SAT0475 DENOSUMAB VERSUS ORAL BISPHOSPHONATE FOR OSTEOPOROSIS IN LONG-TERM GLUCOCORTICOID USERS: A 12-MONTH RANDOMIZED CONTROLLED TRIAL

Background:Objectives:To compare the efficacy of denosumab (DEN) and oral alendronate (ALN) on spinal bone mineral density (BMD) in long-term glucocorticoid users.Methods:Patients receiving long-term prednisolone treatment for medical illnesses were recruited. Inclusion criteria: (1) adult patients ≥18 years of age; (2) prednisolone ≥2.5mg/day for ≥1 year. Exclusion criteria: (1) previous use of DEN, teriparatide; (2) plan for pregnancy; (3) metabolic bone disease or unexplained hypocalcemia; (4) renal insufficiency. Participants were randomized to receive either: (1) DEN (60mg subcutaneously every 6 months); or (2) ALN (70mg/week). Calcium (Caltrate 3000mg/day) and vitamin D3 (cholecalciferol 1000IU/day) was given. BMD (femoral neck, total hip, lumbar spine) at month 0, 6 and 12 months were performed. Markers of bone turnover (serum P1NP and CTX) were also assayed at the same time points. The primary outcome was the difference of lumbar spine BMD change at month 12 between the two groups.Results:139 subjects were recruited (age 50.0±12.7 years): 69 assigned DEN and 70 assigned ALN. Underlying medical diseases: SLE (81%), RA (9.4%) and myositis (5%). Prednisolone dose at entry was 5.7±2.1mg/day. 56% of female patients were postmenopausal. 73(53%) of patients were osteoporotic (T score <-2.5) at the hip, femoral neck or lumbar spine. The mean body mass index (BMI) was 23.1±4.1kg/m2 (11% patients had BMI<18kg/m2). 82(59%) patients were naive to bisphosphonates. Pre-existing fragility or vertebral fracture was present in 19 (14%) patients and 18 patients (13%) had a family history of fractures. Baseline demographic data, osteoporotic risk factors, and BMD at various sites were not significantly different between the two groups at entry. At month 12, a significant gain in BMD at the lumbar spine (+3.5±2.5%; p<0.001) and the hip (+0.9±2.8%; p=0.01) was observed in DEN-treated patients, whereas the corresponding change was +2.5±2.9% (p<0.001) and +1.6±2.7% (p<0.001) in the ALN group. The spinal BMD at month 12 was significantly higher in the DEN than ALN group after adjustment for BMD values at baseline, age, sex and other osteoporosis risk factors that included smoking, drinking, cumulative steroid doses in one year, BMI, menopausal status and personal history of fracture (p=0.045). The differences in hip and femoral neck BMD were not significantly different between the two groups after adjustment for the same confounding factors. No new symptomatic fractures occurred in any participants at month 12. Adverse events were similar in frequency between the two treatment arms. Major infective episodes were uncommon (0.06/patient/year) and similar in the two groups. Minor upper gastrointestinal symptoms and non-specific dizziness were numerically more common in the ALN but arthralgia, minor infections (eg. upper respiratory tract) and new hypertension was more commonly reported in the DEN group. Three patients from ALN and 2 patients from DEN group were withdrawn from the study because of non-compliance but none withdrew because of adverse events.Conclusion:In patients receiving long-term glucocorticoids, DEN is superior to ALN in raising the spinal BMD after 12 months’ treatment. Both DEN and ALN were well tolerated.Acknowledgments:NILDisclosure of Interests:None declared

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P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽

10.1093/rheumatology/keab247.124 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Malika A Swar ◽

Marwan Bukhari

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Bone Mineral Density ◽

Family History ◽

Bone Loss ◽

Femoral Neck ◽

Bone Mineral ◽

Fragility Fracture ◽

Mineral Density ◽

History Of

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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Risk factors for decreased bone mineral density in men with type 2 diabetes.

