THE RISK OF BONE FRACTURES IN POST-POLIOMYELITIS PATIENTS TRANSITIONING TO MIDDLE ADULTHOOD

2020 ◽  
Vol 26 (11) ◽  
pp. 1277-1285
Author(s):  
Rutie Mamlok Sherf ◽  
Dror Cantrell ◽  
Karen Or ◽  
Efrat Marcus ◽  
Alex Shapira ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Clinical Guidelines ◽  
Bone Fractures ◽  
Paralytic Poliomyelitis ◽  
Mineral Density ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome ◽  
T Score

Objective: While osteoporotic fractures are reported in up to 40% of adults with post-poliomyelitis syndrome (PPS), clinical guidelines regarding bone mineral density (BMD) and indications for treatment are scarce. We investigated the characteristics of PPS patients, focusing on fractures and osteoporosis as the primary outcomes. Methods: A cross-sectional retrospective data analysis from medical records of 204 PPS patients regarding their clinical characteristics and long-term outcome, with emphasis on bone metabolism status. Results: Our cohort included 53% women; mean age was 65 years at study entry and 1.7 years at the diagnosis of acute poliomyelitis. The lower limb was involved in 97.5% of patients, and the BMD in the affected limb tended to be lower than the unaffected, with a mean T-score of −1.64 vs. −1.19, respectively ( P = .06). Recurrent falls were documented in 39.2% of patients, and osteoporosis in 20.6%, being more frequent in women ( P = .003) and patients with fractures ( P = .002). At least one fracture occurred in 52.2% of patients, and more than one in 40.3%. The median age for the first fracture was 57.5 years (range, 30 to 83 years), and most fractures occurred in the affected limb (73.2%). Conclusion: Underdiagnosis and delayed treatment of osteoporosis in late-adulthood post-poliomyelitis patients underlie the need for comprehensive clinical guidelines to manage these patients, including recommendations on bone health assessment, medical treatment, and their inclusion as a high-risk group for bone fractures. Abbreviations: aBMD = areal BMD; APP = acute paralytic poliomyelitis; BMD = bone mineral density; BMI = body mass index; BP = bisphosphonate; PBM = peak bone mass; PPS = post-poliomyelitis syndrome; Tsc = T-score; vBMD = volumetric BMD

Bone Mineral Density Assessment by DXA vs. QCT in Postmenopausal Females with Central Obesity

2020 ◽  
Vol 13 (2) ◽  
pp. 153-161
Author(s):  
Lejla Milisic ◽  
Sandra Vegar-Zubovic ◽  
Amina Valjevac ◽  
Suada Hasanovic-Vučković
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Central Obesity ◽  
Quantitative Computed Tomography ◽  
Normal Weight ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.

scholarly journals Fractures, Bone Mineral Density, and Final Height in Craniopharyngioma Patients with a Follow-up of 16 Years

2020 ◽  
Vol 105 (4) ◽  
pp. e1397-e1407 ◽  
Author(s):  
Selveta S van Santen ◽  
Daniel S Olsson ◽  
Marry M van den Heuvel-Eibrink ◽  
Mark Wijnen ◽  
Casper Hammarstrand ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bone Health ◽  
Final Height ◽  
Z Score ◽  
Mineral Density ◽  
Childhood Onset ◽  
Cross Sectional ◽  
T Score

Abstract Context Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. Objective To investigate bone health in patients with craniopharyngioma. Design Retrospective cross-sectional study. Setting Dutch and Swedish referral centers. Patients Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). Main outcome measures Fractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score ≤-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively. Results Fractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhood-onset patients. Conclusions Men with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk.

