scholarly journals BMD status of Postmenopausal Women in relation with BMI: A study with 93 cases

2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Lumbar Vertebrae ◽  
The Body ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Minimal Trauma ◽  
The Mean

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014

scholarly journals Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study

2011 ◽  
Vol 129 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Daniela Fodor ◽  
Cosmina Bondor ◽  
Adriana Albu ◽  
Laura Muntean ◽  
Siao-pin Simon ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Atherosclerotic Plaque ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Osteoporotic Vertebral Fractures ◽  
The Relationship

CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

scholarly journals Quality of Life in Postmenopausal Women and Its Correlation with Bone Mineral Density

2015 ◽  
Vol 26 (3) ◽  
pp. 58-64
Author(s):  
C Zonunsanga ◽  
Hmingthanmawii LNU ◽  
Minggam Pertin ◽  
Chongreilen Chiru ◽  
Romi Singh Nongmaithem ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Significant Positive Association ◽  
The Mean

Abstract Aim To evaluate the quality of life in postmenopausal women and its correlation with bone mineral density. Study design Cross-sectional study. Duration of the study October 2012 to September 2014. Settings Physical Medicine and Rehabilitation Department, Regional Institute of Medical Sciences, Imphal. Study population Postmenopausal women who attended the department during the study period. Materials and Methods Quality of life was assessed using WHOQOL-BREF questionnaire, a validated brief version of the WHOQOL-100. Bone mineral density (BMD) in the lumbar spine, femoral neck and trochanter were measured using dual energy x-ray absorptiometry (DEXA) scan – GE Lunar model. Results A total of 125 patients were studied. The mean t-scores in lumbar spine, femoral neck and trochanter were -2.550 ± 1.209, -1.831 ± 0.921 and -1.621 ± 1.064 respectively. The mean BMD (g/cm2) in lumbar spine, femoral neck and trochanter were 0.867 ± 0.144, 0.789 ± 0.131 and 0.682 ± 0.139 respectively. The mean overall WHOQOL score was 57.68±10.07. There were statistically significant positive association of WHOQOL score with the BMDs in lumbar spine, femoral neck and trochanter (p < 0.05). Multivariate regression showed significant relation of overall WHOQOL score with BMD lumbar spine (b=0.229; R2=0.119), BMD femoral neck (b=0.285; R2=0.129), and BMD trochanter (b=0.245; R2=0.119). Conclusion BMDs in the lumbar spine, femoral neck and trochanter had a positive correlation with quality of life scores. BMD also had a good predictive value in determining the quality of life in postmenopausal women.

Bone Mineral Density Changes In Patients with Paraproteinemia After Treatment with Bortezomib

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4989-4989
Author(s):  
Tamara Berno ◽  
Kenneth Boucher ◽  
Fenghuang Zhan ◽  
Guido J. Tricot ◽  
Benjamin Mughal ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Disease ◽  
Proteasome Inhibitor ◽  
Mineral Density ◽  
T Score ◽  
The Mean

Abstract Abstract 4989 Background: Bone disease is present at diagnosis in almost all patients with multiple myeloma (MM) and can impact substantially on patient morbidity and quality of life. Decreased bone mineral density is also observed not only in MM but also in patients with monoclonal gammopathy of undetermined significance (MGUS). The pathogenesis of bone disease in MM is complex. The activity of proteasome inhibitor bortezomib has been linked to increased bone formation and osteoblastic activation. Evidence from the available clinical data indicates that bortezomib has a positive impact on bone health in MM and demonstrates a bone anabolic effect. Methods: We analyzed retrospectively 53 patients with MM and 16 with MGUS who have completed bone density at least at diagnosis. 21 patients have completed two bone density (3 MGUS and 18 MM). The bone density was obtained in all patients at baseline and in 16 patients repeated after bortezomib treatement with a median time of bortezomib exposure of 6 months. We analyzed T-score values at lumbar spine and at femoral neck. Results: With a median age of 66 years, 41 male and 28 female were analyzed. At baseline the mean lumbar spine T-score of all subjects and of 16 MM treated with bortezomib was -0.50 and -0.76 respectively. At baseline the mean femoral neck T-score for all subjects and for 16 MM treated with Bortezomib was -1.56 and -1.31 respectively. The baseline mean lumbar spine T-score for MGUS and MM was -0.71 and -0.43 respectively. The baseline mean femoral neck T-score of MGUS and MM was -1.61 and -1.54 respectively. In the group of 16 patients treated with Bortezomib we observed from baseline a change in lumbar bone mineral density T-score of 0.36 and at femoral neck bone density T-score of 0.25. Conclusion: These data show that patients treated with proteasome inhibitor showed moderate increment in bone mineral density at lumbar spine and at femoral neck. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Association between Osteoporosis and Metabolic Syndrome in Postmenopausal Women

