scholarly journals Bone Metabolism in Adolescents Undergoing Bariatric Surgery

2020 ◽  
Author(s):  
Madhusmita Misra ◽  
Miriam A Bredella
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Cross Sectional ◽  
Peripheral Skeleton

Abstract Purpose The prevalence of childhood obesity has increased over past decades with a concomitant increase in metabolic and bariatric surgery (MBS). While MBS in adults is associated with bone loss, only a few studies have examined the effect of MBS on the growing skeleton in adolescents. Methods This mini-review summarizes available data on the effects of the most commonly performed MBS (sleeve gastrectomy and gastric bypass) on bone in adolescents. A literature review was performed using PubMed for English-language articles. Results Dual-energy x-ray absorptiometry (DXA) measures of areal bone mineral density (aBMD) and BMD Z scores decreased following all MBS. Volumetric BMD (vBMD) by quantitative computed tomography (QCT) decreased at the lumbar spine while cortical vBMD of the distal radius and tibia increased over a year following sleeve gastrectomy (total vBMD did not change). Reductions in narrow neck and intertrochanteric cross-sectional area and cortical thickness were observed over this duration, and hip strength estimates were deleteriously impacted. Marrow adipose tissue (MAT) of the lumbar spine increased while MAT of the peripheral skeleton decreased a year following sleeve gastrectomy. The amount of weight loss and reductions in lean and fat mass correlated with bone loss at all sites, and with changes in bone microarchitecture at peripheral sites. Conclusion MBS in adolescents is associated with aBMD reductions, and increases in MAT of the axial skeleton, while sleeve gastrectomy is associated with an increase in cortical vBMD and decrease in MAT of the peripheral skeleton. No reductions have been reported in peripheral strength estimates.

scholarly journals Dairy Food Intake Is Not Associated with Measures of Bone Microarchitecture in Men and Women: The Framingham Osteoporosis Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3940
Author(s):  
Courtney L. Millar ◽  
Douglas P. Kiel ◽  
Marian T. Hannan ◽  
Shivani Sahni
Keyword(s):  
Food Intake ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Distal Tibia ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Cross Sectional ◽  
Dairy Food ◽  
Men And Women ◽  
Dairy Foods

Previous studies reported that dairy foods are associated with higher areal bone mineral density (BMD) in older adults. However, data on bone strength and bone microarchitecture are lacking. We determined the association of dairy food intake (milk, yogurt, cheese, milk + yogurt, and milk + yogurt + cheese, servings/week) with high resolution peripheral quantitative computed tomography (HR-pQCT) measures of bone (failure load, cortical BMD, cortical thickness, trabecular BMD, and trabecular number). This cross-sectional study included participants with diet from a food frequency questionnaire (in 2005–2008 and/or 1998–2001) and measurements of cortical and trabecular BMD and microarchitecture at the distal tibia and radius (from HR-pQCT in 2012–2015). Sex-specific multivariable linear regression estimated the association of dairy food intake (energy adjusted) with each bone measure adjusting for covariates. Mean age was 64 (SD 8) years and total milk + yogurt + cheese intake was 10.0 (SD 6.6) and 10.6 (6.4) servings/week in men and women, respectively. No significant associations were observed for any of the dairy foods and bone microarchitecture measures except for cheese intake, which was inversely associated with cortical BMD at the radius (p = 0.001) and tibia (p = 0.002) in women alone. In this cohort of primarily healthy older men and women, dairy intake was not associated with bone microarchitecture. The findings related to cheese intake and bone microarchitecture in women warrant further investigation.

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 Trabecular bone scores in young HIV-infected men: a matched case-control study

2020 ◽  
Author(s):  
Youn Jeong Kim ◽  
Kwi Young Kang ◽  
Juyoung Shin ◽  
Yoonhee Jun ◽  
Sang Il Kim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Cross Sectional ◽  
Young Males ◽  
Matched Case

