scholarly journals Bone Mineral Density Utilization in Patients with Newly Diagnosed Multiple Myeloma: A Single Center Experience

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5386-5386
Author(s):  
Eli Muchtar ◽  
Adi Zelig ◽  
Eyal Robenshtok ◽  
Tzippy Shochat ◽  
Nino Oniashvili ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Vertebral Fracture ◽  
Bone Mineral ◽  
Advisory Board ◽  
Time Interval ◽  
Mineral Density ◽  
T Score ◽  
The Mean

Abstract Introduction: Bone disease is a major cause for morbidity in multiple myeloma (MM), mainly manifested by osteolytic lesions. Bone mineral loss is another aspect of bone involvement, although osteoporosis (with or without compression fractures) in the absence of osteolytic lesions is no more a criterion for treatment initiation in MM. Methods: We performed a retrospective study to evaluate the use of bone mineral density (BMD) exams by dual-energy X-ray absorptiometry (DXA) among MM patients in a tertiary medical care facility. We included 173 patients with symptomatic MM diagnosed between January 2007 and September 2014 who underwent BMD exam at diagnosis. The T-scores of lumbar spine (LS), left femur neck (FN) and left total hip (TH) were obtained and analyzed. In addition, we have specified the lowest T-score at each site. In patients with follow-up exam, we calculated the relative difference between the baseline and follow-up exams as the percentage change in absolute BMD value expressed in g/cm2 as follows: [(BMD at follow-up) - (BMD at baseline)/(BMD at baseline)]*100. Results: The mean lumbar spine T-score was (-1.3), while the low lumbar spine T-score was (-2.0). At the femur level, the mean FN T-score was (-1.5), while the mean TH T-score was (-1.1) and the mean low femur T-score was (-2.2). There was a strong correlation between spine and femur T-scores (r=0.56-0.61, p<0.0001). Nevertheless, on a multivariate regression analysis, different parameters correlated with the T-scores of the LS and the femur sites. The following variables were encountered as significantly associated with the mean T-score value at the lumbar spine: sex (β coefficient= (-0.17), p=0.05), BMI (β coefficient=0.21, p=0.02) and vertebral fracture(s) (β coefficient= (-0.23), p=0.01). Conversely, the following variables were found to be independent predictors of the FN T-score: age (β coefficient= (-0.37), p<0.0001) and vertebral fracture (s) (β coefficient= (-0.25), p=0.005), whereas vitamin D showed a strong trend towards significance (β coefficient= (-0.15), p=0.08). Patients with light chain only disease had lower T-score values compared with patients with IgG myeloma, reaching significance at the femur sites [FN T-score (-1.7) vs. (-1.3), p=0.06; TH T-score (-1.3) vs. (-0.9), p=0.02; femur low T-score (-2.4) vs. (-1.8), p=0.008]. Patients with vertebral fracture(s) had significantly lower T-scores of the spine compared to patients without vertebral fractures. Sixty-three patients (36.4% of all patients) had a follow-up DXA exam at a median of 25 months from the baseline test (range, 12-82 months). Basically, LS T-scores increased, while femur sites' T-scores decreased during follow-up. This did not include patients who achieved complete response (CR) and/or retained it during follow-up, who had improved BMD results at the femur sites as well (Table). Conclusion: DXA-based BMD assessment of myeloma bone disease is a valuable tool that illustrates a differential myeloma-induced bone mineral loss regarding the lumbar spine and femur. Table.Variables associated with change of bone mineral density values at follow-up DXA exam in relation to exam at diagnosisVariable mean [range]Mean change at lumbar spine (LS)Mean change at femur neck (FN)Mean change at total hip (TH)Time interval between tests12-24 months (n=31)4.1% [(-10%) - 25.2%]-4.3% [(-24.8%) - 10.6%]-0.1% [(-17.4%) - 10.4%]Time interval >24 months (n=32)4.8% [(-3.8) - 16.4%]-1.7%[(-19.5%) - 27.2%]-0.1%[(-18.8%) - 14.9%]P value0.500.220.96Autologous stem cell transplantationYes (n=35)4.5% [(-7.6%) - 25.2%]-3.4%[(-24.8%) - 27.2%]-1.1%[(-18.8%) - 14.9%]No (n=28)4.3% [(-10.8) - 19.4%]-2.7%[(-18.3%) - 11.1%]-0.1%[(-17.9%) - 10.4%]P value0.890.760.77Response to first line treatmentCR/sCR (n=22)4.3%[(-10.8%) - 18.1%]0.1%[(-12%) - 18.1%]2.1%[(-10.6%) - 10.4%]Less than CR (n=41)4.5%[(-5.5) - 25.2%]-5%[(-24.8%) - 8.6%]-2.5%[(-18.8%) - 14.9%]P value0.910.010.01Disease status at FU testCR/sCR (n=15)3.9% [(-10.8%) - 19.4%]-1.2%[(-24.8%) - 27.2%]2.4%[(-10%) - 10.4%]Less than CR* (n=48)4.6% [(-5.5%) - 19.4%]-3.6%[(-10%) - 10.9%]-1.9%[(-18.8%) - 14.9%]P value0.80.350.03* All patients with partial response or very good partial response Disclosures Raanani: Pfizer: Other: Advisory Board; Novartis: Other: Advisory Board, Research Funding; BMS: Other: Advisory Board; Ariad: Other: Advisory Board.

