scholarly journals Impact of hypogonadism on bone mineral density and vertebral fractures in HIV-infected men

2021 ◽  
Author(s):  
L. C. Pezzaioli ◽  
T. Porcelli ◽  
A. Delbarba ◽  
F. Maffezzoni ◽  
E. Focà ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Bone Health ◽  
Sex Hormone Binding Globulin ◽  
Gonadal Function ◽  
Mineral Density ◽  
T Score ◽  
Normal Bone Mineral Density ◽  
The Impact

Abstract Purpose Hypogonadism and osteoporosis are frequently reported in HIV-infected men and, besides multifactorial pathogenesis, they might be directly linked because of testicular involvement in bone health. We evaluated the prevalence of osteoporosis and vertebral fractures (VFs) in HIV-infected men, and assessed their relationship with gonadal function. Methods We enrolled 168 HIV-infected men (median age 53). Osteoporosis and osteopenia were defined with T-score ≤  – 2.5SD and T-score between  – 1 and  – 2.5SD, respectively. VFs were assessed by quantitative morphometric analysis. Total testosterone (TT), calculated free testosterone (cFT), Sex Hormone Binding Globulin (SHBG), Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) were obtained; overt hypogonadism was defined on symptoms and low TT or cFT, and classified into primary and secondary according to gonadotropins; compensated hypogonadism was defined as normal TT and cFT with high LH levels. Results Overall, osteoporosis and osteopenia were found in 87.5% of patients, and VFs were detected in 25% of them; hypogonadism was identified in 26.2% of cases. Osteoporotic patients had higher SHBG vs those with normal bone mineral density (BMD). Fractured patients were more frequently hypogonadal and with higher SHBG. SHBG showed negative correlation with both spine and femoral BMD, and positive correlation with VFs. In multivariate models, FSH showed negative impact only on femoral BMD, whereas older age and higher SHBG predicted VFs. Conclusion We found a high burden of bone disease and hypogonadism in HIV-infected men, and we showed that the impact of gonadal function on bone health is more evident on VFs than on BMD.

scholarly journals Fractures, Bone Mineral Density, and Final Height in Craniopharyngioma Patients with a Follow-up of 16 Years

2020 ◽  
Vol 105 (4) ◽  
pp. e1397-e1407 ◽  
Author(s):  
Selveta S van Santen ◽  
Daniel S Olsson ◽  
Marry M van den Heuvel-Eibrink ◽  
Mark Wijnen ◽  
Casper Hammarstrand ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bone Health ◽  
Final Height ◽  
Z Score ◽  
Mineral Density ◽  
Childhood Onset ◽  
Cross Sectional ◽  
T Score

Abstract Context Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. Objective To investigate bone health in patients with craniopharyngioma. Design Retrospective cross-sectional study. Setting Dutch and Swedish referral centers. Patients Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). Main outcome measures Fractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score ≤-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively. Results Fractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhood-onset patients. Conclusions Men with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk.

Effect of spinal degenerative changes on volumetric bone mineral density of the central skeleton as measured by quantitative computed tomography

2005 ◽  
Vol 46 (3) ◽  
pp. 269-275 ◽  
Author(s):  
G. Guglielmi ◽  
I. Floriani ◽  
V. Torri ◽  
J. Li ◽  
C. van Kuijk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Quantitative Computed Tomography ◽  
Degenerative Changes ◽  
Volumetric Bone Mineral Density ◽  
Mineral Density ◽  
The Impact

Purpose: To evaluate the impact of degenerative changes due to osteoarthritis (OA) at the spine on volumetric bone mineral density (BMD) as measured by volumetric quantitative computed tomography (vQCT). Material and Methods: Eighty‐four elderly women (mean age 73±6 years), comprising 33 with vertebral fractures assessed by radiographs and 51 without vertebral fractures, were studied. Trabecular, cortical, and integral BMD were examined at the spine and hip using a helical CT scanner and were compared to dual X‐ray absorptiometry (DXA) measurements at the same sites. OA changes visible on the radiographs were categorized into two grades according to severity. Differences in BMD measures obtained in the two groups of patients defined by OA grade using the described radiologic methods were compared using analysis of variance. Standardized difference (effect sizes) was also compared between radiologic methods. Results: Spinal trabecular BMD did not differ significantly between OA grade 0 and OA grade 1. Spinal cortical and integral BMD measures showed statistically significant differences, as did the lumbar spine DXA BMD measurement (13%, P = 0.02). The QCT measurements at the hip were also higher in OA 1 subjects. Femoral trabecular BMD was 13–15% higher in OA grade 1 subjects than in OA grade 0 subjects. The cortical BMD measures in the CT_TOT_FEM and CT_TROCH ROI's were also higher in the OA 1 subjects. The integral QCT BMD measures in the hip showed difference between grades OA 1 and 0. The DXA measurements in the neck and trochanter ROI's showed smaller differences (9 and 11%, respectively). There were no statistically significant differences in bone size. Conclusion: There is no evidence supporting that trabecular BMD measurements by QCT are influenced by OA. Instead, degenerative changes have an effect on both cortical and integral QCT, and on DXA at the lumbar spine and the hip. For subjects with established OA, assessment of BMD by volumetric QCT may be suggested.

