scholarly journals Bone Mineral Density Changes in Long-Term Kidney Transplant Recipients: A Real-Life Cohort Study of Native Vitamin D Supplementation

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 323
Author(s):  
Yuri Battaglia ◽  
Antonio Bellasi ◽  
Alessandra Bortoluzzi ◽  
Francesco Tondolo ◽  
Pasquale Esposito ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Femoral Neck ◽  
Vitamin D Supplementation ◽  
Z Score ◽  
Mineral Density ◽  
T Score ◽  
The Mean ◽  
25 Oh Vitamin D

Vitamin D insufficiency has been associated with reduced bone mineral density (BMD) in kidney transplant patients (KTRs). However, the efficacy of vitamin D supplementation on BMD remains poorly defined, especially for long-term KTRs. We aimed to investigate the effect of native vitamin D supplementation on the BMD of KTRs during a 2-year follow-up. Demographic, clinical, and laboratory data were collected. BMD was evaluated with standard DEXA that was performed at baseline (before vitamin D supplementation) and at the end of study period. BMD was assessed at lumbar vertebral bodies (LV) and right femoral neck (FN) by a single operator. According to WHO criteria, results were expressed as the T-score (standard deviation (SD) relative to young healthy adults) and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as a T-score ≤ −2.5 SD and a T-score < −1 and a > −2.5 SD, respectively. Based on plasma levels, 25-OH-vitamin D (25-OH-D) was supplemented as recommended for the general population. Data from 100 KTRs were analyzed. The mean study period was 27.7 ± 3.4 months. At study inception, 25-OH-D insufficiency and deficiency were recorded in 65 and 35 patients. At the basal DEXA, the percentage of osteopenia and osteoporosis was 43.3% and 18.6% at LV and 54.1% and 12.2% at FN, respectively. At the end of the study, no differences in the Z-score and T-score gains were observed. During linear mixed model analysis, native vitamin D supplementation was found to have a negative nitration with Z-score changes at the right femoral neck in KTRs (p < 0.05). The mean dose of administered cholecalciferol was 13.396 ± 7.537 UI per week; increased 25-OH-D levels were found (p < 0.0001). Either low BMD or 25-OH-vitamin D concentration was observed in long-term KTRs. Prolonged supplementation with 25-OH-D did not modify BMD, Z-score, or T-score.

scholarly journals P1621VITAMIN D SUPPLEMENTATION: CHANGES IN BONE MINERAL DENSITY IN KIDNEY TRANSPLANT PATIENTS WITH LONG TERM DURATION OF THE GRAFT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yuri Battaglia ◽  
Michele Provenzano ◽  
Francesco Tondolo ◽  
Antonio Bellasi ◽  
Pasquale Esposito ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Kidney Transplant ◽  
Bone Mineral ◽  
Categorical Variables ◽  
Z Score ◽  
Mineral Density ◽  
T Score

