scholarly journals Cross-sectional and Longitudinal Evaluation of Bone Mass in Children and Young Adults with Juvenile Idiopathic Arthritis: The Role of Bone Mass Determinants in a Large Cohort of Patients

2010 ◽  
Vol 37 (9) ◽  
pp. 1935-1943 ◽  
Author(s):  
STEFANO STAGI ◽  
LAURA MASI ◽  
SERENA CAPANNINI ◽  
ROLANDO CIMAZ ◽  
GIULIA TONINI ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Bone Mass ◽  
Bone Mineral ◽  
Large Cohort ◽  
Close Monitoring ◽  
Mineral Density ◽  
Cross Sectional ◽  
Bone Mineral Apparent Density ◽  
Longitudinal Evaluation ◽  
Enthesitis Related Arthritis

Objective.To assess the prevalence of reduced spine bone mineral apparent density (BMAD), and to identify the main predictors of reduced spine BMAD in a cross-sectional and longitudinal evaluation of the same large cohort of patients with juvenile idiopathic arthritis (JIA). There are few prospective data on bone mass evaluation in a large number of patients with JIA, and with enthesitis-related arthritis onset.Methods.Two hundred nineteen patients with JIA (median age 8.7 yrs, range 6.1–13.1 yrs; 104 oligoarticular JIA, 61 polyarticular, 20 systemic, and 34 enthesitis-related arthritis onset) were retrospectively evaluated. A dual-energy x-ray absorptiometry (DEXA) scan at the lumbar spine was performed in all subjects. Of these, 89 consecutive patients were followed up randomly and longitudinally with a second and a third DEXA evaluation. The data obtained were compared with 80 age-matched and sex-matched healthy subjects.Results.At the first DEXA, patients with JIA showed a reduced spine BMAD standard deviation score (SDS) in comparison to controls (p < 0.001). These results were confirmed when the subjects were divided into JIA subtypes (p < 0.005) with the exception of enthesitis-related arthritis onset. Spine BMAD SDS significantly correlated with JIA onset type (p < 0.01), age at JIA onset (p < 0.005), and flares (p = 0.008). The longitudinal evaluation showed that spine BMAD SDS did not significantly improve at the followup in comparison to controls, in all subsets with JIA except for systemic onset (p < 0.05). Spine BMAD correlated with sex (p < 0.01), systemic corticosteroid exposure (p < 0.01), the number of intraarticular corticosteroid injections (p < 0.01), the interval from last steroid injection (p < 0.05), erythrocyte sedimentation rate (p < 0.005), and C-reactive protein levels (p < 0.005).Conclusion.Patients with JIA have a low bone mass and, after a first increase due to therapy, do not reach a healthy condition over time despite our current more effective drugs. These patients have a high risk of osteoporosis in early adulthood. To reduce the risk and improve the bone mass, close monitoring of bone mineral density, better control of disease activity, physical activity, and intake of calcium and vitamin D are recommended. In patients with osteoporosis, therapeutic approaches including bisphosphonates should be considered.

scholarly journals Bone density and metabolism in subjects with microdeletion of chromosome 22q11 (del22q11)

2010 ◽  
Vol 163 (2) ◽  
pp. 329-337 ◽  
Author(s):  
Stefano Stagi ◽  
Elisabetta Lapi ◽  
Eleonora Gambineri ◽  
Cristina Manoni ◽  
Maurizio Genuardi ◽  
...  
Keyword(s):  
Bone Mass ◽  
Bone Mineral ◽  
Young Patients ◽  
Serum Levels ◽  
Close Monitoring ◽  
Total Calcium ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Chromosome 22Q11

