Osteoporotic Fractures and Vertebral Body Reshaping in Children with Glucocorticoid-Treated Rheumatic Disorders

2021 ◽  
Author(s):  
Leanne M Ward ◽  
Jinhui Ma ◽  
Marie-Eve Robinson ◽  
Maya Scharke ◽  
Josephine Ho ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Vertebral Body ◽  
Vertebral Deformity ◽  
Pediatric Population ◽  
Osteoporotic Fractures ◽  
First Year ◽  
Inception Cohort ◽  
Mineral Density ◽  
Z Scores

Abstract Purpose To evaluate the incidence and predictors of osteoporotic fractures and potential for recovery over six years following glucocorticoid (GC) initiation in children with rheumatic disorders. Methods Children with GC-treated rheumatic disorders were evaluated through a prospective inception cohort study led by the Canadian STeroid-induced Osteoporosis in the Pediatric Population (STOPP) Consortium. Clinical outcomes included lumbar spine bone mineral density (LS BMD), vertebral fractures (VF), non-VF, and vertebral body reshaping. Results 136 children with GC-treated rheumatic disorders were enrolled (mean age 9.9 years, SD 4.4). The six-year cumulative fracture incidence was 16.3% for VF, and 10.1% for non-VF. GC exposure was highest in the first six months, and 24/38 VF (63%) occurred in the first two years. Following VF, 16/19 children (84%) had complete vertebral body reshaping. Increases in disease activity and body mass index z-scores in the first year and declines in LS BMD z-scores in the first six months predicted incident VF over the six years, while higher average daily GC doses predicted both incident VF and non-VF. LS BMD z-scores were lowest at 6 months (mean -0.9, SD 1.2) and remained low by six years even when adjusted for height z-scores (-0.6, SD 0.9). Conclusions VF occurred early and were more common than non-VF in children with GC-treated rheumatic disorders. Eight-four percent of children with VF underwent complete vertebral body reshaping, while vertebral deformity persisted in the remainder of children. On average, LS BMD z-scores remained low at six years, consistent with incomplete recovery.

Abstract 4605: Increased Body Mass Index is Protective against Low Bone Mineral Density in Patients with Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Demetrius A Abshire ◽  
Debra K Moser ◽  
Jody L Clasey ◽  
Misook L Chung ◽  
Susan J Pressler ◽  
...  
Keyword(s):  
Heart Failure ◽  
Bone Mineral Density ◽  
Body Mass Index ◽  
Bone Mineral ◽  
Nyha Class ◽  
Obese Patients ◽  
Mineral Density ◽  
Patients With Heart Failure ◽  
Z Scores ◽  
Total Body

Patients with heart failure (HF) may be at greater risk for decreased bone mineral density (BMD) than similarly-aged healthy adults due to limited activity and medications. Being overweight or obese may protect against decreased BMD due to greater weight bearing and hormonal differences. However, these assumptions have never been tested. The purposes were to compare BMD between patients with HF and similarly-aged healthy adults, compare BMD among normal weight, overweight, and obese patients with HF, and determine whether body mass index (BMI) is a predictor of BMD in patients with HF. A total of 119 patients with HF (preserved or non-preserved systolic function, age = 61 ± 12 yrs, 61% NYHA Class III/IV) and 58 community-dwelling older adults free of cardiovascular disease (age = 70 ± 7 yrs) underwent total body dual-energy x-ray absorptiometry scans. Bone mineral density Z-scores (matched for sex, age, weight, and ethnicity) were compared between patients with HF and healthy elders. Patients with HF were divided into four BMI categories to compare differences in total body BMD by BMI. Multiple linear regression was used to test whether BMI predicted BMD in patients with HF after controlling for age, sex, and NYHA class. Patients with HF had lower total body area BMD Z-scores (0.32 ± 1.20) than the healthy elders (0.88 ± 1.30, p = 0.005). Within the HF group, those with a BMI <25 kg/m 2 had lower total body BMD (1.13 ± 0.13 g/cm 2 ) compared to those with BMIs of 25–29.9 kg/m 2+ (1.24 ± 0.13 g/cm 2 , p = 0.002), 30 –34 kg/m 2+ (1.23 ± 0.12 g/cm 2 , p = 0.019), and >34 kg/m 2 (1.26 ± 0.13 g/cm 2 , p < 0.001). In the multiple linear regression, BMI was a significant predictor of BMD in patients with HF (β= 0.337, p < 0.001), explaining an additional 11% of the variance beyond age, sex, and NYHA class (R 2 = 0.40, p <0.001). These results suggest that while HF is associated with decreased BMD, being overweight or obese may be protective against low BMD. This may be another example of better outcomes in overweight and obese patients with HF. This research has received full or partial funding support from the American Heart Association, AHA Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania & West Virginia).

scholarly journals Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8144
Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Oral Bisphosphonates ◽  
Mineral Density ◽  
X Ray ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

Effect Of Body Mass Index On Bone Mineral Density Is Age-specific

2021 ◽  
Author(s):  
Lavanya Cherukuri ◽  
April Kinninger ◽  
Divya Birudaraju ◽  
Suvasini Lakshmanan ◽  
Dong Li ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density

Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures

1998 ◽  
Vol 39 (5) ◽  
pp. 538-542 ◽  
Author(s):  
R. Andresen ◽  
S. Radmer ◽  
D. Banzer
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vertebral Body ◽  
Unknown Etiology ◽  
Insufficiency Fractures ◽  
Mineral Density ◽  
Group Iii ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: the clinical value of spinal quantitative CT (sQCT) and the structural patterns of the vertebral bone were studied Material and Methods: sQCT was performed on 246 patients with a mean age of 57 years for whom conventional lateral radiographies of the thoracic and lumbar spine were available. All patients were suffering from back pain of unknown etiology. the bone mineral density (BMD) of the midvertebral section of 3 lumbar vertebral bodies was determined by means of single-energy-(SE)-weighted QCT (85 kV). Spongiosa architecture and density profile analyses were made in the axial images. This was contrasted to BMD values ascertained in SE QCT. the mean BMD was compared to the number of fractures and the patients were divided into three groups: group I — no fracture; group II — one fracture; and group III 1 fracture Results: the mean BMD was: 134.3 (74.1–187.5) mg hydroxyapatite (HA)/ml in group I; 79.6 (58.6–114.3) mg HA/ml in group II; and 52.4 (13.1–79.1)mg HA/ml in group III. A significant deterioration in spongiosa structure was found with increasing demineralization: strongly rarefied patterns predominated in the fracture groups II and III Conclusion: sQCT provides a good risk assessment of the occurrence of vertebral body insufficiency fractures

Decreased Bone Density in Adolescent Girls With Anorexia Nervosa

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 440-447 ◽  
Author(s):  
Laura K. Bachrach ◽  
David Guido ◽  
Debra Katzman ◽  
Iris F. Litt ◽  
Robert Marcus
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Whole Body ◽  
Mineral Density ◽  
Control Subjects

Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 ± 0.140 vs 1.054 ± 0.139 g/cm2) and significantly lower whole body bone mass (0.700 ± 0.130 vs 0.955 ± 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P &lt; .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness. Low body mass index is an important predictor of this reduction in bone mass.

scholarly journals Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

2019 ◽  
Vol 29 (2) ◽  
pp. 135-143 ◽  
Author(s):  
J. Rodríguez-Carrio ◽  
A. Martínez-Zapico ◽  
I. Cabezas-Rodríguez ◽  
L. Benavente ◽  
Á.I. Pérez-Álvarez ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Subclinical Cardiovascular Disease
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