Changes in Cortical Volumetric Bone Mineral Density and Thickness, and Trabecular Thickness in Lactating Women Postpartum

Abstract Context: Lactation is associated with decreased areal bone mineral density (aBMD). Replenishment occurs especially after ceased lactation. Changes in volumetric bone mineral density (vBMD), microstructure, and dimensional parameters are unknown and may clarify the role of lactation for skeletal health. Objective and Main Outcomes: The objective of the study was to test the hypothesis that lactation is associated with changes in aBMD, vBMD, microstructure, and dimensional parameters. Design: At baseline (0.5 mo after delivery) and 4, 12, and 18 months thereafter, bone was assessed using dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography. Participants and Setting: Eighty-one fair-skinned postpartum women and 21 controls aged 25–40 years were recruited. The completion ratio was 73%. Postpartum women were categorized depending on duration of lactation: 0–3.9, 4–8.9, and 9 months or longer. Results: During the first 4 months, aBMD decreased at several sites (geometric mean ± SE; −0.73% ± 0.21% to −3.98% ± 0.76%) in women lactating at least 4 months. During the same time, cortical vBMD at the ultradistal tibia decreased in women lactating 4–8.9 months (−0.26% ± 0.08%) and 9 months or longer (−0.49% ± 0.10%). At 12 months postpartum, cortical thickness (≥9 mo, −2.48% ± 0.41%) and trabecular thickness (4–8.9 mo, −2.14% ± 0.92%; ≥ 9 mo, −2.56% ± 1.21%) also were lower than baseline. No decreases were found in women lactating less than 4 months or in controls in these parameters. At 18 months postpartum, both cortical vBMD (≥9 mo, −0.77% ± 0.17%) and trabecular thickness (4–8.9 mo, −2.25% ± 1.25%; ≥ 9 mo, −3.21% ± 1.41%) were lower in women with long lactation. Conclusions: Decreases in cortical vBMD, thickness, and trabecular thickness at the ultradistal tibia were found in women lactating 4 months or longer. Longer follow-up is needed to confirm whether women with extended lactation recover fully or whether the changes could potentially lead to an increased risk of fracture in later life.

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Bone microstructural changes revealed by high-resolution peripheral quantitative computed tomography imaging and elevated DKK1 and MIP-1α levels in patients with MGUS

Blood ◽

10.1182/blood-2011-04-351437 ◽

2011 ◽

Vol 118 (25) ◽

pp. 6529-6534 ◽

Cited By ~ 49

Author(s):

Alvin C. Ng ◽

Sundeep Khosla ◽

Natthinee Charatcharoenwitthaya ◽

Shaji K. Kumar ◽

Sara J. Achenbach ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

High Resolution ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Areal Bone Mineral Density ◽

Mineral Density ◽

Trabecular Thickness ◽

Increased Risk

Abstract Recent population-based studies demonstrate an increased fracture risk with monoclonal gammopathy of undetermined significance (MGUS). The etiology of this increased risk remains unclear, however, because areal bone mineral density (aBMD) measurements by dual-energy x-ray absorptiometry cannot assess bone microstructural properties critical to determining bone quality and strength. To better define the skeletal effects of MGUS, we performed aBMD and high-resolution peripheral quantitative computed tomography volumetric bone mineral density (vBMD) measurements in 50 MGUS patients (20 females, 30 males; mean ± SEM age, 70.5 ± 1.4 years) and 100 matched control subjects. Relative to controls, MGUS patients had decreased aBMD at the femoral neck (P = .05) and total femur (P < .05) but no differences at other sites. In contrast, high-resolution peripheral quantitative computed tomography showed markedly diminished cortical thickness (P < .05) and increased endocortical area (P < .01). Average vBMD (P < .01), cortical vBMD (P < .001), and trabecular thickness (P < .01) were all significantly decreased in MGUS patients, suggestive of impaired bone formation. Serum levels of the Wnt pathway inhibitor Dickkopf-related protein 1 (P < .001) and osteoclast-activating factor MIP-1α (P < .05) also were significantly elevated in MGUS patients. Our data provide the first evidence of altered bone microstructure in MGUS and suggest that cytokines elevated in osteolytic myeloma also may be associated with bone loss in MGUS.

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Trabecular volumetric bone mineral density of the occipital bone at preferred screw placement sites measured by quantitative computed tomography

Brain and Spine ◽

10.1016/j.bas.2021.100056 ◽

2021 ◽

Vol 1 ◽

pp. 100056

Author(s):

Manuel Moser ◽

Dominik Adl Amini ◽

Lisa Oezel ◽

Jennifer Shue ◽

John Carrino ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Occipital Bone ◽

Screw Placement ◽

Volumetric Bone Mineral Density ◽

Mineral Density

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Effect of Rheumatoid Arthritis on Volumetric Bone Mineral Density and Bone Geometry, Assessed by Peripheral Quantitative Computed Tomography in Postmenopausal Women Treated with Bisphosphonates