2021 ◽  
Vol 2 (6) ◽  
pp. 15-18
Author(s):  
S. M. Muraduzzaman ◽  
S. Begum ◽  
A. Siddika ◽  
A. Islam ◽  
S. Sultana ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Regression Analysis ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Multiple Logistic Regression Analysis ◽  
Blood Collection ◽  
Mineral Density ◽  
T Score

The risk of osteoporosis is higher in elderly and postmenopausal women. Several studies in different populations investigated the association between osteoporosis and metabolic syndrome (MS); however, the results are conflicting. In our population, no study has yet been conducted to evaluate this relationship in postmenopausal women. The aim of the study was to determine the relationship between osteoporosis and metabolic syndrome in postmenopausal women. In this study, a total of 131 postmenopausal women were included. Clinical history and anthropometric data were recorded and subjected to blood collection and scan for bone mineral density (BMD) and T-score at the lumbar spine and femoral neck and by dual-energy x-ray absorptiometry (DEXA). Osteoporosis and osteopenia were defined from T-score. The lipid profile was estimated by standard spectrophotometric methods. The mean±SD of age (years) of the postmenopausal women was 57.0±8.4. Bone mineral densities (g/cm2) were 0.78±0.17, 0.75±0.16, 0.72±0.16 and T-scores were   -2.32±1.54, -1.52±1.29, -1.53±1.39 respectively in lumbar spine, right femoral neck and left femoral neck. Osteoporosis and osteopenia were found in 58 (44.3%) and 45 (34.4%) study subjects, respectively. Eighty-three (63.4%) of the study subjects have metabolic syndrome (MS). On multiple regression analysis, considering BMD at lumbar spine, right femoral neck or left femoral neck as dependent variable and age, body mass index (BMI), and MS as independent variables, β values for MS with BMD were -0.041 (p = 0.184), 0.002 (p = 0.938), 0.011 (p = 0.688) and with T-score were -0.330 (p = 0.241), -0.005 (p = 0.984), 0.151 (p = 0.599) at lumbar spine and right femoral neck and left femoral neck respectively. The coefficient of osteoporosis with MS in multiple logistic regression analysis was β = 1.311, (p = 0.003). In conclusion, osteoporosis is found to be positively associated with metabolic syndrome in postmenopausal women.

scholarly journals SAT0470 FRAX AND DXA-BASED APPROACHES IN DIAGNOSTICS OF OSTEOPOROSIS RISK IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1192.3-1192
Author(s):  
N. Grygorieva ◽  
V. Povoroznyuk ◽  
N. Dzerovych ◽  
M. Bystrytska
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
Mineral Density ◽  
T Score ◽  
Total Body