Diabetes Mellitus ◽

10.14341/dm12383 ◽

2021 ◽

Vol 23 (5) ◽

pp. 424-433

Author(s):

Olga N. Fazullina ◽

Anton I. Korbut ◽

Maksim V. Dashkin ◽

Vadim V. Klimontov

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Lumbar Spine ◽

Femoral Neck ◽

Fat Mass ◽

Free Testosterone ◽

Mineral Density ◽

T Score ◽

25 Oh Vitamin D

BACKGROUND: Type 2 diabetes and osteoporosis are widespread diseases in the middle-aged and elderly people. Most studies of osteoporosis in patients with type 2 diabetes have been performed in women; meantime risk factors for lowering bone mineral density (BMD) in men have been little studied.AIMS: to identify risk factors for decreased BMD at the lumbar spine, femoral neck and forearm in men with type 2 diabetes.METHODS: Eighty two men from 50 to 75 years old, with duration of diabetes for at least one year, were included in the study. Individuals with known risk factors for secondary osteoporosis were not included. Twenty-three men with normal BMD having no diabetes or obesity were acted as control. The T-score at the lumbar spine, femoral neck and forearm of a non-dominant arm, as well as body composition parameters, were evaluated by dual-energy X-ray absorptiometry. The levels of hormones that affect bone metabolism (parathyroid hormone, free testosterone, 25-OH vitamin D) were measured in blood serum by ELISA. Risk factors for reducing BMD were identified using multivariate regression analysis and receiver operating characteristic (ROC) curves.RESULTS: Among patients with diabetes, 49 individuals had normal BMD and 33 showed decreased T-score values (<-1 SD). Free testosterone <5.92 pg/ml was predictor for decreased BMD at the lumbar spine (OR=4.4, p=0.04). For femoral neck, the risk factors were body weight <95.5 kg (OR=2.8, p=0.04), total fat mass <27 kg (OR=3.3, p=0.03), truncal fat mass<17.5 kg(OR=4.5, p=0.006), android (central abdominal) fat mass <3.2 kg(OR=4.0, p=0.01), gynoid (hip) fat mass <3.5 kg(OR=3.3, p=0.02), and lean mass <59 kg(OR=3.0, p=0.04). Risk factors for reduced BMD at the forearm were diabetes duration>15.5 years (OR=3.7, p=0.03) and HbA1c <8.15% (OR=3.8, p=0.03). Parathyroid hormone and 25-OH-vitamin D did not predict BMD independently.CONCLUSIONS: In men with type 2 diabetes, low free testosterone is a risk factor for decreased BMD in the lumbar spine, and diabetes duration is a risk factor for decreased BMD in the forearm. The presence of obesity is associated with an increase in BMD in the femoral neck; a high HbA1c is associated with an increase in BMD in the forearm.

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Differences in Bone Mineral Density between Adult Vegetarians and Nonvegetarians Become Marginal when Accounting for Differences in Anthropometric Factors

Journal of Nutrition ◽

10.1093/jn/nxaa018 ◽

2020 ◽

Vol 150 (5) ◽

pp. 1266-1271 ◽

Cited By ~ 3

Author(s):

Nena Karavasiloglou ◽

Eliska Selinger ◽

Jan Gojda ◽

Sabine Rohrmann ◽

Tilman Kühn

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Waist Circumference ◽

Femoral Neck ◽

Bone Mineral ◽

Statistical Models ◽

Menopausal Status ◽

Mineral Density ◽

Significant Difference ◽

Race Ethnicity

ABSTRACT Background Persons following plant-based diets have lower bone mineral density (BMD) and higher fracture risk, possibly due to suboptimal nutrient supply. However, anthropometric measures were not considered as potential confounders in many previous studies, and body mass index (BMI) is positively associated with BMD but also generally lower among vegans and vegetarians. Objectives Our objective was to investigate if BMD measurements differ between vegetarians and nonvegetarians from the adult general population when accounting for important determinants of BMD, especially BMI and waist circumference. Methods Using data from the NHANES (cycles 2007–2008 and 2009–2010), we evaluated the differences in BMD (femoral neck, total femoral, and total lumbar spine) between adult vegetarians and nonvegetarians. Linear regression models were used to determine the associations between BMD and diet. Statistical models were adjusted for important factors, i.e., age, sex, race/ethnicity, smoking status, alcohol consumption, serum vitamin D and calcium concentrations, waist circumference, and BMI. Results In statistical models adjusted for age, sex, race/ethnicity, menopausal status, and education level, BMD values were significantly lower among vegetarians than among nonvegetarians (P < 0.001). These differences were attenuated upon adjustment for lifestyle factors, and became statistically nonsignificant upon adjustment for anthropometric variables (BMI and waist circumference) for femoral neck (0.77 compared with 0.79 g/cm2 among vegetarians versus nonvegetarians, P = 0.10) and total femoral BMD (0.88 compared with 0.90 g/cm2, P = 0.12). A small but statistically significant difference remained for total lumbar spine BMD (1.01 compared with 1.04 g/cm2, P = 0.005). Conclusions These findings suggest that lower BMD among adult vegetarians is in larger parts explained by lower BMI and waist circumference.

