The Correlation between Phalangeal Quantitative Ultrasonography and Dual Energy X-ray Absorptiometry in Women with Premature Ovarian Failure

Objectives –With the growing demand for bone densitometry services there is a need for simple, cost-effective and ideally mobile devices which can identify individuals who are at risk of osteoporotic fracture. When new devices are evaluated, it is useful to examine the correlation with the established ‘gold standard’ technique of dual x-ray absorptiometry (DXA). This study examined the correlation between quantitative ultrasound (QUS) measurements performed at the phalanges and conventional DXA measurements of the spine and hip in women with premature ovarian failure – a known risk factor for osteoporosis. Methods - Thirteen white Caucasian women suffering from premature ovarian failure and 19 age- and sex-matched controls were recruited into the study. DXA measurements were performed at the spine and hip, followed by quantitative ultrasonography at phalanges II-V of the non-dominant hand. Results – Significant correlations were observed between the bone transit time (BTT) value from the Bone Profiler and bone mineral density measured at the spine (r=0.66). The spine Z-scores also correlated with many of the ultrasound values (r=0.44 - 0.63). Significant inverse correlations were observed between BMI, weight and ultrasound parameters (r = -0.48 to -0.78). Conclusion – We have reported moderate but significant correlations between phalangeal QUS and DXA parameters. The strongest correlation was observed between BTT and spine BMD, as well as between the Z-scores from the two devices. QUS parameters also demonstrated an inverse correlation with weight and BMI.

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Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

Acta Endocrinologica ◽

10.1530/eje-09-0231 ◽

2009 ◽

Vol 161 (1) ◽

pp. 179-187 ◽

Cited By ~ 75

Author(s):

Anne Bachelot ◽

Agnès Rouxel ◽

Nathalie Massin ◽

Jérome Dulon ◽

Carine Courtillot ◽

...

Keyword(s):

Premature Ovarian Failure ◽

Chromosomal Abnormalities ◽

Phenotypic Variability ◽

Genetic Data ◽

Ovarian Failure ◽

Mineral Density ◽

Genetic Studies ◽

Autoimmune Polyendocrine Syndrome ◽

Design And Methods

ObjectivePremature ovarian failure (POF) encompasses a heterogeneous spectrum of conditions, with phenotypic variability among patients. The etiology of POF remains unknown in most cases. We performed a global phenotyping of POF women with the aim of better orienting attempts at an etiological diagnosis.Design and methodsWe performed a mixed retrospective and prospective study of clinical, biological, histological, morphological, and genetic data relating to 357 consecutive POF patients between 1997 and 2008. The study was conducted at a reproductive endocrinology referral center.ResultsSeventy-six percent of the patients presented with normal puberty and secondary amenorrhea. Family history was present in 14% of the patients, clinical and/or biological autoimmunity in 14.3%. Fifty-six women had a fluctuating form of POF. The presence of follicles was suggested at ultrasonography in 50% of the patients, and observed in 29% at histology; the negative predictive value of the presence of follicles at ultrasonography was 77%. Bone mineral density alterations were found in 58% of the women. Eight patients had X chromosomal abnormalities other than Turner's syndrome, eight other patients evidenced FMR1 pre-mutation. Two other patients had autoimmune polyendocrine syndrome type 2 and 1.ConclusionA genetic cause of POF was identified in 25 patients, i.e. 7% of the whole cohort. POF etiology remains most often undiscovered. Novel strategies of POF phenotyping are in such content mandatory to improve the rate of POF patients for whom etiology is identified.

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Measurement of Bone Mineral Density

Menopause International ◽

10.1177/136218079800400210 ◽

1998 ◽

Vol 4 (2) ◽

pp. 73-76

Author(s):

Nicola Peel

Keyword(s):

High Risk ◽

Current Practice ◽

Standard Technique ◽

Therapeutic Strategies ◽

Response To Treatment ◽

Mineral Density ◽

X Ray ◽

Further Development ◽

Risk Categories ◽

Gold Standard Technique

The development of techniques to measure BMD enables individuals at high risk of osteoporotic fracture to be identified, and their response to treatment to be ascertained. Measurement of the spine and proximal femur by DXA is currently the gold standard technique, but peripheral skeletal measurements using QUS and x-ray based techniques are under evaluation. At the present time measurements should be targeted to individuals within high risk categories in whom knowledge of BMD may influence management. Further development of both diagnostic and therapeutic strategies will require modification of current practice in the future.

