scholarly journals Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication

2021 ◽  
Vol 19 (1) ◽  
pp. 197
Author(s):  
Chun-Sheng Hsu ◽  
Shin-Tsu Chang ◽  
Yuan-Yang Cheng ◽  
Hsu-Tung Lee ◽  
Chih-Hui Chen ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Mortality Risk ◽  
Calcium Level ◽  
Cox Regression ◽  
Mass Density ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Osteoporosis Medication ◽  
The Right

Bone mass density (BMD) has been used universally in osteoporosis diagnosis and management. Adherence to anti-osteoporosis medication is related to mortality risk. This study aimed to investigate the relationship between mortality and low BMD of the femoral neck and vertebra among patients self-discontinuing anti-osteoporosis medication. Between June 2016 and June 2018, this single-center retrospective study recruited 596 participants who self-discontinued anti-osteoporosis medication. Patients were categorized into four groups by BMD of the right femoral neck and lumbar spine. Occurrence and causes of mortality were obtained from medical records. Independent risk factors and the five-year survival of various levels of BMD were analyzed by Cox regression and the Kaplan–Meier survival analysis. BMD value and serum calcium level were significantly lower in the mortality group (p < 0.001). Compared to the reference, the adjusted hazard ratio (HR) for all-cause mortality in patients with lower BMD of both the lumbar spine and femoral neck was 3.03. The five-year cumulative survival rate was also significantly lower (25.2%, p < 0.001). A low calcium level was also associated with mortality (HR: 0.87, 95% CI: 0.76–0.99, p = 0.033). In conclusion, lower BMD and calcium levels were associated with higher mortality risk in patients with poor adherence. Hence, patients self-discontinuing anti-osteoporosis medication should be managed accordingly.

scholarly journals Radiofrequency Multi Echographic Spectrometry (REMS) Technology in Patients With Bone Artifacts

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A249-A249
Author(s):  
Maria Dea Tomai Pitinca ◽  
Carla Caffarelli ◽  
Stefano Gonnelli
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Fracture ◽  
Gamma Nail ◽  
Mineral Density ◽  
Left Femur ◽  
Diagnosis Of Osteoporosis ◽  
T Score ◽  
Femoral Site ◽  
The Right

Abstract Introduction: Dual-energy X-ray Absorptiometry (DXA) is considered the gold standard examination for the evaluation of bone mineral density (BMD). However, it is known that some conditions, such as arthrosis, vertebral collapse, or vertebroplasty, result in an overestimation of the BMD measured by DXA. Conversely, Radiofrequency Echographic Multi-Spectrometry (REMS) technology is able to automatically discard signals related to bone artifacts, such as calcifications or osteophytes, thanks to the identification of unexpected spectral features (Diez-Perez et al. 2019). The aim of this work is to assess the performance of REMS technology in patients with bone alterations that could alter the densitometric examination. Materials: The bone densitometry exams, both REMS and DXA, of patients with evidences of bone alterations at lumbar vertebrae or femoral neck were analysed. Written patient informed consent was obtained before the scans. Results: Eighty-seven patients with spinal artifacts, including 22 patients with vertebroplasty, 26 patients with bone fracture and 38 patients with osteo-arthrosis were considered. At lumbar spine, the mean BMD and T-score values assessed by REMS was lower than the ones measured by DXA. Moreover, the results obtained by the two technologies were not correlated. On the contrary, the BMD and T-score values measured by REMS and DXA at the femoral site were highly correlated (p&lt;0.01), as well as BMD and the T-score values measured by DXA at the femoral neck and by REMS at the lumbar spine (p&lt;0.01). As concerning artifacts involving femoral site, a patient with an intramedullary gamma nail positioned following a displaced pertrochanteric fracture of the left femur underwent a DXA scan of the right femur and a REMS scan of both femurs. A diagnosis of osteoporosis at the right femur was posed by both technologies. At the left femur with intramedullary gamma nail, REMS only made a diagnosis of osteoporosis highly corresponding with the one performed at right femur. Conclusions: The results from the patient series with spinal artifacts and the clinical case with femoral intramedullary gamma nail show the ability of REMS to evaluate anatomical sites that would not be assessable by DXA, such as in case of implanted nails, or that would give unreliable higher BMD values, such as in case of vertebroplasty, osteo-arthrosis and bone fracture. References: Diez-Perez et al. Aging Clin Exp Res 2019;31(10):1375–89

scholarly journals Image Analysis of Periapical Radiograph for Bone Mineral Density Prediction