Abstract Background and Aims In the medical literature, several studies have linked bone mineral density (BMD) with vitamin D deficiency in kidney transplant patients (KTRs). However, in spite of the fact that ergocalciferol, cholecalciferol and calcifediol reduce parathyroid hormone (PTH) and improves calcium levels, their effects on the bone mineral density (BMD) in KTRs remain undefined. In consideration of the lack of data available, we aim at investigating the effect of inactive form of vitamin D supplementation on the BMD over a follow-up period up to 2 year, in a real-life cohort of long-term kidney transplant(KT). Method This study was carried out in KTRs who were followed up in a Nephrology Unit. Exclusion criteria were parathyroidectomy, therapy with bisphosphonate, previous history of bone fractures. Demographic, clinical and immunosuppressive agents were collected. Based on 25-OH-D levels, KTRs were classified as suffering from deficiency (&lt; 30 ng/mL). BMD was evaluated at lumbar vertebral bodies (LV) and right femoral hip (FH) by a single operator, using a standard dual energy X-ray absorptiometry. According to WHO criteria, results were expressed as T-score (standard deviation [SD] relative to young healthy adults), and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as T score ≤ −2.5 SD and T score &lt; −1 and &gt; −2.5 SD, respectively. Laboratory data, 25-OH-D, and BMD were measured at baseline and after 24 months of supplementation therapy. Vitamin D deficiency was corrected using standard treatment strategy recommended for general population. Continuous variables were expressed as mean ± SD whereas categorical variables as percentage. The Student’s t test and chi-square test were used to compare to compare continuous and categorical variables, respectively. For before and after comparisons of continuous variables, the paired t-test or one-sample Wilcoxon signed rank test were used based on variable’s distribution. Results Data pertaining to 111 out of 133 consecutive outpatients were collected, of whom most were males (69.4%), no-smokers (89.1%) and treated with glucocorticoids (84%). The mean age was 53.9±11.6 years and months after transplant was 161.6±128.3. No statistical differences were found among patients with normal BMD, osteopenia or osteoporosis at LV and FH in terms of age at transplant, gender distribution, time on dialysis, BMI and eGFR, serum calcium, serum phosphate, 25-OH-D and iPTH. At baseline, 25-OH-D was 13.9±7.2 ng/ml and the prevalence of osteopenia/osteoporosis was 40.9% (T-Score -1.69±0.37; Z-score -1.16±1.09) and 21.8 % (T-Score -3.15±0.50; Z-score -2.27±0.58) at LV; 55.3 % (T-Score -1.8±0.46; Z-score -0.84±0.633) and 14 % (T-Score -2.83±0.39; Z-score -1.65±0.49) at FH. After 27.6±3.7 months of therapy with cholecalciferol at mean dose of 13.396±7.537 UI at week, 25-OH-D values increased to 29.4±9.4 ng/ml (p&lt;0.0001) while no statistically significant changes were found in Z-score and T-score at both sites, except for a mild improvement in lumbar vertebral Z-score, reaching −0.82± 0.7 (p = 0.06) in KTRs with osteopenia Conclusion Our study showed BMD remained stable after up to 2 years of inactive vitamin D therapy in long-term kidney transplant with vitamin D deficiency. A mild increase in Z-score was observed in the L-spine. Further designated studies should be conducted to demonstrate the effect of vitamin D on BMD.

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.

Decreased Bone Mineral Density among Patients with Hemophilia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1153-1153
Author(s):  
Gregory Gerstner ◽  
Mary Lou Damiano ◽  
Angela Tom ◽  
Christina Worman ◽  
Wendy Schultz ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Hiv Positive ◽  
Severe Hemophilia ◽  
Mineral Density ◽  
T Score ◽  
Vitamin D Levels

Abstract Background: Osteoporosis among adult males is a major and under-recognized problem in the United States. Patients with hemophilia have several predisposing risks for developing decreased bone mineral density (BMD) and osteoporosis, and may represent an important group to target for screening and treatment for fracture prevention. Patients and Methods: Patients over the age of 18 with moderate or severe hemophilia A or B (as defined by factor activity < 5%) and no history of prophylactic factor use prior to age 10 were eligible. Bone mineral densities were obtained using DEXA scans (DXA) along with measurements of joint mobility and physical activity and laboratory parameters. Results: Twenty-eight patients have been consented with accrual ongoing. 21 have undergone DXA scans. Median age of 39 (range 18–61), 86% HCV positive, 26% HIV positive. Median T-score for all sites (lumbar, femoral neck, hip, and other) was −1.7 (−5.8–0.6), with the most effected area being the femoral neck, T-score −1.7 (−5.8–0.8). Based on WHO criteria, 76% of patients had decreased BMD, 33% (n=7) with osteoporosis, and 43% (n=9) with osteopenia. Trends associated with decreased BMD included decreased serum 25-hydroxy-vitamin D levels, increased alkaline phosphatase, and decreased weight. All patients with osteoporosis were HCV positive, and all HIV positive patients had decreased BMD. Median activity scores were lower among osteoporotic patients vs normal BMD. Joint range-of-motion in the lower extremities was limited to 59.5% of predicted values in patients with osteoporosis, 84% in osteopenia, and 93% in patients with normal BMD. Summary: Patients with hemophilia are at markedly increased risk for developing osteoporosis and osteopenia. Potential predictors of risk for decreased BMD are concurrent HCV and HIV infection, low vitamin D levels, elevated alkaline phosphatase, lower weight, decreased range of motion and lower activity scores. More aggressive screening for decreased BMD among moderate and severe hemophilia patients with initiation of therapy is appropriate. Median Values Worst T-Score Activity Score (1–5) Joint ROM (% Pred) Weight (kg) 25-Hydroxy-D (ng/mL) Alk Phos (IU/L) Normal BMD 0.1 5 94.0 91.6 28.0 59 Osteopenia −1.6 4 85.0 80.7 23.0 86 Osteoporosis −3.0 3 68.5 73.0 21.8 99