scholarly journals POS1106 FRAX AND THE EFFECT OF TERIPARATIDE ON BONE MINERAL DENSITY IN SECONDARY OSTEOPOROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 833.2-834
Author(s):  
S. Garcia ◽  
B. M. Fernandes ◽  
M. Rato ◽  
F. Oliveira Pinheiro ◽  
D. Fonseca ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Fracture Probability ◽  
Mineral Density ◽  
T Score

Background:Teriparatide has been shown to increase spine and hip bone mineral density (BMD) and to reduce vertebral and non-vertebral fractures. (1) It is currently not clear whether the effect of teriparatide is dependent on the baseline risk of fracture or osteoporosis (OP) type, a finding that could have an impact on our therapeutic decision.Objectives:Investigate if there is a relationship between teriparatide effect in BMD and baseline 10-year fracture probability, assessed using FRAX®, in primary and secondary OP patients.Methods:This is a longitudinal, retrospective study including consecutive patients with the diagnosis of OP treated with teriparatide for 24 months, with a ten-year follow-up period, at our rheumatology department. Demographic, clinical, laboratorial, BMD and occurrence of fracture data were collected. The 10-year risk of osteoporotic fracture was estimated using the fracture risk assessment tool (FRAX) v 4.1 with the Portuguese population reference. Statistical analysis was performed using the software SPSS 23.0. Correlations between continuous variables were evaluated with spearman coefficient. p<0.05 was considered statistically significant.Results:Eighty patients (88.8% female, median age 65.00 (59; 75)) were included. Forty-nine patients (61.3%) has secondary OP, mainly of cortisonic etiology (61.2%, n=30). Before treatment, median lumbar spine BMD was 0.870 [0.767, 0.964] g/cm2, median T-score of -2.60 (-3.30, -1.90); median total femur BMD was 0.742 [0.667, 0.863] g/cm2, median T-score of -2.10 (-2.80, -1.30); median femoral neck BMD was 0.671 [0.611, 0.787] g/cm2, median T-score of -2.50 [-3.20, -1.85]. Regarding fracture risk, median FRAX-based 10-year major fracture risk (with BMD) at baseline was 16% [10.0; 23], and median hip fracture risk was 7.2% [3.4; 13.8].The median variation of BMD, after finishing teriparatide treatment, in the spine was 0.107 [0.029; 0.228]; median BMD variation in total femur was 0.013 [-0.013; 0.068] and median BMD femoral neck was 0.046 [-0.002; 0.109]. We observed a numerically superior effect, albeit without any statistical significance, of teriparatide on bone mineral density gain in secondary OP (versus primary OP) at lumbar spine, total femur and femoral neck.Most patients continued anti-osteoporotic treatment with a bisphosphonate (81.2%, n=65) and, during follow-up, 17 patients had an incident fracture (8 hip fractures and 6 vertebral fractures), median of 5 [1.75, 8.25] years after ending teriparatide.We found a discrete correlation between FRAX-based hip fracture probability and the variation of bone mineral density in total femur (Spearman’s coefficient 0.248, p = 0.04). There was no correlation between FRAX-based major fracture probability and and the variation of bone mineral density in the spine or femur. When we separately analyze the relationship between the variation in total hip BMD and the FRAX-based fracture risk, depending on whether it is a secondary or primary OP, we find that the correlation is stronger and only remains in secondary OP (Spearman’s coefficient 0.348, p = 0.03).Conclusion:Our data suggest that teriparatide could be an important weapon in the treatment of secondary cause OP, particularly cortisonic, and in patients at high fracture risk, although further larger studies are needed to confirm these findings.References:[1]Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner-Pammer A, Lespessailles E, Minisola S, Body JJ, Geusens P, Möricke R, López-Romero P. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet. 2018 Jan 20;391(10117):230-240. doi: 10.1016/S0140-6736(17)32137-2.Disclosure of Interests:None declared.