Abstract Background Screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) is recommended for male HIV-infected patients only above the age of 50. Recently, trabecular bone score (TBS) has been introduced as a novel tool to assess bone microarchitecture using DXA of the lumbar spine. Few studies have reported TBS values in HIV-infected individuals younger than 50 years of age. This study compared TBS values in young males infected with HIV and matched controls, and investigated the associations between TBS and demographic parameters, clinical parameters, and bone mineral density (BMD) scores. Methods A cross-sectional study of BMD and TBS in HIV-infected men (n = 80) aged between 18 and 50 years and age- and sex-matched controls (n = 80) was conducted. Results The proportion of patients with low BMD (Z-score ≤−2) was significantly greater among HIV-infected patients than among matched controls (21.3% [17/80] vs. 8.8% [7/80], p = 0.027). Mean TBS values were significantly lower in HIV-infected patients than in controls (1.41 ± 0.07 vs. 1.45 ± 0.07, p = 0.008). In both groups, TBS values were positively correlated with BMD at the lumbar spine, femoral neck, and total hip (p < 0.001); however, TBS was not correlated with body mass index. In the HIV group, TBS was negatively correlated with the duration of tenofovir disoproxil fumarate(TDF) exposure (p = 0.04). Conclusion Young men infected with HIV had abnormal bone trabecular microarchitecture, as assessed by both TBS and BMD. TBS values were correlated with both BMD and the duration of TDF exposure.

scholarly journals Long-term Bone Loss and Deterioration of Microarchitecture After Gastric Bypass in African American and Latina Women

2020 ◽  
Author(s):  
Alexandra Krez ◽  
Sanchita Agarwal ◽  
Mariana Bucovsky ◽  
Donald J McMahon ◽  
Yizhong Hu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
African American ◽  
Bone Loss ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Latina Women ◽  
Mineral Density

Abstract Context The prevalence of obesity is burgeoning among African American and Latina women; however, few studies investigating the skeletal effects of bariatric surgery have focused on these groups. Objective To investigate long-term skeletal changes following Roux-en-Y gastric bypass (RYGB) in African American and Latina women. Design Four-year prospective cohort study. Patients African American and Latina women presenting for RYGB (n = 17, mean age 44, body mass index 44 kg/m2) were followed annually for 4 years postoperatively. Main Outcome Measures Dual-energy x-ray absorptiometry (DXA) measured areal bone mineral density (aBMD) at the spine, hip, and forearm, and body composition. High-resolution peripheral quantitative computed tomography measured volumetric bone mineral density (vBMD) and microarchitecture. Individual trabecula segmentation-based morphological analysis assessed trabecular morphology and connectivity. Results Baseline DXA Z-Scores were normal. Weight decreased ~30% at Year 1, then stabilized. Parathyroid hormone (PTH) increased by 50% and 25-hydroxyvitamin D was stable. By Year 4, aBMD had declined at all sites, most substantially in the hip. There was significant, progressive loss of cortical and trabecular vBMD, deterioration of microarchitecture, and increased cortical porosity at both the radius and tibia over 4 years. There was loss of trabecular plates, loss of axially aligned trabeculae, and decreased trabecular connectivity. Whole bone stiffness and failure load declined. Risk factors for bone loss included greater weight loss, rise in PTH, and older age. Conclusions African American and Latina women had substantial and progressive bone loss, deterioration of microarchitecture, and trabecular morphology following RYGB. Further studies are critical to understand the long-term skeletal consequences of bariatric surgery in this population.

scholarly journals Protocol for a pilot randomised controlled trial of zoledronic acid to prevent bone loss following sleeve gastrectomy surgery

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e057483
Author(s):  
Laura E Flores ◽  
Lynn Mack ◽  
Christopher Wichman ◽  
Ashley A Weaver ◽  
Vishal Kothari ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Lumbar Spine ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Controlled Trial ◽  
Menopausal Status ◽  
Rapid Weight Loss ◽  
Mineral Density ◽  
Total Hip ◽  
Vitamin D Levels

IntroductionSleeve gastrectomy (SG) is an increasingly used and effective treatment for obesity; however, the rapid weight loss associated with SG adversely affects bone metabolism predisposing patients to skeletal fragility. Bisphosphonate medications have been evaluated for safety and efficacy in combating bone loss in patients with osteoporosis, but their use in SG-induced bone loss is limited. The goal of this study is to investigate how a one-time infusion of zoledronic acid compares to placebo, in its ability to combat SG-associated bone loss.Methods and analysisThis research protocol is a 9-month, pilot randomized controlled trial (RCT) involving 30 adult SG patients randomised to receive an infusion of either 5 mg of zoledronic acid or placebo, 6 weeks following surgery. To be included participants must be <350 lbs/158.8 kg, free of bone-impacting pathologies or medications, and must have adequate serum calcium and vitamin D levels at baseline. The primary outcome is change in areal bone mineral density (aBMD) at the total hip. Secondary outcomes include change in aBMD of the femoral neck, and lumbar spine, and change in volumetric BMD at the lumbar spine. The primary aim will be tested using a linear mixed model fit with total hip aBMD at 9 months as the outcome. Treatment, participant sex and menopausal status will be considered in analysis. Groups will be compared using contrast statements at 9 months, with change over 9 months being the primary comparison.Ethics and disseminationThis study was approved by the Institutional Review Board of the University of Nebraska Medical Center (IRB820-19). Written consent will be obtained from participants at enrolment by trained staff. Careful and thorough explanation are used in obtainment of consent and voluntariness is emphasised throughout the trial. The findings of this study will be presented locally, nationally, and published in peer-reviewed journals. Additional details will be reported on ClinicalTrials.gov.Trial registration numberNCT04279392

