Assessment of bone mineral density in children with congenital cyanotic heart disease

Abstract Background: Cyanotic CHD is one of many disorders in paediatrics that influence the health of children in different clinical aspects. One of the fundamental aspects that may be affected is bone mineral density. Objectives: The aim of our study is to assess bone mineral density in children with congenital cyanotic heart disease of different anatomical diagnoses. Design/Methods: Cross-sectional, observational study included 39 patients (20 males) with congenital cyanotic heart disease of different anatomical diagnoses following with the cardiology clinic in Mansoura University children’s hospital. All patients were subjected to anthropometric measures, oxygen saturation assessment, and lumber bone mineral density using dual-energy X-ray absorptiometry. Results: Six patients (15.4%) out of the 39 included patients showed bone mineral density reduction, 13 patients (33.3%) showed bone mineral density with Z-score between −1 and −2, while 20 patients (51.3%) showed bone mineral density with Z-score more than −1. Conclusion: Low bone mineral density can be found in children with cyanotic CHD, making it important to consider bone mineral density assessment and early treatment if needed to avoid further complications.

Download Full-text

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

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz279 ◽

2020 ◽

Vol 105 (4) ◽

pp. e1397-e1407 ◽

Cited By ~ 1

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.

Download Full-text

Bone Mineral Density in Premenopausal Women Is Associated with the Dietary Intake of α-Tocopherol: A Cross-Sectional Study

Nutrients ◽

10.3390/nu11102474 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2474

Author(s):

Tamami Odai ◽

Masakazu Terauchi ◽

Asuka Hirose ◽

Kiyoko Kato ◽

Naoyuki Miyasaka

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Dietary Habits ◽

Daily Intake ◽

Premenopausal Women ◽

Z Score ◽

Mineral Density ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Clinical Records

This study aimed to investigate the relationship between the consumption of various nutrients and bone mineral density (BMD) in middle-aged women. This cross-sectional survey was conducted based on the clinical records of 157 women aged 38–76. Their lumbar spine BMD was measured with dual-energy X-ray absorptiometry and dietary habits were assessed with the brief-type self-administered diet history questionnaire. Participants were divided into premenopausal (n = 46) and postmenopausal (n = 111) groups and the correlation between the BMD Z-score (Z-score) and the intakes of 43 nutrients was investigated separately for each group. In premenopausal women, the daily intake of ash, calcium, and α-tocopherol was positively correlated with the Z-score (Pearson’s correlation coefficient, R = 0.31, 0.34, 0.33, p = 0.037, 0.020, 0.027, respectively). When dividing the consumption of ash, calcium, and α-tocopherol into low, middle, and high tertiles, the Z-score significantly differed only between the α-tocopherol tertiles. After adjustment for age, body mass index, and lifestyle factors, daily intake of α-tocopherol remained significantly associated with the Z-score (regression coefficient = 0.452, p = 0.022). No nutrient was found to be significantly correlated with the Z-score in postmenopausal women. Increase in the intake of α-tocopherol could help maintain bone mass in premenopausal women.

Download Full-text

When Should Clinicians Worry about Bone Density for Patients with Epilepsy?

Epilepsy Currents ◽

10.1111/j.1535-7511.2008.00274.x ◽

2008 ◽

Vol 8 (6) ◽

pp. 148-149

Author(s):

Bassel W. Abou-Khalil

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Healthy Children ◽

Z Score ◽

Mineral Density ◽

Progressive Reduction ◽

Cross Sectional ◽

Antiepileptic Medication ◽

Total Body ◽

Patients With Epilepsy

Progressive Bone Deficit in Epilepsy. Sheth RD, Binkley N, Hermann BP. Neurology 2008;70(3):170–176. OBJECTIVE: Chronic treatment with antiepileptic medication is associated with reduced bone mineral density (BMD), which may underlie the two-to sixfold increase in fracture rates observed in patients with epilepsy. The objective was to determine the timing of the BMD deficit in ambulatory children with epilepsy. METHODS: A cross-sectional evaluation was conducted in 82 ambulatory children aged 6 to 18 years (12.4 ± 3.3 years) with epilepsy for <1 year (n = 18), 1 to 5 years (n = 37), and 6 or more years (n = 27). Controls were 32 healthy children aged 12.8 ± 2.6 years. Age- and sex-corrected total body BMD Z-score was measured. RESULTS: Total BMD Z-score was lower in children with epilepsy (0.10 ± 0.96; CI = −0.08, 0.34) compared to controls (0.57 ± 0.74; CI = 0.3, 0.84; p = 0.03). Increasing duration of epilepsy was associated with a progressive reduction in BMD compared to controls (Spearman r = −0.197; p = 0.03). Compared to controls, those with epilepsy for 1 to 5 years had a mean BMD Z-score of 0.13 ± 0.78 (CI = −0.13, 0.39; p = 0.04) and in those treated for 6 or more years BMD was 0.06 ± 1.11 (CI = −0.38, 0.5; p = 0.04). For those with epilepsy for <1 year BMD was 0.23 ±1.1 (CI = −0.31, 0.77; p = 0.21). CONCLUSIONS: Children treated for epilepsy sustain significant bone mineral density (BMD) deficit compared to controls during the initial 1 to 5 years of treatment which progressively worsens thereafter. This progressive BMD deficit may be a contributing factor to the increased fracture risk observed in patients with epilepsy and may accelerate aging-related osteoporosis.

