Bone mineral density status in urolithiasis patients with vitamin D inadequacy followed at a tertiary stone centre

Introduction: We assessed abnormalities in bone mineral density (BMD) and the risk of hip and major osteoporotic fractures in urolithiasis patients with vitamin D inadequacy (VDI) followed at a tertiary stone centre.Methods: Stone-free patients with VDI were invited to undergo dual-energy x-ray absorptiometry (DXA) scans to assess for BMD abnormalities at the femoral neck and lumbar spine. The World Health Organization’s validated Fracture Risk Assessment Tool (FRAX) was used to calculate the risk of hip and major osteoporotic fractures within 10 years. Patients with primary hyperparathyroidism or hypercalcemia were excluded.Results: In total, 50 consecutive patients were included between June 2011 and August 2012, including 26 (52%) males. The median age was 51 years and the median 25-hydroxyl vitamin D (25[OH]D) was 18.8 ng/mL. Thirty patients (60%) had abnormal T-scores on DXA studies. This decreased to 22 (44%) when age-matched Z-scores were used; 36% had osteopenia and 8% had osteoporosis. Femoral neck and lumbar spines were affected in 24% and 32% of patients, respectively. Recurrent stone-formers had significantly lower BMD when compared with first-time stone-formers. Median serum 25(OH)D was comparable between patients with normal and abnormal DXA scans (18.6 vs. 18.8 ng/mL; p = 0.91). Five patients (10%) were at high risk (≥3%) of hip fractures within 10 years.Conclusion: A high prevalence of abnormal DXA scans was found in urolithiasis patients with VDI, including 5 patients (10%) at high risk of hip fractures. Future studies need to assess the economic impact of obtaining DXA scans on urolithiasis patients with VDI, especially in recurrent stone-formers.

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OR27-04 Risk Factors For Low Baseline Bone Mineral Density In Gender Diverse Youth

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1296 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Juanita K Hodax ◽

Charles Brady ◽

Sara A DiVall ◽

Kristen Carlin ◽

Hedieh Khalatbari ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Hormone Therapy ◽

Bone Mineral ◽

Calcium Intake ◽

Z Score ◽

Mineral Density ◽

Transgender Youth ◽

Z Scores ◽

Dxa Scans

Abstract Background Sex steroids such as testosterone and estrogen are necessary for accumulation of bone mass. Transgender youth treated with gonadotropin releasing hormone analogues (GnRHa) to block natal puberty for gender-affirming care are at risk of low bone mineral density (BMD). Previous studies indicate that transfemale patients assigned male at birth (AMAB) have low BMD at baseline, during and after GnRHa treatment despite cross hormone treatment. Transmales assigned female at birth (AFAB), however, have normal BMD at baseline that decreases upon GnRHa treatment, with normalization upon cross hormone therapy. The reason(s) for the low baseline BMD in transfemales is unclear. We aimed to assess the baseline characteristics of transgender youth at a single multidisciplinary gender clinic prior to medical intervention and determine factors associated with BMD. Methods This is a retrospective chart review of patients <19 years old evaluated in the gender clinic. Dual-energy x-ray absorptiometry (DXA) scans were obtained prior to initiation of GnRHa or cross-hormone therapy per Endocrine Society guidelines for the treatment of gender dysphoria. We included patients with DXA scans completed prior to initiation of treatment with GnRHa or cross gender hormones and excluded those with concurrent medical diagnoses that may affect bone density. Data collected were bone mineral density (BMD) Z-scores, anthropometric data, vitamin D and calcium levels, and calcium intake. Multivariable linear regression models were used to assess the impact of vitamin D levels, height Z-score, weight Z-score, and BMI Z-score on subtotal body BMD Z-score, adjusted for sex assigned at birth and age. Results Sixty-four patients were included in our analysis. Of these, 73% were AMAB and 27% AFAB. Gender identity was male in 14%, female in 44%, and non-binary in 42%. Average height Z-score was 0.12, weight Z-score 0.27, and BMI Z-score 0.22 (using sex assigned at birth). Subtotal body BMD Z-scores were greater than zero in 11%, between zero and greater than -2 in 59%, and less than or equal to -2 in 30% of tested patients. AMAB patients had lower BMD Z-scores compared to those AFAB (p<0.05 for all Z-scores). There was a positive association with BMI, height, and weight Z-scores and increasing BMD Z-scores after adjusting for sex assigned at birth and age (p<0.05 for all Z-scores). Patients who consumed <2 servings of calcium per day had lower BMD Z-scores (p<0.05 for all Z-scores). Average vitamin D level was 24 ng/ml (+/- 9.5 SD) with no significant association with BMD Z-scores (adjusted for sex assigned at birth). Conclusions Patients AMAB and patients with calcium intake of < 2 servings/day are associated with lower baseline BMD in a cohort of adolescents seen in a multidisciplinary gender clinic. Height, weight, and BMI are associated linearly with BMD Z-score, following patterns previously described in other populations.

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The 1 alpha-hydroxylase locus is not linked to calcium stone formation or calciuric phenotypes in French-Canadian families.

Journal of the American Society of Nephrology ◽

10.1681/asn.v93425 ◽

1998 ◽

Vol 9 (3) ◽

pp. 425-432 ◽

Cited By ~ 1

Author(s):

P Scott ◽

D Ouimet ◽

Y Proulx ◽

M L Trouvé ◽

G Guay ◽

...