2018 ◽  
Vol 8 (4) ◽  
pp. 2083 ◽  
Author(s):  
Rini Widyaningrum ◽  
Sri Lestari ◽  
Ferry Jie
Keyword(s):  
Bone Mineral Density ◽  
Image Analysis ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Negative Correlation ◽  
Mass Density ◽  
The Body ◽  
Bone Mass Density ◽  
Mineral Density ◽  
T Score

<span>Osteoporosis is a systemic skeletal disease. Parameter from any bone site in the body has possibility to be developed as a predictor of osteoporosis. The alteration in the mandible trabecular bone is visible in periapical radiographs. The aim of this study was to correlate the area parameter and the integrated density of periapical radiograph with bone mineral density. Image analysis of periapical radiograph i.e. measurement of area parameter and integrated density was done on Region of Interest (ROI) by using canny edge detection method. Result of this study showed that the area parameter has asignificant (α&lt;0.05) negative correlation with the bone mass density (BMD) of the lumbar spine (r = -0.371) and T-score of the lumbar spine (r = -0.383). The linear regression test showed that the area parameter only can be used to predict T-score of the lumbar spine (F=5.822, α&lt;0.05). The integrated density showed a significant (α &lt; 0.05) negative correlation with T-score of hip (r = -0.332) and T-score of lumbar spine (r = -0.377). It can be concluded that the area parameter can be used as one of input parameters for computer-aided system of osteoporosis early detection by using periapical radiograph.</span>

scholarly journals Hubungan fraksi area trabekula anterior mandibula dengan kepadatan tulang lumbar spine untuk deteksi dini osteoporosis

2017 ◽  
Vol 3 (1) ◽  
pp. 43
Author(s):  
Sri Lestari ◽  
Rini Widyaningrum
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Mass Density ◽  
Area Fraction ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Anterior Mandible

The relationship of anterior mandible trabecular area with bone mass density of lumbar spine for early detection of osteoporosis. Bone mineral density is an indicator of osteoporosis, including the bone mineral density of lumbar spine. The decrease of lumbar spine bone mass density will cause an alteration in another site, including the mandibular. The aim of this research is to determine the predictor of lumbar spine bone mineral density using trabecular bone image of anterior mandible on periapical radiographs. The research was conducted by extracting the area fraction at mandible trabecular bone using digital periapical radiograph from 25 subjects. Canny edge detection was used in digital image processing for each radiograph. The regions of interest were selected from the image obtained by canny edge detection, so that the area fraction could be measured. A linier regression test was applied to determine a relationship between the area fractions of mandible trabecular bone with the bone mineral density of lumbar spine. The result of linear regression test showed that the area fraction of mandible trabecular bone had a moderate negative correlation with bone mass density of lumbar spine (α = 0.046; R = -0.403). The direction of the correlation was negative (b = -0.145). The area fraction of mandible trabecular bone on periapical radiographs could be used as the predictor for bone mass density of lumbar spine.ABSTRAKKepadatan tulang merupakan indikator osteoporosis, salah satu diantaranya adalah kepadatan tulang pada lumbar spine. Penurunan kepadatan tulang pada lumbar spine mempengaruhi kondisi tulang lain, termasuk tulang rahang bawah (mandibula). Tujuan penelitian ini adalah untuk menentukan prediktor densitas mineral tulang menggunakan citra radiograf periapikal tulang trabekula pada regio anterior rahang bawah. Penelitian dilakukan dengan ekstraksi fraksi area tulang trabekula mandibula yang tercitrakan pada radiograf periapikal digital dari 25 subjek. Pengolahan citra digital pada radiograf periapikal dilakukan dengan menggunakan metode deteksi tepi canny terhadap masing-masing citra radiograf. Region of Interest diseleksi dari citra hasil deteksi canny, sehingga dapat dilakukan pengukuran fraksi area. Uji regresi linier dilakukan untuk mengetahui hubungan antara nilai fraksi area trabekula mandibula dengan tingkat kepadatan tulang pada lumbar spine. Hasil uji regresi linier menunjukkan bahwa nilai fraksi area trabekula mandibula berkorelasi negatif dengan kepadatan tulang dengan kekuatan sedang (α = 0,046; R = -0,403). Adapun arah korelasi antara nilai fraksi area trabekula mandibula dengan kepadatan tulang adalah negatif (b = -0,145). Fraksi area tulang trabekula pada citra radiograf periapikal dapat digunakan sebagai prediktor kepadatan tulang pada lumbar spine.

