Correlation between forearm bone densitometry (BMD) and lumbar spine and proximal femur

Background:Dual energy X-ray absoprtiometry is the reference method to mesure bone mineral density (1). Loss of bone mineral density is significant if it exceeds the least significant change. The threshold value used in general population is 0,03 g/cm2 (2). Patients with obesity are known for having a higher bone mineral density due to metabolism and physiopathology characteristics (3,4).Objectives:The aim of our study was to determine the least significant change in bone densitometry in patients with obesity.Methods:We conducted an interventionnal study in 120 patients with obesity who performed a bone densitometry. We measured twice the bone mineral density at the lumbar spine, the femoral neck and the total hip in the same time (5,6). We determined the least significant change in bone densitometry from each pair of measurements, using the Bland and Altman method. We also determined the least significant change in bone densitometry according to each stage of obesity.Results:The least significant change in bone densitometry in patients with obesity is 0,046g/cm2 at the lumbar spine, 0.069 g/cm2 at the femoral neck and 0.06 g/cm2 at the total hip.Conclusion:The least significant change in bone densitometry in patients with obesity is higher than in general population. These results may improve DXA interpretation in this specific population, and may personnalize their medical care.References:[1]Lees B, Stevenson JC. An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporos Int. mai 1992;2(3):146-52.[2]Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum. oct 2018;85(5):428-40.[3]Shapses SA, Pop LC, Wang Y. Obesity is a concern for bone health with aging. Nutr Res N Y N. mars 2017;39:1-13.[4]Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. juin 2018;17(2):205-17.[5]Roux C, Garnero P, Thomas T, Sabatier J-P, Orcel P, Audran M, et al. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Jt Bone Spine Rev Rhum. janv 2005;72(1):26-31.[6]Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res. août 1999;14(8):1449-56.Disclosure of Interests:None declared.

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The contribution of polymorphism in VDR gene FОKI in the development of osteopenia in pregnancy

Journal of obstetrics and women s diseases ◽

10.17816/jowd66342-48 ◽

2017 ◽

Vol 66 (3) ◽

pp. 42-48

Author(s):

Olga S. Bibkova ◽

Dmitriy S. Sudakov ◽

Evdokia O. Bogdanova ◽

Natalia L. Shaporova ◽

Irina E. Zazerskaya ◽

...

Keyword(s):

Lumbar Spine ◽

Proximal Femur ◽

Genetic Test ◽

Postpartum Women ◽

Distal Forearm ◽

Heterozygous Genotype ◽

Vdr Gene ◽

Z Scores ◽

Moderate Negative Correlation ◽

In Pregnancy

The study involved 89 postpartum women and 97 nonpregnant women aged 20 to 35 years. The results of a genetic test compared with the BMD. In parturients in the lumbar spine the highest IPC and the value of the Z-scores were in patients with genotype FF, and the lowest with the genotype ff. Patients with the heterozygous genotype were charac terized by intermediate values of the BMD and Z-scores in the lumbar spine. A similar results was observed in the proximal femur and the distal forearm. The results of the correlation analysis showed a moderate negative correlation between the ff genotype and the level of BMD in lumbar spine (r = –0,44; p < 0.05) and proximal femur (r = –0.37; p < 0.05).

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Lumbar spine and proximal femur BMD values in Turkish girls and the effect of precocious puberty on BMD.

Medicine Science | International Medical Journal ◽

10.5455/medscience.2012.01.8020 ◽

2012 ◽

Vol 1 (3) ◽

pp. 188

Author(s):

Ersoy Kekilli ◽

Mustafa Aluclu ◽

Fatih Bati ◽

Ismail Koksal

Keyword(s):

Lumbar Spine ◽

Precocious Puberty ◽

Proximal Femur

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Corticosteroid effects on proximal femur and lumbar spine bone loss

Bone and Mineral ◽

10.1016/0169-6009(90)90319-b ◽

1990 ◽

Vol 10 (3) ◽

pp. S289

Author(s):

Philip Sambrook ◽

Susan Kempler ◽

Paul Kelly ◽

Stefan Eberl ◽

Nicholas Pocock ◽

...

Keyword(s):

Lumbar Spine ◽

Bone Loss ◽

Proximal Femur

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Bone Mineral Density Assessment by DXA vs. QCT in Postmenopausal Females with Central Obesity

Current Aging Science ◽

10.2174/1874609812666190912155525 ◽

2020 ◽

Vol 13 (2) ◽

pp. 153-161

Author(s):

Lejla Milisic ◽

Sandra Vegar-Zubovic ◽

Amina Valjevac ◽

Suada Hasanovic-Vučković

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Bone Mineral ◽

Proximal Femur ◽

Central Obesity ◽

Quantitative Computed Tomography ◽

Normal Weight ◽

Mineral Density ◽

Cross Sectional ◽

T Score

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.

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