Bone Mineral Density and Risk of Breast Cancer: Differences by Family History of Breast Cancer

Abstract Background/Aims Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results 1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure M.A. Swar: None. M. Bukhari: None.

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Association of bone mineral density with a first-degree family history of diabetes in normoglycemic postmenopausal women

Menopause ◽

10.1097/gme.0000000000001396 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1284-1288

Author(s):

Lijuan Yang ◽

Xiang Hu ◽

Hailing Zhang ◽

Wei Pan ◽

Weihui Yu ◽

...

Keyword(s):

Bone Mineral Density ◽

Family History ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Family History Of Diabetes ◽

History Of

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Bone Mineral Density in Transfusion Independent Thalassemia Patients.

Blood ◽

10.1182/blood.v108.11.3353.3353 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3353-3353

Author(s):

Zahra Pakbaz ◽

Zhe Zhang ◽

Ellen Fung ◽

Nancy Sweeters ◽

Sylvia Singer ◽

...

Keyword(s):

Bone Mineral Density ◽

Family History ◽

Bone Mineral ◽

Z Score ◽

Low Bone Mass ◽

Mineral Density ◽

Patients Âgés ◽

Z Scores ◽

History Of ◽

The Mean

Abstract Low bone mineral density (BMD) is commonly seen in regularly transfused thalassemia patients; however, there have been few reports for bone mineral density assessment in transfusion independent thalassemia patients. The present report includes the results of BMD assessments in patients with transfusion independent thalassemia who were referred to the bone density clinic through 2002–2006. BMD was evaluated by dual energy x-ray absorptiometry (DXA, Hologic Delphi A). A convenience sample of 24 patients (Females=15) with transfusion independent thalassemia were measured with a mean age of 22.1 ± 13.8 years. Subjects younger than 10 yrs old (n = 7) underwent scans for Lumbar spine (LS; L1-L4) and whole body (WB), patients ages 10–20 (n = 5) were assessed for LS, WB, and non-dominant hip, and for patients older than 20 (n = 12), LS and hip scans were completed. Z-scores specific for age and gender were generated using Zemel BS et al.(J. Bone Min Res 2004) database. Z-scores less than −2.0 were considered as low bone density. Calcium intake was assessed by a brief food frequency questionnaire. Past medical history, medications, history of fractures, and family history of osteoporosis were obtained by chart review and patient interview. Data is presented as Mean ± SD. T-test was used to assess differences in continuous variables. The mean LS Z-score (n = 24) was −1.5 ± 1.0 and the mean hip Z-score (n = 17) was −0.5 ± 1.1. Mean WB Z-score (n = 10) was −2.0 ± 1.2. There was a significant (p<0.001) difference between spine and hip Z-scores. Overall 46% had a Z-score less than −2.0. Thirty-three percent of patients have spine Z-scores of less than −2.0 and 25% spine Z-scores between −2.0 and −1.0. Average spine Z-score in patients younger than 10 years old (n=7) was −1.6 ± 0.5. In WB scans, 50% of the patients had WB Z-scores worse than −2.0. None of the young patients (5–9 yrs; n = 7) consumed inadequate intake of calcium (< 2/3 of RDA age specific) while 75% of patients ages 10–20 (n = 4) years old consumed inadequate intake of calcium (dietary + supplement). Neither spine nor hip Z-score was related to patients’ gender, age, and calcium intake. Two patients reported fractures in the past and two reported family history of osteoporosis. Six patients had delayed puberty and one has hypogonadism. Seven patients have short stature. This data suggests that low bone mass is not only a problem in transfused thalassemia patients, but is also observed in non-transfused patients. The significance and pathophysiology of low bone mass should be studied further in non-transfused patient population, especially in younger children.

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Association between a family history of fractures and bone mineral density in early postmenopausal women

Bone ◽

10.1016/s8756-3282(99)00016-2 ◽

1999 ◽

Vol 24 (5) ◽

pp. 507-512 ◽

Cited By ~ 11

Author(s):

M.J Grainge ◽

C.A.C Coupland ◽

S.J Cliffe ◽

C.E.D Chilvers ◽

D.J Hosking

Keyword(s):

Bone Mineral Density ◽

Family History ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Early Postmenopausal Women ◽

History Of

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Family history of osteoporosis and bone mineral density at the axial skeleton: The rancho bernardo study

Journal of Bone and Mineral Research ◽

10.1002/jbmr.5650090602 ◽

2009 ◽

Vol 9 (6) ◽

pp. 761-769 ◽

Cited By ~ 103

Author(s):

Sharon B. Soroko ◽

Elizabeth Barrett-Connor ◽

Sharon L. Edelstein ◽

Donna Kritz-Silverstein

Keyword(s):

Bone Mineral Density ◽

Family History ◽

Bone Mineral ◽

Axial Skeleton ◽

Mineral Density ◽

History Of

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Bone Mineral Density Screening Among Women with a History of Breast Cancer Treated with Aromatase Inhibitors

Journal of Women s Health ◽

10.1089/jwh.2012.3687 ◽

2013 ◽

Vol 22 (2) ◽

pp. 132-140 ◽

Cited By ~ 9

Author(s):

Leslie Spangler ◽

Onchee Yu ◽

Elizabeth Loggers ◽

Denise M. Boudreau

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Bone Mineral ◽

Aromatase Inhibitors ◽

Mineral Density ◽

History Of

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Evaluation with densitometry of patients with breast cancer and low bone mineral density after 2 years of treatment

Bone Abstracts ◽

10.1530/boneabs.1.pp425 ◽

2013 ◽

Author(s):

Sonia Munoz Gil ◽

Tomas Mut Dolera ◽

Belen C Garrido Lopez ◽

M D Torregrosa Maicas ◽

R Girones Sarrio ◽

...

