Bone Health in Children With Risk Factors for Low Bone Mass

Abstract Purpose: To describe clinical and biological characteristics of pediatric patients with at least one risk factor (RF) for low bone mass for chronological age (LBMca)/childhood osteoporosis (cOP) and to assess its influence on bone mineral density (BMD).Methods: Patients between 2 and 20 years of age with at least 1 RF were recruited. Daily calcium intake, number of previous fractures and other RFs and their distribution among different groups were assessed. Spine and whole body DXA and vertebral morphometry were performed.Results: 103 patients were included. Mean age was 9.8 years old. 52.4% were female. Of the RFs, 84.5% presented insufficient calcium intake, 38.8% were receiving or had received corticosteroids, 31.1% were receiving other treatments with osteotoxic potential, 13.6% led a sedentary lifestyle, 12.6% presented history of fractures, and up to 8.1% had hypovitaminosis D. 38% of the cohort had 2 RFs, 31% had 3 RFs, 15% had 4 RFs, and 12% associated 5 or more RFs. 10.5% met LBMca criteria and 4.8% met cOP criteria. 73% of vertebral BMD was justified by age and hypovitaminosis D (positive effect), and male sex and Hispanic ethnicity (negative effect). 82% of total body less head BMD was justified by age (positive effect), and Hispanic ethnicity and sedentary lifestyle (negative effect).Conclusions: Pediatric populations with risk of LBM/cOP have 2 or more risk factors. Up to 10.5% of children with RFs present LBM and 4.8% have an unknown cOP. RFs related to changes in BMD are age, sex, sedentary lifestyle, ethnicity, and hypovitaminosis D.

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The effect of low-intensity whole-body vibration with or without high-intensity resistance and impact training on risk factors for proximal femur fragility fracture in postmenopausal women with low bone mass: study protocol for the VIBMOR randomized controlled trial

Trials ◽

10.1186/s13063-021-05911-4 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Belinda Beck ◽

Clinton Rubin ◽

Amy Harding ◽

Sanjoy Paul ◽

Mark Forwood

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Bone Mass ◽

Postmenopausal Women ◽

Fragility Fracture ◽

Whole Body Vibration ◽

Trial Registration ◽

Whole Body ◽

Low Bone Mass ◽

Low Intensity

Abstract Background The prevailing medical opinion is that medication is the primary (some might argue, only) effective intervention for osteoporosis. It is nevertheless recognized that osteoporosis medications are not universally effective, tolerated, or acceptable to patients. Mechanical loading, such as vibration and exercise, can also be osteogenic but the degree, relative efficacy, and combined effect is unknown. The purpose of the VIBMOR trial is to determine the efficacy of low-intensity whole-body vibration (LIV), bone-targeted, high-intensity resistance and impact training (HiRIT), or the combination of LIV and HiRIT on risk factors for hip fracture in postmenopausal women with osteopenia and osteoporosis. Methods Postmenopausal women with low areal bone mineral density (aBMD) at the proximal femur and/or lumbar spine, with or without a history of fragility fracture, and either on or off osteoporosis medications will be recruited. Eligible participants will be randomly allocated to one of four trial arms for 9 months: LIV, HiRIT, LIV + HiRIT, or control (low-intensity, home-based exercise). Allocation will be block-randomized, stratified by use of osteoporosis medications. Testing will be performed at three time points: baseline (T0), post-intervention (T1; 9 months), and 1 year thereafter (T2; 21 months) to examine detraining effects. The primary outcome measure will be total hip aBMD determined by dual-energy X-ray absorptiometry (DXA). Secondary outcomes will include aBMD at other regions, anthropometrics, and other indices of bone strength, body composition, physical function, kyphosis, muscle strength and power, balance, falls, and intervention compliance. Exploratory outcomes include bone turnover markers, pelvic floor health, quality of life, physical activity enjoyment, adverse events, and fracture. An economic evaluation will also be conducted. Discussion No previous studies have compared the effect of LIV alone or in combination with bone-targeted HiRIT (with or without osteoporosis medications) on risk factors for hip fracture in postmenopausal women with low bone mass. Should either, both, or combined mechanical interventions be safe and efficacious, alternative therapeutic avenues will be available to individuals at elevated risk of fragility fracture who are unresponsive to or unwilling or unable to take osteoporosis medications. Trial registration Australian New Zealand Clinical Trials Registry (www. anzctr.org.au) (Trial number ANZCTR12615000848505, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 368962); date of registration 14/08/2015 (prospectively registered). Universal Trial Number: U1111-1172-3652.

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Risk Factors for Low Bone Mass in Patients With Ulcerative Colitis Following Ileal Pouch-Anal Anastomosis

The American Journal of Gastroenterology ◽

10.14309/00000434-200903000-00023 ◽

2009 ◽

Vol 104 (3) ◽

pp. 639-646

Author(s):

Bo Shen ◽

Feza H. Remzi ◽

Ioannis K. Oikonomou ◽

Hong Lu ◽

Bret A. Lashner ◽

...

