SPINAL DEFORMITY INDEX AND QUALITY OF LIFE OF PATIENTS WITH A DENSITOMETRIC DIAGNOSIS OF OSTEOPOROSIS

ABSTRACT Objective: To evaluate the existence of a possible significant correlation between the quality of life of outpatients with osteoporosis and the Spinal Deformity Index (SDI), a radiographic method for semiquantitative assessment of the spine that enables the identification of prevalent and incident fractures. Methods: A cross-sectional observational study carried out with female patients, Caucasians, over 50 years of age, with a densitometric diagnosis of osteoporosis and in an outpatient follow-up, who were submitted to the Oswestry Disability Index (ODI) and SF-36 questionnaires to measure the direct and indirect damage of vertebral fragility fractures on quality of life. The scores obtained in these questionnaires were correlated with the SDI scores, calculated from the radiographs of the lumbar and thoracic spine. Results: 48 patients completed the study, with a mean age of 69.6±6.7 years, mean body mass index (BMI) of 25.4±3.4 kg/m2, mean ODI of 25.1±17.9%, mean SF- 36 of 428.7±192.4 and mean SDI of 4.3±3. For the statistical analysis, Spearman's coefficient was used (p ≤ 0.05). Conclusion: There is no statistically significant correlation between the SDI and the scores obtained on the ODI and SF-36 quality of life questionnaires. Level of evidence: III. Study of non-consecutive patients, without gold standard, applied uniformly.

Application of Medical Imaging Based on Deep Learning in the Treatment of Lumbar Degenerative Diseases and Osteoporosis with Bone Cement Screws

Objective. To explore the application value of magnetic resonance spectroscopy (MRS) and GSI-energy spectrum electronic computed tomography (CT) medical imaging based on the deep convolutional neural network (CNN) in the treatment of lumbar degenerative disease and osteoporosis. Methods. There were 56 cases of suspected lumbar degenerative disease and osteoporosis. A group of 56 subjects were examined using 1.5 TMR spectrum (MRS) and dual-energy X-ray absorptiometry (DXA) to collect the lumbar L3 vertebral body fat ratio (FF) and L1~4 vertebral bone mineral density (BMD) value. We divided the subjects into 2 groups with T value -2.5 as the critical point. Set T value > -2.5 as the negative group and T value ≤ -2.5 as the positive group. Pearson’s method is used for FF-MRS and BMD correlation analyses. A group of all patients underwent GSI-energy spectrum CT scan, and X-ray bone mineral density (DXA) test results (bone density per unit area) were used as the gold standard to analyze the diagnosis of osteoporosis by the GSI-energy spectrum CT scan method value. Results. The differences in FF and BMD between the negative group and the positive group were statistically significant ( P < 0.01 ), and there was a highly negative correlation between the average value of FF and BMD. 30 cases were diagnosed as osteoporosis by DXA. The accuracy of GSI-energy spectrum CT medical imaging in diagnosing osteoporosis is 89.30%. The GSI-energy spectrum CT diagnosis of osteoporosis and DXA examination results have good consistency. Conclusion. Based on the deep convolutional neural network (CNN) MRS technology, GSI-energy spectrum CT medical imaging is used in the clinical diagnosis and treatment of lumbar degenerative lesions and osteoporosis. It has a good advantage in assessing bone quality and has good consistency with DXA examination and has better application value high.

