scholarly journals Integrating Muscle Health in Predicting the Risk of Asymptomatic Vertebral Fracture in Older Adults

2021 ◽  
Vol 10 (5) ◽  
pp. 1129
Author(s):  
Yu-Ching Lin ◽  
Yu-Hsiang Juan ◽  
Wing P. Chan ◽  
Kun-Yun Yeh ◽  
Alice M. K. Wong ◽  
...  
Keyword(s):  
Older Adults ◽  
Vertebral Fracture ◽  
Predictive Model ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Skeletal Muscle Index ◽  
Appendicular Skeletal Muscle ◽  
Males And Females ◽  
Muscle Health ◽  
Bone Quantity

Background: The utility of muscle health for predicting asymptomatic vertebral fracture (VF) is uncertain. We aimed to determine the effects of muscle health on bone quantity and quality in the older adults and to integrate these factors into a predictive model for VF. Methods: We prospectively recruited participants with a body mass index <37 kg/m2. The total lean mass (TLM), appendicular skeletal muscle index, presence of sarcopenia, and bone mineral density were determined by dual-energy X-ray absorptiometry, and bone quality by the trabecular bone score (TBS). VF was diagnosed based on spine radiography. Results: A total of 414 females and 186 males were included; 257 participants had VF. Lower TLM was significantly associated with poorer bone quantity and quality in both males and females. A low TBS (OR: 11.302, p = 0.028) and sarcopenia (Odds ratio (OR): 2.820, p = 0.002) were significant predictors of VF in males, but not bone quantity. Moreover, integrating TBS and sarcopenia into the predictive model improved its performance. Conclusions: Although TLM was associated with bone quantity and quality in both sexes, sarcopenia and a low TBS were significant predictors of asymptomatic VF only in male participants.

Factors Influencing Bone Mineral Density Among Adults of Delhi: A Gender Differential

2019 ◽  
Vol 21 (2) ◽  
pp. 199-209 ◽  
Author(s):  
Peteneinuo Rulu ◽  
Meenal Dhall ◽  
Renu Tyagi ◽  
Kshetrimayum Surmala Devi ◽  
Nilupher Feroz ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Older Adults ◽  
Bone Mineral ◽  
Fat Body ◽  
Mineral Density ◽  
Cross Sectional ◽  
Body Adiposity Index ◽  
Adiposity Index ◽  
Body Adiposity ◽  
Males And Females

Objective: The aim of the study was to find out the risk factor of bone mineral density (BMD). Methodology: Cross-sectional data were collected on 233 participants (males and females) with age ranging from 20 to 70 years. The subjects were divided into two groups consisting of young adults of 20–45 years and older adults of >45 years. The BMD was calculated by a heel ultrasonic test. Each subject was measured for various adiposity markers like body fat, body mass index, body shape index (BSI), body adiposity index and lifestyle parameters. Results: BSI was found to be higher among older adults in both males and females. The risk of osteoporosis and osteopenia was also seen to be significantly higher among older adults of >45 years ( p < 0.001). Various factors like age ( p < 0.001), milk intake status ( p < 0.05), education ( p < 0.01), occupation ( p < 0.05) and body adiposity index ( p < 0.05) were found to be risks for osteoporosis and osteopenia. Conclusion: In our study, BMD was found to be highly correlated with age, and the risk of osteopenia and osteoporosis increased as age increased. Illiteracy, milk consumption status, homemakers and higher body adiposity were also identified as risk factors for developing osteopenia and osteoporosis.

scholarly journals Relationship between the changes over time of bone mass and muscle health in children and adults: a systematic review and meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Médéa Locquet ◽  
Charlotte Beaudart ◽  
Nancy Durieux ◽  
Jean-Yves Reginster ◽  
Olivier Bruyère
Keyword(s):  
Systematic Review ◽  
Lean Mass ◽  
Meta Analysis ◽  
Mineral Density ◽  
Cross Sectional ◽  
Ovid Medline ◽  
Parallel Change ◽  
Hip Bmd ◽  
Muscle Health ◽  
Bone Quantity

Abstract Background Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813). Methods We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI). Results Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23–0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004). Conclusion Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.