The Journal of Rheumatology ◽

10.3899/jrheum.110579 ◽

2012 ◽

Vol 39 (6) ◽

pp. 1215-1220 ◽

Cited By ~ 5

Author(s):

SYMEON TOURNIS ◽

VASILIOS SAMDANIS ◽

SAVAS PSARELIS ◽

CHRYSA LIAKOU ◽

JULIA ANTONIOU ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Computed Tomography ◽

Bone Mineral Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Bone Geometry ◽

Peripheral Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Mineral Density

Objective.To investigate the effect of rheumatoid arthritis (RA) on volumetric bone mineral density (vBMD) and bone geometry in postmenopausal women treated with bisphosphonates.Methods.Fifty-three postmenopausal women with RA and 87 control subjects, comparable in terms of age, body mass index, and years since menopause, underwent peripheral quantitative computed tomography (pQCT) of the nondominant tibia.Results.At 4% (trabecular site), trabecular bone mineral content (BMC) and vBMD (p < 0.001) were lower in the RA group, while trabecular area was comparable. At 38% (cortical site), cortical BMC (p < 0.01), area (p < 0.05), and thickness (p < 0.001) were lower in the RA group, whereas vBMD was comparable. Endosteal circumference was higher (p < 0.05), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. In the RA group, muscle area was lower (p < 0.001), while at 14% polar stress strength index was significantly lower (p < 0.01) in patients with RA, indicating impairment of bone mechanical properties.Conclusion.RA is associated with negative effects on both cortical and cancellous bone in postmenopausal women treated with bisphosphonates. Cortical geometric properties are also adversely affected mainly by increased endosteal circumference, whereas trabecular geometric properties are generally preserved.

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Computed Tomography Diagnostic of Uncommon Case of Osteopetrosis in 80-Year-Old Man—Case Report

Medicina ◽

10.3390/medicina56100518 ◽

2020 ◽

Vol 56 (10) ◽

pp. 518

Author(s):

Witold Krupski ◽

Joanna Kruk-Bachonko ◽

Marcin R. Tatara

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Z Score ◽

Mineral Density ◽

T Score ◽

Uncommon Case ◽

Densitometric Data

Background and Objectives: During osteopetrosis course, impaired bone remodeling induces skeletal osteosclerosis and abnormally dense bones, which, however, are brittle and susceptible to low-energy fractures. In this study, radiological evaluation and densitometric measurements of several bones of the skeleton in one of the oldest patients in the world suffering from osteopetrosis was presented. Materials and Methods: Volumetric bone mineral density measurements of the examined bones in an 80-year-old man were performed using two different quantitative computed tomography techniques. Results: The obtained results show higher values of the volumetric bone mineral density of the trabecular bone in lumbar spine than in the cortical bone compartment. T-score and Z-score in this patient reached values of 27–28 and 31–32, respectively. Conclusions: The obtained densitometric data may serve for further diagnostic purposes of osteopetrosis. As documented, the severity of the osteosclerotic changes of bones were higher in this patient than in most other described cases. Moreover, radiological signs diagnosed in this patient were characteristic for all types of osteopetrosis making this case very uncommon.

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Effect of spinal degenerative changes on volumetric bone mineral density of the central skeleton as measured by quantitative computed tomography

Acta Radiologica ◽

10.1080/02841850510012661 ◽

2005 ◽

Vol 46 (3) ◽

pp. 269-275 ◽

Cited By ~ 40

Author(s):

G. Guglielmi ◽

I. Floriani ◽

V. Torri ◽

J. Li ◽

C. van Kuijk ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Lumbar Spine ◽

Bone Mineral ◽

Vertebral Fractures ◽

Quantitative Computed Tomography ◽

Degenerative Changes ◽

Volumetric Bone Mineral Density ◽

Mineral Density ◽

The Impact

Purpose: To evaluate the impact of degenerative changes due to osteoarthritis (OA) at the spine on volumetric bone mineral density (BMD) as measured by volumetric quantitative computed tomography (vQCT). Material and Methods: Eighty‐four elderly women (mean age 73±6 years), comprising 33 with vertebral fractures assessed by radiographs and 51 without vertebral fractures, were studied. Trabecular, cortical, and integral BMD were examined at the spine and hip using a helical CT scanner and were compared to dual X‐ray absorptiometry (DXA) measurements at the same sites. OA changes visible on the radiographs were categorized into two grades according to severity. Differences in BMD measures obtained in the two groups of patients defined by OA grade using the described radiologic methods were compared using analysis of variance. Standardized difference (effect sizes) was also compared between radiologic methods. Results: Spinal trabecular BMD did not differ significantly between OA grade 0 and OA grade 1. Spinal cortical and integral BMD measures showed statistically significant differences, as did the lumbar spine DXA BMD measurement (13%, P = 0.02). The QCT measurements at the hip were also higher in OA 1 subjects. Femoral trabecular BMD was 13–15% higher in OA grade 1 subjects than in OA grade 0 subjects. The cortical BMD measures in the CT_TOT_FEM and CT_TROCH ROI's were also higher in the OA 1 subjects. The integral QCT BMD measures in the hip showed difference between grades OA 1 and 0. The DXA measurements in the neck and trochanter ROI's showed smaller differences (9 and 11%, respectively). There were no statistically significant differences in bone size. Conclusion: There is no evidence supporting that trabecular BMD measurements by QCT are influenced by OA. Instead, degenerative changes have an effect on both cortical and integral QCT, and on DXA at the lumbar spine and the hip. For subjects with established OA, assessment of BMD by volumetric QCT may be suggested.