IntroductionAlthough hypoparathyroidism with hypocalcaemia is one of the most frequent clinical features of monoallelic microdeletion of chromosome 22q11 (22q11DS), bone mass and metabolism have not yet been assessed in these patients.DesignThis study aimed to evaluate bone mass and metabolism in a cohort of patients, both children and adults, with 22q11DS.MethodsIn twenty-eight patients with 22q11DS (median age 12.5, range 6.1–42.8 years), serum levels of ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin and bone-specific alkaline phosphatase (BSAP), and urinary deoxypyridinoline concentrations were evaluated. In these patients, bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DXA) examination, and volumetric BMD (bone mineral apparent density (BMAD)) was calculated.The data obtained from paediatric and adult patients were compared with two age-, sex- and body size-matched healthy subject control groups.ResultsPatients with 22q11DS showed a reduced BMAD Z-score compared with controls (P<0.001). These patients also had significantly lower ionised (P<0.001) and total calcium (P<0.05) levels as well as lower PTH levels (P<0.05), compared with the controls. In particular, children and young patients with 22q11DS had significantly lower serum osteocalcin levels (P<0.001), BSAP levels (P<0.001) and urinary deoxypyridinoline concentrations (P<0.001) than controls. These results were not confirmed in adults.Finally, patients with hypoparathyroidism and/or hypocalcaemia at the time of the study showed significantly lower ionised (P<0.001) and total calcium levels (P<0.001), PTH levels (P<0.05), BSAP levels (P<0.001), osteocalcin levels (P<0.001) and urinary deoxypyridinoline concentrations (P<0.001), compared with patients without hypoparathyroidism and/or hypocalcaemia. Nonetheless, the BMAD Z-score did not show substantial differences between these two groups.ConclusionsSubjects with 22q11DS have a significant reduction in bone mass that appears to be more severe in adults who have already attained peak bone mass than in children who are still growing. Therefore, we suggest a close monitoring of bone mass and metabolism in 22q11DS patients.

scholarly journals Densitas Massa Tulang pada Pasien HIV/AIDS

2017 ◽  
Vol 3 (4) ◽  
pp. 200
Author(s):  
Nadia Ayu Mulansari ◽  
Nanang Sukmana ◽  
Bambang Setyohadi ◽  
Siti Setiati
Keyword(s):  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Mineral ◽  
Mass Density ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Cross Sectional ◽  
Keywords Hiv ◽  
Hiv Seropositive ◽  
Hiv Aids

Pendahuluan. Tingginya angka kejadian HIV/AIDS pada usia muda yang mencapai 50% dari total kasus HIV/AIDS di Indonesia menjadi permasalahan yang serius, khususnya terkait kualitas hidup pasien. Selain infeksi oportunistik, keadaan osteopenia dan juga osteoporosis sering ditemukan pada pasien dengan HIV/AIDS. Namun demikian, penelitian mengenai gambaran massa tulang pada pasien HIV/AIDS di Indonesia sampai saat ini belum didapatkan.Metode. Studi potong lintang dilakukan pada pasien dewasa dengan infeksi HIV naif antiretroviral di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada Februari-Mei 2008. Pemeriksaan bone mineral density (BMD) dilakukan dengan menggunakan DXA scanning. Hasil. Berdasarkan pemeriksaan BMD didapatkan sebanyak 29,3% subjek ostopenia, 1,3% osteoporosis dan sisanya normal. Osteopenia/osteoporosis didapatkan lebih besar pada subjek yang mengonsumsi alkohol, merokok, hitung limfosit CD4+ <200 sel/mm3 dan IMT<18,5 dengan proporsi masing-masing secara berturut-turut yaitu 53,6%; 36,9%; 35,5%; dan 37,6%. Lama infeksi HIV pada penelitian ini tidak menunjukkan hasil yang berbeda.Simpulan. Didapatkan keadaan osteopenia dan osteoporosis pada pasien dengan HIV/AIDS. Pada pasien HIV/AIDS dengan riwayat merokok, konsumsi alkohol, hitung limfosit CD4+ <200 sel/mm3 dam IMT rendah, didapatkan angka osteopenia/osteoporosis yang lebih tinggi.Kata kunci: HIV, naif antiretroviral, osteopenia/osteoporosis Bone Mass Density in HIV/AIDS PatientsIntroduction. Indonesia has a high incidence of young HIV-positive population which is 20-29 years of age is in the highest group (50%). For this reason, it is important to make a better quality of life for them. Unfortunately, beside all the opportunistic infection, it was proved that osteopenia/osteoporosis has become a new emerging metabolic condition for HIV-infected patients. There is still no study about the description of bone mass density in HIV/AIDS patients in Indonesia. Methods. A cross sectional study was conducted in a total of 75 HIV-seropositive antiretroviral-naïve patients. Bone mineral density (BMD) was determined by dual energy X-ray absorptiometry in lumbar spine. Results. Seventy-five subjects had been recruited. Low BMD was found in 29.3% HIV-seropositive patients with osteopenia and 1,3% with osteoporosis. There was a higher number of osteopenia/osteoporosis in subjects who consume alcohol, smoking, lymphocyte CD4 <200 cells/mm3 and low body mass index (BMI). Duration of infection did not show any differences in both HIV with osteopenia/osteoporosis and subjects with normal bone condition. Conclusions. Osteopenia and osteoporosis were found in patients with HIV/AIDS in RSCM with lower bone density in subjects who consumed alcohol, smoke, lymphocyte CD4 <200 cells/mm3 and low BMI. Keywords: HIV, antiretroviral naïve, osteopenia/osteoporosis 

scholarly journals Association between Hypertension, Antihypertensive Drugs, and Osteoporosis in Postmenopausal Syrian Women: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Nermeen Hijazi ◽  
Zaynab Alourfi
Keyword(s):  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Mineral ◽  
Antihypertensive Drugs ◽  
Cross Sectional Study ◽  
World Health ◽  
Low Bone Mass ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional

