The Bone Microarchitecture Deficit in Patients with Hemophilia Is Influenced by Arthropathy, Hepatitis C Infection, and Physical Activity

2021 ◽  
Author(s):  
Katharina Holstein ◽  
Leonora Witt ◽  
Tim Rolvien ◽  
Florian Langer ◽  
Anna Matysiak ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Bone Turnover ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Primary Prophylaxis ◽  
Peripheral Quantitative Computed Tomography ◽  
Low Grade ◽  
Hepatitis C Infection ◽  
Mineral Density ◽  
High Bone

AbstractLow bone mineral density (BMD) is common in patients with hemophilia (PWHs). The aim of the present study was to describe BMD and microarchitecture in PWHs in Northern Germany and to determine factors contributing to possible skeletal alterations. Demographic characteristics, BMD and microarchitecture, bone metabolism markers, and orthopaedic joint score (OJS) were assessed during routine check-ups. Areal BMD was assessed by dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine. Volumetric BMD and microarchitecture were quantified by high-resolution peripheral quantitative computed tomography at the distal radius and tibia. Eighty male PWHs (median age, 33 years; range, 18–77) were retrospectively analyzed, of whom 67 (84.0%) and 13 (16.0%) had hemophilia A and B, respectively. Fifty-four (68.0%), six (7.0%), and 20 (25.0%) patients had severe, moderate, or mild hemophilia, and 35 (44.0%) were hepatitis C virus (HCV) positive. DXA analysis revealed low BMD (Z-score ≤ − 2.0) in 27.5% of PWHs, and higher bone turnover values were associated with lower BMD. Bone microarchitecture was dominated by cortical deficits at the radius and trabecular deficits at the tibia. Cortical deficits at the radius were influenced by lower body mass index, low-grade inflammation, and treatment regimen (higher cortical thickness on primary prophylaxis). Trabecular alterations at the tibia were mainly associated with OJS and HCV status. A positive effect of self-reported sportive activity on BMD could be shown. In conclusion, our findings demonstrate that the site-specific microarchitectural deficit observed in PWHs is primarily negatively influenced by poor joint status, inflammation, HCV infection, and high bone turnover.

scholarly journals The Negative Impacts of Acromegaly on Bone Microstructure Not Fully Reversible

2021 ◽  
Vol 12 ◽  
Author(s):  
Lian Duan ◽  
Shengmin Yang ◽  
Lin Jie Wang ◽  
Yuelun Zhang ◽  
Ran Li ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Bone Microstructure ◽  
Volumetric Bone Mineral Density ◽  
Healthy Controls ◽  
Mineral Density ◽  
Intergroup Comparison ◽  
Microstructure Parameters ◽  
Active Patients

PurposeThis study aimed to evaluate the bone turnover markers and bone microarchitecture parameters derived from high-resolution peripheral quantitative computed tomography (HR-pQCT) in active and controlled acromegaly patients.MethodsThis cross-sectional study involved 55 acromegaly patients from a tertiary hospital (23 males and 32 females, aged 45.0 ± 11.6 years). Firstly, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and markers for bone turnover were assessed. Next, we derived peripheral bone microstructure parameters and volumetric bone mineral density (vBMD) through HR-pQCT. These parameters were compared between acromegaly patients and 110 healthy controls, as well as between 27 active and 28 controlled acromegaly patients. Moreover, the relationship between GH/IGF-1 and bone microstructure parameters was analyzed through multiple linear regression.ResultsAs compared with healthy controls, acromegaly patients exhibited elevated cortical vBMD, reduced trabecular vBMD, and increased trabecular inhomogeneity in the distal radius and tibia. While controlled acromegaly patients had slower bone turnover, they did not necessarily have better bone microstructure relative to active patients in intergroup comparison. Nevertheless, multiple regression indicated that higher IGF-1 was associated with lower tibial stiffness and failure load. Additionally, males with higher IGF-1 typically had larger trabecular separation, lower trabecular number, and larger cortical pores in the radius. Moreover, patients with elevated GH typically had more porous cortical bone in the radius and fewer trabeculae in the tibia. However, the compromised bone strength in active patients was partially compensated by increased bone thickness. Furthermore, no significant linkage was observed between elevated GH/IGF-1 and the most important HR-pQCT parameters such as trabecular volumetric bone density.ConclusionAcromegaly adversely affected bone quality, even in controlled patients. As the deterioration in bone microstructure due to prolonged GH/IGF-1 exposure was not fully reversible, clinicians should be aware of the bone fragility of acromegaly patients even after they had achieved biochemical remission.

scholarly journals Association of bone microarchitecture with parathyroid hormone concentration and calcium intake in men: the STRAMBO study

2011 ◽  
Vol 165 (1) ◽  
pp. 151-159 ◽  
Author(s):  
A Chaitou ◽  
S Boutroy ◽  
N Vilayphiou ◽  
A Varennes ◽  
M Richard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Bone Turnover ◽  
Calcium Intake ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Distal Tibia ◽  
Volumetric Bone Mineral Density ◽  
Mineral Density ◽  
Low Calcium