Keyword(s):

Risk Factors ◽

Ulcerative Colitis ◽

Bone Mass ◽

Ileal Pouch ◽

Ileal Pouch Anal Anastomosis ◽

Low Bone Mass ◽

Anal Anastomosis

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Serum sclerostin levels in men with idiopathic osteoporosis

Acta Endocrinologica ◽

10.1530/eje-12-1074 ◽

2013 ◽

Vol 168 (4) ◽

pp. 615-620 ◽

Cited By ~ 19

Author(s):

B Lapauw ◽

S Vandewalle ◽

Y Taes ◽

S Goemaere ◽

H Zmierczak ◽

...

Keyword(s):

Bone Mass ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Whole Body ◽

Control Group ◽

Volumetric Bone Mineral Density ◽

Low Bone Mass ◽

Mineral Density ◽

Bone Parameters ◽

Idiopathic Osteoporosis

ObjectiveSclerostin inhibits osteoblast differentiation and bone formation. If aberrant sclerostin action is involved in less efficient bone acquisition in men with idiopathic low bone mass, this might be reflected in higher serum sclerostin levels.MethodsIn 116 men with idiopathic osteoporosis (≤65 years old), 40 of their sons and healthy controls, areal bone parameters were measured using dual-energy X-ray absorptiometry, and volumetric and geometric bone parameters were measured using peripheral quantitative computed tomography. Serum analytes were measured using immunoassays and estradiol (E2) levels using liquid chromatography–tandem mass spectrometry.ResultsMen with idiopathic low bone mass had lower levels of sclerostin than the controls (0.54±0.17 vs 0.66±0.23 ng/ml;P<0.001). In both groups, sclerostin levels were strongly associated with age; when adjusting for age, no associations with anthropometrics were observed (P>0.14). In multivariate analyses, sclerostin levels displayed a positive association with whole-body bone mineral content (BMC) and areal BMD (aBMD), as well as with trabecular and cortical volumetric bone mineral density (vBMD) at the tibia in the probands. No clear associations were observed in the control group, neither were sclerostin levels associated with BMC at the radius or lumbar spine (allP>0.11). Testosterone, but not E2, was inversely related to sclerostin levels in the probands. No difference in sclerostin levels was found in their sons when compared with their controls.ConclusionLower rather than higher serum sclerostin levels in the probands with idiopathic low bone mass suggest that aberrant sclerostin secretion is not involved in the pathogenesis of low bone mass in these subjects.

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Low bone mass in patients with motor disability: prevalence and risk factors in 59 Finnish children

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.2009.03464.x ◽

2010 ◽

Vol 52 (3) ◽

pp. 276-282 ◽

Cited By ~ 21

Author(s):

PÄIVI KILPINEN-LOISA ◽

TAAVA PAASIO ◽

MARTTI SOIVA ◽

ULLA MAIJA RITANEN ◽

PENTTI LAUTALA ◽

...

Keyword(s):

Risk Factors ◽

Bone Mass ◽

Low Bone Mass ◽

Motor Disability ◽

Disability Prevalence

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Low bone mass and fast rate of bone loss at menopause: equal risk factors for future fracture. A 15-year follow-up study

Maturitas ◽

10.1016/s0378-5122(97)88490-3 ◽

1997 ◽

Vol 26 (2) ◽

pp. 154-155

Author(s):

B.J. Riis ◽

M.A. Hansen ◽

A.M. Jensen ◽

K. Overgaard ◽

C. Christiansen

Keyword(s):

Risk Factors ◽

Bone Loss ◽

Bone Mass ◽

Fast Rate ◽

Low Bone Mass ◽

Follow Up Study ◽

Future Fracture ◽

Rate Of Bone Loss

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Low bone mass and hypovitaminosis D in haemophilia: A single‐centre study in patients with severe and moderate haemophilia A and B

Haemophilia ◽

10.1111/hae.14127 ◽

2020 ◽

Vol 26 (5) ◽

pp. 898-906

Author(s):

Silvia Linari ◽

Daniela Melchiorre ◽

Lisa Pieri ◽

Lorenzo Tofani ◽

Alessandra Fanelli ◽

...