Background:Nowadays, the bone mineral density (BMD) measured by DXA and FRAX®are the most important methods for fracture risk assessment. Rheumatoid arthritis is a crucial disease for bone loss and osteoporosis development [1] which is included into FRAX algorithm. Ukrainian version of FRAX [2] is а new one and its value should also be assessed in patients with RA.Objectives:Our study was aimed to assess the parameters of BMD and FRAX in postmenopausal women with RA.Methods:We have examined 635 postmenopausal females aged 50-89 years old which were divided into 2 groups: 1st(control, n=313) – without any factors which have influence on bone metabolism, 2d(n=322) – patients with RA. The 10-year probabilities of hip fracture and major osteoporotic fractures were calculated without BMD parameter using the Ukrainian FRAX model [2]. The DXA was used to measure the lumbar spine, femoral neck and total body BMDs; the T-score was calculated (DISCOVERY Wi, Hologic, Inc., USA).Results:FRAX indexes for major osteoporotic and hip fractures were significantly higher in patients with RA (Me [25-75Q]): 9.7 [6.8-15.0] and 3.1 [1.5-6.2] % compared to 6.0 [3.8-8.5] and 1.2 [0.6-2.4] % in females from the control group (p<0.001). 45.3 % of women with RA required antiosteoporotic treatment according to Ukrainian FRAX threshold ratio without measure of BMD compared to 12.1% of subjects from control group. Only 3.4% of patients with RA had FRAX indexes which were less than low threshold (requirement of additional DEXA measurement) compared to 31.3 % of females from control group.BMD of femoral neck and distal radius were reliably lower in subjects with RA and consisted 0.65±0.13 and 0.69±0.12 g/cm in 1stand 2dgroups, accordingly (p<0.001) and 0.56±0.10 and 0.58±0.09 g/cm (p=0.02) without any significant differences at lumbar spine and total body BMDs. 16.6 % of subjects from the control group and 31.6 % of females with RA had osteoporosis according to DXA parameters (T-score ≤-2.5 SD).Conclusion:FRAX should be used more widely in clinical practice for detection of risk of osteoporotic fractures in subjects with RA.References:[1]Povoroznyuk V.V., Grygorieva N.V., Karasevska T.A., Dzerovich N.I. Bone Mineral Density and Trabecular Bone Score Indices in Women with Rheumatoid Arthritis According to the Age and Use of Glucocorticoids. SM Rheumatol. 2017; 1(1): 1002.[2]Povoroznyuk V, Grygorieva N, Kanis JA, Johansson H, McCloskey EV. Ukrainian FRAX: criteria for diagnostics and treatment of osteoporosis // Pain. Joint. Spine.-2019.-9(4).-7-16.Disclosure of Interests:None declared

scholarly journals Dietary Approaches to Stop Hypertension, Mediterranean, and Alternative Healthy Eating indices are associated with bone health among Puerto Rican adults from the Boston Puerto Rican Osteoporosis Study

2020 ◽  
Vol 111 (6) ◽  
pp. 1267-1277 ◽  
Author(s):  
Sabrina E Noel ◽  
Kelsey M Mangano ◽  
Josiemer Mattei ◽  
John L Griffith ◽  
Bess Dawson-Hughes ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Puerto Rican ◽  
Postmenopausal Women ◽  
Premenopausal Women ◽  
Dietary Quality ◽  
Dash Score ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip

Abstract Background Conflicting results on associations between dietary quality and bone have been noted across populations, and this has been understudied in Puerto Ricans, a population at higher risk of osteoporosis than previously appreciated. Objective To compare cross-sectional associations between 3 dietary quality indices [Dietary Approaches to Stop Hypertension (DASH), Alternative Health Eating Index (AHEI-2010), and Mediterranean Diet Score (MeDS)] with bone outcomes. Method Participants (n = 865–896) from the Boston Puerto Rican Osteoporosis Study (BPROS) with complete bone and dietary data were included. Indices were calculated from validated food frequency data. Bone mineral density (BMD) was measured using DXA. Associations between dietary indices (z-scores) and their individual components with BMD and osteoporosis were tested with ANCOVA and logistic regression, respectively, at the lumbar spine and femoral neck, stratified by male, premenopausal women, and postmenopausal women. Results Participants were 59.9 y ± 7.6 y and mostly female (71%). Among postmenopausal women not taking estrogen, DASH (score: 11–38) was associated with higher trochanter (0.026 ± 0.006 g/cm2, P &lt;0.001), femoral neck (0.022 ± 0.006 g/cm2, P &lt;0.001), total hip (0.029 ± 0.006 g/cm2, P &lt;0.001), and lumbar spine BMD (0.025 ± 0.007 g/cm2, P = 0.001). AHEI (score: 25–86) was also associated with spine and all hip sites (P &lt;0.02), whereas MeDS (0–9) was associated only with total hip (P = 0.01) and trochanter BMD (P = 0.007) in postmenopausal women. All indices were associated with a lower likelihood of osteoporosis (OR from 0.54 to 0.75). None of the results were significant for men or premenopausal women. Conclusions Although all appeared protective, DASH was more positively associated with BMD than AHEI or MeDS in postmenopausal women not taking estrogen. Methodological differences across scores suggest that a bone-specific index that builds on existing indices and that can be used to address dietary differences across cultural and ethnic minority populations should be considered.

scholarly journals Dose-dependent effects of inhaled corticosteroids on bone mineral density in postmenopausal women with asthma or COPD: A registry-based cohort study