scholarly journals SAT-405 Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP): A Useful Tool?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lívia Marcela Santos ◽  
Monique Nakayama Ohe ◽  
Sthefanie Giovanna Pallone ◽  
Ilda Sizue Kunii ◽  
Renata Elen Costa Silva ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Primary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Assessment Method ◽  
Bone Fragility ◽  
Control Group ◽  
Mineral Density ◽  
Roc Curve Analysis

Abstract Background: PHP is a common disorder, and regardless of being an asymptomatic entity, often leads to bone loss and osteoporosis. TBS is a software-based assessment method of trabecular bone structure of the spine based on the analysis of pixels in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS measurements in combination with DXA values by searching for more accurate bone fragility risk assessment among PHP patients. Methods: From June/2017 to January/2019, all patients who met the criteria for PHP diagnosis prior to surgery were selected to take part in this study. Control group was composed by non-family related healthy volunteers. Bone mineral density (BMD) by DXA (DXA; Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, distal third of the non-dominant radius and TBS values by InSight were determined in 64 PHP patients and 63 controls. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured in all patients and control group. Results: Primary hyperparathyroidism patients presented significant lower BMD values in all evaluated sites compared to controls. TBS measurements were also statistically different among PHP patients and controls (mean TBS PHP=1233 vs TBS controls= 1280, p=0.044). Patients and controls didn’t differ in age, sex, menopausal state or BMI (body mass index). Osteoporosis diagnosis by DXA analysis was observed in 50% of PHP patients and in 26.6% of controls. Self-reported or image-diagnosed fracture occurred in 15 PHP (23.4%) patients and in 11 (17.5%) controls. Among these fractures, vertebral fracture account for 9 (14%) in PHP group and 4 (6.3%) in controls. ROC curve analysis showed that the TBS value &lt; 1187 is associated to significant high risk of vertebral fracture (sensibility 87.5%, specificity 67.3%) among PHP patients. Conclusion: TBS, used as a complement to DXA measurements, is a useful tool to better assess fragility risk among PHP patients.

scholarly journals Skeletal Effects of Levothyroxine for Subclinical Hypothyroidism in Older Adults: A TRUST Randomized Trial Nested Study

2019 ◽  
Vol 105 (1) ◽  
pp. 336-343 ◽  
Author(s):  
Elena Gonzalez Rodriguez ◽  
Mirah Stuber ◽  
Cinzia Del Giovane ◽  
Martin Feller ◽  
Tinh-Hai Collet ◽  
...  
Keyword(s):  
Older Adults ◽  
Subclinical Hypothyroidism ◽  
Trabecular Bone Score ◽  
Community Dwelling ◽  
Dose Titration ◽  
Mineral Density ◽  
Double Blind ◽  
Procollagen Type ◽  
Hip Bmd ◽  
Turnover Markers

Abstract Context Both thyroid dysfunction and levothyroxine (LT4) therapy have been associated with bone loss, but studies on the effect of LT4 for subclinical hypothyroidism (SHypo) on bone yielded conflicting results. Objective To assess the effect of LT4 treatment on bone mineral density (BMD), Trabecular Bone Score (TBS), and bone turnover markers (BTMs) in older adults with SHypo. Design and Intervention Planned nested substudy of the double-blind placebo-controlled TRUST trial. Participants with SHypo were randomized to LT4 with dose titration versus placebo with computerized mock titration. Setting and Participants 196 community-dwelling adults over 65 years enrolled at the Swiss TRUST sites had baseline and 1-year follow-up bone examinations; 4 participants withdrew due to adverse events not related to treatment. Main Outcome Measures One-year percentage changes of BMD, TBS, and 2 serum BTMs (serum CTX-1 [sCTX] and procollagen type 1 N-terminal polypeptide [P1NP]). Student’s t-test for unadjusted analyses and linear regression adjusted for clinical center and sex were performed. Results Mean age was 74.3 years ± 5.7, 45.4% were women, and 19.6% were osteoporotic. The unadjusted 1-year change in lumbar spine BMD was similar between LT4 (+0.8%) and placebo-treated groups (–0.6%; between-groups difference +1.4%: 95% confidence interval [CI] –0.1 to 2.9, P = .059). Likewise, there were no between-group differences in 1-year change in TBS (–1.3%: 95% CI –3.1 to 0.6, P = .19), total hip BMD (–0.2%: 95% CI –1.1 to 0.1, P = .61), or BTMs levels (sCTX +24.1%: 95% CI –7.9 to 56.2, P = .14), or after adjustment for clinical centers and sex. Conclusions Over 1-year levothyroxine had no effect on bone health in older adults with SHypo. Registration ClinicalTrial.gov NCT01660126 and NCT02491008