Effect of denosumab on bone mineral density (T-score classification of −1.0 to −2.5) in postmenopausal Japanese women receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 552-552
Author(s):  
Katsuhiko Nakatsukasa ◽  
Takayuki Matsuda ◽  
Tetsuya Taguchi
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
Prospective Study ◽  
Hormone Receptor ◽  
Mineral Density ◽  
Hormone Receptor Positive ◽  
The Right

552 Background: Adjuvant aromatase inhibitor (AI) therapy is well established in postmenopausal women with hormone receptor-positive breast cancer, but such therapy is associated with bone loss and increased fracture risk. Denosumab, a fully human monoclonal antibody against receptor of nuclear-κB ligand, was previously proven to protect against AI-induced bone loss. In Japan, however, the efficacy of denosumab in the treatment of AI-associated bone loss has not been proven in a prospective study. Methods: This non-randomized prospective study was conducted at four institutions in Japan. we prospectively evaluated the bone mineral density (BMD) of the lumbar spine and bilateral femoral neck in hormone-receptor positive clinical stageⅠ–ⅢA, postoperative postmenopausal breast cancer patients who were scheduled for treatment with AI as adjuvant endocrine therapy or during AI adjuvant therapy. They received supplemental calcium, vitamin D and subcutaneous denosumab 60mg (n=103) every six months. At enrollment, all patients were required to have evidence of low bone mass, excluding osteoporosis. The primary endpoint was percentage change in lumbar spine BMD from baseline to month 12. The secondary endpoint was percentage change in bilateral femoral neck BMD from baseline to month 12. This is the first trial where the right and left femoral neck BMD are measured separately. Results: We enrolled 103 patients between November, 2014 to October, 2016. At 12 months, lumber spine BMD increased by 4.7 %. The patients who were administered prior AI therapy (n=60) had a 4.8 % increase, and the patients without prior AI therapy (n=40) had a 4.6 % increase. At 12 months, the right and left femoral neck BMD increased by 2.9 % and 2.0 %, respectively. Hypocalcemia ≥ grade2, osteonecrosis of the jaw (ONJ) and non-traumatic clinical fracture were absent in this study. Conclusions: Twice-yearly treatment with denosumab was associated with consistently greater gains in BMD among Japanese women receiving adjuvant AI therapy, regardless of whether prior AI therapy was administered. Clinical trial information: UMIN000013863.

scholarly journals Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis

2014 ◽  
Vol 60 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Roberta Vanacor ◽  
Fabiana V. Raimundo ◽  
Natália A. Marcondes ◽  
Bruno P. Corte ◽  
Aline M. Ascoli ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cystic Fibrosis ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Body Mass ◽  
Mass Density ◽  
Bone Mass Density ◽  
Z Score ◽  
Low Bone Mass ◽  
Mineral Density

Objective The aim of this cross-sectional study was to evaluate the prevalence of low bone mass density in cystic fibrosis patients as well as to evaluate the factors associated with bone mass in such patients. Methods Bone mass density was measured by dual-photon X-ray absorptiometry of lumbar spine (L1-L4), in patients ≤19 years old, or lumbar spine and femur (total and neck) in patients ≥20 years old. Evaluations of nutritional status, biochemical parameters, and lung function were performed. Medication data were obtained from medical records. Results Fifty-eight patients were included in the study (25 males/ 33 females), mean age 23.9 years (16-53years). The prevalence of bone mass below the expected range for age at any site was 20.7%. None of the subjects had history of fracture. Lumbar spine Z-score in cystic fibrosis patients correlated positively with body mass index (r= 0.3, p=0.001), and forced expiratory volume in the first second (% predicted) (r=0.415, p=0.022). Mean lumbar spine Z-score was higher in women (p=0.001), in patients with no pancreatic insufficiency (p=0.032), and in patients with no hospitalization in the last 3 months (p=0.02). After multivariate analysis, body mass index (p= 0.001) and sex (p=0.001) were independently associated with Z-score in lumbar spine. Conclusion Low bone mass is a frequent problem in patients with CF, being independently associated with body mass index, and male sex.

