scholarly journals Inter-relation of Hypocalcaemia with Established Osteoporosis and DXA Analysis: A prospective study of 100 Indian subjects.

2020 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Lumbar Spine ◽  
Clinical Signs ◽  
Dual Emission ◽  
Keywords Osteoporosis ◽  
X Ray ◽  
Total Hip ◽  
T Score ◽  
Ionic Calcium ◽  
A Prospective Study ◽  
Rule Out

Purpose: The purpose of the study was to screen the presence of hypocalcemia and clinical signs specific to hypocalcemia in dual-emission X-ray absorptiometry proven osteoporotic patients and also to analyze variations of T scores at specific anatomical regions in lumbar spine and hip. Type: Prospective cohort. Materials and Methods: One hundred patients who had T score of <?2.5 at any of the lumbar levels or in total lumbar T score were selected. Ionic calcium levels (normal – 1.1–1.135 mmol/L) of each patient were calculated. Trousseau’s sign and Chvostek’s sign were checked. Analysis of T scores was done for each patient. Results: Twelve out of 100 patients had hypocalcemia. Out of whom, only one patient had positive Trousseau’s sign and none had Chvostek’s sign present. In normocalcemic patients (n = 88), seven patients had positive Trousseau’s sign and three had Chvostek’s sign present. Average total lumbar T score of 100 patients was ?3.0 (±1.1 SD). After calculating the averages, the L3 had least T score of ?3.3 (±0.9 SD) and L1 had highest T score of ?2.5 (±1.3 SD), respectively. Twenty-seven patients had total hip T scores <?2.5 and 72 patients had T scores <?2.5 at Ward’s triangle. Similarly, average total hip T score of 100 patients was ?2.0 (±1.6 SD); average T score at Ward’s angle was much lower at ?2.9 (±1.4SD). Conclusion: L3 vertebra and Ward’s triangle are most sensitive indicators of osteoporosis. Although theoretically unlikely, hypocalcemia can be present in osteoporotic patients. Trousseau’s sign and Chvostek’s sign may be present in patients with established hypocalcemia; however, their absence does not rule out the diagnosis. Keywords: Osteoporosis, hypocalcemia, T score, ward’s triangle.

scholarly journals Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Nils Wirries ◽  
Michael Schwarze ◽  
Dorothea Daentzer ◽  
Michael Skutek
Keyword(s):  
Lumbar Spine ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Mutual Influence ◽  
Negative Impact ◽  
Clinical Signs ◽  
Clinical Results ◽  
Total Hip ◽  
One Year ◽  
Spine Disorders

Lumbar spine disorders (LSD) might influence the outcome after total hip arthroplasty (THA). Despite a known common prevalence of LSD and degenerative hip disorders, this study investigates their mutual influence in case of co-existence with the purpose to advance surgeons planning and patient’s prognosis. Patients with and without LSD were compared before and at the one-year postoperative examination. For clinical evaluation the WOMAC was assessed. The radiological analysis focused on cup anteversion and inclination. The total group included 203 consecutive patients. The overall incidence of LSD was 51.0%. Patients with LSD were on average 4.3 years older and had a 1.8 higher BMI than non-LSD patients (P<0.05). The cup positioning and the clinical results were comparable between both groups before and at the last time of follow up (P>0.05). No hip dislocations nor clinical signs of impingement were seen.We can conclude that there is a high degree of co-existence of LSD and hip disorders. However, a strong negative impact of LSD to clinical or radiologic results could not be confirmed in our study.

Comparison of Bone Mineral Density at Hip and Lumbar Spine in Patients with Femoral Neck Fractures and Pertrochanteric Fractures

2021 ◽  
Vol 23 (1) ◽  
pp. 45-49
Author(s):  
Chulin Chewakidakarn ◽  
Varah Yuenyongviwat
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Dual Energy ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
Mineral Density ◽  
Pertrochanteric Fractures ◽  
X Ray ◽  
Total Hip