Long-Term Outcome of Bone Mineral Density in Children who Underwent a Successful Liver Transplantation

2004 ◽  
Vol 78 (6) ◽  
pp. 899-903 ◽  
Author(s):  
Lorenzo D’Antiga ◽  
Donatella Ballan ◽  
Giovanni Luisetto ◽  
Umberto Cillo ◽  
Graziella Guariso ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Transplantation ◽  
Bone Mineral ◽  
Mineral Density ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Frequency of Low Bone Mineral Density (BMD) in Patients with Liver Cirrhosis

2021 ◽  
pp. 47-52
Author(s):  
Ihsanullah Rajar ◽  
Nasrullah Aamer ◽  
Narindar Kumar ◽  
Prem Kumar ◽  
Kapeel Raja ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Bone Mineral ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Low Bone Mineral Density ◽  
Femur Neck

Objective: The objective of this study was to evaluate the low bone mineral density (BMD) in patients with liver cirrhosis. Methodology: This cross sectional study on 151 Liver cirrhotic patients was conducted at Liaquat University Hospital Hyderabad/Jamshoro. This study duration was 6 months, July 2015 to December 2015. The Assessment of bone mineral density (BMD) for each relevant patient was done using ultrasound impedance Dual Energy X-ray Absorptiometry  (DEXA) by senior pathologist having ≥05 years of experience, across the calcaneum, at lumbar spine  (LS) and femur neck (FN),  were computed by using computer supported device. The BMD was expressed in terms of T score. The WHO standard value was utilized to define the low BMD / osteoporosis is T score -1.5. Results: The mean age of subjects was 31.32±6.18 years. Out of all, 62.9% were males whereas 37.1% were females. About 21% patients had low/abnormal bone mineral density (BMD). Among these, 17.9% had bone mineral density (BMD) of -1.5 to -2.5 and 4% had BMD of <-2.5. Rest of 78.1% patients had a normal (>-1.5) bone mineral density (BMD). Majority of patients, 63.6% had a CTP grade B of liver cirrhosis, whereas 22.5% had A grade and 13.9% had C grade of liver cirrhosis. Conclusion: Conclusively, the risk of low bone mineral density (BMD) was evidently high for patients with hepatic cirrhosis. Male gender and age above 30 years were found at greater risk and CTP grade B of cirrhosis was most common.

ASYMMETRY OF BONE MINERAL DENSITY OF THE HIPS IN PATIENTS WITH UNILATERAL KNEE OSTEOARTHRITIS: A CROSS-SECTIONAL STUDY

2011 ◽  
Vol 14 (01) ◽  
pp. 1150005 ◽  
Author(s):  
Alireza Ashraf ◽  
Seyed Mostafa Jazayeri Shooshtari ◽  
Kaynoosh Homayouni ◽  
Sharareh Roshanzamir ◽  
Mohsen Zafarghasempoor ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Knee Osteoarthritis ◽  
Bone Mineral ◽  
Lumbar Vertebrae ◽  
Cross Sectional Study ◽  
Z Score ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Background: Osteoarthritis of any joint may exert different effects on bone mineral density that may be the result of several mechanisms including change in the pattern of weight load distribution. In this cross-sectional study we tried to find correlations between unilateral knee osteoarthritis and bone mineral density of hips and lumbar vertebrae. Methods: Forty three patients with knee osteoarthritis (unilateral or more severe in one side) were recruited in this study. The American college of Rheumatology Criteria was followed for the diagnosis of osteoarthritis. Dual X-Ray absorptiometry was used to obtain the T score and the Z score of the hips and lumbar vertebrae. Results: The T score and Z score of the hip and T score of the femoral neck, at the side with ipsilateral knee osteoarthritis was lower than the other side (p < 0.05). The mean Z score and T score of the vertebrae was negative irrespective of the side of osteoarthritis. Conclusions: Bone mineral density of the hip with ipsilateral knee osteoarthritis was lower than the other side, which suggests that BMD may be sensitive to some extent in detecting osteoporosis in these patients; it has also been observed that osteoarthritis might not affect bone mineral density of the hips and lumbar vertebrae in the same manner or to the same extent.

scholarly journals Alkaline phosphatase is a predictor of Bone Mineral Density in postmenopausal females