The Risk of Low Bone Mineral Density with Long-Term G-CSF Therapy for Severe Chronic Neutropenia.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1484-1484 ◽  
Author(s):  
L. A. DiMeglio ◽  
Audrey Anna Bolyard ◽  
Tracy M. Marrero ◽  
Blanche P Alter ◽  
Mary Ann Bonilla ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Sufficient Information ◽  
Z Score ◽  
Mineral Density ◽  
Cyclic Neutropenia ◽  
T Score ◽  
Low Bone Mineral Density ◽  
Chronic Neutropenia

Abstract Abstract 1484 Low bone mineral density (BMD) is a known risk factor for fractures. Low BMD has been reported in individuals with severe chronic neutropenia (SCN), and attributed both to the diseases causing neutropenia and to G-CSF therapy. However, given the rarity of SCN, few data exist regarding associations of BMD z-scores with disease characteristics such as type of neutropenia and duration of G-CSF therapy. We present data here obtained from BMD reports collected through the Severe Chronic Neutropenia International Registry (SCNIR). We reviewed BMDs on 128 subjects [40 children (< 21 years of age), 87 females] having sufficient information about lumbar spine BMD by dual-xray absorptiometry (DXA) for evaluation. For subjects with multiple BMD measurements available, the most recent one was used for analysis. Mean age was 32.0 years (range 0.6–85 years). 57 subjects had idiopathic SCN (mean age 40 years), 40 had congenital (mean age 15 years), 28 were cyclic (mean age 41 years) and 3 were autoimmune (mean age 18 years). 122 subjects had received G-CSF at the time of the BMD assessment (mean 8.8 years, range 0.1–19.9 years). 11 of the adults were on bisphosphonate therapy for low BMD at the time of the BMD assessment; no children were on anti-resorptive therapy. BMDs in these subjects were, on average, low. For the children, the BMD z-score (age matched mean ±1 standard deviation) was -1.0 ± 1.1, with 17.5% of children having BMDs that were low for age (Z-score < -2.0). For the adults the BMD t-score was -1.1 ± 1.4, with 46% of adults meeting t-score criteria for osteopenia (≤ -1.0) and 9% meeting criteria for osteoporosis (< -2.5). BMDs were lowest in those with congenital neutropenia, followed by those with cyclic neutropenia. For children, BMDs were lower in those who had received longer G-CSF therapy (r= -0.506, p=0.002). This association was not seen in adults (r= 0.074, p= 0.5). The low BMDs and the correlation of lower BMD with longer G-CSF treatment in children suggests there is an association of bone loss with the childhood diseases causing SCN. The data also suggest that regular assessments of bone health should be made in SCN patients, particularly those on long-term G-CSF therapy. Disclosures: Boxer: Amgen, Inc.: Equity Ownership. Dale:Amgen: Consultancy, Research Funding.