Keyword(s):

Vitamin D ◽

Quantitative Trait ◽

Stone Formation ◽

Calcium Stone ◽

Stone Formers ◽

Vitamin D Levels ◽

Calcium Urolithiasis ◽

Recurrent Stone ◽

Recurrent Stone Formers ◽

Sib Pairs

Calcium urolithiasis is often associated with increased intestinal absorption and urine excretion of calcium, and has been suggested to result from increased vitamin D production. The role of the enzyme 1 alpha-hydroxylase, the rate-limiting step in active vitamin D production, was evaluated in 36 families, including 28 sibships with at least a pair of affected sibs, using qualitative and quantitative trait linkage analyses. Sibs with a verified calcium urolithiasis passage (n = 117) had higher 24-h calciuria (P = 0.03), oxaluria (P = 0.02), fasting and postcalcium loading urine calcium/creatinine (Ca/cr) ratios (P = 0.008 and P = 0.002, respectively), and serum 1,25(OH)2 vitamin D levels (P = 0.02) compared with nonstone-forming sibs (n = 120). Markers from a 9-centiMorgan interval encompassing the VDD1 locus on chromosome 12q13-14 (putative 1 alpha-hydroxylase) were analyzed in 28 sibships (146 sib pairs) of single and recurrent stone formers and in 14 sibships (65 sib pairs) with recurrent-only (> or = 3 episodes) stone-forming sibs. Two-point and multipoint analyses did not reveal excess in alleles shared among affected sibs at the VDD1 locus. Linkage of stone formation to the VDD1 locus could be excluded, respectively, with a lambda d of 2.0 (single and recurrent stone formers) and 3.25 (recurrent stone formers). Quantitative trait analyses revealed no evidence for linkage to 24-h calciuria and oxaluria, serum 1,25(OH)2 vitamin D levels, and Ca/cr ratios. This study shows absence of linkage of the putative 1 alpha-hydroxylase locus to calcium stone formation or to quantitative traits associated with idiopathic hypercalciuria. In addition, there is coaggregation of calciuric and oxaluric phenotypes with stone formation.

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MP82-05 AN ASSESSMENT OF SERUM TESTOSTERONE, SERUM ESTROGEN, VITAMIN D AND BONE MINERAL DENSITY IN ADULT IDIOPATHIC CALCIGEROUS RENAL STONE FORMERS

The Journal of Urology ◽

10.1016/j.juro.2016.02.2146 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Santosh Kumar ◽

Siddharth Jain ◽

Shrawan Kumar Singh ◽

Arup K Mandal ◽

Anupam Lal ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Renal Stone ◽

Serum Testosterone ◽

Mineral Density ◽

Stone Formers

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Denosumab for the Treatment of Postmenopausal Women at Increased Risk of Osteoporotic Fractures

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s6173 ◽

2011 ◽

Vol 3 ◽

pp. CMT.S6173

Author(s):

Cesar E. Bogado

Keyword(s):

Bone Mineral Density ◽

Monoclonal Antibody ◽

High Risk ◽

Postmenopausal Osteoporosis ◽

Human Monoclonal Antibody ◽

Significant Risk ◽

Osteoporotic Fractures ◽

Mineral Density ◽

Increased Risk ◽

Formation Function

Denosumab is the first fully human monoclonal antibody that inhibits the formation, function and survival of osteoclasts by blocking the interaction of RANKL with its osteoclastic receptor RANK. Clinical studies have shown that the decreased bone resorption and increased bone mineral density resulting from the use of denosumab 60 mg twice yearly entail significant risk reduction of vertebral, hip and non-vertebral fractures in women with postmenopausal osteoporosis, with an acceptable rate of side effects so far. Denosumab offers a new choice for the treatment of postmenopausal osteoporosis in patients at high risk for fractures.

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PTH and 1.25 vitamin D response to a low-calcium diet is associated with bone mineral density in renal stone formers

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfn091 ◽

2008 ◽

Vol 23 (8) ◽

pp. 2563-2570 ◽

Cited By ~ 11

Author(s):

A. Pasch ◽

F. J. Frey ◽

U. Eisenberger ◽

M. G. Mohaupt ◽

O. Bonny

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Renal Stone ◽

Mineral Density ◽

Calcium Diet ◽

Low Calcium Diet ◽

Low Calcium ◽

Stone Formers

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Characteristics of osteoporosis in patients with rheumatic diseases

Health care of Tajikistan ◽

10.52888/0514-2515-2021-350-48-54 ◽

2021 ◽

pp. 48-54

Author(s):

O. Kh. Mirzovaliev ◽

S. M. Shukurova

Keyword(s):

Risk Factors ◽

High Risk ◽

Rheumatic Diseases ◽

Absolute Risk ◽

Osteoporotic Fractures ◽

Case Histories ◽

Mineral Density ◽

Major Osteoporotic Fractures ◽

History Of

Aim. To present a comprehensive assessment of rheumatic diseases in association with osteoporosis.Material and methods. A retrospective analysis was made of 180 case histories with various RDs, who were under inpatient observation at the Sughd Regional Clinical Hospital for the period 2018-2019 for the frequency of osteoporosis (OP). Densitometry was used to determine the projection mineral density (in g / cm2) in various parts of the skeleton.Results. When asked about a history of fractures, every third respondent (33.3%) answered positively. According to the results of densitometry, osteoporosis in patients with inflammatory RD was diagnosed in 32.2% of patients. At the same time, the indicators differed significantly by nosology, and the frequency of OP correlated with the intake of corticosteroids. Osteoporosis was detected in every third patient with OA according to densitometry data and in 25% of cases in patients with gout. The results of the analysis to assess the absolute risk of major osteoporotic fractures according to FRAX showed high risk in 2 groups.Conclusion. Thus, the nature and frequency of risk factors for osteoporosis in patients with RA and OA have their characteristics. A history of fractures in patients with RA is often associated with long-term use of GCS, and the presence of menopause in women and the presence of cardiometabolic concomitant diseases play an important role in the progression of AP in patients with OA.

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