scholarly journals Prediction of Vertebral Fractures by Trabecular Bone Score in Patients With Ankylosing Spondylitis

2021 ◽  
pp. S53-S60
Author(s):  
Z. Killinger ◽  
M. Kužma ◽  
S. Tomková ◽  
K. Brázdilová ◽  
P. Jackuliak ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Vertebral Fracture ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Cross Sectional Study ◽  
Vertebral Fracture Assessment ◽  
Mineral Density ◽  
Multiple Fractures ◽  
Lateral Spine ◽  
Cross Sectional

Ankylosing spondylarthritis (AS) is associated falsely increased lumbar spine bone mineral density (BMD). New tool for discrimination of subjects at fracture risk is needed. Vertebral fracture (VF) prediction of routine methods for osteoporosis assessment, BMD and trabecular bone score (TBS), in patients with AS. Cross-sectional study of all AS patients regularly followed at the rheumatology outpatient clinics of two centers. All subjects undergone BMD measurement at lumbar spine (LS), total hip (TH) and femoral neck (FN) using Hologic® Horizon device. TBS at L1-4 in all subjects by TBS InSight® software were assessed. Vertebral fracture assessment (VFA) was performed using the lateral spine imaging IVA™ and graded using Genant semi-quantitative approach. 119 AS subjects (90 males/29 females), mean age 47.6 years were included in the study. In 20 patients 34 VFs were detected, from whom 7 patients had multiple fractures. Subjects with VF were older and had lower FN BMD, TBS in comparison to non-VF subjects. No differences in LS BMD, FN BMD or BASDAI between groups were observed. Among patients with VF only 3 had T-score less than -2.5 but 7 has TBS less than 1.23 which means highly degraded microarchitecture. AS patients with VF have lower TBS and FN BMD in comparison to non-VF subjects. In addition, TBS was able to detect 20 % more VFs than BMD. Therefore, TBS seems promising in VF discrimination among patients with AS.

scholarly journals AB0711 USEFULNESS OF THE TRABECULAR BONE SCORE AS A PREDICTOR OF VERTEBRAL FRACTURE IN PATIENTS WITH AXIAL SPONDYLOARTHROPATHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1650.3-1651
Author(s):  
A. V. Orenes Vera ◽  
L. Montolio-Chiva ◽  
I. Vázquez-Gómez ◽  
E. Flores ◽  
E. Valls-Pascual ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lumbar Spine ◽  
Vertebral Fracture ◽  
Trabecular Bone ◽  
Vertebral Fractures ◽  
Trabecular Bone Score ◽  
Univariate Analysis ◽  
Mineral Density ◽  
Total Hip ◽  
The Mean