Background. Geriatric hip fractures, including femoral neck and pertrochanteric fractures, are common nowadays, which is related to increasing numbers of elderly people worldwide. Osteoporosis is an important risk factor associated with hip fractures. This study aimed to describe the association of hip fractures and osteoporosis at different BMD measurement sites and determine any differences between these two types of hip fracture. Material and methods. A retrospective study conducted in a university hospital in the south of Thailand enrolled 223 patients aged over 50 years with low-energy trauma hip fractures. Each patient had undergone dual energy x-ray absorptiometry (DXA) within 2 weeks of injury. T-scores were recorded for the total hip, femoral neck and lumbar spine areas and classified as normal, osteopenia and osteoporosis according to WHO osteoporosis diagnostic criteria. Results. The highest proportion of T-scores in the osteoporotic range were registered at the femoral neck (68.6%) compared to total hip (52.9%) and lumbar spine (47.7%). At least 31.4% of patients were in the non-osteoporotic range. No significant differences were found at all sites of BMD measurement between the two types of fracture. Conclusions. 1. At least 1/3 of patients with geriatric hip fractures had their T-scores in the normal to oste­ope­nic range. 2. BMD in different areas is not different between types of hip fractures.

SAT0444 PREVALENCE OF VERTEBRAL FRACTURES BY BONE FRAGILITY IN PATIENTS BEFORE AND 1 YEAR AFTER LIVER TRANSPLANTATION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1179.1-1179
Author(s):  
C. Plurien ◽  
D. Mulleman ◽  
D. Chu Miow Lin ◽  
E. Salame ◽  
P. Goupille ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Fragility ◽  
Research Support ◽  
Total Hip ◽  
T Score ◽  
Bone Remodeling Markers ◽  
High Incidence

Background:Bone fragility is frequent in patients awaiting orthotopic liver transplantation (OLT) for severe liver disease, leading to a high prevalence of fractures, particularly vertebral ones. During the year following OLT, there is an early decrease in bone density and a high incidence of new vertebral fractures (VF).Objectives:To determine the prevalence of VF due to bone fragility during the year after OLT in a large population of patients.Methods:We conducted a cohort, prospective, descriptive, monocentric study including all the patients with severe chronic liver disease and awaiting OLT. Patients were seen during the pre-transplant period and one year after OLT. At each visit demographic, clinical, biological (including bone remodeling markers) and bone mineral density (BMD) data with VFA (Vertebral fracture Assessment) were collected. We estimated the incidence of VF after OLT. We compared biological and morphological data.Results:We have seen 272 patients before OLT (median age 59 years [Interquartile Range IQR: 53; 64], 75% male). Hepatopathy was due to alcoholic disease for 187 patients (69%). Before OLT, 12% had T-score<-2.5 SD (Standard Deviation) at lumbar spine site, 10% at total hip site and 10% at femoral neck site. Among the 272 patients, 31 had at least one VF (for a total of 49 VF). After OLT, we have seen 101 patients (median of 14 months [IQR: 5; 40] after OLT). For those 101 patients seen before and after OLT: we noted 18 VF for 12 patients (11.8%) before OLT and 29 VF for 18 patients (17.8%) after OLT on VFA. The VF incidence was 8.8 for 100 patients-years. During the year following OLT, there was a significant decrease of T-score at femoral neck and total hip sites. The number of osteoporotic patients was 13/101 (12.8%) at femoral neck and 14/101 (13.8%) at total hip. There was no significant change at the lumbar spine. Bone remodeling markers were significantly higher after OLT than before: CTX (μg/L) from 0.350 [IQR: 0.260; 0.501] before OLT to 0.490 [IQR: 0.279; 0.762] after OLT and osteocalcin (mg/mL) from 17 [IQR: 12; 22] to 30 [IQR: 19; 43], p<0.001. Fifteen of those 101 patients had an anti-osteoporotic drug prescribed before OLT despite being justified for 30 patients.Conclusion:Despite bone fragility and a high fracture risk, patients undergoing OLT are not enough treated for osteoporotic disease. It seems justified to offer a systematic rheumatology visit to detect bone damage before OLT and 6 months after OLT when the damage is the most significant. The drug prescription should be systematically proposed in a situation of fracture before OLT and/or in case of low bone parameters after OLT.References:[1]Krol CG, et al. Longitudinal Changes in BMD and Fracture Risk in Orthotopic Liver Transplant Recipients Not Using Bone-Modifying Treatment. J Bone Miner Res 2014;29(8):1763‑9.[2]Butin S, et al. High incidence of vertebral osteoporotic fracture within the first year after liver transplantation. Clin Exp Rheumatol 2017;35(6):913‑8.Acknowledgments:Elsa Cattelain-Lopez; Fabienne Chalier; Nelly Jaccaz-ValleeDisclosure of Interests:Chloe Plurien: None declared, Denis Mulleman Grant/research support from: Non-governmental organisation Lions Club Tours Val de France, French Society for Rheumatology., Consultant of: Pfizer, Novartis., Delphine Chu Miow Lin: None declared, Ephrem Salame: None declared, Philippe Goupille Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Isabelle Griffoul: None declared

scholarly journals Comparative studies of bone density by quantitative ultrasound (QUS) with dual-energy X-ray absorptiometry (DEXA) scan