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Effect of Zoledronic Acid on Bone Mineral Density in Thalassemia-Induced Osteoporosis: Results of a Phase II Clinical Trial.

Blood ◽

10.1182/blood.v106.11.3826.3826 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3826-3826

Author(s):

Ali Taher ◽

Sami Azar ◽

Wael Shamseddeen ◽

Dany Habr ◽

Adlette Inati ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Zoledronic Acid ◽

Femoral Neck ◽

Adverse Events ◽

Bone Mineral ◽

Beta Thalassemia ◽

Mineral Density ◽

Significant Change

Abstract Background: Osteoporosis is an important cause of morbidity in beta-thalassemia patients. Bisphosphonates are potent inhibitors of osteoclast activity and have been recently used for the treatment of osteoporosis in beta-thalassemia. The aim of this study is to assess the efficacy and safety of zoledronic acid in Lebanese thalassemics with osteoporosis. Methods: Eighteen thalassemic patients (13 thalassemia major and 5 intermedia) with osteoporosis defined as Z-score <−2.5 were given zoledronic acid 4 mg i.v. every 3 months over a period of 12 months (Total of 4 doses administered). The efficacy of treatment was assessed by measuring Bone Mineral Density (BMD) at the lumbar spine, femoral neck and hip at baseline, 6 and 12 months. Other efficacy measurements included markers of bone formation and resorption (bone alkaline phosphatase (BAP), osteocalcin (OC), and urinary deoxypyridinoline (Dpd)), assessment of pain score, analgesic score, and performance score measured at baseline and at 3-month intervals. Safety assessment included regular physical exams, standard hematology and clinical chemistry tests, and adverse events recording. All patients were on Ca/Vitamin D supplementation prior to and during the study. Ten thalassemic osteoporotic patients were followed up only with serial BMDs as controls. Results: The characteristics of all patients are shown in Table 1. Both groups had no significant difference with respect to age, gender and baseline BMD. Patients taking zoledronic acid had a significant increase in their spine, femoral neck, trochanter and total hip BMD measurements over the 12-month period (all p-values<0.05). Patients in the control group, on the other hand, did not have any significant change except in the spine BMD. The BMD values are presented in Table 2. There was a significant change in the levels of the OC and BAP over the 12-month follow-up in the treatment group (p=0.00 for both). Dpd levels did not significantly change overall (p=0.06) although they decreased throughout the study. Reported adverse events included joint pain in 9 patients (50%) after the 1st dose and in 2 (11.1%) after the 2nd dose and responding very well to oral analgesics. Two patients (11.1%) had perioral numbness and 3 (16.7%) had low grade fever after the 1st dose. No treatment-related adverse events were reported after the 3rd and 4th doses. No patients withdrew from the study. Conclusions: Treatment of Lebanese thalassemic osteoporotic patients with zoledronic acid 4 mg every 3 months is effective in increasing BMD at the lumbar spine and hip and is well-tolerated. Well-controlled studies with longer follow-up are needed to determine the fracture-reduction benefits and the most optimal zoledronic acid treatment dose and frequency in this patient population. Table 1: Main characteristics of the studied groups Table 2: BMD values of the treatment and control groups

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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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Citrate Effects and Bone Mineral Density (BMD) in Serial Long-Term Apheresis Donors.