Background:In axial spondyloarthritis (axSpA) the risk of vertebral fracture is increased, not always corresponding with the values of bone mineral density (BMD). One possible explanation is that syndesmophytes interfere with these values. We consider whether the evaluation of trabecular microarchitecture by an accessible methodlike the Trabecular Bone Score (TBS), that does not involve additional irradiation neither seem to be influenced by the presence of syndesmophytes, may be an advantage to estimate the risk of fracture.Objectives:To estimate the prevalence of vertebral fractures in patients with axSpA. To assess the diagnostic accuracy of TBS and BMD for vertebral fracture, and if it is influenced by the presence of syndesmophytes. To analyze the correlation between the absolute values of BMD and TBS in the lumbar spine.Methods:Cross-sectional study. Patients were consecutive recruited. We collected demographic (sex, age), clinical (syndesmophytes, vertebral fracture, BASDAI, BASFI, time of evolution of axSpA, treatment) and analytical variables [vitamin D (1,25-OHD), CRP and ESR]. The BMD was determined using the Lunar Prodigy ProTM densitometer from GE Healthcare, to which the TBS iNsight® software version 2.2 was added to perform the TBS analysis. The presence of fracture was evaluated by radiology. The statistical analysis was performed with the SPSS 22.0 and OpenEpi softwares.Results:84 patients were included, 60 men and 24 women, with a mean age of 59 years (± SD 13). 51.2% had lumbar syndesmophytes. The prevalence of fractures was 13.7%, 95 CI (7.8-22.9). 51.2% were treated with NSAIDs, and 48.8% with biological drugs. The evolution of axSpA was > 10 years in 65.5%. The mean scores of BASDAI and BASFI were 3.7 and 4.3 respectively (± SD 2.2 and 2.3). The mean CRP value was 8.5 mg / L (± SD 8.4), ESR 12.2 mm / h (± SD 11.4) and 1.25-OHD 27.9 ng / dL (± SD 13.6).According to the lumbar and femoral T Score, 9.5% and 15.5% of the patients were in the range of osteoporosis respectively.19% patients had a low TBS value (≤1.23).Regarding the influence of syndesmophytes on TBS and BMD values, we found significant differences in lumbar spine BMD (p = 0.01) but not in total hip and femoral neck BMD (p = 0.2 and 0.3 respectively) nor in the TBS (p = 0.1).Regarding the correlation of TBS and BMD values of the spine, no correlation was observed in patients with syndesmophytes, while a moderate correlation (r = 0.4, p = 0.02) was observed in patients without syndesmophytes.In the univariate analysis, the factors related to the presence of vertebral fracture were age, female sex, absolute BMD values in the lumbar spine and total hip, and TBS values. No relationship was found with the rest of the variables. In the multivariate analysis, only the TBS showed a significant association with the presence of fractures (p =0.02).Regarding the predictive capacity of fractures, TBS showed a higher sensitivity than that of BMD (55.6% versus 18.2% and 30% of BMD in the spine and hip respectively), being the specificity comparable (85.3% versus 91.3% and 85.1% of BMD in column and hip respectively).Conclusion:the prevalence of fractures was 13.7% among the patients studied, 95 CI (7.8-22.9). The presence of syndesmophytes influenced the values of lumbar BMD but not the hip BMD or those of the TBS. We found a correlation between the values of BMD of the spine and TBS only in patients who did not have syndesmophytes. Only TBS values were significantly related to the presence of fractures in the multivariate analysis. TBS showed greater sensitivity with similar specificity than BMD for the detection of vertebral fractures.Disclosure of Interests:Ana V Orenes Vera: None declared, L Montolio-Chiva: None declared, I Vázquez-Gómez: None declared, Eduardo Flores: None declared, Elia Valls-Pascual Grant/research support from: Roche, Novartis, and AbbVie, Speakers bureau: AbbVie, Lilly, Pfizer, MSD, Novartis, Janssen, Bristol Myers Squibb, UCB Pharma, À Martínez-Ferrer: None declared, Desamparados Ybañez: None declared, Luis García-Ferrer: None declared, María Vega-Martínez: None declared, Magdalena Graells-Ferrer: None declared, A Sendra-García: None declared, V Núñez-Monje: None declared, Inmaculada Torner Hernández: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis

Effect of dietary protein intake on bone mineral density and fracture incidence in older adults in the Health, Aging, and Body Composition study

2021 ◽  
Author(s):  
Ashley A Weaver ◽  
Janet A Tooze ◽  
Jane A Cauley ◽  
Douglas C Bauer ◽  
Frances A Tylavsky ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Older Adults ◽  
Body Composition ◽  
Vertebral Fracture ◽  
Protein Intake ◽  
Whole Body ◽  
Mineral Density ◽  
Health Aging ◽  
Lower Protein