scholarly journals Trabecular bone scores in young HIV-infected men: a matched case-control study

2019 ◽  
Author(s):  
Youn Jeong Kim ◽  
Kwi Young Kang ◽  
Yoonhee Jun ◽  
Sang Il Kim ◽  
Kim Yang Ree
Keyword(s):  
Lumbar Spine ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Cross Sectional ◽  
Young Males ◽  
Matched Case

Abstract Background Screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) is recommended for male HIV-infected patients only above the age of 50. Recently, trabecular bone score (TBS) has been introduced as a novel tool to assess bone microarchitecture using DXA of the lumbar spine. Few studies have reported TBS values in HIV-infected individuals younger than 50 years of age. This study compared TBS values in young males infected with HIV and matched controls, and investigated the associations between TBS and demographic parameters, clinical parameters, and bone mineral density (BMD) scores. Methods A cross-sectional study of BMD and TBS in HIV-infected men (n = 80) aged between 18 and 50 years and age- and sex-matched controls (n = 80) was conducted. Results The proportion of patients with low BMD (Z-score ≤−2) was significantly greater among HIV-infected patients than among matched controls (21.3% [17/80] vs. 8.8% [7/80], p = 0.027). Mean TBS values were significantly lower in HIV-infected patients than in controls (1.41 ± 0.07 vs. 1.45 ± 0.07, p = 0.008). In both groups, TBS values were positively correlated with BMD at the lumbar spine, femoral neck, and total hip (p < 0.001); however, TBS was not correlated with body mass index. In the HIV group, TBS was negatively correlated with the duration of tenofovir disoproxil fumarate(TDF) exposure (p = 0.04). Conclusion Young men infected with HIV had abnormal bone trabecular microarchitecture, as assessed by both TBS and BMD. TBS values were correlated with both BMD and the duration of TDF exposure.

RELATIONSHIP BETWEEN SERUM OC AND SCTX WITH BONE MINERAL DENSITY IN PREDICTING BONE LOSS AND TREATING FOR POSTMENOPAUSAL OSTEOPOROSIS WOMEN OVER 45 YEARS OLD WITH FOSAMAX PLUS THERAPY

2017 ◽  
pp. 126-231
Author(s):  
Van Duc Tran ◽  
Van An Le ◽  
Hai Thuy Nguyen
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Prospective Study ◽  
Key Words ◽  
Postmenopausal Osteoporosis ◽  
Negative Correlation ◽  
Mineral Density ◽  
Cross Sectional ◽  
Femur Neck

Backgrounds: Serum OC and ssCTX are correlated with BMD and have early changes under antiresorptive therapies. This study was aimed to find correlations between serum OC, sCTX and BMD changes in women over 45 and evaluated early changes of the two markers in postmenopausal osteoporotic women with Fosamax plus therapy. Materials and Methods: Cross-sectional and prospective study. 142 women over 45 were tested for serum OC and sCTX and determined BMD at lumbar spine and femur neck. 37 postmenopausal osteoporotic women of the group were treated with Fosamax plus therapy. Results: OC and sCTX showed negative correlation with BMD of lumbar spine and femur neck in all of women over 45. The correlation between sCTX and BMD of femur neck was not significant. The lowest values of OC and sCTX to predict bone loss in non-osteoporotic women were 14.46ng/ml (ss = 76.1%, sp = 40%) and 396.25pg/ml (ss = 66%, sp = 52%). The decreasing rates of serum OC and sCTX after 3 and 6 months with Fosamax plus therapy were 41.6%, 55% (p ˂ 0.0001) and 78.3%, 72% (p ˂ 0.0001), respectively. Slow increasing rates of BMD at two sites were 4.2% (p ˂ 0.001) and 3.6% (p ˃ 0.05), irrespectively. Conclusions: OC and sCTX were inversely correlated to BMD of lumbar spine and femur neck in all of women over 45. The lowest values of OC and sCTX to predict bone loss in non-osteoporotic women were 14.46ng/ml and 396.25pg/ml. Serum OC và sCTX decreased early in comparision to BMD improvement in postmenopausal osteoporotic women with Fosamax plus therapy. Key words: oC, sCTX, postmenopausal osteoporotic women, Fosamax plus