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Quantitative Ultrasound and Dual X-Ray Absorptiometry as Indicators of Bone Mineral Density in Young Women and Nutritional Factors Affecting It

Nutrients ◽

10.3390/nu11102336 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2336 ◽

Cited By ~ 3

Author(s):

Katie Schraders ◽

Giancarla Zatta ◽

Marlena Kruger ◽

Jane Coad ◽

Janet Weber ◽

...

Keyword(s):

Dietary Intake ◽

Bone Mineral ◽

Young Women ◽

Quantitative Ultrasound ◽

Calcium Intake ◽

Broadband Ultrasound Attenuation ◽

Mineral Density ◽

X Ray ◽

Z Scores ◽

Osteoporosis Risk

Young adulthood is an important stage in the accrual of bone mass. Young women are often unaware of the need, and how to optimize modifiable risk factors, particularly intake of nutrients associated with good bone health. In this study, an accessible way to estimate osteoporosis risk, quantitative ultrasound (QUS), is compared to the gold-standard technique dual X-ray absorptiometry (DXA) in a group of 54 healthy young women (18–26 years) from Manawatu, New Zealand, and the relationship with nutrient intake is investigated. Broadband ultrasound attenuation and speed of sound (BUA, SOS) were assessed by QUS calcaneal scans and bone mineral concentration/density (BMC/BMD) were determined by DXA scans of the lumbar spine and hip (total and femoral neck). Dietary intake of energy, protein, and calcium was estimated using three-day food diaries and questionnaires. DXA mean Z-scores (>−2.0) for the hip (0.19) and spine (0.2) and QUS mean Z-scores (>−1.0) (0.41) were within the expected ranges. DXA (BMD) and QUS (BUA, SOS) measurements were strongly correlated. Median intakes of protein and calcium were 83.7 g/day and 784 mg/day, respectively. Protein intake was adequate and, whilst median calcium intake was higher than national average, it was below the Estimated Average Requirement (EAR). No significant relationship was found between dietary intake of calcium or protein and BMD or BMC. To conclude, QUS may provide a reasonable indicator of osteoporosis risk in young women but may not be an appropriate diagnostic tool. Increased calcium intake is recommended for this group, regardless of BMD.

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Relation between Hand Bone Mineral Density, Degree of Joint Destruction, and Hand Function in Adults Rheumatoid Arthritis Patients

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2021.2.3.52 ◽

2021 ◽

Vol 2 (3) ◽

pp. 116-121

Author(s):

Aya N. Abdelrafee ◽

Mohamed G. E. Zaki ◽

Abeer K. El Zohiery ◽

Manar A. Azab

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Hand Function ◽

Joint Destruction ◽

Pinch Strength ◽

Dominant Hand ◽

Mineral Density ◽

X Ray ◽

Hand Disability

Background: Rheumatoid Arthritis [RA] is a chronic systemic disease that affects the functional capacity of the hand due to inflammatory arthritis and joint destruction. RA patients have difficulties with everyday life activities and daily living activities. The prevalence of osteoporosis is estimated to be about twice that of the general population. Dual-energy X-ray absorptiometry (DEXA) is the most precise tool for detecting loss in bone mineral density in RA. Aim of the study: This study aims to investigate the relation between generalized bone mineral density (BMD) and each of hand joint destruction and hand function in order to find out its possible role in assessment of rheumatoid hand disability. Patients and Methods: Fifty patients diagnosed as RA based on the 2010 ACR Rheumatoid Arthritis Classification Criteria were included in this study. All patients were subjected to the following scores: Duruöz Hand Index (DHI), Grip Ability Test (GAT), Grip strength test, and Pinch strength tests for assessing the function of the dominant hand of each patient. The participants were also subjected to plain x-ray evaluated by van der Heijde-modified total Sharp score (vdH-S) to assess the damage of the joints of the dominant hand, and Dual-energy X-ray absorptiometry (DEXA) to assess the Bone Mineral Density. Results: The current study showed that wrist BMD was correlated with grip strength, pinch strength, GAT, and van der Heijde modified sharp score of the dominant hand. Moreover, X-ray joint findings were significantly correlated with each of total grip ability test, grip strength, and pinch strength as the hand disability manifested more with joint damage. Conclusion: In conclusion, Osteoporosis, hand function, and joint damage in RA are correlated suggesting related pathophysiological mechanisms. The Severity of RA could be related to osteoporosis as well as joint destruction and hand disability.