scholarly journals Clinical significance of osteodensitometry in patients with sarcoidosis

2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 67-71
Author(s):  
Ivana Bozic ◽  
Svetozar Damjanovic ◽  
Djuro Macut ◽  
Violeta Mihailovic-Vucinic
Keyword(s):  
Bone Mineral Density ◽  
Bone Density ◽  
Bone Strength ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Normal Bone Mineral Density ◽  
Osseous Involvement ◽  
Mineral Bone Density

Introduction. Sarcoidosis is a chronic, multi-organ, inflammatory disease which predominantly affects the lungs. Although direct osseous involvement in sarcoidosis is rare, patients with this disease, regardless of the presence of osseous lesions, are at a great risk of developing osteoporosis. Osteoporosis is a consequence of the disease itself, as well as of its treatment. Osteodensitometry. Osteodensitometry is the gold standard for osteoporosis diagnosis, and it is based on the assessment of the bone mineral density. One of the main drawbacks of osteodensitometry as a method for osteoporosis verification is its inability to determine bone micro-architectonics, which is a significant element of bone strength. Mineral Bone Density in Patients with Sarcoidosis. It has been shown that newly diagnosed, yet untreated patients with sarcoidosis have rapid bone remodeling, although their mineral bone density is normal or low to normal. This suggests that the low bone strength in patients with sarcoidosis is a consequence of mechanisms that predominantly disturb the bone micro-architectonics, but they do not have a significant effect on the bone mineral density at the same time. Vertebral Fractures and their Diagnosis in Patients with Sarcoidosis. Normal bone mineral density in patients with sarcoidosis does not preclude skeletal fractures, primarily vertebral fractures. Osteodensitometry devices allow a relatively easy detection of vertebral fractures in patients with sarcoidosis. Conclusion. Osteodensitometry is recommended in every patient with sarcoidosis initially as well as during the follow up and treatment. Even if osteodensitometry is normal, the possibility of vertebral fractures should not be overlooked in these patients.

scholarly journals Enzyme-inducing antiseizure drugs associate with low bone mineral density in men with epilepsy

2021 ◽  
Author(s):  
Aline de Fátima Dias ◽  
Lucas Scárdua Silva ◽  
Rafael Batista João ◽  
Amanda Canal Rigotti ◽  
Gabriel Ferri Baltazar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Age Of Onset ◽  
Young Group ◽  
Categorical Variables ◽  
Mineral Density ◽  
Chi Square ◽  
T Score ◽  
Age Range ◽  
The Impact

Introduction: Little is known about the impact of enzyme-inducing antiseizure drugs (EI-ASD) on the reduction of Bone Mineral Density (BMD) in men with epilepsy (MWE). Objectives: To evaluate the BMD in MWE exposed to EI-ASDs (phenytoin, carbamazepine and phenobarbital) and its relationship with the duration of epilepsy. Methods: We evaluated BMD from 74 consecutive MWE (median age (range), 52.5 (25- 74) years) exposed to previous or current EI-ASDs, followed at UNICAMP-Brazil. Individuals were split into two groups (young-group, 31 individuals [25-49 years]; older group, 43 subjects, [50-74 years]). The BMD test evaluated t-score indexes from the femoral neck, whole femur and lumbar spine. Osteopenia was defined with t-score of - 1.0 to -2.4; osteoporosis, with T-scores lower than -2.5. Data were extracted from medical records. We analyzed data with SPSS22, performed chi-square tests for categorical variables and applied a partial correlation test (controlled for age) between BD scores and duration of epilepsy. Results: BMD was reduced in 49/74 men (66.2%). Both groups presented equivalent proportions of BMD abnormalities (p=0.087) (young-group [14/41 normal (45%), 12/31 osteopenia (39%), 5/31 osteoporosis (16%)]; older-group [11/43 normal (26%), 16/43 osteopenia (37%), 16/43 osteoporosis (37%)]. BMD did not correlate with the duration of disease or age of onset. Conclusion: BMD reduction is highly prevalent in MWE exposed to EI-ASD, including young individuals. Data suggest that exposure to EI-ASD may associate with early BMD reduction, which evolve to osteopenia and osteoporosis. BMD evaluation in MWE and appropriate treatment may be necessary to reduce fractures’ risk.