scholarly journals AB0609 RADIOFREQUENCY ECHOGRAPHIC MULTI-SPECTROMETRY FOR THE ASSESSMENT OF BOTH FEMORA IN PREGNANT WOMEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1340.1-1340
Author(s):  
E. Kirilova ◽  
N. Kirilov ◽  
S. Vladeva
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Pregnant Women ◽  
Bone Mineral ◽  
Dual Energy ◽  
Z Score ◽  
Mineral Density ◽  
X Ray ◽  
The Mean ◽  
The Right

Background:Radiofrequency Echographic Multi-Spectrometry (REMS) is a non-ionizing innovative approach for the assessment of REMS-based bone mineral density (BMD) of the axial skeleton. The principle of the REMS technology is based on the analysis of native raw unfiltered ultrasound signals during an echographic scan of the lumbar spine or the femoral neck [1]. Several studies demonstrated the high concordance with dual energy X-ray absorptiometry (DXA) in terms of measured BMD with this novel technology [2,3]. In previous published literature it was envisaged to apply this technology for the examination of the axial bone density in pregnant women. Pregnancy-associated bone loss has been demonstrated as decreased bone mineral density (BMD) in previous studies [4].Objectives:The aim of the current study is to compare the BMD values of both femora between pregnant and non-pregnant women matched for age and BMI using the novel REMS technology.Methods:Of total fifty women twenty pregnant women (40%) and thirty non-pregnant women (60%) were included in the study. The mean age of the pregnant women was 32 years ± 5 standard deviations (SD), (range 25-41 years) and the mean age of the non-pregnant women was 30 years ± 6 standard deviations (SD), (range 24-39 years). REMS approach was used to assess REMS-based BMD and REMS-based Z-score values of the femoral neck. Furthermore, body mass index (BMI) and gestational age in weeks were evaluated.Results:The mean BMI of the pregnant women was 26 kg/m2 ± 7 kg/m2 (range 14 kg/m2-42 kg/m2) and those of the non-pregnant women was 25 kg/m2 ± 5 kg/m2 (range 16 kg/m2-35 kg/m2). The mean gestational age was 20 weeks’ gestation ± 5 weeks’ gestation (range 13-27 weeks’ gestation). REMS-based mean BMD of the left femoral neck of the pregnant women was 0.793 g/cm2 ± 0.167 g/cm2 (range 0.563 g/cm2-1.154 g/cm2). REMS-based mean BMD of the right femoral neck of the pregnant women was 0.828 g/cm2 ± 0.153 g/cm2 (range 0.570 g/cm2-1.161 g/cm2). After comparing left femoral neck BMD with the right femoral neck BMD of the pregnant women, we found a linear correlation (R=0.764). Left femoral neck BMD value (0.793 g/cm2) of the pregnant women was significantly lower than those of the non-pregnant women (0.854 g/cm2), p=0.002. The mean left femoral Z-score of the pregnant women (-0.1 SD with range -2.5 SD-2.9 SD) was also significantly lower compared to those of the non-pregnant women (1.2 SD with range -1.5 SD-3.1 SD), p=0.003.Conclusion:This is the first study which provides data about BMD and Z-score values of both femora in pregnant women assessed with the radiation-free REMS technology. Pregnant women demonstrated significantly lower femoral neck BMD values and Z-scores compared to those of the non-pregnant women. Innovative REMS method could be very helpful for making decision about the treatment of pregnant women who are at risk of lower BMD due to concomitant diseases and/or treatment associated with osteoporosis.References:[1]Casciaro S, Conversano F, Pisani P, Muratore M. New perspectives in echographic diagnosis of osteoporosis on hip and spine. Clin Cases Miner Bone Metab. 2015; 12(2):142-150.[2]Nikolov M, Nikolov N. AB0908 Assessment of the impact of the lean mass with body composition by dual-energy x-ray absorptiometry on the bone mineral density. Annals of the Rheumatic Diseases 2020; 79:1756.[3]Chakova M., Chernev D., Kashukeeva P., Krustev P., Abedinov F. Lumbar Sympathectomy - Literature Review. International Journal of Science and Research (IJSR) Volume 7 Issue 8, August 2018 ISSN (Online): 2319-7064.[4]Degennaro, V. A.; Cagninelli, G.; Lombardi, F. A. “VP34.12: First assessment of maternal status during pregnancy by means of radiofrequency echographic multi-spectrometry technology”. Ultrasound in Obstetrics & Gynecology. 2020, 56 (S1): 199.Disclosure of Interests:None declared.