Bone Mineral Density Changes In Patients with Paraproteinemia After Treatment with Bortezomib

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4989-4989
Author(s):  
Tamara Berno ◽  
Kenneth Boucher ◽  
Fenghuang Zhan ◽  
Guido J. Tricot ◽  
Benjamin Mughal ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Disease ◽  
Proteasome Inhibitor ◽  
Mineral Density ◽  
T Score ◽  
The Mean

Abstract Abstract 4989 Background: Bone disease is present at diagnosis in almost all patients with multiple myeloma (MM) and can impact substantially on patient morbidity and quality of life. Decreased bone mineral density is also observed not only in MM but also in patients with monoclonal gammopathy of undetermined significance (MGUS). The pathogenesis of bone disease in MM is complex. The activity of proteasome inhibitor bortezomib has been linked to increased bone formation and osteoblastic activation. Evidence from the available clinical data indicates that bortezomib has a positive impact on bone health in MM and demonstrates a bone anabolic effect. Methods: We analyzed retrospectively 53 patients with MM and 16 with MGUS who have completed bone density at least at diagnosis. 21 patients have completed two bone density (3 MGUS and 18 MM). The bone density was obtained in all patients at baseline and in 16 patients repeated after bortezomib treatement with a median time of bortezomib exposure of 6 months. We analyzed T-score values at lumbar spine and at femoral neck. Results: With a median age of 66 years, 41 male and 28 female were analyzed. At baseline the mean lumbar spine T-score of all subjects and of 16 MM treated with bortezomib was -0.50 and -0.76 respectively. At baseline the mean femoral neck T-score for all subjects and for 16 MM treated with Bortezomib was -1.56 and -1.31 respectively. The baseline mean lumbar spine T-score for MGUS and MM was -0.71 and -0.43 respectively. The baseline mean femoral neck T-score of MGUS and MM was -1.61 and -1.54 respectively. In the group of 16 patients treated with Bortezomib we observed from baseline a change in lumbar bone mineral density T-score of 0.36 and at femoral neck bone density T-score of 0.25. Conclusion: These data show that patients treated with proteasome inhibitor showed moderate increment in bone mineral density at lumbar spine and at femoral neck. Disclosures: No relevant conflicts of interest to declare.

Impact of adjuvant aromatase inhibitors on bone mineral density in breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11616-e11616
Author(s):  
C. N. Lai ◽  
P. D. Correa ◽  
A. Alhasso
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Aromatase Inhibitors ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
T Score ◽  
Estrogen Production

e11616 Aims: It is well known that aromatase inhibitors (AI) are associated with significant reduction in bone mineral density (BMD) through suppression of estrogen production. This effect has been confirmed in several studies. It is considered important that we evaluate our patients and assess their baseline BMD in the adjuvant setting in relation to the use of AIs. Methods: 122 patients on adjuvant AI were evaluated retrospectively. AIs were used either as upfront, early switch or extended adjuvant therapy. BMD (T score for hip and lumbar spine) was evaluated using DEXA scanning at baseline and annually thereafter. Risk factors for osteoporosis were assessed prior to each scan. Results: Mean baseline T scores for lumbar spine and hip were - 0.95 and - 0.79 respectively. The corresponding T scores after 1 year of treatment were -1.06 and -0.92 respectively. This represents 10.6% and 17.4% reduction in T scores for the spine and hip. 24 patients (19.7%) required anti osteoporosis therapy on the basis of their baseline T Score and they were predominantly osteoporotic. 77 patients had chemotherapy as well and had a more significant reduction in their T scores (29% reduction at the hips) in comparison to non chemotherapy patients. Patients on upfront AIs had lower baseline mean T scores (- 0.932 at hip and - 1.119 at L- Spine) and at follow up (- 1.066 at hip and -1.165 at L spine) in comparison to those on the switch approach (baseline: - 0.666 hip, - 0.816 spine; follow up: - 0.809 hip, - 0.974 spine) Conclusions: AIs are associated with decreased BMD particularly for patients who had chemotherapy. Normal T scores at baseline are reassuring and in the absence of other risk factors probably do not require further scanning. Those with low T scores (<-1.5) will require continued follow up, however, the optimal scanning interval is not yet fully established and longer follow up is required. No significant financial relationships to disclose.