Abstract Background Dietary recommendations may underestimate the protein older adults need for optimal bone health. This study sought to determine associations of protein intake with bone mineral density (BMD) and fracture among community-dwelling white and black older adults. Methods Protein as a percentage of total energy intake (TEI) was assessed with a food frequency questionnaire in 2,160 older adults (73.5±2.8 years; 51.5% women; 35.8% black) in the Health, Aging, and Body Composition prospective cohort. Hip, femoral neck, and whole body BMD was assessed by dual-energy x-ray absorptiometry at baseline and 4 years, and lumbar trabecular, cortical, and integral BMD was assessed by computed tomography at baseline and 5 years. Fragility fractures over 5 years were adjudicated from self-report data collected every 6 months. Associations with tertiles of protein intake were assessed using analysis of covariance for BMD and multivariate Cox regression for fracture, adjusting for confounders. Results Participants in the upper protein tertile (≥15% TEI) had 1.8-6.0% higher mean hip and lumbar spine BMD compared to the lower protein tertile (&lt;13% TEI; p&lt;0.05). Protein intake did not affect change in BMD at any site over the follow-up period. Participants in the upper protein tertile had a reduced risk of clinical vertebral fracture over five years of follow-up (Hazard Ratio: 0.36 [95% Confidence Intervals (CI), 0.14, 0.97] vs. lower protein tertile, p=0.04). Conclusions Older adults with higher protein intake (≥15% TEI) had higher BMD at the hip, whole body, and lumbar spine, and a lower risk of vertebral fracture.

scholarly journals Vertebral Fracture Assessment in Postmenopausal Women With Postsurgical Hypoparathyroidism

2021 ◽  
Author(s):  
Cristiana Cipriani ◽  
Salvatore Minisola ◽  
John P Bilezikian ◽  
Davide Diacinti ◽  
Luciano Colangelo ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Postmenopausal Women ◽  
Trabecular Bone Score ◽  
Cross Sectional Study ◽  
Qualitative Assessment ◽  
Vertebral Fracture Assessment ◽  
Control Group ◽  
Mineral Density ◽  
Cross Sectional ◽  
Fracture Assessment

Abstract Context Hypoparathyroidism is a rare endocrine disorder whose skeletal features include suppression of bone turnover and greater volume and width of the trabecular compartment. Few and inconsistent data are available on the prevalence of vertebral fractures (VF). Objective To evaluate the prevalence of VF assessed by vertebral fracture assessment (VFA) in postmenopausal women with chronic postsurgical hypoparathyroidism. Design Cross-sectional study Setting Ambulatory referral center. Patients or Other Participants Fifty postmenopausal women (mean age 65.4 ± 9 years) with chronic postsurgical hypoparathyroidism and 40 age-matched healthy postmenopausal women (mean age 64.2 ± 8.6). Main outcome measures Lumbar spine, femoral neck, and total hip bone mineral density were measured by dual X-ray absorptiometry (Hologic Inc., USA) in all subjects. Site-matched spine trabecular bone score was calculated by TBS iNsight (Medimaps, Switzerland). Assessment of VF was made by VFA (iDXA, Lunar GE, USA) using the semiquantitative method and the algorithm-based qualitative assessment. Results All-site BMD values were higher in the hypoparathyroid vs the control group. By VFA, we observed a 16% prevalence of VF in hypoparathyroid women vs 7.5% in control subjects. Among those with hypoparathyroidism who fractured, 5 (62.5%) had grade 1 wedge, 2 (25%) had grade 2 wedge, and 1 (12.5%) had grade 2 wedge and grade 2 biconcave VF. In the hypoparathyroid group, 57% with VFs and 32% without VFs had symptoms of hypoparathyroidism. Conclusion We demonstrate for the first time that in postmenopausal women with chronic postsurgical hypoparathyroidism, VFs are demonstrable by VFA despite normal BMD.

scholarly journals Relationship between the Changes over Time of Bone and Muscle Health in Children and Adults: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Locquet Médéa ◽  
Beaudart Charlotte ◽  
Durieux Nancy ◽  
Reginster Jean-Yves ◽  
Bruyère Olivier
Keyword(s):  
Systematic Review ◽  
Lean Mass ◽  
Meta Analysis ◽  
P Value ◽  
Mineral Density ◽  
Cross Sectional ◽  
Parallel Change ◽  
Hip Bmd ◽  
Muscle Health ◽  
Bone Quantity

AbstractVarious cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813). We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI). Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23-0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value <0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004). Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.

Sign in / Sign up

Export Citation Format

Share Document