scholarly journals Bone Mineral Density Trends During the First Year After Laparoscopic Sleeve Gastrectomy—a Cohort Study on 241 Patients

2021 ◽  
Author(s):  
Elisabeta Malinici ◽  
Anca Sirbu ◽  
Miruna Popa ◽  
Marian Andrei ◽  
Sorin Ioacara ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Bone Mineral ◽  
Bone Health ◽  
Significant Loss ◽  
Baseline Body Mass Index ◽  
Mineral Density ◽  
Total Bone Mineral Density ◽  
The Impact

Abstract Purpose Laparoscopic sleeve gastrectomy (LSG) is an effective weight loss procedure, but detrimental effects on bone health have been described. We aimed to assess the dynamics of regional and total bone mineral density (BMD) in a cohort of patients undergoing LSG and to capture gender differences in terms of evolution. Materials and Methods We conducted a retrospective study on 241 patients who underwent LSG to determine the regional and total BMD changes at 6 and 12 months after the intervention. Results One hundred ten males and 140 females (97 pre-, 43 postmenopausal) were included. Mean baseline body mass index (BMI) was 44.16 ± 6.11 kg/m2 in males and 41.60 ± 5.54 kg/m2 in females, reaching 28.62 ± 4.26 kg/m2 and 27.39 ± 4.2 kg/m2, respectively, at 12 months. BMD showed a continuous decline, with significant loss from 6 months postoperatively. There was a positive correlation between BMD and BMI decline at 12 months (r = 0.134, p < 0.05). Total BMD loss at 12 months was significantly greater in males than premenopausal females, independent of BMI variation and age. During the first 6 months, men lost significantly more bone mass than premenopausal and postmenopausal women (BMD variation was 2.62%, 0.27%, 1.58%, respectively). The second period (6–12 months) was similar in all three groups, revealing a further steady (~ 1.4%) BMD decline. Conclusions Our results are consistent with previous findings that LSG negatively impacts BMD, stressing the importance of bone health-oriented measures in postoperative care. Moreover, the impact that seems more significant in males warrants future exploration, as it might change clinical practice. Graphical abstract

scholarly journals The Connection Between Vitamin K and Bone Health

2015 ◽  
Vol 8 (2) ◽  
Author(s):  
Jamy (Ning) Fu
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vitamin K ◽  
Bone Health ◽  
Bone Fractures ◽  
The Body ◽  
Mineral Density ◽  
Densité Minérale Osseuse ◽  
The Impact ◽  
Viable Method

Vitamin K is essential to the body because it is known to help blood coagulate and activate osteocalcin, a protein involved in maintaining healthy bones. In this review, one study observing the impact of vitamin K supplementation on patients’ bone mineral densities and three studies focusing on the effects of vitamin K supplementation on the incidence of bone fractures are discussed to determine whether the vitamin may be important for maintaining bone health. While some promising results, such as an increase in bone mineral density of subjects after vitamin K supplementation arose, the conclusions reached by the four studies were not statistically significant enough to justify the importance of vitamin K in maintaining bone health. Well-controlled studies that are unbiased, statistically powerful, and focused on vitamin K’s effects on bone density are required in the future to provide further insight on whether vitamin K supplementation is a viable method of improving bone health. La vitamine K est essentielle pour le corps, car il est connu pour assister dans la coagulation du sang ainsi qu’activer l'ostéocalcine, une protéine impliquée dans le maintien de la santé des os. Ici, une étude dirigé vers les observations de l'impact de la consommation de suppléments de la vitamine K sur la densité minérale osseuse de patients, puis trois autres études portant sur les effets de la consommation de suppléments de la vitamine K sur l'incidence des fractures osseuses sont examinées afin de déterminer si la vitamine soit une facteur important dans le maintien de la santé des os. Tandis que des résultats sont révélés prometteurs, comme ceux montrant une augmentation de la densité minérale osseuse des sujets après la consommation des suppléments de la vitamine K, l’ensemble de conclusions tirées des quatre études ne présente pas suffisamment de données qui pourraient suggérer une corrélation entre la consommation des suppléments de la vitamine K et la santé des os. Des études supplémentaires portant sur les effets de la vitamine K sur la densité osseuse, mené dans des conditions contrôlés, bien conçus, impartiales, qui produiront des résultats persuasifs, sont nécessaires à être effectuer à l'avenir afin de donner un meilleur aperçu de l’effet de la supplémentation en vitamine K comme une méthode viable dans l’entretien de la santé des os.