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Bone Mineral ◽

Mineral Density ◽

Low Bone Mineral Density

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SAT0462 ASSESSMENT OF BONE MINERAL DENSITY IN INFLAMMATORY BOWEL DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6007 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1188.1-1188

Author(s):

C. Daldoul ◽

N. El Amri ◽

K. Baccouche ◽

H. Zeglaoui ◽

E. Bouajina

Keyword(s):

Bone Mineral Density ◽

Inflammatory Bowel Disease ◽

Bone Mineral ◽

Bowel Disease ◽

Mineral Density ◽

Femoral Site ◽

Significant Difference ◽

History Of ◽

Inflammatory Bowel ◽

The Mean

Background:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is considered as a risk factor of low bone mineral density (BMD). In fact, the prevalence of osteoporosis ranges from 17% to 41% in IBD patients. The possible contributing factors may include malabsorption, glucocorticoid treatment and coexisting comorbiditiesObjectives:The purpose of our work was to determine the frequency and the determinants of osteoporosis in patients with IBD and to assess whether there is a difference in BMD status between UC and CD.Methods:This is a retrospective study, over a period of 5 years (from January 2014 to December 2018) and including patients followed for IBD who had a measurement of BMD by DEXA. Clinical, anthropometric and densitometric data (BMD at the femoral and vertebral site) were recorded. The WHO criteria for the definition of osteoporosis and osteopenia were applied.Results:One hundred and five patients were collected; among them 45 were men and 60 were women. The average age was 45.89 years old. The average body mass index (BMI) was 25.81 kg/m2 [16.44-44.15]. CD and UC were diagnosed in respectively 57.1% and 42.9%. A personal history of fragility fracture was noted in 4.8%. Hypothyroidism was associated in one case. Early menopause was recorded in 7.6%. 46.8% patients were treated with corticosteroids. The mean BMD at the vertebral site was 1.023 g/cm3 [0.569-1.489 g/cm3]. Mean BMD at the femoral site was 0.920g/cm3 [0.553-1.286g / cm3]. The mean T-score at the femoral site and the vertebral site were -1.04 SD and -1.27 SD, respectively. Osteoporosis was found in 25.7% and osteopenia in 37.1%. Osteoporosis among CD and UC patients was found in respectively 63% and 37%. The age of the osteoporotic patients was significantly higher compared to those who were not osteoporotic (52.23 vs 43.67 years, p = 0.01). We found a significantly higher percentage of osteoporosis among men compared to women (35.6% vs 18.3%, p=0.046). The BMI was significantly lower in the osteoporotic patients (23.87 vs 26.48 kg/m2, p=0.035) and we found a significant correlation between BMI and BMD at the femoral site (p=0.01). No increase in the frequency of osteoporosis was noted in patients treated with corticosteroids (27.9% vs 21.6%, p=0.479). Comparing the UC and CD patients, no difference was found in baseline characteristics, use of steroids or history of fracture. No statistically significant difference was found between UC and CD patients for osteoporosis(p=0.478), BMD at the femoral site (p=0.529) and at the vertebral site (p=0.568).Conclusion:Osteoporosis was found in 25.7% of IBD patients without any difference between CD and UC. This decline does not seem to be related to the treatment with corticosteroids but rather to the disease itself. Hence the interest of an early screening of this silent disease.Disclosure of Interests:None declared

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Effects of One-Year Adjuvant Treatment with Tamoxifen on Bone Mineral Density in Postmenopausal Breast Cancer Women

Tumori Journal ◽

10.1177/030089169608200114 ◽

1996 ◽

Vol 82 (1) ◽

pp. 65-67 ◽

Cited By ~ 10

Author(s):

Sandro Barni ◽

Paolo Lissoni ◽

Gabriele Tancini ◽

Antonio Ardizzoia ◽

Marina Cazzaniga

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Alkaline Phosphatase ◽

Bone Mineral Content ◽

Bone Mineral ◽

Adjuvant Treatment ◽

Mineral Content ◽

Postmenopausal Breast Cancer ◽

Mineral Density ◽

One Year

In this study, the authors have analyzed the possible effects of one-year adjuvant treatment with tamoxifen on bone mineral density in postmenopausal breast cancer women. Bone mineral content was studied by photon absorptiometry (I-125), whereas bone balance was analyzed indirectly by serum PTH, osteocalcin, calcitonin, calcium and alkaline phosphatase levels. Bone mineral content and serum bone-related substances were measured before starting treatment and after one year. Results were analyzed using Student's t test for paired data. No difference was found between the two measurements for bone mineral content, PTH, calcitonin, calcium and alkaline phosphatase levels. Measurements at entry and after one year of treatment showed a statistically significant difference ( P < 0.001) only for osteocalcin. In accordance with other authors, we can conclude that treatment with tamoxifen does not cause an increase in menopausal bone resorption. The finding that osteocalcin levels decreased after one year of therapy with tamoxifen is interesting, but further studies are necessary to clarify the role of such levels in predicting a turnover of bone balance towards osteoblastic activity.

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