Background. Osteoporosis and hypertension are frequent and often coexisting diseases among the elderly. Recent studies suggested that both diseases may share the same etiopathology. Moreover, the treatment of hypertension can affect the bone mineral density and worsen osteoporosis. The aim of this cross-sectional study was to assess the prevalence of low bone mass and osteoporosis in postmenopausal Syrian women and investigate their relationship with hypertension and antihypertensive drugs. Methods. 813 postmenopausal women were involved in this cross-sectional study, aged between 40 and 96 yrs. Their menopause duration ranged between 1 and 43 yrs. Bone mineral density was measured using a dual-energy X-ray absorptiometry at the total lumbar spine (L1-L4) and left hip. T-score values were used to determine the diagnosis of osteoporosis. The existence of HTN was defined as blood pressure ≥130/85 mmHg or a history of hypertension medication. Results. Using the world health organization criteria, 24% had osteoporosis and 45.2% had low bone mass. The incidence of osteoporosis and low bone mass significantly increased with age and menopause duration and decreased with BMI. Prevalence of hypertension was almost equal among the women who had or did not have osteoporosis. However, hypertensive women who used thiazides or beta blockers had higher values of total lumbar BMD compared with the women who did not. Conclusion. Hypertension in postmenopausal Syrian women aged over 40 was not found to be associated with osteoporosis. However, the mean total lumbar BMD of the hypertensive women who took thiazide diuretics or beta blocker was found to be increased significantly comparing to the women who did not take either.

ACQUISITION OF BONE MASS DURING EARLY ADULTHOOD: A PROSPECTIVE COHORT STUDY

2005 ◽  
Vol 09 (04) ◽  
pp. 205-211
Author(s):  
Yesim Gökçe-Kutsal ◽  
Şule Arslan ◽  
Ayçe Atalay
Keyword(s):  
Bone Mass ◽  
Bone Mineral ◽  
Current Knowledge ◽  
Early Adulthood ◽  
Early Years ◽  
Activity Level ◽  
Bone Area ◽  
Mineral Density ◽  
Cross Sectional ◽  
Bone Gain

Since most of our current knowledge about the concept of bone gain during adolescence or early adulthood comes from the cross-sectional studies, we aimed to evaluate natural course of changes in bone mineral density prospectively during early adulthood in a cohort. Twenty-two volunteers (15 female, 7 male) with the mean age of 20.0 ± 0.69 years were enrolled into the study. Subjects with any known secondary cause of osteoporosis were excluded from the study. Demographic variables, anthropometric measurements were recorded. Subjects underwent an interview about risk factors for osteoporosis. Physical activity level and calcium intake were evaluated by European Vertebral Osteoporosis Study questionnaire. Lumbar and femoral bone mineral densities were measured using Dual Energy X-ray Absorptiometry (DXA) at baseline and two years after. L1-4 BMD increased from 0.925 ± 0.099 g/cm2 to 0.957 ± 0.094 g/cm2(p = 0.002) and total femur BMD increased from 0.866 ± 0.113g/cm2 to 0.908 ± 0.108g/cm2(p = 0.0001). BMC of L1-4 increased significantly (p = 0.022), however there was no change in bone area measurements (p = 0.82). In case of femoral total measurements, both BMC and bone area demonstrated significant increase over the study period (p = 0.0001 and p = 0.0001). There were significant positive differences in bone mineral densities for L3, L4 measurements in males and for L3 measurements in females (p = 0.028, p = 0.018 and p = 0.02 respectively). Different from the bone gain during adolescent years which is usually attributed to volumetric expansion of the bones; we were able to demonstrate that bone gain continues through early years of adulthood. It would be rational to extend preventive measures beyond adolescence, into early adulthood to optimize the bone mass.

scholarly journals Bone mineral density and its correlation with Vitamin D status in healthy adults of Manipur – A cross-sectional study

2020 ◽  
pp. 6-9
Author(s):  
Dr karthika M ◽  
Prakash Chandra Bhardwaj ◽  
Laimayum Amarnath Sharma ◽  
W Kanan ◽  
W Asoka Singh
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mass ◽  
Enzyme Immunoassay ◽  
Bone Mineral ◽  
Healthy Adult ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional

