Lower bone mass detected at femoral neck and lumbar spine in lower-weight vs normal-weight small-boned women

The loss of bone mass and consequently bone strength in persons aged forty and beyond is a continuing problem to the orthopaedic community. This progressive loss has been documented by various means such as radiographs, autopsy materials, CAT scans, and single or dual photon absorptiometrv. Orthopaedic problems arising from osteoporosis include fractures of the lumbar spine, distal radius and the femoral neck. Likewise, this age group represents the fraction of the population that will require prosthetic replacement of a joint. Unfortunately, little information is available concerning the mechanical properties of osteoporotic bones and its interaction with prosthetic devices.

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Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.75.4.1060 ◽

1992 ◽

Vol 75 (4) ◽

pp. 1060-1065 ◽

Cited By ~ 226

Author(s):

G. Theintz

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Bone Mass ◽

Marked Reduction ◽

Mass Accumulation ◽

Female Subjects

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Risk of bone loss in men with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458504ms993oa ◽

2004 ◽

Vol 10 (2) ◽

pp. 170-175 ◽

Cited By ~ 73

Author(s):

Bianca Weinstock-Guttman ◽

Eileen Gallagher ◽

Monika Baier ◽

Lydia Green ◽

Joan Feichter ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Lumbar Spine ◽

Bone Loss ◽

Femoral Neck ◽

Bone Mass ◽

Multivariate Linear Regression Analysis ◽

Mineral Density ◽

Factors Associated ◽

Dexa Scan

Context: O steoporosis and the increased fracture risk associated with osteoporosis become apparent in men appro ximately 10 years later than women. However, in recent studies, appro ximately 20% of healthy men in the age range 55-64 years were found to be osteopenic. Emerging data suggest a significantly increased prevalence of osteoporosis in men and women with multiple sclerosis (MS) compared to age-matched controls, but no specific clinical testing recommendations are available for men. Objective: To determine the proportion of male MS patients with osteoporosis and to identify the factors associated with the reduction in bone mass. Design: C onsecutive male MS patients seen at our MS clinic were screened with dual-X-ray absorptiometry (DEXA) scan for determining the bone mineral density (BMD). A ll patients had neurological Expanded Disability Status Scale (EDSS) evaluation. The results were compared to healthy age-matched male reference population using the Z score and to a cohort of women MS patients and women controls. C alcium, total testosterone, sex-hormone binding globulin (SHBG), 25-hydro xy-vitamin-D, and parathyroid hormone (PTH) were evaluated in male patients with decreased BMD. Relevant data on body mass index (BMI), medicatio n, alcohol consumption, smoking, and sexual dysfunction were recorded. Setting: Academic MS C entre. Patients and other participants: Forty consecutive male MS patients, age mean 51.2±8.7 years, and mean EDSS of 5.8±1.9 were evaluated with DEXA scan. O f these, 17.5% patients were relapsing - remitting (RR) MS, 57.5% were secondary progressive (SP) MS and 25% were primary progressive (PP) MS. Main outcome measure: Proportion of male MS patients with reduced BMD at the lumbar spine and femoral neck. Results: Thirty-two (80%) of our patients had a reduced bone mass of either lumbar spine or the femoral neck; of these 17 patients (42.5%) had osteopenia and 15 patients (37.5%) had osteoporosis. Twenty-o ne per cent (eight out of 38 patients) had vertebral, rib or extremities fractures. Multivariate linear regression analysis indicated that the EDSS (P B-0.0001) and BMI (P =0.0004) were the important factors associated with low BMD at the femoral neck and the EDSS was the important factor (P =0.0017) associated with low BMD at the lumbar spine. The same factors emerged as significantly associated with the corresponding Z scores, which are corrected for age and sex. No clear association between intravenous steroid therapy and BMD was evident in the multivariate analysis. Low levels of 25-hydroxy-vitamin-D were seen in 37.5% of patients. Conclusions: The proportion of male MS patients with reduced bone mass is high and disproportionate to their age and ambulation, consistent with an association between the MS disease process and patho logical bone loss. Increased awareness and bone density screening of male and female MS patients over 40 years of age is warranted.

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Agreement between bone mass measured by computed tomography in lumbar spine, femoral neck and femoral condyles in patients with proximal femoral fractures

Injury Extra ◽

10.1016/j.injury.2006.12.127 ◽

2007 ◽

Vol 38 (4) ◽

pp. 148-149

Author(s):

G. Singh ◽

A. Høiseth ◽

K. Strømsøe ◽

M. Tchudi

Keyword(s):

Computed Tomography ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mass ◽

Femoral Fractures ◽

Proximal Femoral Fractures ◽

Femoral Condyles

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Is Playing Soccer More Osteogenic for Females Before the Pubertal Spurt?