scholarly journals Determination of Indicators of Mineral Bone Density in Patients with Fibrous Changes in Liver Parenchema

2021 ◽  
Vol 6 (5) ◽  
pp. 158-162
Author(s):  
V. M. Zhdan ◽  
◽  
I. V. Ivanytskyi ◽  
Ju. A. Ishejkina
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Liver Fibrosis ◽  
Bone Tissue ◽  
Bone Mineral ◽  
Mineral Density ◽  
T Score ◽  
High Prevalence ◽  
The Mean

The purpose of the study was to determine the features of the development of osteoporotic changes in bones in patients with liver fibrosis against the background of non-alcoholic steatohepatosis. Materials and methods. 79 patients with non-alcoholic steatohepatosis and liver fibrosis were examined. 38 surveyed persons were women, 41 were men. The average age of the patients was 42.5±5.8 years. All patients were excluded from comorbidities for inclusion in the study. For female patients, it was imperative to maintain menstrual function. The degree of liver fibrosis was established based on 2D shear wave elastometry in SWE mode. The patients included to study have liver fibrosis F1 - F3 according to METAVIR. Determination of bone mineral density was performed using a DEXXUM T X-ray densitometer by dual energy absorptiometry. Results and discussion. In patients with fibrotic changes in the liver, a decrease in bone mineral density was found in 49.3%. Osteopenia and osteoporosis in women occurred in 47.4%, which was significantly more frequent than among men – 26.8%, p = 0.014. There was a significant relationship between the duration of the presence of steatohepatosis and the incidence of osteoporosis and osteopenia: among patients with a duration of steatohepatosis of less than 7 years, a decrease in bone mineral density was noted in 62.5% of cases, and with a duration of more than 7 years – already in 89.3% of patients (χ2 = 5.5; p = 0.011). Among patients with liver fibrosis F3 METAVIR, a decrease in bone mineral density was observed in 85.7%. Among patients with liver fibrosis F1-2 METAVIR, osteoporosis and osteopenia were found in 46% (p = 0.0008). In patients with METAVIR F3 fibrosis, osteoporotic changes were observed in 85.2% of cases. An isolated decrease in the mineral density of the lumbar spine was diagnosed in 12 (30.7% of patients with a decrease in bone mineral density). In 9 patients (23%), there was a combination of a decrease in mineral density of the spine with a decrease in mineral density of the hip, the mean T score of the vertebrae was -2.5±0.2, the mean T score of the femoral neck was 2.1±0.3. In patients with F1-F2 fibrosis METAVIR, bone mineral density decreased mainly to the level of osteopenia, isolated osteopenia of the lumbar spine was diagnosed in 18 (46%) patients, there was no decrease in hip mineral density in this group of patients, the mean criterion of T vertebrae was 1.5±0.15. Conclusion. Patients with steatohepatosis and hepatic fibrosis are characterized by a high prevalence of osteoporosis and osteopenia. The risk of developing this complication is higher in patients with fibrosis stages F3 METAVIR; the decrease in bone mineral density in patients with steatohepatosis and liver fibrosis is influenced not only by population risk factors, but also by the duration of the presence of steatohepatosis; the severity of liver fibrosis METAVIR affects the localization of changes in the bone tissue. In patients with degrees of fibrosis F1 - F2, trabecular bone tissue is affected, and in patients with degrees of fibrosis F3, trabecular and cortical bone tissue is equally affected

93 Does Spinal Bone Mineral Density Predict An Absolute 10 Year Probability of Sustaining A Major Osteoporotic Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Nandi ◽  
N Obiechina ◽  
A Timperley ◽  
F Al-Khalidi
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Negative Correlation ◽  
Pearson Correlation ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
T Score ◽  
The Mean