2017 ◽  
Author(s):  
Wenjia Chen ◽  
Kate M. Johnson ◽  
J. Mark FitzGerald ◽  
Mohsen Sadatsafavi ◽  
William D. Leslie
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip ◽  
Hip Bmd ◽  
Sectional Analysis

ABSTRACTBackgroundThe effect of long-term inhaled corticosteroid (ICS) therapy on the bone health of older adults remains unclear due to its possible impact on bone mineral density (BMD).ObjectiveTo evaluate, cross-sectionally and longitudinally, the impact of ICS use on BMD in postmenopausal women with asthma or chronic obstructive pulmonary disease (COPD).MethodsWe used a population-based bone densitometry registry linked with administrative health data of the province of Manitoba, Canada (1999–2013), to identify women with diagnosed asthma or COPD. ICS use was defined as cumulative dispensed days prior to baseline BMD (cross-sectional analysis), and medication possession ratio (MPR) between two BMD measurements (longitudinal analysis). Results were adjusted for multiple covariates including the underlying respiratory diagnosis and its severity.ResultsIn the cross sectional analysis, compared with non-users, women with the highest tertile of prior ICS exposure had lower baseline BMD at the femoral neck (-0.09 standard deviations [SD] below a healthy young adult, 95% CI: −0.16, −0.02) and total hip (-0.14 SD, 95% CI: −0.22, −0.05), but not at the lumbar spine. Longitudinally, the highest tertile of ICS exposure was associated with a slight decline in total hip BMD relative to non-users (-0.02 SD/year, 95% CI: −0.04, −0.01), with no significant effect at the femoral neck and lumbar spine. Middle and lower tertiles of ICS use had no significant effects.ConclusionHigh exposure to ICS was associated with a small adverse effect on baseline hip BMD and total hip BMD loss in post-menopausal women with asthma or COPD.

scholarly journals Association between Bone Mineral Density and Hypertension in Postmenopausal Women

2021 ◽  
Vol 3 (4) ◽  
pp. 116-120
Author(s):  
S. M. Muraduzzaman ◽  
S. Begum ◽  
S. Ali ◽  
S. Sultana ◽  
M. Saiedullah ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
The Elderly ◽  
Inverse Association ◽  
Mineral Density ◽  
T Score ◽  
Confounding Variables

Background: Low bone mineral density (BMD) is a common disorder in the elderly and found to be most prevalent in postmenopausal women which are thought to be associated with several factors including hypertension, however, results are inconsistent in different studies. Aim of the study: This study aimed to explore the association between BMD and hypertension in postmenopausal women. Methods and materials: In this study, total 76 postmenopausal women were included. BMD was determined at the lumbar spine and femoral neck by dual-energy x-ray absorptiometry (DEXA). Anthropometric data and status of hypertension and diabetes were collected according to a pre-structured questioner. Results: Age (mean±SD) of the postmenopausal women was 57±9 years. Among them, 46 (60.5%) subjects were hypertensive and 30 (39.5%) were normotensive. Bone mineral density (g/cm2) in normotensive women and in hypertensive women were 0.79±0.15 vs 0.74±0.15 (p=0.160) at lumbar spine; 0.70±0.12 vs 0.69±0.13 (p=0.271) at right femoral neck and 0.73±0.15 vs 0.71±0.13 (p=0.592), respectively. T-scores at lumbar spine, right and left femoral neck in normotensive and hypertensive postmenopausal women were -2.28±1.37 vs -2.75±1.35 (p=0.153), -1.70±1.16 vs -1.95±1.07 (p=0.363) and -1.82±0.95 vs -1.93±1.01 (p=0.632) respectively. On multiple regression analysis, BMD and T-score only at lumbar spine showed inverse association with hypertension (β=-0.069, p=0.045; β=-0.612, p=0.050) on adjusting confounding variables. Conclusion: Hypertension is independently associated with BMD and T-score measured from the lumbar spine but not with BMD and T-score measured from the femoral neck in postmenopausal women.

