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

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.

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

2020 ◽  
Vol 105 (4) ◽  
pp. e1397-e1407 ◽  
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.

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

Nutrients ◽  
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.

scholarly journals Associations of Polyunsaturated Fatty Acid Intake with Bone Mineral Density in Postmenopausal Women

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Margaret Harris ◽  
Vanessa Farrell ◽  
Linda Houtkooper ◽  
Scott Going ◽  
Timothy Lohman
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Secondary Analysis ◽  
Mineral Density ◽  
Dietary Pufa ◽  
Cross Sectional ◽  
Pufa Intake ◽  
Total Body

A secondary analysis of cross-sectional data was analyzed from 6 cohorts (Fall 1995–Fall 1997) of postmenopausal women (n=266;56.6±4.7years) participating in the Bone Estrogen Strength Training (BEST) study (a 12-month, block-randomized, clinical trial). Bone mineral density (BMD) was measured at femur neck and trochanter, lumbar spine (L2–L4), and total body BMD using dual-energy X-ray absorptiometry (DXA). Mean dietary polyunsaturated fatty acids (PUFAs) intakes were assessed using 8 days of diet records. Multiple linear regression was used to examine associations between dietary PUFAs and BMD. Covariates included in the models were total energy intake, body weight at year 1, years after menopause, exercise, use of hormone therapy (HT), total calcium, and total iron intakes. In the total sample, lumbar spine and total body BMD had significant negative associations with dietary PUFA intake atP<0.05. In the non-HT group, no significant associations between dietary PUFA intake and BMD were seen. In the HT group, significant inverse associations with dietary PUFA intake were seen in the spine, total body, and Ward’s triangle BMD, suggesting that HT may influence PUFA associations with BMD. This study is registered with clinicaltrials.gov, identifier:NCT00000399.

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

2011 ◽  
Vol 14 (01) ◽  
pp. 1150005 ◽  
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.

scholarly journals Are consumption of dairy products and physical activity independently related to bone mineral density of 6-year-old children? Longitudinal and cross-sectional analyses in a birth cohort from Brazil

2018 ◽  
Vol 21 (14) ◽  
pp. 2654-2664 ◽  
Author(s):  
Renata M Bielemann ◽  
Juliana dos S Vaz ◽  
Marlos R Domingues ◽  
Alicia Matijasevich ◽  
Iná S Santos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Birth Cohort ◽  
Bone Mineral ◽  
Dairy Products ◽  
Mineral Density ◽  
Cross Sectional ◽  
Maternal Report ◽  
Total Body

AbstractObjectiveTo evaluate cross-sectional and longitudinal associations of consumption of dairy products and physical activity (PA) with bone mineral density (BMD).DesignCohort study with children from the 2004 Pelotas (Brazil) Birth Cohort.SettingPelotas, a medium-sized Brazilian city.SubjectsThe study started in 2004 and mothers/children were interviewed/measured periodically from birth to age 6 years. PA was measured by maternal proxy at 4 and 6 years and by accelerometry at 6 years. Consumption of dairy products was measured using 24 h food recall (at 4 years) and FFQ (at 6 years). Total-body and lumbar-spine BMD (g/cm2) were measured by dual-energy X-ray absorptiometry.ResultsAt 6 years, BMD was measured in 3444 children and 2636 children provided data on objectively measured PA by accelerometry. Consumption of dairy products at 4 years was associated with higher lumbar-spine BMD at 6 years in boys, while current consumption was positively associated with BMD in both sexes (P < 0·001). PA assessed by maternal report at 4 and 6 years of age was associated with higher BMD at 6 years in boys. PA assessed by accelerometry was positively related to total-body and lumbar-spine BMD in boys and lumbar-spine BMD in girls. We did not find evidence for an interaction between PA and consumption of dairy products on BMD.ConclusionsWe observed positive and independent longitudinal and cross-sectional associations between consumption of dairy products and PA with BMD in the total body and at the lumbar spine in young children.

Juvenile lupus and serum vitamin D levels: A cross-sectional study

Lupus ◽  
2020 ◽  
Vol 29 (13) ◽  
pp. 1752-1758
Author(s):  
Samar abd Alhamed Tabra ◽  
Hend Hassan Abdelnabi ◽  
Nivine Fathi Mahmoud Darwish ◽  
Amal Mohammed El-Barbary ◽  
Muhammad Tarek AbdelGhafar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Healthy Children ◽  
Z Score ◽  
Mineral Density ◽  
Vitamin D Levels ◽  
Significant Difference