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Sundus Tariq ◽  
Saba Tariq ◽  
Khalid Parvez Lone ◽  
Saba Khaliq
Keyword(s):  
Bone Mineral Density ◽  
Alkaline Phosphatase ◽  
Prediction Model ◽  
Bone Mineral ◽  
Elevated Serum ◽  
Cross Sectional Study ◽  
Stepwise Multiple Regression ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Objectives: The study was planned to determine whether serum calcium, phosphate and alkaline phosphatase (ALP) are predictors of bone mineral density (BMD) in postmenopausal non-osteoporotic, osteopenic, and osteoporotic females. Methods: In this cross sectional study, conducted at Shaikh Zayed Hospital, Lahore in the year 2014-2015, postmenopausal females between 50-70 years of age were taken and divided into three groups non-osteoporotic (n=52), osteopenic (n=69) and osteoporotic (n=47). Serum ALP, phosphate and calcium were used in a stepwise multiple regression analysis to predict T-score in these groups. Results: In normal postmenopausal females, the prediction model was statistically significant, F(2, 41) = 6.041, p < 0.05 and showed a T-score variance of 22%. T-score was primarily predicted by higher levels of phosphate and calcium. In postmenopausal osteopenic females, T-score was only predicted by lower levels of ALP. The model was statistically significant, F(1, 59) = 4.995, p < 0.05, and accounted for approximately 7% of the variance of T-score. In postmenopausal osteoporotic females, the prediction model contained no predictors. Conclusion: Our study suggested that calcium and phosphate are the strongest predictors of T-score in postmenopausal normal females, while in postmenopausal osteopenic females ALP was the strongest predictor of T-score. Elevated serum ALP levels may help in determining loss of BMD in postmenopausal females. doi: https://doi.org/10.12669/pjms.35.3.188 How to cite this:Tariq S, Tariq S, Lone KP, Khaliq S. Alkaline phosphatase is a predictor of Bone Mineral Density in postmenopausal females. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.188 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Protective role of serum uric acid for bone loss in postmenopausal women

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 157-160
Author(s):  
Hephzibah Kirubamani N
Keyword(s):  
Bone Mineral Density ◽  
Uric Acid ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Antioxidant Properties ◽  
Density Lipoprotein ◽  
Protective Role ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Researchers had found that there is an association between oxidative stress and osteoporosis. Postmenopausal osteoporosis causes major public health problems. Since Uric acid has strong antioxidant properties, it will improve bone quality. This cross-sectional observational study was done to determine the association of Uric Acid and Bone Mineral Density of 75 healthy postmenopausal women who came for a master health checkup. The mean age was 60.5 years.  After ethical clearance and informed consent, women were recruited for the study at Saveetha Medical Hospital Chennai. Women with medical conditions or who were using drugs affecting bone metabolism or uric acid were excluded. Basic investigations were Hb, serum UA, blood urea, serum creatinine, serum calcium and alkaline phosphatase, blood glucose and glycosylated Hb.  Total Cholesterol, HDL, LDL, VLDL, 25 hydroxy Vitamin D were also done. Serum UA levels were graded as <3.9, 3.9–4.9, 5–6.1, and ≥6.2  mg/dl. Bone Mineral Density (BMD) was calculated with Dual Energy X-ray Absorptiometer (DXA). Osteoporosis was defined as BMD   T-score −2.5 and below. BMD with a T-score of -1  −2.5 was classified as osteopenia (WHO).  In women with high UA, there were significantly higher levels of low-density lipoprotein, and calcium, as compared to women with low UA group (p<0.05). High UA group, as compared to the low UA group, also had lower levels of high-density lipoprotein (p<0.001). Women with higher   Uric acid levels had lower BMI, lesser years of duration of Menopause and increased BMD. Serum   UA level had a positive correlation with the Lumbar BMD T score and    Right Femoral Neck BMD T Score. In UA >5.4mg/dl group Osteoporosis was nil.