The levels of vitamin D have an important effect on bone mass in young and old. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling, and hence bone density. Objective: The present study was conducted to determine the status of serum 25(OH)D and BMD of healthy adult men in Manipur and also to find out the relationship of 25(OH)D level with BMD. Methods: A cross-sectional study was conducted in Department of Physiology in collaboration with the Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal from October 2014 to September 2016. 100 Healthy adult males in Manipur in the age group 18-35years and ≥50years were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. The serum 25-OH vitamin D level was estimated by using an enzyme immunoassay (EIA) kit (IDS immunodiagnostic systems, United Kingdom). The BMD of lumbar spine was determined using enCORE – based X-ray bone densitometer (Lunar Prodigy advance, GE Medical Systems, USA) which is based on DEXA scan. Results: The present study revealed that the majority of subjects with insufficiency of 25(OH)D had low bone mass, whereas all the subjects with 25(OH)D deficiency had BMD readings consistent with osteopenia or osteoporosis in both the age groups. This study also showed a positive correlation between BMD and 25(OH)D in most subjects, particularly in the groups with insufficiency or deficiency of 25(OH)D.Conclusion: In conclusion, the study shows a positive relationship between the serum 25 (OH) D concentrations and BMD. Keywords: Serum 25(OH)D; Bone mineral density (BMD); Enzyme immunoassay (EIA).

Breast-feeding and formula feeding in healthy term infants and bone health at age 10 years

2013 ◽  
Vol 110 (6) ◽  
pp. 1061-1067 ◽  
Author(s):  
M. S. Fewtrell ◽  
K. Kennedy ◽  
Peter R. Murgatroyd ◽  
J. E. Williams ◽  
S. Chomtho ◽  
...  
Keyword(s):  
Bone Mass ◽  
Infant Formula ◽  
Breast Feeding ◽  
Bone Mineral ◽  
Bone Health ◽  
Infant Nutrition ◽  
Mineral Density ◽  
Short Term ◽  
Term Infants ◽  
Bone Mineral Apparent Density

Few studies have investigated the effects of infant nutrition on later bone health in term infants, although low sn-2 palmitate in infant formulas has been shown to result in the formation of stool fatty acid soaps, reduced Ca absorption and lower bone mass in the short term. To investigate the effect of (1) breast-feeding (BF) and (2) the type of infant formula (standard fat blend v. high-sn-2 fat blend) on bone mass at age 10 years, anthropometry and bone mass (from dual-energy X-ray absorptiometry (GE Lunar Prodigy); lumbar spine (LS) and total body less head; adjusted for size (bone mineral apparent density standard deviation score (SDS) and regression)) were measured in 10-year-old subjects born at term and either breast-fed (n 34) or randomised to a standard control formula (n 27) or a high-sn-2 palmitate formula (n 30) for the first 12 weeks of life. At follow-up, previously BF children were older but lighter (by 0·5 SDS, P= 0·03) than formula-fed children with a lower LS bone mineral density SDS (by 0·44, P= 0·03), but size-adjusted bone mass did not differ. There were no significant differences in bone mass between the formula-fed groups. These findings suggest that there is no significant effect of BF or high-sn-2 infant formula on size-adjusted bone mass in mid-childhood, and that the effects of infant nutrition on bone mass previously reported may be confined to the short term. A larger study would be required to exclude smaller effects.

scholarly journals Transwomen and bone mineral density: a cross-sectional study in Brazilian population

2020 ◽  
Vol 93 (1111) ◽  
pp. 20190935
Author(s):  
Kadija Rahal Chrisostomo ◽  
Thelma L. Skare ◽  
Henrique Rahal Chrisostomo ◽  
Edna J. Litenski Barbosa ◽  
Renato Nisihara
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Confidence Interval ◽  
Bone Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Hormonal Treatment ◽  
Z Score ◽  
Mineral Density ◽  
Cross Sectional