ObjectiveIn the elderly, vitamin D deficit, low calcium intake, and impaired bone microarchitecture are associated with higher risk of hip fracture. We assessed the association of bone microarchitecture with calcium intake and serum concentrations of 25-hydroxycholecalciferol (25OHD) and parathyroid hormone (PTH) in men.DesignCross-sectional analysis was performed in 1064 men aged 20–87 years not taking vitamin D or calcium supplements.MethodsDaily calcium intake was assessed using a food frequency questionnaire. Bone microarchitecture was assessed at distal radius and tibia by high-resolution peripheral quantitative computed tomography. We measured serum and urinary levels of biochemical bone turnover markers (BTMs). Statistical models were adjusted for age, weight, height, and glomerular filtration rate.ResultsIn 500 men aged <65 years, lower 25OHD levels and low calcium intake were associated with lower trabecular volumetric bone mineral density (Dtrab) at the distal tibia, due to lower trabecular number (Tb.N). Low calcium intake was associated with lower cortical thickness (Ct.Th). Higher PTH level was associated with higher BTM levels. In 563 men aged ≥65 years, the highest PTH quartile was associated with lower Ct.Th (tibia), lower Dtrab (both sites), and lower Tb.N (radius) compared with the lowest quartile. Low calcium intake was associated with lower Tb.N and more heterogenous trabecular distribution. BTM positively correlated with the PTH concentration.ConclusionIn older men, elevated PTH concentration is associated with high bone turnover, poor trabecular microarchitecture (radius and tibia), and, at the distal tibia, lower Ct.Th. Low calcium intake is associated with lower Tb.N and more heterogenous trabecular distribution.

High-resolution Peripheral Quantitative Computed Tomography Imaging in the Assessment of Periarticular Bone of Metacarpophalangeal and Wrist Joints

2016 ◽  
Vol 43 (10) ◽  
pp. 1921-1934 ◽  
Author(s):  
Sujay Nagaraj ◽  
Stephanie Finzel ◽  
Kathryn S. Stok ◽  
Cheryl Barnabe ◽  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Bone Microarchitecture ◽  
Image Interpretation ◽  
Quantitative Computed Tomography ◽  
High Sensitivity ◽  
Peripheral Quantitative Computed Tomography ◽  
Joint Space ◽  
Mineral Density ◽  
Wrist Joints

Objective.To synthesize descriptions of periarticular findings at the metacarpophalangeal (MCP) and wrist joints in different types of arthritis and in the normal state imaged by high-resolution peripheral quantitative computed tomography (HR-pQCT); to assemble the literature reporting on the ability of HR-pQCT to detect findings relative to other imaging modalities; and to collate results on the reproducibility of image interpretation.Methods.A systematic literature review was performed using terms for HR-pQCT and MCP or wrist joints using medical literature databases and conference abstracts. Any study describing predefined pathology findings, comparison to another radiographic technique, or a measure of reproducibility was included with no limitation by disease state.Results.We identified 44 studies meeting inclusion criteria from the 1901 articles identified by our search. All 44 reported on pathology findings, including erosions (n = 31), bone microarchitecture (n = 10) and bone mineral density (n = 10) variables, joint space evaluation (n = 7), or osteophyte characterization (n = 7). Seventeen of the studies compared HR-pQCT findings to either plain radiography (n = 9), ultrasound (n = 4), magnetic resonance imaging (n = 5), or microcomputed tomography (n = 2), with HR-pQCT having high sensitivity for erosion detection. Twenty-four studies included an assessment of reproducibility with good to excellent metrics, and highlighting the critical importance of positioning when assessing joint space variables.Conclusion.Despite high sensitivity for erosion detection and good reproducibility, more research is required to determine where HR-pQCT can be applied to enhance our understanding of periarticular bone changes in a variety of arthritis conditions.

The effect of gestagens on bone turnover in sheep

2002 ◽  
Vol 15 (04) ◽  
pp. 205-209
Author(s):  
K. Bruppacher ◽  
F. Janett ◽  
J. Auer ◽  
F. Zeifang ◽  
E. Schneider ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Turnover ◽  
Quantitative Computed Tomography ◽  
Distal Tibia ◽  
Peripheral Quantitative Computed Tomography ◽  
Control Group ◽  
Mineral Density ◽  
Total Alkaline Phosphatase ◽  
Group B ◽  
Total Alkaline

SummaryThe effects of two gestagens on bone turnover were investigated in three groups of female sheep comparable in age and weight. Group A (n = 10) was given a single intramuscular injection of 50 mg chlormadinon acetate (CMA), group B (n = 9) received 140 mg medroxyprogesterone acetate (MPA), and control group C (n = 9) received 5 ml physiological NaCI-solution. Plasma progesterone was measured weekly over 3 months. Bone mineral density (BMD) in the right distal tibia and calcaneus were determined every four weeks during the four months of the study duration, using peripheral quantitative computed tomography (pQCT). At the same times total alkaline phosphatase (AP) was determined. No significant changes of BMD were found in the three groups during the four months. Total alkaline phosphatase showed a significant decrease of 36-45% in all groups during the first six weeks. Sheep seem to have a comparable bone metabolism to humans with respect to the short term effect of gestagens, i. e. MPA and CMA.

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