
- Department of General Surgery, Division of Oncologic and Endocrine Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Abdullah Norain
- Department of General Surgery, Division of Oncologic and Endocrine Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA
| | | | - Nabil Wasif
- Department of General Surgery, Division of Oncologic and Endocrine Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Patricia A Cronin
- Department of General Surgery, Division of Oncologic and Endocrine Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Chee-Chee H Stucky
- Department of General Surgery, Division of Oncologic and Endocrine Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA
| |
Collapse
|
46
|
Kalabiska I, Zsakai A, Annar D, Malina RM, Szabo T. Sport Activity Load and Skeletomuscular Robustness in Elite Youth Athletes. Int J Environ Res Public Health 2022; 19:5083. [PMID: 35564478 DOI: 10.3390/ijerph19095083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022]
Abstract
In an earlier report, bone mineral reference values for young athletes were developed. This study addressed variations in bone mineral parameters of young athletes participating in sports with different mechanical loads. The bone mineral status of 1793 male and female athletes, 11 to 20 years of age, in several sports was measured with DEXA. Specific bone mineral parameters were converted to z-scores relative to age- and sex-specific reference values specified by the DEXA software. Z-score profiles and principal components analyses were used to identify body structural components in the young athletes and to evaluate the associations between the identified component and type of sport defined by mechanical load. A unique skeletomuscular robusticity of male wrestlers, pentathletes, and cyclists was noted: wrestlers had significantly more developed skeletomuscular robusticity and bone mineral density compared to the age-group average among elite athletes, while pentathletes and cyclists had lower bone mineral parameters than the age-group references among elite athletes. Among female athletes, bone mineral parameters of both the trunk and extremities of rhythmic gymnasts and pentathletes were significantly lower compared to the age-group means for elite athletes. The bone mineral development of elite young athletes varies with the impact forces associated with their respective sports. The skeletal development of cyclists, pentathletes, and rhythmic gymnasts should be monitored regularly as their bone development lags behind that of their athlete peers and the reference for the general population.
Collapse
|
47
|
Ipek Işıkcı N, Abuqbeitah M, Demir M. The Interference of Gamma Rays With Bone Mineral Density Measurements in 177Lu-PSMA and DOTATATE Therapy. J Clin Densitom 2022; 25:237-243. [PMID: 34654625 DOI: 10.1016/j.jocd.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022]
Abstract
The main purpose was to describe the interference of gamma radiation emitted by 177Lu with simultaneous bone mineral density BMD measures for patients undergoing 177Lu-PSMA and 177Lu DOTATATE therapy. A cohort of 9 patients underwent 177Lu-PSMA therapy were randomly selected to speculate the activity in the abdominopelvic region. So that, SPECT/CT scan at 24 h was used with attenuation and scatter correction. The activities were derived from the delineated ROIs over the abdominopelvic zone showing a range of 34-274 MBq. Next, a water path was placed under spine phantom mimicking L1-L4 vertebrae and followed by consecutive DEXA scans made by Hologic 4500 W and GE-Lunar DPX-NT systems. Five scans were performed without/and with different Lu-177 activities 37, 185, 370 and 555 MBq under the same geometric conditions. The obtained BMD readings of L1-L4 by the Hologic device were 1.027, 1.024, 1.021, 1.013, and 1.006 g/cm2 with presence of 0, 37, 185, 370, and 555 MBq 177Lu activity, respectively. Whereas, in Lunar device, it was found as higher as 1.163, 1.121, 1.09, 1.072, and 1.043, respectively. There was no statistically significant difference between both devices (pvalue ≥ 0.05). The fluctuation ranges in the L1-L4 BMD readings at the presence of 37-555 MBq were 0.3%-2%, and 3.6%-10.3% for Hologic and Lunar systems, respectively. It was emphasized that gamma radiation emitted by 177Lu relatively influence DEXA scans and the yielded BMD measures. Postponing DEXA scans as early as 8 d after 177Lu-PMSA and 11 d after 177Lu-DOTATATE therapies is recommended to avoid the erroneous contribution of gamma radiation and provide precise bone assessment.