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Increased Risk of Osteopenic Fractures in Elderly Patients with Gaucher Disease.

Blood ◽

10.1182/blood.v110.11.2403.2403 ◽

2007 ◽

Vol 110 (11) ◽

pp. 2403-2403

Author(s):

Neal J. Weinreb ◽

Lisa Costantini

Keyword(s):

Gaucher Disease ◽

Dual Energy ◽

Mineral Density ◽

Common Cause ◽

X Ray ◽

Enzyme Replacement ◽

Normal Bone ◽

Increased Risk ◽

Z Scores ◽

Risk Treatment

Abstract Bone disease is a common cause of morbidity in Gaucher disease (GD). 60% of adult patients (pts) have decreased bone mineral density (BMD). However, in elderly pts, statistically “normal” BMD may not indicate functionally normal bone strength. Here we report serial dual energy x-ray absorptiometry (DXA) scores and fracture (Fx) occurrence for 29 GD pts age 57–88 (9M, 20F) treated with enzyme replacement therapy (ERT) with imiglucerase, often in conjunction with bisphosphonates. Results: Lumbar (L) spine Z-scores were mostly normal during 9.2 ± 4.9 y on ERT: median −0.50; mean (SD) −0.05 (0.41); centiles 10–90: −1.81 - 1.21. Nonetheless, new Fxs occurred in 13 of 29 (44.8%) pts: hip (6), spine (4), other location (11), multiple sites (7). Fx occurred in 5/8 (62.5%) pts with splenectomy v 8/21 (38.1%) pts without and in 7/20 (35%) N370S homozygotes v 6/9 (67%) with other genotypes. 10y Fx probability: 42% (CI 17–55). L spine T-scores were < −1 for 18/29 pts, indicating persistent osteopenia/osteoporosis in 62%, and < −2.68 in 25%. New Fx occurred in 8/15 (53.0%) pts with T-scores ≤ the median of −1.60 v 5/14 (35.7%) with T-scores > −1.60. Pts with low T scores were predominantly women (13/15F v 7/14M) and had higher use of bisphosphonates (86.7% v. 35.7%). Fx were not restricted to pts with the lowest T-scores. Findings were similar for femoral neck T-scores. Conclusions: Normal DXA Z-scores in elderly GD pts do not indicate low Fx risk. Low T-scores, as seen in our pts, do confer an important Fx risk. The 42% 10y Fx probability in our elderly GD pts is higher than expected for comparably aged individuals without GD. Because other risk factors such as Fx history, nutritional status, and concurrent illness were similar in our pts regardless of Fx status, cumulative pathophysiology from long-standing, untreated GD may independently increase Fx risk. Treatment with ERT may allow pts to achieve normal Z-scores. However, starting ERT late in life, even in conjunction with bisphosphonates, may not reverse established osteopenia/osteoporosis sufficiently to avoid future Fx. Therefore, detection of bone loss in young pts and early therapeutic intervention to achieve and maintain normal BMD is an important component of GD management.

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Diagnosis of Osteoporosis using modified U-net architecture with attention unit in DEXA and X-ray images

Journal of X-Ray Science and Technology ◽

10.3233/xst-200692 ◽

2020 ◽

Vol 28 (5) ◽

pp. 953-973 ◽

Cited By ~ 1

Author(s):

S.M. Nazia Fathima ◽

R. Tamilselvi ◽

M. Parisa Beham ◽

D. Sabarinathan

Keyword(s):