scholarly journals AB1082 INFLUENCE OF THE VARIATION OF THE OPERATOR, PATIENT POSITION AND DEVICE ON THE MEASUREMENT PERFORMANCE OF RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1830.1-1830
Author(s):  
C. Caffarelli ◽  
G. Adami ◽  
G. Arioli ◽  
G. Bianchi ◽  
M. L. Brandi ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
High Performance ◽  
Mineral Density ◽  
Research Support ◽  
Short Term ◽  
Alphabetical Order ◽  
Patient Position ◽  
Term Monitoring

Background:The monitoring of bone mineral density (BMD) is a key aspect for patients undergoing pharmacological treatments that might cause BMD changes at non-physiological rates. At present, the short-term follow-up of patients under treatment in terms of BMD change with time remains an unmet clinical need, since the current techniques, including the gold standard dual X-ray absorptiometry (DXA), require at least 1 year between two consecutive measurements [1]. Therefore, an effective strategy for the assessment of BMD should guarantee high accuracy, precision and repeatability of the measurements.Objectives:The aim is to assess the influence of the variation 1) in patient position, 2) operator (both intra- and inter-) and 3) device on the REMS performance at lumbar spine and femoral neck.Methods:210 women were enrolled, divided in 7 groups of 30-patient each for the assessment of the parameters of interest, i.e. inter-device, intra- and inter-operator repeatability for lumbar spine scans and inter-patient position, inter-device, intra- and inter-operator repeatability for femoral neck scans.All patients underwent 2 REMS scans at lumbar spine or femoral neck, performed by the same operator or by 2 different operators or by the same operator using 2 different devices or in different patient position (i.e. supine without constraints or with a constrained 25°-rotation of the leg). The percentage coefficient of variation (CV%) with 95% confidence interval and least significant change for a 95% confidence level (LSC) have been calculated.Results:For lumbar spine, intra-operator repeatability resulted in CV%=0.37% (95%CI: 0.26%-0.48%), with LSC=1.02%, inter-operator repeatability resulted in CV%=0.55% (95% CI: 0.42%-0.68%), with LSC=1.52%, inter-device repeatability resulted in CV%=0.53% (95% CI: 0.40%-0.66%), with LSC=1.47%.For femoral neck, intra-operator repeatability resulted in CV%=0.33% (95%CI: 0.23%-0.43%), with LSC=0.91%, inter-operator repeatability resulted in CV%=0.47% (95% CI: 0.35%-0.59%), with LSC=1.30%, inter-device repeatability resulted in CV%=0.42% (95% CI: 0.30%-0.51%), with LSC=1.16%, inter-patient position repeatability resulted in CV%=0.24% (95% CI: 0.18%-0.30%), with LSC=0.66%.Conclusion:REMS densitometry is highly precise for both anatomical sites, showing high performance in repeatability. These results suggest that REMS might be a suitable technology for short-term monitoring. Moreover, thanks to its ionizing radiation-free approach, it might be applied for population mass investigations and prevention programs also in paediatric patients and pregnant women.References:Note:Carla Caffarelli, Giovanni Adami§, Giovanni Arioli§, Gerolamo Bianchi§, Maria Luisa Brandi§, Sergio Casciaro§, Luisella Cianferotti§, Delia Ciardo§, Francesco Conversano§, Davide Gatti§, Giuseppe Girasole§, Monica Manfredini§, Maurizio Muratore§, Paola Pisani§, Eugenio Quarta§, Laura Quarta§, Stefano Gonnelli§Equal contributors listed in alphabetical orderDisclosure of Interests:Carla Caffarelli: None declared, Giovanni Adami: None declared, Giovanni Arioli *: None declared, Gerolamo Bianchi Grant/research support from: Celgene, Consultant of: Amgen, Janssen, Merck Sharp & Dohme, Novartis, UCB, Speakers bureau: Abbvie, Abiogen, Alfa-Sigma, Amgen, BMS, Celgene, Chiesi, Eli Lilly, GSK, Janssen, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi Genzyme, Servier, UCB, Maria Luisa Brandi: None declared, Sergio Casciaro: None declared, Luisella Cianferotti: None declared, Delia Ciardo: None declared, Francesco Conversano: None declared, Davide Gatti Speakers bureau: Davide Gatti reports personal fees from Abiogen, Amgen, Janssen-Cilag, Mundipharma, outside the submitted work., Giuseppe Girasole: None declared, Monica Manfedini: None declared, Maurizio Muratore: None declared, Paola Pisani: None declared, Eugenio Quarta: None declared, Laura Quarta: None declared, Stefano Gonnelli: None declared