Download Full-text

ASYMMETRY OF BONE MINERAL DENSITY OF THE HIPS IN PATIENTS WITH UNILATERAL KNEE OSTEOARTHRITIS: A CROSS-SECTIONAL STUDY

Journal of Musculoskeletal Research ◽

10.1142/s0218957711500059 ◽

2011 ◽

Vol 14 (01) ◽

pp. 1150005 ◽

Cited By ~ 1

Author(s):

Alireza Ashraf ◽

Seyed Mostafa Jazayeri Shooshtari ◽

Kaynoosh Homayouni ◽

Sharareh Roshanzamir ◽

Mohsen Zafarghasempoor ◽

...

Keyword(s):

Bone Mineral Density ◽

Knee Osteoarthritis ◽

Bone Mineral ◽

Lumbar Vertebrae ◽

Cross Sectional Study ◽

Z Score ◽

Sectional Study ◽

Mineral Density ◽

Cross Sectional ◽

T Score

Background: Osteoarthritis of any joint may exert different effects on bone mineral density that may be the result of several mechanisms including change in the pattern of weight load distribution. In this cross-sectional study we tried to find correlations between unilateral knee osteoarthritis and bone mineral density of hips and lumbar vertebrae. Methods: Forty three patients with knee osteoarthritis (unilateral or more severe in one side) were recruited in this study. The American college of Rheumatology Criteria was followed for the diagnosis of osteoarthritis. Dual X-Ray absorptiometry was used to obtain the T score and the Z score of the hips and lumbar vertebrae. Results: The T score and Z score of the hip and T score of the femoral neck, at the side with ipsilateral knee osteoarthritis was lower than the other side (p < 0.05). The mean Z score and T score of the vertebrae was negative irrespective of the side of osteoarthritis. Conclusions: Bone mineral density of the hip with ipsilateral knee osteoarthritis was lower than the other side, which suggests that BMD may be sensitive to some extent in detecting osteoporosis in these patients; it has also been observed that osteoarthritis might not affect bone mineral density of the hips and lumbar vertebrae in the same manner or to the same extent.

Download Full-text

Transwomen and bone mineral density: a cross-sectional study in Brazilian population

British Journal of Radiology ◽

10.1259/bjr.20190935 ◽

2020 ◽

Vol 93 (1111) ◽

pp. 20190935

Author(s):

Kadija Rahal Chrisostomo ◽

Thelma L. Skare ◽

Henrique Rahal Chrisostomo ◽

Edna J. Litenski Barbosa ◽

Renato Nisihara

Keyword(s):

Bone Mineral Density ◽

Body Composition ◽

Confidence Interval ◽

Bone Mass ◽

Body Mass ◽

Bone Mineral ◽

Hormonal Treatment ◽

Z Score ◽

Mineral Density ◽

Cross Sectional

Objectives: Transgender individuals submitted to hormone or surgical treatment may have alterations in their bone metabolism as these elements are important players in bone remodeling. We aimed to study bone mineral density (BMD) and body composition in transwomen undergoing cross-sex hormonal treatment (CSHT) from Brazil for over 3 years, comparing them with female and male controls. Methods: 93 individuals (31 transwomen, 31 females and 31 males paired for age and body mass index) were studied for bone mass, and body composition by densitometry (by DXA). Epidemiological and clinical data were collected through direct questioning. Results: Low bone mass (T score ≤2) was found in 12.9% of transwomen; in 3.2% of females and 3.3% of males. Transwomen individuals had lower spine Z score (0.26 ± 1.42 vs 0.50 ± 1.19) and femur Z score (−0.41 ± 0.95 vs 0.29 ± 1.04) than females. They had lower total femur Z score than males (−0.41 ± 0.95 vs 0.20 ± 0.83). Lean mass values correlated positively with total femur BMD (ρ = 0.40; 95% confidence interval = 0.009–0.68; p = 0.04) and BMD in femoral neck (ρ = 0.48; 95% confidence interval = 0.11–0.74; p = 0.01) but neither the type of therapy received nor the time that they were used, impacted bone mass. Conclusion: Low BMD is found frequently in transwomen and it is correlated with lean body mass. Advances in knowledge: There are few studies of the effects of hormone therapy on the bones and muscles of transwomen. This study demonstrated that significant changes occur, and that the population studied needs greater care in musculoskeletal health.

Download Full-text

Association between reproductive factors and postmenopausal osteoporosis

Osteologie/Osteology ◽

10.1055/s-0037-1620001 ◽

2011 ◽

Vol 20 (03) ◽

pp. 248-251

Author(s):

H. R. Meybodi ◽

N. Khalili ◽

P. Khashayar ◽

R. Heshmat ◽

A. Hossein-nezhad ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Reproductive Factors ◽

Population Based ◽

Age At Menarche ◽

Mineral Density ◽

Cross Sectional ◽

Number Of Children ◽

Menstrual History ◽

Duration Of Breastfeeding

SummaryThe present cross-sectional research was designed to study possible correlations between clinical reproductive factors and bone mineral density (BMD) values.Using the data gathered by the population-based Iranian Multicenter Osteoporosis Study (IMOS), we investigated the correlation found between reproductive factors and osteoporosis. Subjects were recruited from five major cities of Iran. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry and the results were analyzed against the age at menarche and at menopause, number of pregnancies, children and abortions, and the history (and duration) of breastfeeding.Data was available for 2528 women. Gravidity and number of children were reversely correlated with BMD. Younger age at menarche was associated with higher BMD values, whereas there was no significant correlation between age at menopause and menstrual history and BMD.Our study suggests that clinical reproductive factors, particularly number of children and breastfeeding, could be incorporated as predictors of BMD levels in women. Given the controversial results obtained in different studies, longitudinal studies should be carried out to enlighten the importance of these factors and the rationale of their use to predict BMD values in different settings.

Download Full-text