Impact of Pharmacist-Led Community Bone Mineral Density Screenings

2005 ◽  
Vol 39 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Kelly M Summers ◽  
Tina Penick Brock
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Bone Mineral ◽  
Care Service ◽  
Treatment Recommendation ◽  
Caffeine Intake ◽  
Mineral Density ◽  
T Score ◽  
Patients At Risk ◽  
The Impact

BACKGROUND: Osteoporosis-associated fractures burden both individuals and the overall healthcare system. Bone mineral density (BMD) screening remains the gold standard measure for identifying patients at risk. OBJECTIVE: To determine the impact of convenient, pharmacist-led BMD screening and counseling sessions on identification and education of patients at risk for or with osteoporosis. METHODS: Nonpregnant persons >18 years of age were eligible for enrollment in this descriptive study. At an urban retail pharmacy, participants underwent risk factor assessment, peripheral BMD scanning, and personalized counseling. At 3 and 6 months after screening, subjects were questioned by telephone regarding any subsequent primary care provider (PCP) interactions, as well as any behaviors initiated and/or medications modified. RESULTS: Of the 102 subjects screened, 22.6% and 11.7% were identified as being at medium risk (T score −1.0 to −2.5) and high risk (T score −2.5 or less) for osteoporosis, respectively. By 6 months, 42.5% of the participants reported increasing their dietary intake of calcium, 29.3% began or increased calcium supplements, and 54.9% positively modified smoking status, exercise level, alcohol consumption, or caffeine intake. Additionally, 24 of 52 subjects who had discussed their results with a PCP by 6 months also received a treatment recommendation. Eighty-nine participants reported the community location increased their likelihood of receiving a BMD scan. CONCLUSIONS: Overall, pharmacist-led BMD screenings that include individualized counseling sessions appear convenient, accessible, and beneficial for patients. With the establishment of clinical benefit of and positive reception to such screenings, pharmacists can now look toward securing consistent reimbursement for this vital pharmaceutical care service.

scholarly journals Influence of a diet and physical activity on the nutritional status of soldiers of the Polish Air Cavalry units

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Jerzy Bertrandt ◽  
Anna Anyzewska ◽  
Roman Lakomy ◽  
Tomasz Lepionka ◽  
Ewa Szarska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Nutritional Status ◽  
Bone Mineral ◽  
Negative Correlation ◽  
Dominant Hand ◽  
Mineral Density ◽  
T Score ◽  
Diet And Physical Activity ◽  
The Impact

AbstractIntroductionResearch from recent years indicate a problem of excessive body weight among soldiers, who due to the kind of carried out work should reveal the best health and fitness. Moreover, proper nutritional status in case of soldiers is extremely important, as it significantly affects their physical fitness. The aim of the study was to determine impact of the diet and physical activity on selected indicators of protein-energy and mineral nutritional status.Materials and methodsOne hundred and twenty male soldiers (aged: 28 ± 5; years of service: 5 ± 5), serving completed validated for Polish population the Food Frequency Questionnaire and long-form International Physical Activity Questionnaire. Body composition was determined by an electric bioimpedance method (TANITA MC-780) and bone mineral density of forearm bone of the non-dominant hand was assessed by the DEXA densitometric method, using apparatus EXA 3000.Results and discussionThis study confirmed the impact of both the diet and physical activity on selected measures of soldiers’ nutritional status, i.e. fat mass index and bone mineral density. Out of selected 61 products negative correlation between FMI and frequency of apples and pears consumption (r = -0.23, p = 0,023), and positive correlation with frequency of beer (r = 0.20, p = 0.049) and vodka and spirits drinking (r = 0.26, p = 0.010) consumption were found. While the T-score value positively correlated with frequency of tropical fruits (r = 0.23, p = 0.024), avocado (r = 0.25, p = 0.014), fine-grained not refined groats (r = 0.22, p = 0.030) and eggs (r = 0.29, p = 0.004) consumption. A negative correlation was found for frequency of refined bread (r = -0.24, p = 0.019), sausages(r = -0.35, p < 0.023), high-quality cold cuts (r = -0.25, p = 0.014, sugar to sweeten beverages (r = -0.31, p = 0.002), biscuits and cakes (r = -0.23, p = 0.016), salty snacks (r = -0.23, p = 0.023), fruit juices and nectars (r = -0.28, p = 0.005) and sugar-sweetened beverages (r = -0.34, p = 0.001). A negative correlation with FMI (r = -0.22, p = 0.036) for weekly physical activity expressed in MET-minutes/week was found. Positive correlations were found between T-score value and physical activity expressed in MET-minutes per week in total, housework, house maintenance and caring for family (r = 0.22; p = 0.040), and recreation, sport and physical activity in leisure time (r = 0.25, p = 0.019), as well as moderate physical activity (r = 0.28, p = 0.008) and intense one (r = 0.21, p = 0.046). The founded abnormalities in nutritional status, as well as numerous nutritional errors indicate a need for further monitoring of this group of soldiers, not only in terms of accuracy of nutritional status, their diet and physical activity, but also wider understood health behavior

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