scholarly journals AB0910 SARCOPENIA AND BONE MINERAL DENSITY IN MEN WITH CORONARY HEART DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1757.2-1757
Author(s):  
T. Raskina ◽  
I. Grigoreva ◽  
J. Averkieva ◽  
A. Kokov ◽  
V. Masenko
Keyword(s):  
Bone Mineral Density ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Muscle Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Group 3 ◽  
Group 2

Objectives:To examine bone mineral density (BMD) in men with coronary heart disease (CHD), depending on the state of the muscle mass, strength and function.Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD and T-criterion (standart deviation, SD) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the Lunar Prodigy Primo bone densitometer (USA). The following reference intervals were used: normal BMD values (T-criterion ≥-1), osteopenia (OPe) (T-criterion from -1 to -2.5), and osteoporosis (OP) (T-criterion <-2.5).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “ skeletalmuscular index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2.Results:The femoral neck BMD in the examined patients was 0.96 (0.89; 1.03) g/cm2, which corresponds to -0.50 (-1.00; 0) SD according to the T-criterion, in the lumbar spine -1.23 (1.11; 1.32) g/cm2and 0.4 (-0.50; 1.20) SD according to the T-criterion.In accordance with the recommendations of the European working group on sarcopenia in Older people (EWGSOP, 2010, 2018), the patients were divided into 3 groups: 31 patients without sarcopenia (group 1), 21 patients with isolated muscle loss (presarcopenia) (group 2) and 27 patients with sarcopenia (group 3).BMD in the femoral neck in the group of patients without sarcopenia was 0.96 (0.72; 1.26) g/cm2, which corresponds to -0.50 (-0.8; 0.2) SD according to the T-criterion, in the lumbar spine – 1.19 (1.10; 1.275) g/cm2and 0.1 (-0.6; 0.8) SD according to the T-criterion. BMD in the femoral neck in the group of patients with presarcopenia (group 2) – 0.995 (0.94; 1.04) g/cm2and -0.3 (-0.70; 0) SD according to the T-criterion, in the lumbar spine – 1.32 (1.24; 1.40) g/cm2and 1.20 (0.50; 1.90) SD according to the T-criterion. In patients with established sarcopenia (group 3), the following indicators of BMD and T-criterion were recorded: 0.95 (0.845; 0.98) g/cm2and -0.60 (-1.40; -0.40) SD and 1.23 (0.085; 1.31) g/cm2and 0.4 (-0.8; 1.1) SD in the femoral neck and lumbar spine, respectively.A comparative analysis of the results of the DXA found that patients with sarcopenia had a significant decrease in the BMD and T-criterion in the femoral neck compared to patients with presarcopenia (p=0.039 and p=0.040, respectively). There were no differences between the groups of patients without sarcopenia and with sarcopenia and presarcopenia (p>0.05).It was found that patients with sarcopenia had significantly lower BMD and T-criterion in the lumbar spine compared to patients with presarcopenia (p=0.017 and p=0.0165, respectively). The values of the BMD and T-criterion in the groups of patients without sarcopenia and with presarcopenia and sarcopenia in the lumbar spine were comparable (p>0.05).Conclusion:The presence of sarcopenia is associated with loss of BMD in the femoral neck and in the lumbar spine. The results obtained confirm the high probability of common pathogenetic links between OP and sarcopenia.Disclosure of Interests:None declared

scholarly journals POS1112 COMPARISON OF TWO APPROACHES IN FRACTURES RISK ASSESSMENT IN WOMEN WITH RHEUMATOID ARTHRITIS AND GLUCOCORTICOID USE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 836.1-836
Author(s):  
N. Grygorieva ◽  
V. Povoroznyuk
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Assessment ◽  
Clinical Practice ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Fracture Risk Assessment ◽  
Lifestyle Modifications ◽  
Mineral Density ◽  
Dxa Scan

