scholarly journals Preoperative and Postoperative Bone Mineral Density Change and Risk Factor Analysis in Patients with a GH-Secreting Pituitary Adenoma

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Li’nan Qin ◽  
Xiaopeng Guo ◽  
Lu Gao ◽  
Zihao Wang ◽  
Chenzhe Feng ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Pituitary Adenomas ◽  
Disease Duration ◽  
Femoral Shaft ◽  
Mineral Density ◽  
Total Hip

Purpose. This study analysed changes in bone mineral density (BMD) at different sites in patients with acromegaly and postoperative BMD changes and explored risk factors associated with BMD. Methods. Clinical data of 39 patients with growth hormone- (GH-) secreting pituitary adenomas and 29 patients with nonfunctioning pituitary adenomas who were newly diagnosed in neurosurgery from January 2016 to December 2018 were retrospectively analysed, including measurements of preoperative and postoperative BMD, serum GH glucose inhibition, random GH and IGF-1, and other anterior pituitary hormones. Results. The average patient age and disease duration were 43.74 (33.41–54.07) years and 72.15 (22.82–121.48) months, respectively. Compared with patients with nonfunctioning adenomas, patients with GH-secreting pituitary adenomas had significantly higher BMDs at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites (p<0.05). The BMD Z score at L1 and femoral neck sites significantly increased (p<0.05). Thirteen patients underwent re-examination of BMD 1 year postsurgery, and the BMD Z score was reduced to normal levels at L1, L2, L3, L4, L1-L4, and L2-L4 compared with preoperative levels (p<0.05). Postoperative BMD Z scores in the femoral neck and total hip were significantly increased (p<0.05). Disease duration was negatively correlated with the lumbar-spine BMD Z score. IGF-1 burden was negatively correlated with the BMD Z score at L1 and L1–L4. Multiple regression analysis showed that IGF-1 burden was a risk factor for a BMD Z score decrease at L1 and L1–L4. Conclusion. BMD in patients with GH-secreting pituitary adenomas (compared with nonfunctional adenomas) increased at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites. Lumbar-spine BMD Z score recovered to normal levels postsurgically when GH and IGF-1 levels were controlled. BMD Z score was negatively correlated with disease duration and IGF-1 burden in patients with GH-secreting pituitary adenomas, and IGF-1 burden was an independent risk factor for reduced lumbar-spine BMD Z score.

scholarly journals Reduction in femoral neck and total hip bone mineral density following hospitalisation for diabetes-related foot ulceration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marcel M. Nejatian ◽  
Salar Sobhi ◽  
Blake N. Sanchez ◽  
Kathryn Linn ◽  
Laurens Manning ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fat Mass ◽  
Mineral Density ◽  
Contralateral Limb ◽  
Foot Ulceration ◽  
Total Hip ◽  
Hip Bmd

AbstractManagement of diabetes-related foot ulceration (DFU) includes pressure offloading resulting in a period of reduced activity. The metabolic effects of this are unknown. This study aims to investigate changes in bone mineral density (BMD) and body composition 12 weeks after hospitalisation for DFU. A longitudinal, prospective, observational study of 22 people hospitalised for DFU was conducted. Total body, lumbar spine, hip and forearm BMD, and total lean and fat mass were measured by dual-energy X-ray absorptiometry (DXA) during and 12 weeks after hospitalisation for DFU. Significant losses in total hip BMD of the ipsilateral limb (− 1.7%, p < 0.001), total hip BMD of the contralateral limb (− 1.4%, p = 0.005), femoral neck BMD of the ipsilateral limb (− 2.8%, p < 0.001) and femoral neck BMD of the contralateral limb (− 2.2%, p = 0.008) were observed after 12 weeks. Lumbar spine and forearm BMD were unchanged. HbA1c improved from 75 mmol/mol (9.2%) to 64 mmol/mol (8.0%) (p = 0.002). No significant changes to lean and fat mass were demonstrated. Total hip and femoral neck BMD decreased bilaterally 12 weeks after hospitalisation for DFU. Future research is required to confirm the persistence and clinical implications of these losses.

scholarly journals Positive Effect of Teriparatide on Areal Bone Mineral Density in Young Women with Anorexia Nervosa: A Pilot Study

2021 ◽  
Author(s):  
Gabriella Milos ◽  
Hanspeter Moergeli ◽  
Cynthia Sob ◽  
Doris Wisler ◽  
Mariusz Wasila ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Anorexia Nervosa ◽  
Lumbar Spine ◽  
Pilot Study ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Young Women ◽  
Fragility Fracture ◽  
Mineral Density ◽  
Total Hip