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 Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh

2008 ◽  
Vol 99 (6) ◽  
pp. 1322-1329 ◽  
Author(s):  
Md Zahirul Islam ◽  
Abu Ahmed Shamim ◽  
Virpi Kemi ◽  
Antti Nevanlinna ◽  
Mohammad Akhtaruzzaman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Bone Mineral Status ◽  
Garment Factory ◽  
High Prevalence ◽  
The Mean

The manufacture of garments is the main industry in Bangladesh and employs 1·6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18–36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36·7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16 % of the subjects were found to be vitamin D-deficient (S-25OHD < 25 nmol/l). We observed a high prevalence (88·5 %) of vitamin D insufficiency (S-25OHD < 50 nmol/l) as well as a significant inverse relationship between S-25OHD and S-iPTH (r − 0·25, P ≤ 0·001). A decrease in S-25OHD ( < 38 nmol/l) and an increase in S-iPTH (>21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < − 2·5 had a trend of lower values of BMI, waist–hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.

scholarly journals Changes in bone mineral density over 10 years in patients with early rheumatoid arthritis

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001142
Author(s):  
Lisa Theander ◽  
Minna Willim ◽  
Jan Åke Nilsson ◽  
Magnus Karlsson ◽  
Kristina E Åkesson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Z Score ◽  
Mineral Density ◽  
Early Ra ◽  
Z Scores ◽  
The Mean

ObjectivesTo investigate changes in bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) over a 10-year period.MethodsConsecutive patients with early RA (symptom duration <12 months) were followed according to a structured programme and examined with dual-energy X-ray absorptiometry (DXA) at inclusion and after 2, 5 and 10 years. Mean Z-scores over the study period were estimated using mixed linear effect models. Changes in Z-scores between follow-up visits were analysed using paired T-tests.ResultsAt inclusion, 220 patients were examined with DXA. At the femoral neck, the mean Z-score over 10 years was −0.33 (95 % CI −0.57 to −0.08) in men and −0.07 (−0.22 to 0.08) in women. Men had significantly lower BMD at the femoral neck than expected by age at inclusion (intercept Z-score value −0.35; 95 % CI −0.61 to −0.09), whereas there was no such difference in women. At the lumbar spine, the mean Z-score over the study period for men was −0.05 (−0.29 to 0.19) and for women 0.06 (−0.10 to 0.21). In paired comparisons of BMD at different follow-up visits, femoral neck Z-scores for men decreased significantly from inclusion to the 5-year follow-up. After 5 years, no further reduction was seen.ConclusionsIn this observational study of a limited sample, men with early RA had reduced femoral neck BMD at diagnosis, with a further significant but marginal decline during the first 5 years. Lumbar spine BMD Z-scores were not reduced in men or women with early RA. Data on 10-year follow-up were limited.

scholarly journals BONE MINERAL DENSITY AND VITAMIN D RECEPTOR GENETIC VARIANTS IN EGYPTIAN CHILDREN WITH BETA THALASSEMIA ON VITAMIN D SUPPLEMENTATION

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Hadeer A Abbassy ◽  
Reham Abdel Haleem Abo Elwafa ◽  
Omneya Magdy Omar
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Genetic Variants ◽  
Vitamin D Supplementation ◽  
Beta Thalassemia ◽  
Z Score ◽  
Mineral Density ◽  
Vitamin D Receptors ◽  
Egyptian Children