Abstract Introduction Spine and hip bone mineral density (BMD) have previously been shown to predict the risk of sustaining future fractures. Although these have been shown in population studies, there is a paucity of trials looking at the relationship between BMD and 10 year probability of major osteoporotic fractures (Using FRAX UK without BMD) in patients with previous fragility fractures. Aims To evaluate the correlation between spinal T-score and an absolute 10 year probability of sustaining a major osteoporotic fracture (using FRAX without BMD) in patients with prior fragility fractures. Methods A retrospective cross-sectional analysis of 202 patients (29 males and 173 females) with prior fragility fractures attending a fracture prevention clinic between January and August 2019 was performed. Patients with pathological and high impact traumatic fractures were excluded. The BMD at the spine was determined using the lowest T-score of the vertebrae from L1 to L4. Using the FRAX (UK) without BMD, the absolute 10 year probability of sustaining a major osteoporotic fracture was calculated for each patient. Statistical analysis was performed using SPSS 26 software. Results The mean T-score at the spine was −1.15 (SD +/− 1.90) for all patients, −0.68 (SD +/− 0.45) for males and − 1.23 (SD +/− 0.14) for females. The mean FRAX score without BMD for major osteoporotic fracture was 18.5% (SD +/− 8.84) for all patients, 11.41% (SD +/−0.62) and 19.7% (SD +/−0.68) for males and females respectively. Pearson correlation coefficient showed a statistically significant, slightly negative correlation between spinal T- score and the FRAX (UK) without BMD (r = −0.157; p &lt; 0.05). Correlation was not statistically significant when males (r = 0.109; p = 0.59) and females (r = 0.148; p = 0.053) were considered independently. Conclusion In patients with prior fragility fracture spinal BMD has a statistically significant negative correlation with an absolute 10 year probability of sustaining a major osteoporotic fracture.

Estimation of Central Osteopenia in Children With Chronic Polyarthritis Treated With Glucocorticoids

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1127-1130
Author(s):  
Antero Kotaniemi ◽  
Anneli Savolainen ◽  
Hannu Kautiainen ◽  
Heikki Kröger
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Size ◽  
Mineral Density ◽  
Volumetric Density ◽  
Chronic Polyarthritis ◽  
The Mean ◽  
Bone Volumetric Density

Study objective. To investigate the degree and determinants of osteopenia in juvenile chronic polyarthritis. Design. Retrospective case-control study of central bone mineral density. Setting. Rheumatism Foundation Hospital and Kuopio University Hospital, Finland. Subjects. A sample of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treated with systemic glucocorticoids and a control sample of 44 healthy girls matched for age. Main outcome measures. Bone mineral density and bone size (width) measured by dual-energy x-ray absorptiometry and bone volumetric density calculated as an approximation of true bone density at both the lumbar spine and femoral neck. Results. The girls with juvenile chronic arthritis had reduced bone mineral density, bone size, and bone volumetric density at both the lumbar spine and femoral neck (statistically significant findings, P = .022 for the bone size of the femoral neck and P &lt; .001 for the other parameters). At the spine, the mean bone mineral density was 80%, the mean bone size 89%, and the mean bone volumetric density 89% of the values in the control group. At the femoral neck, the values were 78%, 93%, and 83%, respectively. The groups were matched for age, but the girls with arthritis were smaller and lighter. In the juvenile arthritis group, the femoral bone mineral density and bone volumetric density and the spinal bone width correlated negatively with the mean glucocorticoid dose. Conclusion. Axial bone mineral density is clearly reduced in severe juvenile polyarthritis and is mediated by both decreased bone volumetric density and diminished growth.

scholarly journals TO DETERMINE THE PREVALENCE OF LOW BONE MINERAL DENSITY (OSTEOPENIA AND OSTEOPOROSIS) IN INDIAN PATIENTS WITH CIRRHOSIS OF LIVER AWAITING LIVER TRANSPLANTATION AS PER CURRENTLY USED HOLOGIC DXA DATABASE

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Sharad Deshmukh ◽  
Suchita Deshmukh ◽  
Sarojni A Parameswran ◽  
P Pirmanayagam ◽  
N Murgan ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Transplantation ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Indian Patients ◽  
History Of ◽  
The Mean ◽  
Cirrhosis Of Liver