AbstractThe present pilot study investigated the effect of Teriparatide 1–34 rh-PTH (TPT) in young women diagnosed with anorexia nervosa (AN), and markedly compromised Bone Mineral Density (BMD). Patients were included who had (i) very low BMD (defined as Z-Score <  − 2.5 or T-Score <  − 2.5 if available) in at least one of the assessed localizations (lumbar spine L1–L4, total hip, femoral neck) without any previous fragility fracture; or (ii) low bone mineral density (defined as Z-Score <  − 1.5 or T-Score <  − 1.5 if available) in at least one of the assessed localizations (lumbar spine L1–L4, total hip, femoral neck) and at least one previous fragility fracture. Ten patients with an age range of 21–33 were recruited and their bone outcome was assessed after 12, 18, and 24 months. After 24 months of TPT treatment, BMD improved by 13.5% in the spine, 5.0% in the femoral neck, and 4.0% in the hip. Radius cortical bone density (− 2.6%) and radius cortical thickness (− 6.4%) decreased significantly, while in tibia there was no significant decrease. Neither in radius nor in tibia a significant change in trabecular bone parameters occurred. During the treatment, the patients’ body weight did not increase significantly. Patients did not experience severe adverse events; only mild side effects were observed. Although these results emerged from a single-arm prospective study, it seems that AN patients with a severely compromised bone situation can benefit from TPT. Larger studies are needed to ascertain the effect of this promising substance.

scholarly journals Association between renal function and bone mineral density in healthy postmenopausal Chinese women

2019 ◽  
Author(s):  
Shuang Li ◽  
Junkun Zhan ◽  
Yanjiao Wang ◽  
Yi Wang ◽  
Jieyu He ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Renal Function ◽  
Risk Factor ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Chinese Women ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip ◽  
The Relationship

Abstract Background: The relationship between renal function and bone mineral density (BMD) is controversial. The aim of this study was to determine the relationship of renal function with BMD and osteoporosis risk in healthy postmenopausal Chinese women. Methods: A cross-sectional study was conducted in 776 healthy postmenopausal Chinese women. Dual-energy X-ray absorptiometry was used to measure BMDs. Clinical, demographic, and biochemical data were obtained at the time of image acquisition. Estimated glomerular filtration rate (eGFR) was calculated using a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Results: Women with eGFR levels of at least 90 ml/min/1.73 m 2 had a lower prevalence of osteoporosis compared with women with decreased eGFR levels (eGFR <90.0 ml/min/1.73 m 2 ). BMDs at femoral neck and total hip were significantly lower in the lower eGFR class than the higher class (0.717 ± 0.106 vs 0.744 ± 0.125 g/cm 2 , P < 0.01; 0.796 ± 0.116 vs 0.823 ± 0.129 g/cm 2 , P < 0.01, respectively). eGFR was positively correlated with BMDs at femoral neck and total hip in unadjusted analysis ( P <0.05). After controlling for age, menopausal duration and body mass index (BMI), decreased eGFR was not a risk factor for osteoporosis. Conclusions: After adjustments for age, menopausal duration and BMI, the decline in renal function was not an independent risk factor for osteoporosis in healthy postmenopausal Chinese women.

scholarly journals Changes in Bone Mineral Density Following Conventional Oral Phosphonate Treatment of Hypophosphatemic Osteomalacia: a case-control study

2019 ◽  
Author(s):  
Yue Guo ◽  
Xian-Ping Wu ◽  
Ying-Hui Zhou ◽  
Chen-Yi Tang ◽  
Min Wang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Conventional Treatment ◽  
Control Group ◽  
Mineral Density ◽  
Total Hip ◽  
Hypophosphatemic Osteomalacia ◽  
Phosphate Supplementation

Abstract Background: There are limited clinical studies aimed at solving the problem of the efficiency of conventional treatment with oral phosphate and calcitriol in adults with hypophosphatemic osteomalacia (HO). In addition, there still had no good non-hazardous markers to evaluate the severity of bone loss of osteomalacia before and after treatment. Therefore, the purpose of this study was to assess the efficacy of conventional treatment with a self-blended phosphate supplementation and calcitriol on patients with HO and whether bone mineral density (BMD) can helpful for monitoring the efficacy. Methods: 21 HO patients and 105 healthy controls were enrolled. HO patients with calcium and calcitriol were divided into three phosphate treatment groups: Patients in group A (n=3) received continuous phosphate supplementation, patients in group B (n=5) received intermittent phosphate supplementation and patients in group C (n=3) received no phosphate supplementation. 11 of 21 HO patients were recalled for detection of BMD of the lumbar spine (L1–L4), femoral neck, and total left hip three years after the treatment. Results: The average initial serum phosphorus level of the patient group was approximately 50% lower than that of the control group. Lower BMD was significantly observed in the HO group than the control group at the lumbar spine and total hip. Continuous treatment with the phosphate supplement could increase BMD in the lumbar spine and total hip by 33.4–52.3% and the femoral neck increased by 43.2–79.3% compared with baseline, and the effect appears to be continued once treatment is discontinued. Conclusions: These findings suggest that conventional therapy can improve bone mineral defects in patients with HO, especially in the femoral neck. Detection of BMD in HO patients is a good tool to assess the extent of bone defects and the therapeutic effect.