Collapse
Affiliation(s)
- Nazenin Ipek Işıkcı
- Department of Computer Engineering, Faculty of Engineering and Architecture, Nisantasi University, Istanbul, Turkey.
| | - Mohammad Abuqbeitah
- Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Mustafa Demir
- Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
48
|
Holubiac IȘ, Leuciuc FV, Crăciun DM, Dobrescu T. Effect of Strength Training Protocol on Bone Mineral Density for Postmenopausal Women with Osteopenia/Osteoporosis Assessed by Dual-Energy X-ray Absorptiometry ( DEXA). Sensors (Basel) 2022; 22:s22051904. [PMID: 35271050 PMCID: PMC8915025 DOI: 10.3390/s22051904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 05/09/2023]
Abstract
This study aims to introduce a resistance training protocol (6 repetitions × 70% of 1 maximum repetition (1RM), followed by 6 repetitions × 50% of 1RM within the same set) specifically designed for postmenopausal women with osteopenia/osteoporosis and monitor the effect of the protocol on bone mineral density (BMD) in the lumbar spine, assessed by dual-energy X-ray absorptiometry (DEXA). The subjects included in the study were 29 postmenopausal women (56.5 ± 2.8 years) with osteopenia or osteoporosis; they were separated into two groups: the experimental group (n = 15), in which the subjects participated in the strength training protocol for a period of 6 months; and the control group (n = 14), in which the subjects did not take part in any physical activity. BMD in the lumbar spine was measured by DEXA. The measurements were performed at the beginning and end of the study. A statistically significant increase (Δ% = 1.82%) in BMD was observed at the end of the study for the exercise group (0.778 ± 0.042 at baseline vs. 0.792 ± 0.046 after 6 months, p = 0.018, 95% CI [-0.025, -0.003]); while an increase was observed for the control group (Δ% = 0.14%), the difference was not statistically significant (0.762 ± 0.057 at baseline vs. 0.763 ± 0.059, p = 0.85, 95% CI [-0.013, 0.011]). In conclusion, our strength training protocol seems to be effective in increasing BMD among women with osteopenia/osteoporosis and represents an affordable strategy for preventing future bone loss.
Collapse
Affiliation(s)
- Iulian Ștefan Holubiac
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
| | - Florin Valentin Leuciuc
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
- Correspondence:
| | - Daniela Maria Crăciun
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
| | - Tatiana Dobrescu
- Department of Physical Education and Sport Performance, Vasile Alecsandri University, 600115 Bacau, Romania;
| |
Collapse
|
49
|
Battaglia Y, Bellasi A, Bortoluzzi A, Tondolo F, Esposito P, Provenzano M, Russo D, Andreucci M, Cianciolo G, Storari A. Bone Mineral Density Changes in Long-Term Kidney Transplant Recipients: A Real-Life Cohort Study of Native Vitamin D Supplementation. Nutrients 2022; 14:nu14020323. [PMID: 35057505 PMCID: PMC8780110 DOI: 10.3390/nu14020323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 02/07/2023] Open
Abstract
Vitamin D insufficiency has been associated with reduced bone mineral density (BMD) in kidney transplant patients (KTRs). However, the efficacy of vitamin D supplementation on BMD remains poorly defined, especially for long-term KTRs. We aimed to investigate the effect of native vitamin D supplementation on the BMD of KTRs during a 2-year follow-up. Demographic, clinical, and laboratory data were collected. BMD was evaluated with standard DEXA that was performed at baseline (before vitamin D supplementation) and at the end of study period. BMD was assessed at lumbar vertebral bodies (LV) and right femoral neck (FN) by a single operator. According to WHO criteria, results were expressed as the T-score (standard deviation (SD) relative to young healthy adults) and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as a T-score ≤ -2.5 SD and a T-score < -1 and a > -2.5 SD, respectively. Based on plasma levels, 25-OH-vitamin D (25-OH-D) was supplemented as recommended for the general population. Data from 100 KTRs were analyzed. The mean study period was 27.7 ± 3.4 months. At study inception, 25-OH-D insufficiency and deficiency were recorded in 65 and 35 patients. At the basal DEXA, the percentage of osteopenia and osteoporosis was 43.3% and 18.6% at LV and 54.1% and 12.2% at FN, respectively. At the end of the study, no differences in the Z-score and T-score gains were observed. During linear mixed model analysis, native vitamin D supplementation was found to have a negative nitration with Z-score changes at the right femoral neck in KTRs (p < 0.05). The mean dose of administered cholecalciferol was 13.396 ± 7.537 UI per week; increased 25-OH-D levels were found (p < 0.0001). Either low BMD or 25-OH-vitamin D concentration was observed in long-term KTRs. Prolonged supplementation with 25-OH-D did not modify BMD, Z-score, or T-score.