Bone Mineral Density ◽

Classification Accuracy ◽

Standard Technique ◽

Dual Energy ◽

Mineral Density ◽

Medical Field ◽

Current Standard ◽

Diagnosis Of Osteoporosis ◽

X Ray ◽

T Score

BACKGROUND: Osteoporosis, a silent killing disease of fracture risk, is normally determined based on the bone mineral density (BMD) and T-score values measured in bone. However, development of standard algorithms for accurate segmentation and BMD measurement from X-ray images is a challenge in the medical field. OBJECTIVE: The purpose of this work is to more accurately measure BMD from X-ray images, which can overcome the limitations of the current standard technique to measure BMD using Dual Energy X-ray Absorptiometry (DEXA) such as non-availability and inaccessibility of DEXA machines in developing countries. In addition, this work also attempts to analyze the DEXA scan images for better segmentation and measurement of BMD. METHODS: This work employs a modified U-Net with Attention unit for accurate segmentation of bone region from X-Ray and DEXA images. A linear regression model is developed to compute BMD and T-score. Based on the value of T-score, the images are then classified as normal, osteopenia or osteoporosis. RESULTS: The proposed network is experimented with the two internally collected datasets namely, DEXSIT and XSITRAY, comprised of DEXA and X-ray images, respectively. The proposed method achieved an accuracy of 88% on both datasets. The Dice score on DEXSIT and XSITRAY is 0.94 and 0.92, respectively. CONCLUSION: Our modified U-Net with attention unit achieves significantly higher results in terms of Dice score and classification accuracy. The computed BMD and T-score values of the proposed method are also compared with the respective clinical reports for validation. Hence, using the digitized X-Ray images can be used to detect osteoporosis efficiently and accurately.

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Diagnosed changes of bone mineral density and level of calciotropic hormones in children with juvenile hyperthyroidism

Modern pediatrics. Ukraine ◽

10.15574/sp.2021.115.23 ◽

2021 ◽

pp. 23-30

Author(s):

S.T. Muratova ◽

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Alkaline Phosphatase ◽

Bone Metabolism ◽

Bone Mineral ◽

Inverse Correlation ◽

Dual Energy ◽

Mineral Density ◽

Calciotropic Hormones ◽

X Ray

The development of the skeletal system occur during childhood. Thyroid hormones play an important role in the skeleton's maturation and maintenance of the structure and mass of bones. Juvenile hyperthyroidism affects bone metabolism. This study aimed to identify abnormalities in bone mineral density and the level of calciotropic hormones in juvenile hyperthyroidism to further improve the diagnosis of complications of juvenile hyperthyroidism. Materials and methods. The study was conducted by 21 health controls and 71 children and adolescents with juvenile hyperthyroidism. Anthropometric indicators were calculated using the WHO Anthro Plus personal computer software. Thyroid status and thyroid antibodies, osteocalcin, parathyroid hormone, vitamin D, calcium, phosphorus, alkaline phosphatase were determined using a closed-type immunochemistry analyzer Cobas e 411 Hitachi company Hoffman Le Roche (Switzerland) and its reagents. Bone mineral density was evaluated by dual-energy absorptiometry on a Stratos X-ray densitometer from Diagnostic Medical Systems, France. Results. In juvenile hypertrichosis, in comparison with the control, significantly low values of vitamin D and calcium in the blood serum were noted, the mean values of osteocalcin and alkaline phosphatase were substantially higher. There was no significant difference in the levels of parathyroid hormone and phosphorus in the blood serum in the compared groups. In 45.1% of patients, a decrease in bone mass was diagnosed compared to the age norm. A reliable direct correlation of vitamin D and calcium with bone density was revealed in all X-ray densitometry parameters and a reliable inverse correlation of osteocalcin, alkaline phosphatase and bone mineral density. Osteocalcin had a stronger inverse correlation with all dual-energy X-ray absorptiometry parameters and became a better biomarker than alkaline phosphatase. Conclusions. There is a decrease in bone mineral density in children with juvenile hyperthyroidism. Changes in the level of calciotropic hormones indicate a deranged bone metabolism. Serum osteocalcin can be used as a biomarker of bone metabolism in children with juvenile hyperthyroidism. It is recommended to assess the bones' condition during the initial examination of children with juvenile hyperthyroidism. The study was carried out following the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the parents of the children was obtained for the research. The author declares no conflicts of interest. Key words: juvenile hyperthyroidism, children, adolescents, bone mineral density; dual energy X-ray absorptiometry, osteocalcin, vitamin D.

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