Blood ◽

10.1182/blood.v108.11.953.953 ◽

2006 ◽

Vol 108 (11) ◽

pp. 953-953 ◽

Cited By ~ 1

Author(s):

Charles Bolan ◽

Jeremiah Ronquillo ◽

Yu Ying Yau ◽

Robert Wesley ◽

Stacey Cecco ◽

...

Keyword(s):

Femoral Neck ◽

Bone Metabolism ◽

Menopausal Status ◽

Pharmacologic Therapy ◽

Calcium Balance ◽

Mineral Density ◽

Positive Effects ◽

Bmd Testing ◽

Induced Changes

Abstract -Background: Citrate-induced changes in biochemical markers of calcium balance and bone metabolism have been described for at least 24 hours after plateletpheresis. However, the long-term effect of frequent apheresis on BMD and calcium balance has not been determined. Methods: Volunteer platelet donors (PD) and financially-compensated lymphocyte donors (LD), each with > 50 donations over 10 yrs, were compared with volunteer whole blood (WB) donor controls. All subjects underwent BMD testing by dual energy x-ray absorptiometry (Delphi Advanced Instrument, Hologic, MA). Laboratory evaluations were performed at baseline, and immediately and at 1, 4, and 14 days after apheresis. The minimum interapheresis donation period established by institutional policy was 4 wks in PD, and 3 weeks in LD, thus additional BMD assessments were performed in community platelet donors (APD), each with > 100 donations over 10 yrs, conducted at a minimum interapheresis interval of 2 weeks. Results: Seventy–six PD, 53 LD, 118 WB, and 21 APD donors were evaluated. PD were older (57 vs 50 yo), weighed less (80 vs 88 kg), and were more likely to be female (41% vs 26%) and Caucasian (99 vs 64%) than LD. WB had intermediate demographic values (53 yo, 85 kg, 40% female, 77% Caucasian). APD had similar age (58 yo), wt (88 kg), and race (100% Caucasian) but were 95% male and had a mean of 206 lifetime donations versus 88 for PD and 80 for LD. Compared to PD, LD underwent larger procedures (7 vs 5 liters) at lower citrate infusion rates (1.3 vs 1.6 mg/kg/min). PD also exhibited attenuated post-apheresis changes in ionized Ca (iCa, 0.97 vs 0.93 mmole/L) and intact PTH (iPTH, 87 vs 106 pg/mL), and had more marked post-apheresis changes in markers of bone breakdown (c-telopeptides; 73 vs 43% increase) and bone remodeling (osteocalcin, 50 vs 25% increase). LD, but not PD, had persistent 10 to 20% increases in iPTH levels on days 1, 4, and 14 after apheresis, while both LD and PD demonstrated smaller, but statistically significant increases in iCa, total Ca, and phosphorus on day 14 after apheresis. PD had higher mean BMD than the gender, race, and age adjusted reference standards at all sites tested, and had higher BMD values at the femoral neck, hip and radius than WB controls matched for race, gender, menopausal status, age (± 5 yrs) and weight (± 10 kg). A similar, but less pronounced pattern was observed in LD, with mean BMD values significantly higher than reference values or matched WB controls only at the femoral neck. The frequency of osteopenia (36, 15, and 49%) and osteoporosis (4, 8 and 13%) in PD, LD and WB donors, respectively, tended to be lower in the frequent apheresis donors. BMD in APD donors did not differ significantly from WB controls and was significantly lower than PD at the femoral neck and hip. Conclusion: Apheresis induces citrate-mediated biochemical effects consistent with an acute period of bone resorption followed by a more gradual period of recovery. Repetitive, frequent plateletpheresis in PD subjects was associated with positive effects on bone density, as has been described with the use of PTH as a pharmacologic therapy for low BMD in other clinical settings. The net effects on calcium balance, bone metabolism, and BMD may be further impacted by alterations in the frequency and intensity of citrate administration.