2019 ◽  
Vol 9 (1) ◽  
pp. 8-12
Author(s):  
Alark Devkota Rajouria ◽  
Madur Dev Bhattarai ◽  
Manil Ratna Bajracharya ◽  
Buddha Bahadur Karki
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Quantitative Ultrasound ◽  
Screening Tool ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorp­tiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis. Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius. Results: Significant correlations were observed between QUS and DEXA T score. Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.

scholarly journals Calcaneal BMD Obtained by Dual X-Ray and Laser Predicts Future Hip Fractures—A Prospective Study on 4 398 Swedish Women

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Torkel B. Brismar ◽  
Imre Janszky ◽  
L. I. M. Toft
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Area Under Curve ◽  
Fracture Rate ◽  
X Ray ◽  
T Score ◽  
National Patient Register ◽  
National Patient ◽  
A Prospective Study

The predictive value of dual X-ray and laser (DXL) calcaneal BMD (BMDDXL) on hip fractures was prospectively studied in 4,398 females aged 55 to 99 years. The average follow-up period was 3 years and 11 months with a total of 17,270 person years. Fractures were identified from the national patient register. After inclusion, 130 females sustained a hip fracture. The age adjusted hazard ratio for T-score <−2.5 versus >−2.5 was 2.64. Of all patients who sustained a hip fracture 78% had a T-score of −2.5 or below. The annual hip fracture rate was 0.26% at T-scores ≥−2, but 1.5% at T-scores ≤−2.5. The area under curve for the model including calcanealBMDDXL, follow-up time, and age to prospectively predict hip fractures was 0.84.Conclusions. CalcanealBMDDXLobtained by DXL Calscan predicts hip fractures and may therefore be suitable for diagnosing osteoporosis and for predicting fracture risk.

scholarly journals AB0617 BISPHOSPHONATES DANS L’OSTÉOPOROSE ET LE RISQUE D’OSTÉONÉCROSE DE LA MÂCHOIRE, ENVIRON 896 CAS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1343.1-1343
Author(s):  
A. R. Halidou ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Corticosteroid Therapy ◽  
Osteonecrosis Of The Jaw ◽  
Mineral Density ◽  
Duration Of Treatment ◽  
Treatment Of Osteoporosis ◽  
Total Hip ◽  
T Score