Evaluation of Differences in Bone-Mineral Density in 51 Men Age 65–93 Years: A Cross-Sectional Study

2003 ◽  
Vol 11 (4) ◽  
pp. 470-486 ◽  
Author(s):  
Joyce E. Ballard ◽  
Lorraine S. Wallace ◽  
David B. Holiday ◽  
Cassandra Herron ◽  
Liberty L. Harrington ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bone Fractures ◽  
Age Groups ◽  
White Men ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Lean Tissue ◽  
Cross Sectional ◽  
History Of

This study assessed differences in bone-mineral density (BMD) and lean and fat tissues between 5 age groups of White men age 65–93 years. Lean and fat tissues were measured with absorptiometry and anthropometry, and BMD, with dual-energy X-ray absorptiometry. Forearm, spinal, and femoral T scores were used to classify BMD as normal, osteopenic, or osteoporotic. A questionnaire evaluated previous physical activity, calcium intake, and bone fractures. Significantly lower values in body weight, lean tissue, and forearm BMD occurred in the older age groups. Significant, positive relationships were found between total lean tissue and radial, spinal, and hip BMDs. For the total group, osteopenic and osteoporotic T scores, respectively, were femoral neck 70.6% and 9.8%, radius 27.5% and 25.5%, and spine 25.5% and 7.8%. Differences in BMD values were found between levels of lifestyle factors (dietary calcium and history of previous fractures). In conclusion, elderly men should be encouraged to maintain adequate total lean tissue because of its association with BMD.

scholarly journals Strong Genetic Effects on Bone Mineral Density in Multiple Locations with Two Different Techniques: Results from a Cross-Sectional Twin Study

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 248
Author(s):  
Marton Piroska ◽  
David Laszlo Tarnoki ◽  
Helga Szabo ◽  
Zsofia Jokkel ◽  
Szilvia Meszaros ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Fractures ◽  
Genetic Component ◽  
Mineral Density ◽  
Cross Sectional ◽  
X Ray ◽  
Total Hip ◽  
Genetic Components

Background and Objectives: Previous studies have demonstrated that risk of hip fracture is at least partly heritable. The aim of this study was to determine the magnitude of the genetic component of bone mineral density (BMD), using both X-ray and ultrasound assessment at multiple sites. Materials and Methods: 216 adult, healthy Hungarian twins (124 monozygotic, MZ, 92 dizygotic, DZ; mean age 54.2 ± 14.3 years), recruited from the Hungarian Twin Registry with no history of oncologic disease underwent cross-sectional BMD studies. We measured BMD, T- and Z-scores with dual energy X-ray absorptiometry (DEXA) at multiple sites (lumbar spine, femoral neck, total hip and radius). Quantitative bone ultrasound (QUS) was also performed, resulting in a calculated value of estimated bone mineral density (eBMD) in the heel bone. Heritability was calculated using the univariate ACE model. Results: Bone density had a strong genetic component at all sites with estimates of heritability ranging from 0.613 to 0.838 in the total sample. Lumbar BMD and calcaneus eBMD had major genetic components with estimates of 0.828 and 0.838 respectively, and least heritable (0.653) at the total hip. BMD of the radius had also a strong genetic component with an estimate of 0.806. No common environmental effect was found. The remaining variance was influenced by unique environment (0.162 to 0.387). In females only, slightly higher additive genetic estimates were found, especially in the case of the femoral neck and total hip. Conclusion: Bone mineral density is strongly heritable, especially in females at all locations using both DEXA and QUS, which may explain the importance of family history as a risk factor for bone fractures. Unshared environmental effects account for the rest of the variance with slight differences in magnitude across various bone regions, supporting the role of lifestyle in preventing osteoporotic fractures with various efficacy in different bone regions.