Bone Mineral Density Change in Systemic Lupus Erythematosus: A 5-year Followup Study

2014 ◽  
Vol 41 (10) ◽  
pp. 1990-1997 ◽  
Author(s):  
Tracy Y. Zhu ◽  
James F. Griffith ◽  
Sze-Ki Au ◽  
Xiao-Lin Tang ◽  
Anthony W. Kwok ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Total Hip

Objective.To determine changes of bone mineral density (BMD) over a 5-year period in a cohort of female patients with systemic lupus erythematosus (SLE) and to identify factors predictive of BMD loss.Methods.Our longitudinal study involved 125 female patients with SLE with a mean (SD) age of 46.5 years (10.1) and a median disease duration of 10.4 years. Demographics and clinical data were collected and BMD at the femoral neck, total hip, and lumbar spine (L1-4) was performed by using dual-energy x-ray absorptiometry at baseline and followup.Results.Average percentage changes of BMD over a mean followup of 5 years were −2.41% at the femoral neck, −1.63% at the total hip, and −0.62% at the lumbar spine, with significant changes at both the femoral neck (p < 0.0001) and total hip (p < 0.0005), but not at the lumbar spine (p = 0.128). Disease flare, new organ damage, and use of glucocorticoids during followup were significantly associated with larger decreases in BMD. BMD loss was arrested at the femoral neck and BMD increased at the total hip and lumbar spine in patients receiving antiosteoporosis therapy. In multivariate analyses, use of antiosteoporosis therapy was independently associated with increased BMD at any site and new organ damage was an independent predictor of BMD loss at the femoral neck.Conclusion.Significant BMD loss at the hip over a period of 5 years was found in patients with SLE. Disease activity, disease damage, and use of glucocorticoids are the disease-specific variables that contribute to bone loss in SLE.

scholarly journals Dose-dependent effects of inhaled corticosteroids on bone mineral density in postmenopausal women with asthma or COPD: A registry-based cohort study

2017 ◽  
Author(s):  
Wenjia Chen ◽  
Kate M. Johnson ◽  
J. Mark FitzGerald ◽  
Mohsen Sadatsafavi ◽  
William D. Leslie
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip ◽  
Hip Bmd ◽  
Sectional Analysis

ABSTRACTBackgroundThe effect of long-term inhaled corticosteroid (ICS) therapy on the bone health of older adults remains unclear due to its possible impact on bone mineral density (BMD).ObjectiveTo evaluate, cross-sectionally and longitudinally, the impact of ICS use on BMD in postmenopausal women with asthma or chronic obstructive pulmonary disease (COPD).MethodsWe used a population-based bone densitometry registry linked with administrative health data of the province of Manitoba, Canada (1999–2013), to identify women with diagnosed asthma or COPD. ICS use was defined as cumulative dispensed days prior to baseline BMD (cross-sectional analysis), and medication possession ratio (MPR) between two BMD measurements (longitudinal analysis). Results were adjusted for multiple covariates including the underlying respiratory diagnosis and its severity.ResultsIn the cross sectional analysis, compared with non-users, women with the highest tertile of prior ICS exposure had lower baseline BMD at the femoral neck (-0.09 standard deviations [SD] below a healthy young adult, 95% CI: −0.16, −0.02) and total hip (-0.14 SD, 95% CI: −0.22, −0.05), but not at the lumbar spine. Longitudinally, the highest tertile of ICS exposure was associated with a slight decline in total hip BMD relative to non-users (-0.02 SD/year, 95% CI: −0.04, −0.01), with no significant effect at the femoral neck and lumbar spine. Middle and lower tertiles of ICS use had no significant effects.ConclusionHigh exposure to ICS was associated with a small adverse effect on baseline hip BMD and total hip BMD loss in post-menopausal women with asthma or COPD.

scholarly journals Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096469
Author(s):  
Shuai Lu ◽  
Maoqi Gong ◽  
Yejun Zha ◽  
Aimin Cui ◽  
Chen Chen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Great Trochanter ◽  
Severe Damage ◽  
Mineral Density ◽  
Total Hip ◽  
Z Scores