Background:Bisphosphonates (BF) are used in the treatment of osteoporosis, Paget’s disease of bone, hypercalcemia and in patients with cancer. When used to treat osteoporosis, the optimal duration of treatment is 3 to 5 years; however, their long-term use has been rarely associated with osteonecrosis of the jaw.Objectives:To assess the risk of developing osteonecrosis of the jaw in patients followed for osteoporosis and on bisphosphonates (BP).Methods:Type of study: retrospective study conducted at the rheumatology department of the IBN ROCHD CHU in Casablanca.Duration: from October 2013 to October 2020 (7 years).Inclusion criteria: all patients followed for osteoporosis in the weakening osteopathies unit of the bone and treated with oral or intravenous bisphosphonates.Exclusion criteria: patients followed for other than osteoporosis.Results:896 patients were treated during this period. The average age was 62.74 years (28 to 90 years), of which 85.16% were women and 14.84% were men, for a sex ratio (F / M) of 5.74. As a history, 18.75% of patients are diabetic, 26.56% followed for breast neoplasm, 14.06% of patients had received long-term corticosteroid therapy for various pathologies such as chronic inflammatory rheumatism. Osteoporosis was postmenopausal in 687 patients, ie 76.67% of cases, 14.06% after long-term corticosteroid therapy, 8.15% following hormone therapy (anti-aromatases) and 6.92% following chemotherapy; note that 18.16% of these patients were found in at least two of the situations. The mean bone mineral density (BMD), T-score pair considered in all [T-score (BMD)] is -3 (0.736) in the lumbar spine (L1-L4), -2.9 (0.658) at the femoral neck, -2.6 (0.804) at the total hip before the start of treatment. 69.97% of the patients were put on Alendronic acid, 12.50% on Residronic acid, 10.93% on Zolidronic acid, 3.46% on Pamidronic acid and 3.14% received Strontium Ranelate, note that before the start of the treatment all the patients benefited from a dental consultation followed by care of any lesions, the bisphosphonates were only introduced after having ruled out all their dental contraindications, the average duration of treatment for all the molecules was 4.71 years (2 to 5 years) and no patient developed osteonecrosis of the jaw. The change in control BMD on average after 2 years of treatment was -2.7 (0.782) at the lumbar spine, -2.6 (0.749) at the femoral neck and -2.4 (0.713) at the hip total, after 5 years -2.4 (0.874) at the spine, -2.1 (0.809) at the femoral neck and -1.93 (861) at the total hip.Conclusion:The occurrence of ONJ in the treatment of osteoporosis with the use of BFs is rare, and appears to be unpredictable; but maintaining therapeutic caution, consisting in diagnosing and treating any dental lesions before starting treatment, can considerably reduce or even cancel the risk of occurrence; especially in patients treated with long-term intravenous pamidronate.References:[1]Dr Halidou Idrissa Abdoul-Rahamane, Pr Kawtar Nassar, PR Saadia Janani.[2]Rheumatology department of the IBN ROCHD CHU in CASABLANCA. Casablanca Faculty of Medicine and Pharmacy. Hassan II University. MoroccoDisclosure of Interests:None declared.

scholarly journals Osteoporosis in spine surgery patients: what is the best way to diagnose osteoporosis in this population?

2020 ◽  
Vol 49 (2) ◽  
pp. E4 ◽  
Author(s):  
Jeffery D. St. Jeor ◽  
Taylor J. Jackson ◽  
Ashley E. Xiong ◽  
Aamir Kadri ◽  
Brett A. Freedman ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Fracture Risk ◽  
Spine Surgery ◽  
Bone Health ◽  
Assessment Tools ◽  
Lumbar Spine Surgery ◽  
Total Hip ◽  
T Score ◽  
Preoperative Optimization ◽  
The Mean

OBJECTIVEThe goal of this study was to compare different recognized definitions of osteoporosis in patients with degenerative lumbar spine pathology undergoing elective spinal fusion surgery to determine which patient population should be considered for preoperative optimization.METHODSA retrospective review of patients in whom lumbar spine surgery was planned at 2 academic medical centers was performed, and the rate of osteoporosis was compared based on different recognized definitions. Assessments were made based on dual-energy x-ray absorptiometry (DXA), CT Hounsfield units (HU), trabecular bone score (TBS), and fracture risk assessment tool (FRAX). The rate of osteoporosis was compared based on different definitions: 1) the WHO definition (T-score ≤ −2.5) at total hip or spine; 2) CT HU of < 110; 3) National Bone Health Alliance (NBHA) guidelines; and 4) “expanded spine” criteria, which includes patients meeting NBHA criteria and/or HU < 110, and/or “degraded” TBS in the setting of an osteopenic T-score. Inclusion criteria were adult patients with a DXA scan of the total hip and/or spine performed within 1 year and a lumbar spine CT scan within 6 months of the physician visit.RESULTSTwo hundred forty-four patients were included. The mean age was 68.3 years, with 70.5% female, 96.7% Caucasian, and the mean BMI was 28.8. Fracture history was reported in 53.8% of patients. The proportion of patients identified with osteoporosis on DXA, HUs, NBHA guidelines, and the authors’ proposed “expanded spine” criteria was 25.4%, 36.5%, 75%, and 81.9%, respectively. Of the patients not identified with osteoporosis on DXA, 31.3% had osteoporosis based on HU, 55.1% had osteoporosis with NBHA, and 70.4% had osteoporosis with expanded spine criteria (p < 0.05), with poor correlations among the different assessment tools.CONCLUSIONSLimitations in the use of DXA T-scores alone to diagnose osteoporosis in patients with lumbar spondylosis has prompted interest in additional methods of evaluating bone health in the spine, such as CT HU, TBS, and FRAX, to inform guidelines that aim to reduce fracture risk. However, no current osteoporosis assessment was developed with a focus on improving outcomes in spinal surgery. Therefore, the authors propose an expanded spine definition for osteoporosis to identify a more comprehensive cohort of patients with potential poor bone health who could be considered for preoperative optimization, although further study is needed to validate these results in terms of clinical outcomes.