Bone Mineral Density And Its Associated Factors In Vietnamese Women Over 40 Years Of Age: A Descriptive Cross-Sectional Study

2020 ◽  
Vol 16 ◽  
Author(s):  
Tam Thai Thanh Tran ◽  
Phu Dac Pham ◽  
Thang Nguyen ◽  
Diem Thi Ngoc Pham ◽  
Sam Phan Hai Nguyen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Associated Factors ◽  
Mineral Density ◽  
Cross Sectional ◽  
Vietnamese Women ◽  
The Mean ◽  
Over 40 Years

Background: Low measured bone mineral density (BMD) in clinical settings is known as an indirect indicator of osteoporosis and fracture risk. Objective: To evaluate the mean BMD at the lumbar spine and femoral neck and the correlation between BMD and some associated factors in women aged over 40 years. Methods: A prospective cross-sectional research was performed. The study group included 168 healthy women aged over 40 years having annual health surveillance at Can Tho University of Medicine and Pharmacy Hospital. BMD at lumbar spine and femoral neck were measured by dualenergy X-ray absorptiometry (DEXA) method from 6/2017 to 5/2018. Results: The results recorded that the mean BMD at the lumbar spine and femoral neck were 0.92±0.2g/cm2 and 0.84±0.15g/cm2 , respectively. BMD at the lumbar spine and femoral neck had significant positive correlation with height (r=0.353, p<0.001; r=0.394, p<0.001), weight (r=0.435, p<0.001; r=0.414, p<0.001), BMI (r=0.33, p<0.001; r=0.284, p<0.001) while having significant negative correlation with age (r=-0.609, p<0.00; r=-0.561; p<0.001), time elapsed since menopauseTESM (r=-0.495, p<0.001; r=-0.523; p<0.001), and number of giving birth (r=-0.381, p<0.001; r=- 0.268, p<0.001). Conclusion: The mean BMD at the lumbar spine and femoral neck which had a significant correlation with age, TESM, number of giving birth, height, weight and BMI were rather high. Targeted future research is suggested to point out a strategy that directly impacts osteoporosis and fracture risks outcomes in healthy Vietnamese women over 40 years of age.

scholarly journals Bone mineral density and quantitative ultrasound in adults with cystic fibrosis

2002 ◽  
pp. 531-536 ◽  
Author(s):  
F Flohr ◽  
A Lutz ◽  
EM App ◽  
H Matthys ◽  
M Reincke
Keyword(s):  
Bone Mineral Density ◽  
Cystic Fibrosis ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Stiffness Index ◽  
Mineral Density ◽  
T Score ◽  
The Mean ◽  
Oral Glucocorticoids

OBJECTIVE: With increasing life span osteoporosis becomes a more recognized problem in patients with cystic fibrosis (CF). The aim of this cross-sectional study in 75 adult patients with CF (mean age 25.3 years) was to assess the prevalence of low bone mineral density (BMD) by dual-energy x-ray absorptiometry (DEXA) and, for the first time, by quantitative ultrasound (QUS), and to identify predicting factors. DESIGN AND METHODS: Bone status was assessed at the lumbar spine (L2-L4) and the femoral neck by DEXA, and at the calcaneus by QUS (stiffness index). These data were correlated with a variety of clinical and anthropomorphic variables. Biochemical markers of bone turnover such as osteocalcin, bone-specific alkaline phosphatase, crosslinks in urine, 25-hydroxy vitamin D (25-OH vitamin D), parathyroid hormone, calcium and free testosterone were determined by standard assays. RESULTS: The mean BMD T score (+/-s.e.m.) was -1.4+/-0.17 at the lumbar spine, and -0.54+/-0.16 at the femoral neck. The mean T score of the calcaneal stiffness index was -0.83+/-0.19. Based on a lumbar spine T score <-2.5 by DEXA, 27% of the patients had osteoporosis. Multiple regression analysis showed that the forced expiratory volume in one second (FEV1) and the use of oral glucocorticoids were independent predictors of low lumbar spine BMD, whereas body mass index (BMI) and the use of oral glucocorticoids were independent predictors of low femoral neck BMD. The stiffness index correlated moderately with BMD (0.49-0.62, P<0.0001). QUS had a sensitivity and specificity of only 57% and 89% respectively for diagnosing 'osteoporosis' (based on a femoral neck T score <-2.5 by DEXA). Positive and negative predictive values were 36% and 95% respectively. CONCLUSIONS: Low BMD is frequent in adults with CF and is most strongly correlated with disease severity (BMI, FEV1) and the use of glucocorticoids. Calcaneal QUS might help to screen out patients with a normal BMD, but sensitivity and specificity were not sufficiently high to replace DEXA in these patients.

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