Objective Primary hyperparathyroidism (PHPT) is relatively common in China and results in severe damage to the skeletal system. This study aimed to investigate changes in bone mineral density (BMD) over 2 years in patients with PHPT after parathyroidectomy. Methods This retrospective cohort study included patients with PHPT who underwent parathyroidectomy between January 2010 and December 2015. BMD and T-scores and Z-scores of the lumbar spine (L1, L2, L3, and L4) and total hip (femoral neck, great trochanter, and Ward’s triangle) at baseline and 2 years after surgery were measured by dual-energy X-ray absorptiometry. Results Thirty patients with moderate to severe PHPT (17 men and 13 women) aged 38.90±15.48 years were included. BMD, and T-score and Z-score values at the lumbar spine and total hip at 6 months, 1 year, and 2 years after parathyroidectomy were significantly improved compared with preoperative values. Improvement in BMD was largest at L4 (46.7%) and smallest at L1 (37.4%) in the lumbar spine 2 years after parathyroidectomy. For the total hip, the increase in BMD was largest at Ward’s triangle (42.6%) and smallest at the femoral neck (37.5%). Conclusions BMD of the lumbar spine and total hip is improved after parathyroidectomy in patients with PHPT.

scholarly journals Bone Mineral Density Response With Denosumab in Combination With Standard or High-Dose Teriparatide: The DATA-HD RCT

2019 ◽  
Vol 105 (3) ◽  
pp. 890-897 ◽  
Author(s):  
Sabashini K Ramchand ◽  
Natalie L David ◽  
Benjamin Z Leder ◽  
Joy N Tsai
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Total Duration ◽  
Response Rates ◽  
High Dose ◽  
Mineral Density ◽  
Total Hip

Abstract Context In the Denosumab and High-Dose Teriparatide Administration (DATA-HD) study, we reported that 15 months of combined high-dose (HD) teriparatide and denosumab increased mean areal bone mineral density (aBMD) at the hip and spine more than combined denosumab and standard-dose (SD) teriparatide. Objective In the current analysis, we compare the individual rates of aBMD response between the treatment groups. Design Single-site, open-label, randomized controlled trial in which postmenopausal women received either teriparatide 20-μg daily (SD) or 40-μg daily (HD) given months 0 through 9, overlapped with denosumab 60 mg, given months 3 through 15 (15 months’ total duration). The proportion of participants in the SD and HD groups experiencing total hip, femoral neck, and lumbar spine aBMD gains of &gt;3%, &gt;6%, and &gt;9% were compared. Participants Postmenopausal women with osteoporosis completing all study visits (n = 60). Main outcome measure(s) aBMD (dual x-ray absorptiometry). Results At the end of the 15-month treatment period, a higher proportion of women in the HD group had aBMD increases &gt;3% (83% vs. 58%, P = .037) and &gt;6% (45% vs. 19%, P = .034) at the total hip, and &gt;3% at the femoral neck (86% vs. 63%, P = .044). At the lumbar spine, &gt;3% response rates were similar, whereas the &gt;6% and &gt;9% response rates were greater in the HD group (100% vs. 79%, P = .012 and 93% vs. 59%, P = .003, respectively). Conclusion Compared with the SD regimen, more women treated with the HD regimen achieved clinically meaningful and rapid gains in hip and spine aBMD. These results suggest that this approach may provide unique benefits in the treatment of postmenopausal osteoporosis.

scholarly journals Effects of Teriparatide in Postmenopausal Women with Osteoporosis on Prior Alendronate or Raloxifene: Differences between Stopping and Continuing the Antiresorptive Agent

2009 ◽  
Vol 94 (10) ◽  
pp. 3772-3780 ◽  
Author(s):  
Felicia Cosman ◽  
Robert A. Wermers ◽  
Christopher Recknor ◽  
Karen F. Mauck ◽  
Li Xie ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Total Hip ◽  
Hip Bmd ◽  
Switch Group

Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures: We measured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401%); bone ALP (15 vs. 71%); βCTX (27 vs. 250%); all P &lt; 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. −0.8%; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8%; P = 0.003) and total hip (3.2 vs. 0.9%; P = 0.02), but not in femoral neck (2.7 vs. 2.3%; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259%; P &lt; 0.001), bone ALP (31 vs. 44%; P = 0.035), and βCTX (67 vs. 144%; P = 0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5%; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1%), total hip (2.8 vs. 1.8%), and femoral neck (3.8 vs. 2.2%) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide. In patients treated with alendronate or raloxifene, adding teriparatide results in a greater bone mineral density response, and appears to be at least as safe as switching to teriparatide.

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