scholarly journals POS1109 MULTIVARIATE ANALYSIS OF RISK FACTORS FOR REDUCED BONE MINERAL DENSITY ASSESSED WITH RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 835.1-835
Author(s):  
Z. Batalov ◽  
M. Nikolov ◽  
N. Nikolov
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Risk Factor ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Body Fat ◽  
Significant Risk ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background:Radiofrequency echographic multi spectrometry (REMS) is an innovative radiation-free approach for the assessment of bone mineral density (BMD) at axial sites. The principle of this technology is based on the analysis of native raw unfiltered ultrasound signals, the so called radiofrequency ultrasound signals, acquired during an echographic scan of the lumbar spine and/or femoral neck. [1]. A previous published study showed a high degree of correlation between the T-score values provided by the two techniques-REMS and dual energy X-ray absorptiometry for both lumbar spine and femoral neck [2]. REMS software outputs information about BMD (g/cm2), T-scores, Z-scores [standard deviations (SD)], percentage of body fat and basal metabolic rate [BMR (kcal/daily)] [3].Objectives:The aim of the current study is to investigate the multivariate significant risk factors for reduced BMD through REMS technology.Methods:In this study, a total of 273 women with mean age 62 years (yrs.) ± 12 yrs. (range 25-88 yrs.) underwent REMS assessments. Subjects were divided into two groups after acquiring information about the spinal T-scores: 1st group with T-scores ≥-1 SD and 2nd group with T-scores <-1 SD. Age, weight, height, body mass index (BMI), basal metabolic rate (BMR), body fat and menopausal status were the risk factors included in the multivariate statistical analyses. Binary logistic regression was used to assess which are the significant risk factors for T-score <-1 SD. Youden’s indices were calculated for selecting the cut-off points for each risk factor.Results:273 women had mean weight of 70.5 kg. ± 15.7 kg. (range 39.4-127 kg.), mean height 157.1 cm. ± 8.8 cm. (range 100-182 cm.) and mean body mass index (BMI) 28.6 kg/cm2 ± 6.1 kg/cm2 (range 14.9-47.5 kg/cm2). The mean body fat of the subjects was 37.8% ± 8.8% (range 9-52%) and the mean BMR was 1274.01 kcal/daily ± 163.17 kcal/daily (range 929.7-1908.4 kcal/daily). 260 women (95.2%) were attributed to postmenopausal. Age (p=0.000), BMI (p=0.015), menopause (p=0.006) and BMR (p=0.000) were the multivariate significant risk factors for T-score <-1 SD. Odds ratio for the risk factor age was 1.16, so each added year of the women’s age increased the risk for T-score <-1 SD by 1.16%. Women over the age of 65 yrs. showed the highest risk for spinal T-score <-1 SD. The odds ratio of the menopause as a risk factor for spinal T-score <-1 SD was 9.54, so postmenopausal women showed about 9.5 times higher risk of T-score <-1 SD of the lumbar spine than women who still have their period. The increase of BMI by one kg/cm2 decreased the probability of spinal T-score <-1 SD by 0.15% and the increase of BMR by one kcal/daily decreased this probability by 0.02%. Women with BMI above 28.63 kg/cm2 and those with BMR >1331.75 kcal/daily were unlikely to develop spinal T-score <-1 SD.Conclusion:In the current study, multivariate regression analysis was used to develop a specific REMS-based risk prediction model for spinal BMD, corresponding to T-score <-1 SD. Postmenopausal women over age of 65 yrs. with BMI lower than 28.63 kg/cm2 and BMR <1331.75 kcal/daily were at the highest risk for T-score <-1 SD of the lumbar spine.References:[1]Pisani P, Renna MD, Conversano F, Casciaro E, Muratore M, et al. (2013) Screening and early diagnosis of osteoporosis through X-ray and ultrasound-based techniques. World J Radiol 5(11): 398-410.[2]Kirilov N. Analysis of dual-energy x-ray absorptiometry images using computer vision methods. (2020) Trakia Journal of Sciences, Vol. 18, Suppl. 1, pp 114-117.[3]Kirilova E, Kirilov N, Popov I, Vladeva S. (2019) Bone mineral density of lumbar spine and femoral neck assessed by novel echographic approach-Radiofrequency Echographic Multi Spectrometry (REMS). Clin. Cases Miner. Bone Metab., 16 (1), pp. 14-17.Disclosure of Interests:None declared.