Background:Nowadays, FRAX is the most useful tool for osteoporotic fracture risk assessment that is included in many guidelines. Rheumatoid arthritis (RA) and glucocorticoid (CG) use are two crucial factors for osteoporotic fractures included in FRAX algorithm. According to the last ACR guidelines for the treatment of GC-induced osteoporosis [1], it was recommended to divide the patients into three groups of fracture risk (high, medium and low) that have a great impact on treatment decision. Recently, we received own Ukrainian thresholds [2] for the national version of FRAX that are age-dependent and now widely used in clinical practice.Objectives:Our study was aimed to compare two approaches (ACR-2017 and Ukrainian (2019) recommendations) in fracture risk assessment in women with RA and GC use.Methods:We examined 195 females with RA aged 40-89 years old who took GC (at dose ≥5 mg/d for ≥3 months) due to RA. The 10-year probabilities of major osteoporotic (MOFs) and hip fractures (HFs) were calculated with and without bone mineral density (BMD) using the Ukrainian FRAX model [3]. The DXA was used to measure the lumbar spine, femoral neck and total body BMDs; T and Z scores were calculated (DISCOVERY Wi, Hologic, Inc., USA).Results:FRAX indexes for MOFs and HFs without BMD in patients with RA and GC were (Me [25-75Q]) 12.0 [8.1-18.0] and 4.2 [1.7-7.2] %. The correspondent FRAX indexes with BMD were 13.5 [8.5-20.0] and 5.1 [1.8-8.7] %.50 % of examined women had previous fractures and 20 % had previous vertebral fractures. BMD of the femoral neck consisted of 0.62±0.13 and L1-L4 BMD was 0.85±0.15 g/cm2. 89 % of females had low BMD at the lumbar spine and / or femoral neck (49 % osteoporosis and 40 % osteopenia).61 % of women required antiosteoporotic treatment according to ACR-2017 guideline (17.4 % of them a hadhigh risk of MOF and 43.1 % moderate one) without BMD measurement and 64 % of subjects after DXA scan.According to Ukrainian national guideline, 57 % of patients required antiosteoporotic treatment without BMD measurement and 42 % – after additional DXA examination. After BMD measurement in subjects who required the DXA scan, 78.2 % of females with RA and GC use required antiosteoporotic treatment (additionally to calcium and vitamin D, lifestyle modifications).Conclusion:Approximately 60 % of subjects with RA and GC use required antiosteoporotic treatment without additional DXA measurement according to correspondent FRAX indexes from both guidelines. The proportion of women requiring treatment after DXA scan is slightly higher according to Ukrainian recommendations. It proves that both of them can be used effectively in daily clinical practice for fracture risk assessment in females with RA.References:[1]Buckley L, Guyatt G, Fink HA, Cannon M et al. 2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis & Rheumatology, 2017;69(8), 1521–1537. DOI:10.1002/art.40137[2]Povoroznyuk V, Grygorieva N, Kanis JA et al. Ukrainian FRAX: criteria for diagnostics and treatment of osteoporosis. Pain. Joint. Spine. 2019;9(4):7-16. DOI: 10.22141/2224-1507.9.4.2019.191921[3]Povoroznyuk VV, Grygorieva NV, Kanis JA et al. Epidemiology of hip fracture and the development of FRAX in Ukraine. Arch Osteoporos. 2017;12(1):53. DOI: 10.1007/s11657-017-0343-2.Disclosure of Interests:Nataliia Grygorieva Consultant of: Servier, Redis, Vladyslav Povoroznyuk: None declared.

scholarly journals Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefana Catalina Bilha ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Dumitru D. Branisteanu ◽  
Laura Mihalache ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

Sign in / Sign up

Export Citation Format

Share Document