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AB0617 BISPHOSPHONATES DANS L’OSTÉOPOROSE ET LE RISQUE D’OSTÉONÉCROSE DE LA MÂCHOIRE, ENVIRON 896 CAS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2399 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1343.1-1343

Author(s):

A. R. Halidou ◽

K. Nassar ◽

S. Janani

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Corticosteroid Therapy ◽

Osteonecrosis Of The Jaw ◽

Mineral Density ◽

Duration Of Treatment ◽

Treatment Of Osteoporosis ◽

Total Hip ◽

T Score

Background:Bisphosphonates (BF) are used in the treatment of osteoporosis, Paget’s disease of bone, hypercalcemia and in patients with cancer. When used to treat osteoporosis, the optimal duration of treatment is 3 to 5 years; however, their long-term use has been rarely associated with osteonecrosis of the jaw.Objectives:To assess the risk of developing osteonecrosis of the jaw in patients followed for osteoporosis and on bisphosphonates (BP).Methods:Type of study: retrospective study conducted at the rheumatology department of the IBN ROCHD CHU in Casablanca.Duration: from October 2013 to October 2020 (7 years).Inclusion criteria: all patients followed for osteoporosis in the weakening osteopathies unit of the bone and treated with oral or intravenous bisphosphonates.Exclusion criteria: patients followed for other than osteoporosis.Results:896 patients were treated during this period. The average age was 62.74 years (28 to 90 years), of which 85.16% were women and 14.84% were men, for a sex ratio (F / M) of 5.74. As a history, 18.75% of patients are diabetic, 26.56% followed for breast neoplasm, 14.06% of patients had received long-term corticosteroid therapy for various pathologies such as chronic inflammatory rheumatism. Osteoporosis was postmenopausal in 687 patients, ie 76.67% of cases, 14.06% after long-term corticosteroid therapy, 8.15% following hormone therapy (anti-aromatases) and 6.92% following chemotherapy; note that 18.16% of these patients were found in at least two of the situations. The mean bone mineral density (BMD), T-score pair considered in all [T-score (BMD)] is -3 (0.736) in the lumbar spine (L1-L4), -2.9 (0.658) at the femoral neck, -2.6 (0.804) at the total hip before the start of treatment. 69.97% of the patients were put on Alendronic acid, 12.50% on Residronic acid, 10.93% on Zolidronic acid, 3.46% on Pamidronic acid and 3.14% received Strontium Ranelate, note that before the start of the treatment all the patients benefited from a dental consultation followed by care of any lesions, the bisphosphonates were only introduced after having ruled out all their dental contraindications, the average duration of treatment for all the molecules was 4.71 years (2 to 5 years) and no patient developed osteonecrosis of the jaw. The change in control BMD on average after 2 years of treatment was -2.7 (0.782) at the lumbar spine, -2.6 (0.749) at the femoral neck and -2.4 (0.713) at the hip total, after 5 years -2.4 (0.874) at the spine, -2.1 (0.809) at the femoral neck and -1.93 (861) at the total hip.Conclusion:The occurrence of ONJ in the treatment of osteoporosis with the use of BFs is rare, and appears to be unpredictable; but maintaining therapeutic caution, consisting in diagnosing and treating any dental lesions before starting treatment, can considerably reduce or even cancel the risk of occurrence; especially in patients treated with long-term intravenous pamidronate.References:[1]Dr Halidou Idrissa Abdoul-Rahamane, Pr Kawtar Nassar, PR Saadia Janani.[2]Rheumatology department of the IBN ROCHD CHU in CASABLANCA. Casablanca Faculty of Medicine and Pharmacy. Hassan II University. MoroccoDisclosure of Interests:None declared.

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The association between low bone mineral density and coronary artery calcification in osteoporotic and non-osteoporotic patients in a tertiary center in Saudi Arabia

Annals of Saudi Medicine ◽

10.5144/0256-4947.2021.101 ◽

2021 ◽

Vol 41 (2) ◽

pp. 101-108

Author(s):

Ahmed L. Fathala ◽

Sami Alkulaybi ◽

Abdulrahman Khawaji ◽

Abdelghafour Alomari ◽

Ahmed Almuhaideb

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Saudi Arabia ◽

Coronary Artery ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Coronary Artery Calcification ◽