scholarly journals Comparison of Bone Mineral Densitometry at 2 Sites Versus 3 Sites in Patients Suspicious for Osteoporosis

2019 ◽  
Vol 12 ◽  
pp. 117954411984901 ◽  
Author(s):  
Ahad Azami ◽  
Hasan Anari ◽  
Manouchehr Iranparvar ◽  
Amin Azizi ◽  
Afshin Habibzadeh
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Femur Neck ◽  
Bone Mineral Densitometry

Objectives: In this study, we aim to evaluate the bone mineral density (BMD) results of 2 standard sites with 3 sites including wrist in diagnosing osteoporosis. Methods: We evaluated the BMD results of 1272 individuals referred for suspected osteoporosis between 2012 and 2015. Those individuals were included with BMD at lumbar spine, femur neck, and wrist. Bone mineral density was measured using a dual-energy X-ray absorptiometry (DXA) device. Bone mineral density and T score were measured for all 3 sites. Results: There was significant correlation between wrist T score with hip T score ( r = 0.606, P < .001) and lumbar T score ( r = 0.527, P < .001). With BMD of 2 sites, patients had osteopenia in 46.3% and osteoporosis in 23.7%, while by adding wrist T-BMD, subjects had osteopenia in 46.6% and osteoporosis in 33%. Between BMD at 2 sites and 3 sites, there was concordance in 81.9%, minor discordance in 17.6%, and major discordance in 0.5%. Conclusions: We observed discordance between BMD measurements of 2 sites and 3 sites, with latter detecting more cases with osteoporosis. In fact, measurement of T scores of wrist along with lumbar and femur neck improves the diagnosis.

scholarly journals P0896TRABECULAR BONE SCORE PREDICTS OSTEOPOROTIC FRACTURE IN CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Lumbar Spine ◽  
Kidney Disease ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Osteoporotic Fracture ◽  
Risk Group ◽  
Total Hip ◽  
T Score ◽  
Femur Neck

Abstract Background and Aims Chronic kidney disease and mineral bone disease (CKD-MBD) is a common complication of CKD and this is associated with higher risk of fracture, morbidity and mortality. Current guidelines recommend measurement of bone mineral density (BMD) in CKD patients. However, the focus is only on bone turnover and bone density, and there is no guideline for trabecular bone score (TBS) for trabecular bone microarchitecture in CKD patients. We aim to evaluate the role of TBS in predicting osteoporotic fracture in CKD patients Method We retrospectively enrolled 125 patients with CKD between 2016 and March 2019. Lumbar spine TBS was extracted from dual-energy X-ray absorptiometry, and we categorized the TBS into three groups as lowest (≥ 1.31), moderate (1.31-1.23), and highest risk group (≤ 1.23). The logistic regression analysis was used to assess osteoporotic fracture risk. Results Of 125 patients, mean age was 65.9 ± 14.2 years, 49.6% were on dialysis, 11.2% was highest risk group by TBS. Patients with highest risk group by TBS were significantly older, had lower height, weight, serum 25-OH vitamin D, serum sodium level, BMD T-score (lumbar spine, femur neck and total hip) than lower risk group. TBS significantly correlated with BMD T-score (lumbar spine, femur neck and total hip), height, weight and serum creatinine level (P &lt;0.001). Osteoporotic fracture was identified in 20 (16.0%) patients. In univariate analyses, old age, women, lower weight, TBS tertile group, lower potassium level were significantly associated with osteoporotic fracture. In multivariate analyses, only highest risk group by TBS was significantly associated with increased osteoporotic fracture risk after adjustment for demographic, comorbid, medication use, and previous fracture. Conclusion Lumbar spine TBS significantly correlated with BMD T-score and predicts osteoporotic fractures in patients with CKD.

Sign in / Sign up

Export Citation Format

Share Document