Background: Abnormalities in the bone metabolism observed in chronic liver disease are referred to as hepatic osteodystrophy. Osteoporosis and osteopenia are each part of this condition. Both conditions have a significant impact on morbidity, causing fractures that may result in chronic pain, long-lasting immobility, and deformity. Prevalence of fracture in patients with liver transplantation ranges from 15% - 65%. A high rate of fracturing is seen within the initial 1–2 years after transplantation. Aim: To determine the prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation as per currently used Hologic DXA database Methods: This was a prospective observational study done at the department of gastroenterology and hepatology, Apollo Hospitals, Chennai from April 2011 to March 2013. All patients who fulfilled the inclusion criteria underwent detailed history taking, physical examination and relevant laboratory investigations. One hundred patients were selected for the scope of the study. Results: Sixty-eight per cent of patients were in the age group of 45 to 65 years. The mean age ± SD of the study subjects was 51.2 ± 9.7 years. The mean age for male patients was 50.5 ± 10.1 years, and for females was 54 ± 7.3 years. Cirrhosis was due to alcohol in 36% of the patients, viral hepatitis in 28% (HBV in 10% and HCV in 18%) patients. 42% were in Child’s class B, and the remaining 58% were in Child’s class C. MELD score was less than 20 in 62% patients. One third was diabetic; one third gave the history of backache. History of smoking was present in one fifth (20%) patients, and a history of fracture (most of them were traumatic) was present in 13% of patients. By using Hologic DXA database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 44% and 38 % patients respectively. At the femoral neck, osteopenia and osteoporosis were diagnosed in 45% and 9% of patients. By using ICMR database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 38% and 17% patients respectively. Similarly, at the femoral neck, osteopenia and osteoporosis were diagnosed in 34% and 5%. By using the Hologic DXA database, osteopenia and osteoporosis were diagnosed in 42% and 40 % patients. By using ICMR database, osteopenia and osteoporosis were diagnosed in 43% and 19% patients respectively. Conclusion: In light of the above results, the present study revealed a high prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation. The lumbar spine was the most frequently and severely affected site in hepatic osteodystrophy. Keywords: Osteopenia, Osteoporosis, Low Bone Mineral Density, Liver Cirrhosis

Bone Mineral Density Assessment by DXA vs. QCT in Postmenopausal Females with Central Obesity

2020 ◽  
Vol 13 (2) ◽  
pp. 153-161
Author(s):  
Lejla Milisic ◽  
Sandra Vegar-Zubovic ◽  
Amina Valjevac ◽  
Suada Hasanovic-Vučković
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Central Obesity ◽  
Quantitative Computed Tomography ◽  
Normal Weight ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.

scholarly journals Can lumbar spine bone mineral density predict readmission in denosumab-treated patients with chronic kidney disease?

2016 ◽  
Vol 65 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Ben-Chung Cheng ◽  
Ying-Chou Chen
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Kidney Diseases ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Mineral Density ◽  
Retrospective Case ◽  
T Score ◽  
Readmission Risk

This study investigated whether bone mineral density (BMD) affects readmission risk in patients with chronic kidney diseases (CKD) who received denosumab therapy. The study design was a retrospective case review of patients with CKD. Baseline age, sex, and body mass index were recorded for all patients included in the study. All comorbidities were recorded. All subjects underwent dual energy X-ray absorptiometry assay of the lumbar spine and right hip for BMD. The primary outcome was readmission. Predictive variables were categorized and compared between readmitted and non-readmitted patients. Logistic regression was used for multivariable analysis. A total of 121 patients with CKD who received denosumab therapy were enrolled. Of these, 29 were readmitted within 2 years, and 92 had no readmission. The lumbar BMD differed between the readmission (−2.94±0.68) and non-readmission (−2.09±1.48) groups. The readmission group had a lower T score than the non-readmission group. When adjusted for potential confounding factors, a decreased lumbar BMD had a higher readmission risk. When the cut-off points determined by receiver operating characteristic curve analysis were applied, the most precise point was set at a T score of −3. Osteoporosis in patients with CKD is associated with a high risk of readmission; the best predictor after denosumab therapy was the lumbar spine T score. A lower T score (especially if <−3) was associated with a higher probability of fracture readmission. It is essential to optimize primary and secondary prevention in these patients to improve their quality of life.

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