Background: Low bone mineral density (BMD) is a characteristic feature of Beta thalassemia major (βTM) patients. Vitamin D is important for bone mineralization. Vitamin D receptors (VDR) genetic variants may be related to vitamin D status and BMD.Objectives:  To evaluate the effect of VDR genetic variants on vitamin D levels and BMD in βTM Egyptian patients supplemented with vitamin D.Methods: This study was conducted on forty children with βTM and forty unrelated healthy sex and age-matched controls. Serum calcium, phosphorus, ALP, ferritin and vitamin D were measured. VDR genetic variants (BsmI, TaqI, and FokI) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). BMD was measured by dual-energy X-ray densitometry (DEXA) of the lumbar spine.Results: In βTM patients, 22.5% had deficient, 50% had insufficient and only 27.5% had sufficient levels of vitamin D. BMD Z score was significantly lower in βTM patients compared to controls (p<0.001). Osteopenia and osteoporosis of lumbar spines were observed in 70% and 22.5% of βTM patients respectively. BsmI bb and FokI Ff and ff genotypic variants were significantly associated with lower vitamin D and BMD Z score. No association was observed with TaqI genotypic variants.Conclusions: We reported a high prevalence of low BMD in βTM despite vitamin D supplementation. The BsmI bb, FokI Ff and ff genotypic variants of VDR can be considered as risk factors for the occurrence of osteoporosis in these children. Vitamin D doses should be adjusted individually according to the genetic makeup of each patient.

scholarly journals AB0477 EFFECT OF ANTI-TNF THERAPY ON BONE MINERAL DENSITY IN ANKYLOSING SPONDYLORTHITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1266.1-1266
Author(s):  
A. Ajerouassi ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Spinal Mobility ◽  
Tnf Alpha ◽  
Control Group ◽  
Mineral Density ◽  
T Score ◽  
Significant Difference ◽  
The Mean

Background:Osteoporosis is common in spondyloarthritis, due to reduced spinal mobility, and inflammation. Anti-inflammatory treatments have a beneficial effect on the bone, and there is a significant increase in bone density during treatment with anti-TNF alpha.Objectives:to study bone mineral density in patients with ankylosing spondyloarthritis (AS) treated with anti-TNF alpha.Methods:This is a retrospective descriptive study of patients with AS meeting the modified New York criteria. Bone mineral density, assessed by dual energy x-ray absorptiometry (DXA), of AS patients treated with anti-TNF alpha was compared to that of a control group of AS patients not treated with anti-TNF alpha.Inclusion criteria:- Male patients- Patients who do not have an abnormality disrupting phosphocalcic and bone metabolism- For Patients on anti-TNF alpha: the treatment must be received for more than 6 monthsResults:A total of 22 patients were included, including 11 patients on anti-TNF alpha and 11 patients not on anti-TNF. The mean age (standard deviation) was 28 (± 7.2) years and 41 (± 14.8) in the cases and controls respectively. The mean body mass index in the AS group on anti-TNF was 22.16 kg / m2 and in the control group was 19.64 kg / m2. In the AS group on anti-TNF alpha, the mean bone mineral density of the spine was 1.092 g / cm2 (mean T score = -0.63) and that of the femoral neck, the mean bone mineral density was 0.888g / cm2 (mean T score = -1.04). In the control group, the mean bone mineral density of the spine was 0.959 g / cm2 (mean T score = -1.91) and the mean bone mineral density of the femoral neck was 0.774 g / cm2 (mean T score = -1.99). Bone mineral density in the spine and cervix was higher in the group receiving anti-TNF alpha (p = 0.09, p = 0.173 respectively)Conclusion:Our study shows the increase, although not statistically significant, in bone mineral density in AS patients receiving anti-TNF alpha agents compared to controls. Our results agree with those of the literature which support the bone protective effect of anti-TNF alpha. The non-significant difference can be explained by the delay in the introduction of biotherapy at the advanced stage of the structural evolution of AS. The best solution is to start TNF inhibitors at the early inflammatory stage of AS.Disclosure of Interests:None declared.

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