Journal of Human Kinetics ◽

10.2478/hukin-2018-0074 ◽

2019 ◽

Vol 67 (1) ◽

pp. 153-161

Author(s):

Gabriel Lozano-Berges ◽

Ángel Matute-Llorente ◽

Alejandro Gómez-Bruton ◽

Alex González-Agüero ◽

Germán Vicente-Rodríguez ◽

...

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Bone Mass ◽

Weight Bearing ◽

Analysis Of Covariance ◽

Soccer Players ◽

Training Experience ◽

Cross Sectional ◽

Male And Female ◽

Pubertal Status

AbstractThe aims of this study were to assess bone mass in children and adolescent soccer players and to evaluate the influence of both gender and pubertal status on bone mass. A total of 110 soccer players (75 males / 35 females; 12.73 ± 0.65 / 12.76 ± 0.59 years) participated in this cross-sectional study. They were divided into two groups according to their pubertal status. Bone and lean masses were measured with Dual-energy X-ray Absorptiometry. An independent t-test and an adjusted by subtotal lean and training experience multivariate analysis of covariance were used to analyse the differences in bone mass values between genders and maturity status. Female soccer players presented higher bone mass values than their male counterparts in most of the measured weight-bearing sites. Moreover, when stratifying by pubertal status, peripubertal and postpubertal females had higher subtotal body and lumbar spine bone mass than males. Comparing between pubertal status groups before adjustment, both male and female postpubertal players showed higher bone mass than their pubertal counterparts. After adjusting, these differences disappeared and, in fact results were inverted as bone mass at the femoral neck was higher in both male and female peripubertal soccer players than in postpubertal players. Bone mass seems to be more intensely stimulated by playing soccer in female than male players, particularly in the lumbar spine. The results of peripubertal players showing higher bone mass at the femoral neck after adjusting suggest that playing soccer during the peripubertal stage could be an effective activity to achieve optimal bone mass values.

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An Updated Reference for Calculating Bone Mineral Density T-Scores

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab180 ◽

2021 ◽

Author(s):

Shanshan Xue ◽

Yuzheng Zhang ◽

Wenjing Qiao ◽

Qianqian Zhao ◽

Dingjie Guo ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mass ◽

Bone Mineral ◽

Low Bone Mass ◽

Mineral Density ◽

Opposite Pattern ◽

T Score ◽

Peak Bmd

Abstract Context Bone mineral density (BMD) T-score reference may be updated when the peak BMD of the population is unclear and may need to be updated. Objective To update BMD T-score references using the peak BMD from the most recent National Health and Nutrition Examination Survey (NHANES) data. Design Cross-sectional study. Setting The NHANES 2005-2014. Participants Non-Hispanic white females between the ages 10-40 years (N=1549) were our target population to estimate peak BMD (SD). Individuals aged≥50 years (N=5523) were used to compare the percentages of osteoporosis and low bone mass based on existing and updated BMD T-score references. Main Outcome Measurements: BMD data within the age at attainment of peak BMD±5 years were used to calculate updated BMD T-score references. Results The updated average of BMD (SD) for diagnosing osteoporosis at the femoral neck and lumbar spine were 0.888 g/cm 2 (0.121 g/cm 2) and 1.065 g/cm 2 (0.122 g/cm 2), respectively. The percentages of individuals with osteoporosis at the femoral neck and low bone mass at the femoral neck and lumbar spine based on the updated BMD T-score references were higher than the percentages of people designated with these outcomes under the existing guidelines (P<0.001). However, we observed the opposite pattern for lumbar spine osteoporosis (P<0.001). Conclusions We calculated new BMD T-score references at the femoral neck and lumbar spine. We found significant differences in the percentages of individuals classified as having osteoporosis and low bone mass between the updated and existing BMD T-score references.

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Long-term maintenance of the anabolic effects of GH on the skeleton in successfully treated patients with acromegaly

Acta Endocrinologica ◽

10.1530/eje.1.01820 ◽

2005 ◽

Vol 152 (1) ◽

pp. 53-60 ◽

Cited By ~ 14

Author(s):