scholarly journals AB0772 OSTEOPOROSIS AND ITS RELATIONSHIP WITH THE SERUM URIC ACID LEVEL IN PATIENTS WITH PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1684.1-1684
Author(s):  
H. H. Gezer ◽  
D. Erdem Gürsoy ◽  
S. Acer Kasman ◽  
N. Öz ◽  
M. T. Duruöz
Keyword(s):  
Bone Mineral Density ◽  
Psoriatic Arthritis ◽  
Bone Mineral ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Z Scores ◽  
The Mean

Background:Although osteoporosis is an inherent comorbidity in inflammatory rheumatic disease and the risk of bone loss is high in patients with several rheumatic diseases, evidence is limited in psoriatic arthritis (PsA). One of the most prominent features in PsA is increased serum urate (SU) levels. Due to its antioxidant effects and protective role against osteoporosis, high SU levels are associated with increased bone mineral density (BMD) and reduced bone loss in the healthy population, and in patients with rheumatoid arthritis. However, whether this association is also present in patients with PsA has not been investigated.Objectives:The aim of this study was to evaluate PsA patients with respect to the presence of osteoporosis and its association with SU levels.Methods:This ongoing study included 86 patients (68 female, 18 male) who were diagnosed with PsA according to the CASPAR criteria and had indications for BMD testing according to the National Osteoporosis Foundation. Clinical characteristics including body mass index (BMI), pain VAS, patient global VAS, enthesitis, and tender and swollen joint counts were recorded. Evaluations included the PASI, PsAQoL, and HAQ. Disease activity was assessed using the DAPSA, BASDAI, and MDA. Osteoporosis was defined as a BMD T-score of -2.5 or less and osteopenia as a BMD T-score between -1 and -2.5 (WHO osteoporosis).Results:The mean age of the study group was 55.4 (SD:9.2) years and the mean disease duration was 84.5 (SD:91.6) months. Indicators of secondary osteoporosis were type-1 diabetes mellitus (1%), hyperthyroidism (2.3%), early menopause (<age 40) (8.1%), and chronic liver disease (9.3%). As for the steroid use, the rates of never, previous and current users were 33.7%, 20.9% and 22.1%, respectively. Osteoporosis was found in 9.3% and osteopenia in 33.7% of the patients. A history of vertebral compression fractures or any fracture was present in 20.9% of the patients, half of whom were in postmenopausal. BMD L1-L4T- and Z-scores were lower in female patients (p<0.05). DAPSA remission and MDA rates were 6% and 15%, respectively. Bone mineral density was similar across DAPSA disease activity categories (remission-low-moderate-high) (p>0.05). The frequency of osteoporosis did not differ significantly between patients with DAPSA remission and non-remission (p>0.05). The mean L1-L4T- and Z-scores, and BMD g/cm2were significantly higher in patients with MDA than those without MDA (p<0.05). The mean SU level was 5 (SD:1.3) mg/dl, and 18.6% of the patients had a SU level of 6 mg/dl or higher. There was no significant correlation between SU and BMD (p>0.05). BMI showed a weak correlation with femur total T-score (r=0.244). PASI showed weak inverse correlations with femur neck T-score (r=-0.286) and total femur T-score (r=-0.245). BMD variables showed no correlations with disease duration, acute phase reactants, BASDAI, PsAQoL, and cumulative steroid dose.Conclusion:Patients with PsA did not have an increased prevalence of low BMD despite fractures. Osteoporosis was associated with MDA and the severity of psoriasis, but not with DAPSA, SU level, functional impairment, and quality of life.References:[1]Gulati AM, Michelsen B, Diamantopoulos A, et al. Osteoporosis in psoriatic arthritis: a cross-sectional study of an outpatient clinic population. RMD Open 2018;4: e000631. DOI: 10.1136/rmdopen-2017-000631[2]Han W, Bai X, Wang N, Han L, Sun X, Chen X. Association between lumbar bone mineral density and serum uric acid in postmenopausal women: a cross-sectional study of healthy Chinese population. Arch Osteoporosis 2017; 12:50. DOI: 10.1007/s11657-017-0345-0.Disclosure of Interests:None declared

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