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Effect of Rhythmic Gymnastics on Volumetric Bone Mineral Density and Bone Geometry in Premenarcheal Female Athletes and Controls

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2009-2382 ◽

2010 ◽

Vol 95 (6) ◽

pp. 2755-2762 ◽

Cited By ~ 29

Author(s):

S. Tournis ◽

E. Michopoulou ◽

I. G. Fatouros ◽

I. Paspati ◽

M. Michalopoulou ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Bone Geometry ◽

Bone Age ◽

Peripheral Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Mineral Density ◽

Muscle Area ◽

Positive Effects

Abstract Context and Objective: Weight-bearing exercise during growth exerts positive effects on the skeleton. Our objective was to test the hypothesis that long-term elite rhythmic gymnastics exerts positive effects on volumetric bone mineral density and geometry and to determine whether exercise-induced bone adaptation is associated with increased periosteal bone formation or medullary contraction using tibial peripheral quantitative computed tomography and bone turnover markers. Design and Setting: We conducted a cross-sectional study at a tertiary center. Subjects: We studied 26 elite premenarcheal female rhythmic gymnasts (RG) and 23 female controls, aged 9–13 yr. Main Outcome Measures: We measured bone age, volumetric bone mineral density, bone mineral content (BMC), cortical thickness, cortical and trabecular area, and polar stress strength index (SSIp) by peripheral quantitative computed tomography of the left tibia proximal to the distal metaphysis (trabecular) at 14, 38 (cortical), and 66% (muscle mass) from the distal end and bone turnover markers. Results: The two groups were comparable according to height and chronological and bone age. After weight adjustment, cortical BMC, area, and thickness at 38% were significantly higher in RG (P < 0.005–0.001). Periosteal circumference, SSIp, and muscle area were higher in RG (P < 0.01–0.001). Muscle area was significantly associated with cortical BMC, area, and SSIp, whereas years of training showed positive association with cortical BMC, area, and thickness independent of chronological age. Conclusions: RG in premenarcheal girls may induce positive adaptations on the skeleton, especially in cortical bone. Increased duration of exercise is associated with a positive response of bone geometry.

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Effect of Primary Hyperparathyroidism on Volumetric Bone Mineral Density and Bone Geometry Assessed by Peripheral Quantitative Computed Tomography in Postmenopausal Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2005-2102 ◽

2006 ◽

Vol 91 (5) ◽

pp. 1748-1753 ◽

Cited By ~ 56

Author(s):

Ioannis Charopoulos ◽

Symeon Tournis ◽

George Trovas ◽

Panagiota Raptou ◽

Philippos Kaldrymides ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Healthy Controls ◽

Strength Index ◽

Mineral Density

Context: Primary hyperparathyroidism (PH) is characterized by inappropriate PTH elevation with or without hypercalcemia. Bone disease involves catabolic action at cortical sites, whereas cancellous sites and geometry might be relatively preserved. Objective: Our objective was to examine the effect of PH on quantitative and qualitative bone characteristics using peripheral quantitative computed tomography at the tibia in postmenopausal women with PH and healthy controls. Design and Setting: We conducted a cross-sectional study at a tertiary referral center. Patients: Fifty-two postmenopausal women with PH and 56 healthy controls, comparable for age and anthropometric measures, participated. Intervention: There was no intervention. Main Outcome Measure: We assessed volumetric bone mineral density (vBMD), bone mineral content (BMC), cortical thickness, cortical and trabecular area, peri- and endosteal circumference, and polar stress strength index assessed by peripheral quantitative computed tomography of the left tibia at 4% (cancellous), 14% (transition zone), and 38% (cortical) from the distal end. Results: At 4%, there was a significant decrease of trabecular BMC and vBMD (P < 0.001), effect particularly evident in hypercalcemic patients, whereas trabecular area was comparable. At 38%, cortical BMC (P < 0.01), vBMD (P < 0.01), area (P < 0.05), and thickness (P < 0.001) were reduced in the PH group, particularly in hypercalcemic patients. Endosteal circumference increased (P < 0.001), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. At 14%, polar stress strength index was significantly decreased (P < 0.01) in hypercalcemic patients, indicating impairment of bone mechanical properties. Conclusions: Normocalcemic PH is characterized by catabolic actions at both cortical and cancellous sites (38 and 4%, respectively), an effect accentuated in hypercalcemic patients. Cortical geometric properties are adversely affected even in normocalcemic patients, whereas trabecular properties are generally preserved.

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