Keyword(s):

Bone Mass ◽

Hypovitaminosis D ◽

Haemophilia A ◽

Low Bone Mass ◽

Single Centre ◽

Centre Study ◽

Single Centre Study

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Risk Factors and Assessment of Low Bone Mass in the Young Adult Female

Korean Journal of Family Medicine ◽

10.4082/kjfm.2009.30.12.924 ◽

2009 ◽

Vol 30 (12) ◽

pp. 924 ◽

Cited By ~ 3

Author(s):

Hee-Jeong Choi

Keyword(s):

Risk Factors ◽

Young Adult ◽

Bone Mass ◽

Adult Female ◽

Low Bone Mass

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Bone Mineral Changes during Pregnancy and Lactation: A Longitudinal Cohort Study

Clinical Science ◽

10.1042/cs0940405 ◽

1998 ◽

Vol 94 (4) ◽

pp. 405-412 ◽

Cited By ~ 108

Author(s):

Niels Kolthoff ◽

PIA Eiken ◽

Bent Kristensen ◽

Stig Pors Nielsen

Keyword(s):

Bone Mineral Density ◽

Bone Mass ◽

Bone Mineral ◽

Calcium Intake ◽

Whole Body ◽

Weight Changes ◽

Mineral Density ◽

High Calcium Intake ◽

High Calcium ◽

Pregnancy And Lactation

1. The influence of pregnancy, lactation and weaning on bone mineral density in healthy women was investigated during a 2 year prospective study of 59 pregnant and lactating women from the 18th week of gestation. 2. Bone mineral density was measured by dual energy X-ray absorptiometry at the non-dominant radius ultra distally and more proximally in the 18th and 37th weeks of gestation, and 0, 3, 6, 12 and 18 months after delivery. Measurements of bone mineral density of the lumbar spine, the proximal femur and the whole body were performed at all dates after delivery. 3. Reappearance of menstruation after delivery averaged 6.1 months; mean lactating period was 8.7 months. During pregnancy and lactation bone mineral density tended to decrease, but different measuring sites showed different patterns of bone mineral density changes. The reduction in the ultra distal radius during pregnancy amounted to 2%, and no further changes were observed here during lactation. After delivery, reduction in mean bone mineral density was most pronounced in the spine (5.2% in 3 months), but the fall in bone mass tended to revert after resumption of menstruation. Bone mineral density was still reduced by 3.3% after 12 months in women with menstruation resumption later than 8 months after delivery. No significant reduction was observed 18 months after delivery. No association with calcium intake, weight changes or initial bone mineral density was observed. High calcium intake did not protect against bone mineral loss in the spine and the femur. 4. Thus it can be concluded that bone loss during pregnancy and lactation took place mainly from the trabecular skeleton. Resumption of menstruation tended to result in a regain of bone mass towards baseline.

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Low Bone Mass is Associated with Increased Carotid Intima Media Thickness in Men with Type 2 Diabetes Mellitus

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s11843 ◽

2013 ◽

Vol 6 ◽

pp. CMED.S11843 ◽

Cited By ~ 2

Author(s):

Mario de Almeida Pereira Coutinho ◽

Elba Bandeira ◽

Juliana Maria Coelho Maia de Almeida ◽

Emanuelle Tenorio Albuquerque Madruga Godoi ◽

Germana Vasconcelos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Mass ◽

Abdominal Circumference ◽

Low Bone Mass ◽

Statin Use

Osteoporosis and atherosclerosis share common risk factors and the association of low bone mass with increased cardiovascular morbidity and mortality has been demonstrated in some studies. Nevertheless, most studies have been focused on women and only a few on individuals with type 2 diabetes mellitus (T2DM). The measurement of carotid intimal-medial thickness (CIMT) is able to detect early atherosclerotic changes and is a predictive marker of cardiovascular events. The aim of this study was to assess the CIMT and its relationship with bone mineral density (BMD) (in the femoral neck (FN) and lumbar spine (LS)) in men with T2DM. We conducted a cross-sectional study with 24 men with T2DM (aged 61 ± 6.4 years) and evaluated metabolic factors, bone densitometry values, and CIMT measured using B-mode Logic-E ultrasound machine. More than 5 years since the diagnosis of T2DM had passed in 75% of the patients, 41.6% were in statin use, mean body mass index (BMI) was 28.1 ± 3.4 kg/m2, abdominal circumference (AC) 97.8 ± 8.4 cm, systolic blood pressure (SBP) 143.8 ± 18.3 mmHg, diastolic blood pressure (DBP) 85.8 ± 12.3 mmHg, HbA1C 7.5% ± 1.3%, Triglycerides 141.7 ± 73 mg/dL, LDL-cholesterol 103.3 ± 35.9 mg/dL, HDL-cholesterol 41.6 ± 11.6 mg/dL. The patients were stratified into groups according to BMD. The group with normal BMD at FN had mean CIMT of 0.7 mm and the group with low bone mass (osteopenia or osteoporosis) had CIMT of 0.86 mm ( P = 0.007). In addition, there were no significant differences between groups regarding age, duration of T2DM, BMI, AC, SBP, DBP, statin use, smoking, HbA1C, cholesterol, or triglycerides. Our data demonstrate a negative association between BMD at the FN and CIMT in type 2 diabetic men, which was unrelated to the traditional risk factors for atherosclerotic disease and degree of diabetes control.

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