Background Juvenile systemic lupus erythematosus (JSLE) is usually associated with vitamin D deficiency and low bone mineral density. Objectives To evaluate serum levels of 25-OH vitamin D in JSLE patients and to correlate these findings with disease activity and bone density. Methods This study was conducted on 100 patients with JSLE and 100 healthy children as controls. Disease duration and SLEDAI for disease activity were evaluated. CBC, anti-dsDNA, C3,C4,24hr urinary proteins, creatinine, estimated glomerular filtration rate(e-GFR),Ca,P,PTH, 25 (OH) D levels, and bone mineral density(BMD)Z score were measured. Results There were significant differences in mean 25(OH)D concentration between patients group (19.37 ± 9.72 ng/ml) and controls 35.90 ± 9.66 ng/ml(p < 0.05), with significant difference between active and inactive patients (p < 0.05).There were significant negative correlations between serum 25(OH)D and SLEDAI (r-0.545, p 0.001), steroid dose (r-0.561, p 0.001), anti-dsDNA (r-0.685, p 0.006), 24 hr-proteinuria (r-0.738, p 0.001) and PTH (r-0.335, p 0.001), significant positive correlations between 25(OH)D and C3 (r0.617, p 0.001),C4 (r0.544, p 0.001) serum Ca (r0.424, p 0.001) and Z score (r0.561, p 0.001),with non-significant correlations between 25(OH)D and serum P and both disease & steroid duration, (p > 0.05). Conclusion Vitamin D deficiency is common in JSLE, it’s correlated significantly with disease activity and bone mineral density.

scholarly journals Effect of Androgen Deprivation Therapy on Bone Mineral Density in a Prostate Cancer Cohort in New Zealand: A Pilot Study

2017 ◽  
Vol 11 ◽  
pp. 117955491773344 ◽  
Author(s):  
Alice Wang ◽  
Nishi Karunasinghe ◽  
Lindsay Plank ◽  
Shuotun Zhu ◽  
Sue Osborne ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Serum Levels ◽  
Type I ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Cross ◽  
Total Body ◽  
Sectional Analysis

Introduction: Reduction in bone mineral density (BMD) is a common side effect of androgen deprivation therapy (ADT). We aimed to examine the cross-sectional and longitudinal variation in BMD and associated bone markers in patients with nonmetastatic prostate cancer (PCa) managed with and without ADT. Methods: Bone mineral density of the total body, lumbar spine, femoral neck, ultradistal forearm, and one-third distal radius was measured in 88 patients with PCa without bone metastases at baseline and at 6 months. Patients were categorized into 4 groups: (1) acute ADT (≤6 months), (2) chronic ADT (>6 months), (3) former ADT, and (4) no ADT (controls). Serum levels of bone metabolism markers, procollagen type I N-terminal propeptide (PINP) and C-terminal cross-linking telopeptide of type I collagen (CTX), were also measured. Results: In the cross-sectional analysis, men receiving chronic ADT had significantly lower total body BMD as compared with former ADT users and men with no ADT. In longitudinal analysis, a significant reduction in ultradistal forearm BMD was observed in both acute and chronic ADT users after 6 months (4.08% and 2.7%, P = .012 and .026, respectively). A significant reduction in total body BMD was observed in acute ADT users (2.99%, P = .032). Former ADT users had a significant increase in both lumbar spine and femoral neck BMD (2.84% and 1.59%, P = .008 and .002, respectively). The changes in BMD were not significantly different between acute and chronic ADT users. In the cross-sectional analysis, higher levels of PINP and CTX were observed in acute and chronic ADT users than former ADT users or PCa controls. In longitudinal analysis, the level of serum PINP and CTX did not change significantly from baseline to 6 months in acute, chronic, and former ADT users, or PCa controls, and the percentage change did not differ among the 4 groups. Conclusions: Men on acute ADT had a similar rate of bone loss to men on chronic ADT. Reversibility in ADT-induced bone loss was observed in those who discontinued ADT. Serum levels of PINP and CTX were higher in acute and chronic ADT users and levels returned to the range of PCa controls when treatment was withdrawn.

scholarly journals Duchenne Muscular Dystrophy and Bone Mineral Density

2021 ◽  
Author(s):  
Luana da Costa Lima ◽  
Evellyn Câmara Grilo ◽  
Thais Alves Cunha ◽  
Bárbara Gurgel Magalhães de Araújo ◽  
José Brandão-Neto ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Bone Mineral ◽  
Negative Correlation ◽  
Z Score ◽  
Mineral Density ◽  
Lower Lumbar Spine ◽  
Total Body

Abstract Duchenne muscular dystrophy (DMD) patients are at risk of developing conditions that can compromise their bone health, such as fractures and walking impairment. We aimed to assess bone mineral density as a function of the age of DMD patients. The cross-sectional study included 48 patients distributed into four groups by age: G1 (5.1-9.2 years), G2 (9.3-10.7 years), G3 (11.2-15.9 years), and G4 (18-24.7 years). Lumbar spine and total body bone mineral density (BMD) measurements were performed with dual-energy X-ray absorptiometry. There was a moderate negative correlation between age and the lumbar spine BMD z-score (p = 0.001; r = -0.45) and a strong negative correlation between age and the total body BMD z-score (p = 0.001; r = -0.79). The lumbar spine BMD z-scores in G3 and G4 were significantly lower than those in G1 and G2 (p < 0.05). The total body BMD z-score in G3 was lower than those in G1 and G2 (p < 0.05), and in G4 was lower ​​than those in the other groups (p < 0.05). Conclusion: The older patients had lower lumbar spine and total body BMD z-score values than younger patients. Moreover, these values ​​were negatively correlated with the age of the patients.

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