Mineral Density ◽

Cad Risk

BACKGROUND: Cardiovascular disease (CVD) and osteoporosis are major health-care concerns worldwide. The evidence is contradictory on whether a relationship exists between low bone mineral density (BMD) determined by dual-energy absorptiometry (DXA scan) and coronary artery calcification (CAC) measured by computed tomography. Currently, there are no data on patients from Saudi Arabia. OBJECTIVE: Examine the relationship between CAC and BMD in both genders and study the influence of traditional coronary artery disease (CAD) risk factors and osteoporosis. DESIGN: Retrospective, cross-sectional, analytical. SETTING: Single tertiary care center. PATIENTS AND METHODS: We searched radiology databases for patients who underwent both DXA and CAC score scanning within six months of each other. The inclusion criterion was an absence of any history of CAD. MAIN OUTCOME MEASURE: Association between osteoporosis and CAC. SAMPLE SIZE: 195 (34 osteoporosic, 161 normal BMD or osteopenic) RESULTS: Most of the study population (57.4%) were females. The mean age of all patients was 63.6 (10.1) years. Participants with CAC scores of 0 were significantly younger than those who had CAC scores >0. The presence of diabetes mellitus, hypertension, and hypercholesterolemia was higher in patients with CAC scores >0. CAC score and other CAD risk factors were not significantly different between the osteoporotic and nonosteoporotic groups, except for body mass index. A high CAC score (>100) was present in 28%, 20%, 11%, and 30% of participants with no osteoporosis, osteoporosis of the lumbar spine, osteoporosis of the femoral neck, and participants with osteoporosis of both the lumbar spine and femoral neck, respectively ( P =.762), suggesting there is no association between CAC and the presence of osteoporosis. CONCLUSIONS: Osteoporosis is not associated with higher CAC scores in Saudi Arabia and CAD risk factors are not significantly prevalent in osteoporosis. It appears that CAC and osteoporosis are independent age-related diseases that share common risk factors. LIMITATIONS: Single-center, retrospective. CONFLICT OF INTEREST: None.

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Characteristics of osteoporosis in patients with rheumatic diseases

Health care of Tajikistan ◽

10.52888/0514-2515-2021-350-48-54 ◽

2021 ◽

pp. 48-54

Author(s):

O. Kh. Mirzovaliev ◽

S. M. Shukurova

Keyword(s):

Risk Factors ◽

High Risk ◽

Rheumatic Diseases ◽

Absolute Risk ◽

Osteoporotic Fractures ◽

Case Histories ◽

Mineral Density ◽

Major Osteoporotic Fractures ◽

History Of

Aim. To present a comprehensive assessment of rheumatic diseases in association with osteoporosis.Material and methods. A retrospective analysis was made of 180 case histories with various RDs, who were under inpatient observation at the Sughd Regional Clinical Hospital for the period 2018-2019 for the frequency of osteoporosis (OP). Densitometry was used to determine the projection mineral density (in g / cm2) in various parts of the skeleton.Results. When asked about a history of fractures, every third respondent (33.3%) answered positively. According to the results of densitometry, osteoporosis in patients with inflammatory RD was diagnosed in 32.2% of patients. At the same time, the indicators differed significantly by nosology, and the frequency of OP correlated with the intake of corticosteroids. Osteoporosis was detected in every third patient with OA according to densitometry data and in 25% of cases in patients with gout. The results of the analysis to assess the absolute risk of major osteoporotic fractures according to FRAX showed high risk in 2 groups.Conclusion. Thus, the nature and frequency of risk factors for osteoporosis in patients with RA and OA have their characteristics. A history of fractures in patients with RA is often associated with long-term use of GCS, and the presence of menopause in women and the presence of cardiometabolic concomitant diseases play an important role in the progression of AP in patients with OA.

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High Bone Mineral Density of the Lumbar Spine Is Positively Associated with Breast Cancer

BioMed Research International ◽

10.1155/2019/8010356 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Larissa Vaz Gonçalves ◽

Karine Anusca Martins ◽

Jordana Carolina Marques Godinho-Mota ◽

Raquel Machado Schincaglia ◽

Ana Luisa Lima Sousa ◽

...

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Menopausal Status ◽

Total Sample ◽

University Hospital ◽

High Bone Mineral Density ◽

Mineral Density

Objective. The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. Methods. A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1–L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. Results. Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02–5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. Conclusions. High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed.

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