Nienke R Biermasz ◽

Neveen A T Hamdy ◽

Alberto M Pereira ◽

Johannes A Romijn ◽

Ferdinand Roelfsema

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Bone Mass ◽

Successful Treatment ◽

Mineral Density ◽

Men And Women ◽

Pituitary Irradiation ◽

Gonadal Status ◽

Gh Excess

Introduction: The anabolic actions of growth hormone (GH) are well documented. In acromegaly, the skeletal effects of chronic GH excess have been mainly addressed by evaluating bone mineral density (BMD). Most data were obtained in patients with active acromegaly, and apparently high or normal BMD was observed in the absence of hypogonadism. Data on BMD are not available after successful treatment of acromegaly. Whether the positive effect of GH excess on bone mass is maintained in the long term after clinical and biochemical cure of acromegaly remains to be established. Patients and methods: In a cross-sectional study design, lumbar spine and femoral neck BMD was measured in 79 acromegalic patients cured or well controlled on octreotide treatment (45 male and 34 female patients; mean age 57±1 years). Successful treatment (by surgery, radiotherapy and/or use of octreotide) was defined as normal age-adjusted IGF-I. Mean time after biochemical remission was 10.2±7 years. Results: Normal or increased BMD was observed at the femoral neck and lumbar spine in both men and women in remission after treatment for acromegaly. Similar results were obtained in patients in remission for 5 years or longer. Osteoporosis was present in 15% of the patients, with similar prevalence in men and women. There was no relationship between BMD and duration or severity of GH excess before treatment, gonadal status and presence of pituitary hormone deficiencies. Pituitary irradiation was a strong negative predictor of bone mass at the femoral neck. Long-term bone loss was observed only at the femoral neck. Conclusion: Our data suggest that the anabolic effect of GH on trabecular and cortical bone remains demonstrable after remission of acromegaly, although it may not be maintained at cortical sites in the long term. In the present study, the lack of effect of gonadal status on BMD may be explained by the presence of only mild hypogonadism and by our policy of prompt hormonal replacement therapy for severe hypogonadism. The negative effect of pituitary irradiation on femoral neck BMD remains intriguing, although it is probably related to some degree of the diminished GH secretion frequently observed after this form of treatment.

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Bone Mineral Recovery after Parathyroidectomy in Patients with Primary and Renal Hyperparathyroidism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.83.11.5249 ◽

1998 ◽

Vol 83 (11) ◽

pp. 3845-3851 ◽

Cited By ~ 65

Author(s):

Mohamed Abdelhadi ◽

Jörgen Nordenström

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Renal Transplant ◽

Bone Density ◽

Femoral Neck ◽

Bone Mass ◽

Distal Radius ◽

Bone Mineral ◽

Mineral Density ◽

Total Body

Patients with hyperparathyroidism (HPT) generally display reduced bone mass due to excessive PTH activity. The effect of parathyroidectomy on bone mass changes in different types of HPT, however, is not well understood. Bone mineral density (BMD) was measured in the distal radius, total body, femoral neck, and lumbar spine by dual energy x-ray absorptiometry in four groups of patients with different hyperparathyroid conditions: primary symptomatic HPT (n = 54), primary asymptomatic (mild) HPT (n = 24), HPT associated with hemodialysis (n = 20), and HPT associated with renal transplant (n = 30). Subsets of patients with primary symptomatic HPT (n= 52), HPT associated with hemodialysis (n = 19), and HPT associated with renal transplant (n = 15) underwent parathyroidectomy, and bone density was measured longitudinally for 3 yr. Patients with primary asymptomatic (mild) HPT did not undergo surgery and were followed prospectively. Before surgery, all groups showed a greater reduction of bone mineral density in cortical bone (distal radius) than in predominantly trabecular bone (lumbar spine). In primary symptomatic HPT, the BMD z-score of the distal radius was −1.80 ± 0.21 (±sem), and the corresponding figures for the total body, femoral neck, and lumbar spine were −0.60 ± 0.15, −0.54 ± 0.14, and −0.53 ± 0.18 compared with those of an age- and sex-matched reference group. In renal HPT BMD z-scores were −2.51± 0.38 (hemodialysis patients) and −2.83 ± 0.43 (renal transplant patients) for the distal radius and between −0.81 and− 1.46 for the other measured sites. After parathyroidectomy, BMD increased by 1–8% at all sites in patients with primary symptomatic HPT and HPT associated with renal transplant. The largest increase in bone mass was observed in patients with HPT associated with hemodialysis, in whom the improvement amounted to 7–23%. In patients with primary HPT and HPT associated with hemodialysis, this increase in bone density resulted in virtual recovery from their preoperative bone loss. The majority of patients with asymptomatic primary HPT disease (n = 21) maintained their bone density during the follow-up period and have not shown evidence of increases in serum calcium or PTH levels, but three patients followed conservatively underwent parathyroidectomy due to progressive deterioration of BMD. We conclude that, regardless of the etiology, a large proportion of HPT patients show reduced bone density. In patients with primary symptomatic HPT and patients with HPT associated with hemodialysis, bone density increases after parathyroidectomy to an extent that largely restores the preoperative bone loss. However, no anabolic effect of parathyroidectomy on bone mass was observed in patients with HPT associated with renal transplant, probably because of their immunosuppressive therapy.

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