Collapse
Affiliation(s)
- Yuri Battaglia
- Department of Medicine, University of Verona, 37129 Verona, Italy
- Nephrology and Dialysis Unit, Pederzoli Hospital, 37019 Verona, Italy
- Correspondence:
| | - Antonio Bellasi
- Nephrology Unit, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland;
| | - Alessandra Bortoluzzi
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and St. Anna University-Hospital, 44124 Ferrara, Italy;
| | - Francesco Tondolo
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.T.); (G.C.)
| | - Pasquale Esposito
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy;
- Clinica Nefrologica, Dialisi, Trapianto, IRCCS Ospedale Policlinico San Martino, 16142 Genoa, Italy
| | - Michele Provenzano
- Nephrology and Dialysis Unit, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (M.P.); (M.A.)
| | - Domenico Russo
- Department of Public Health, University Federico II, 80100 Napoli, Italy;
| | - Michele Andreucci
- Nephrology and Dialysis Unit, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (M.P.); (M.A.)
| | - Giuseppe Cianciolo
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.T.); (G.C.)
| | - Alda Storari
- Nephrology and Dialysis Unit, St. Anna University-Hospital, 44124 Ferrara, Italy;
| |
Collapse
|
50
|
Ranganath LR, Khedr M, Mistry A, Vinjamuri S, Gallagher JA. Treatment of osteoporotic fractures in alkaptonuria by teriparatide stimulates bone formation and decreases fracture rate - A report of two cases. Bone Rep 2021; 15:101151. [PMID: 34926730 PMCID: PMC8649650 DOI: 10.1016/j.bonr.2021.101151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Two cases of advanced alkaptonuria (AKU) with co-existing osteoporosis are described. Case 1 developed multiple non-vertebral fragility fractures, while Case 2 developed vertebral fragility fractures, both refractory to bisphosphonates. Difficulties in diagnosing osteoporosis in AKU complicated by extensive calcifying and ossifying spondylosis are discussed. Both patients continued to fracture despite nitisinone therapy for metabolic control of AKU, as well as bisphosphonate antiresorptive therapy for osteoporosis. Subsequently the patients were treated with teriparatide 20 μg subcutaneous injections daily for two years, leading to reduction in fractures soon after commencing therapy in both cases. Markers of bone remodelling P1NP and CTX were stimulated. No complications due hypercalcaemia or calcification were encountered in either case. We conclude that teriparatide is an effective adjunct in the treatment of AKU when bisphosphonates prove ineffective. Two case of osteoporosis are described in patients with the ultra-rare genetic disorder, Alkaptonuria (AKU) Diagnosis of osteoporosis in AKU is complicated by extensive calcifying and ossifying spondylosis Treatment of AKU with Nitisinone and or antiresorptive did not improve bone health in these patients Teriparatide led to a reduction in fractures and is an effective adjunct in AKU when bisphosphonates prove ineffective
Collapse
Affiliation(s)
- L R Ranganath
- Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom.,IACD, University of Liverpool, William Henry Duncan Building, West Derby Street, Liverpool L7 8TX, United Kingdom
| | - M Khedr
- Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
| | - A Mistry
- Department of Radiology, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
| | - S Vinjamuri
- Department of Nuclear Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
| | - J A Gallagher
- IACD, University of Liverpool, William Henry Duncan Building, West Derby Street, Liverpool L7 8TX, United Kingdom
| |
Collapse
|