scholarly journals The Effects of Ivacaftor on Bone Density and Microarchitecture in Children and Adults with Cystic Fibrosis

2020 ◽  
Author(s):  
Melissa S Putman ◽  
Logan B Greenblatt ◽  
Michael Bruce ◽  
Taisha Joseph ◽  
Hang Lee ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Bone Density ◽  
Outcome Measures ◽  
Bone Microarchitecture ◽  
Medical Center ◽  
Academic Medical Center ◽  
Quantitative Computed Tomography ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
The Impact

Abstract Context Cystic fibrosis (CF) transmembrane conductance (CFTR) dysfunction may play a role in CF-related bone disease (CFBD). Ivacaftor is a CFTR potentiator effective in improving pulmonary and nutritional outcomes in patients with the G551D-CFTR mutation. The effects of ivacaftor on bone health are unknown. Objective To determine the impact of ivacaftor on bone density and microarchitecture in children and adults with CF. Design Prospective observational multiple cohort study. Setting Outpatient clinical research center within a tertiary academic medical center. Patients or Other Participants Three cohorts of age-, race-, and gender-matched subjects were enrolled: 26 subjects (15 adults and 11 children) with CF and the G551D-CFTR mutation who were planning to start or had started treatment with ivacaftor within 3 months (Ivacaftor cohort), 26 subjects with CF were not treated with ivacaftor (CF Control cohort), and 26 healthy volunteers. Interventions All treatments, including Ivacaftor, were managed by the subjects’ pulmonologists. Main Outcome Measures Bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT), areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) and bone turnover markers at baseline, 1, and 2 years. Results Cortical volume, area, and porosity at the radius and tibia increased significantly in adults in the Ivacaftor cohort. No significant differences were observed in changes in aBMD, trabecular microarchitecture, or estimated bone strength in adults or in any outcome measures in children. Conclusions Treatment with ivacaftor was associated with increases in cortical microarchitecture in adults with CF. Further studies are needed to understand the implications of these findings.

scholarly journals Trabecular bone scores in young HIV-infected men: a matched case-control study

2020 ◽  
Author(s):  
Youn Jeong Kim ◽  
Kwi Young Kang ◽  
Juyoung Shin ◽  
Yoonhee Jun ◽  
Sang Il Kim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Cross Sectional ◽  
Young Males ◽  
Matched Case

Abstract Background Screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) is recommended for male HIV-infected patients only above the age of 50. Recently, trabecular bone score (TBS) has been introduced as a novel tool to assess bone microarchitecture using DXA of the lumbar spine. Few studies have reported TBS values in HIV-infected individuals younger than 50 years of age. This study compared TBS values in young males infected with HIV and matched controls, and investigated the associations between TBS and demographic parameters, clinical parameters, and bone mineral density (BMD) scores. Methods A cross-sectional study of BMD and TBS in HIV-infected men (n = 80) aged between 18 and 50 years and age- and sex-matched controls (n = 80) was conducted. Results The proportion of patients with low BMD (Z-score ≤−2) was significantly greater among HIV-infected patients than among matched controls (21.3% [17/80] vs. 8.8% [7/80], p = 0.027). Mean TBS values were significantly lower in HIV-infected patients than in controls (1.41 ± 0.07 vs. 1.45 ± 0.07, p = 0.008). In both groups, TBS values were positively correlated with BMD at the lumbar spine, femoral neck, and total hip (p < 0.001); however, TBS was not correlated with body mass index. In the HIV group, TBS was negatively correlated with the duration of tenofovir disoproxil fumarate(TDF) exposure (p = 0.04). Conclusion Young men infected with HIV had abnormal bone trabecular microarchitecture, as assessed by both TBS and BMD. TBS values were correlated with both BMD and the duration of TDF exposure.

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