Objectives: Transgender individuals submitted to hormone or surgical treatment may have alterations in their bone metabolism as these elements are important players in bone remodeling. We aimed to study bone mineral density (BMD) and body composition in transwomen undergoing cross-sex hormonal treatment (CSHT) from Brazil for over 3 years, comparing them with female and male controls. Methods: 93 individuals (31 transwomen, 31 females and 31 males paired for age and body mass index) were studied for bone mass, and body composition by densitometry (by DXA). Epidemiological and clinical data were collected through direct questioning. Results: Low bone mass (T score ≤2) was found in 12.9% of transwomen; in 3.2% of females and 3.3% of males. Transwomen individuals had lower spine Z score (0.26 ± 1.42 vs 0.50 ± 1.19) and femur Z score (−0.41 ± 0.95 vs 0.29 ± 1.04) than females. They had lower total femur Z score than males (−0.41 ± 0.95 vs 0.20 ± 0.83). Lean mass values correlated positively with total femur BMD (ρ = 0.40; 95% confidence interval = 0.009–0.68; p = 0.04) and BMD in femoral neck (ρ = 0.48; 95% confidence interval = 0.11–0.74; p = 0.01) but neither the type of therapy received nor the time that they were used, impacted bone mass. Conclusion: Low BMD is found frequently in transwomen and it is correlated with lean body mass. Advances in knowledge: There are few studies of the effects of hormone therapy on the bones and muscles of transwomen. This study demonstrated that significant changes occur, and that the population studied needs greater care in musculoskeletal health.

Bone mineral density in immigrants from southern China to Denmark. A cross-sectional study

1996 ◽  
Vol 134 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Q Wang ◽  
P Ravn ◽  
S Wang ◽  
K Overgaard ◽  
C Hassager ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mass ◽  
Bone Mineral ◽  
Southern China ◽  
Premenopausal Women ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional

Wang Q, Ravn P, Wang S, Overgaard K, Hassager C, Christiansen C. Bone mineral density in immigrants from southern China to Denmark: a cross-sectional study. Eur J Endocrinol 1996;134:163–7. ISSN 0804–4643 Immigration from Japan to USA has been shown to increase bone mineral density (BMD) and body fat in women. The effects of immigration between other geographical areas on bone mass and body composition are largely unknown, especially in men. In the present study, we measured bone mass and body composition by dual energy X-ray absorptiometry (Hologic QDR-2000) in 73 healthy premenopausal women (age 35 ± 8 years) and 69 men (age 40 ± 12 years) who had immigrated from southern China to Denmark 2 months to 36 years ago. The BMD measurements (Total BMD, trunk BMD and leg BMD) were related positively to years since immigration (YSI) (R2 = 0.10–0.16, p < 0.05) in premenopausal women, but not in men. Fat distribution was related mainly to age in both premenopausal women and men (R2 = 0.16–0.26, p < 0.05). For comparison, we included 51 white, Danish premenopausal women (age 36 ± 6 years). Chinese premenopausal women with a YSI below or equal to 12 years (N = 38) had significantly lower total and regional BMD (trunk, legs, arms) (p < 0.05), while women with a YSI above 12 years (N = 35) had significantly lower BMD in the legs only (p < 0.05) when compared to the Danish premenopausal women. After correction for age, weight and height, Chinese premenopausal women with a YSI below or equal to 12 years still had significantly lower BMD in all regions (4–7%, p < 0.05), whereas no differences in BMD were found between Chinese premenopausal women with a YSI above 12 years compared with Danish premenopausal women. In conclusion, Chinese premenopausal women who immigrated to Denmark more than 12 years ago have a similar BMD to that of Danish premenopausal women. In the group who immigrated less than 12 years ago, a significantly lower BMD was found. P Ravn, Center for Clinical and Basic Research, Ballerup Byvej 222, DK-2750 Ballerup, Denmark

Association between reproductive factors and postmenopausal osteoporosis

2011 ◽  
Vol 20 (03) ◽  
pp. 248-251
Author(s):  
H. R. Meybodi ◽  
N. Khalili ◽  
P. Khashayar ◽  
R. Heshmat ◽  
A. Hossein-nezhad ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Reproductive Factors ◽  
Population Based ◽  
Age At Menarche ◽  
Mineral Density ◽  
Cross Sectional ◽  
Number Of Children ◽  
Menstrual History ◽  
Duration Of Breastfeeding

SummaryThe present cross-sectional research was designed to study possible correlations between clinical reproductive factors and bone mineral density (BMD) values.Using the data gathered by the population-based Iranian Multicenter Osteoporosis Study (IMOS), we investigated the correlation found between reproductive factors and osteoporosis. Subjects were recruited from five major cities of Iran. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry and the results were analyzed against the age at menarche and at menopause, number of pregnancies, children and abortions, and the history (and duration) of breastfeeding.Data was available for 2528 women. Gravidity and number of children were reversely correlated with BMD. Younger age at menarche was associated with higher BMD values, whereas there was no significant correlation between age at menopause and menstrual history and BMD.Our study suggests that clinical reproductive factors, particularly number of children and breastfeeding, could be incorporated as predictors of BMD levels in women. Given the controversial results obtained in different studies, longitudinal studies should be carried out to enlighten the importance of these factors and the rationale of their use to predict BMD values in different settings.

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