Association of Serum Osteocalcin and Neutrophil-Lymphocyte Ratio with Bone Mineral Density for the Diagnosis of Osteoporosis

Introduction: Osteoporosis is often under diagnosed, under treated and imposed a considerable economic burden on the health system. About two fifth of the post-menopausal women of Bangladesh are affected. Early diagnosis is necessary to halt the disease process. Serum osteocalcin, neutrophil-lymphocyte ratio (NLR) increases and bone mineral density (BMD) decreases in osteoporosis. There is no specific diagnostic test for osteoporosis except BMD. It is costly, has radiation hazard and not available in all laboratories in our country. On the other hand, serum osteocalcin and NLR are easily available and a promising marker which can be done as routine blood test for the diagnosis of osteoporosis. Objective: The objective of the study was to evaluate the association of serum osteocalcin and NLR with BMD for the diagnosis of osteoporosis. Materials and methods: This cross-sectional study was conducted in the Department of Laboratory Medicine and the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from March, 2020 to February, 2021. A total 50 diagnosed patient of osteoporosis, who fulfil the inclusion and exclusion criteria were selected as study population. They were grouped as normal, osteopenia and osteoporosis according to T-score of BMD report. Serum osteocalcin and NLR evaluated from routine blood test. Statistical analysis was done by statistical package for social science (SPSS) software windows version 22. Results: Negative Pearson’s correlation was found between serum osteocalcin with T-score of BMD (r=-0.812, p=0.002) and between NLR with T-score of BMD (r=-0.826, p=0.001). In receiver operating characteristic (ROC) curve analysis, cut off value of serum osteocalcin was 18.65 ng/mL having sensitivity 67.0% and specificity 70.0% with a cut off value of NLR was 4.54 with sensitivity 72.0% and specificity 75.0%. Conclusion: Serum osteocalcin and NLR has significant negative correlation with T-score of BMD. Because of high sensitivity and specificity, serum osteocalcin and NLR may be used to diagnosis of osteoporosis

Higher serum alkaline phosphatase value indicates the need for bone mineral density testing in non-metastatic prostate cancer patients undergoing androgen deprivation therapy

Purpose Osteoporosis is a well-known adverse effect of androgen deprivation therapy for prostate cancer. This study aimed to reveal the factors associated with the diagnosis of osteoporosis in prostate cancer patients undergoing androgen deprivation therapy. Methods This retrospective cross-sectional study included 106 prostate cancer patients treated with androgen deprivation therapy. Patients with bone metastasis at the initiation of androgen deprivation therapy and those with castration-resistant prostate cancer were excluded. Bone mineral density was measured at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Osteoporosis was defined as bone mineral density equal to or below either −2.5 SD or 70% of the mean in young adults. The association between clinicopathological variables and bone mineral density or diagnosis of osteoporosis was investigated. Results Thirty-six (34%) patients were found to have osteoporosis. The incidence of osteoporosis increased in a stepwise manner depending on the duration of androgen deprivation therapy. Multivariate logistic regression analysis identified a longer duration of androgen deprivation therapy (months, odd’s ratio = 1.017, P = 0.006), lower body mass index (kg/m2, odd’s ratio = 0.801, P = 0.005) and higher serum alkaline phosphatase value (U/l, odd’s ratio 1.007, P = 0.014) as the factors independently associated with the diagnosis of osteoporosis. Eleven out of 50 (22%), 14 out of 35 (40%) and 11 out of 20 patients (55%) were osteoporotic in the patients with serum alkaline phosphatase values &lt;238 U/l, 238–322 U/l and &gt;322 U/l, respectively (P = 0.022). Conclusions Osteoporosis is common in prostate cancer patients undergoing androgen deprivation therapy; furthermore, its incidence increases depending on the duration of androgen deprivation therapy. Bone mineral density testing should be considered for all patients on androgen deprivation therapy, especially for those with a lower body mass index and higher serum alkaline phosphatase value.

FEATURES OF MANAGEMENT IN PATIENTS WITH OSTEOPOROSIS AND DIABETES MELLITUS

The number of patients with diabetes mellitus in the world has been progressively increasing in recent years, therefore, the fight against complications of diabetes mellitus is an important problem of our time. The purpose of our review is to analyze the literature data on the risks of osteoporosis in patients with diabetes mellitus, effective diagnostic methods, as well as current recommendations for the treatment and prevention of osteoporosis in this category of patients. Results. We have processed and analyzed literary sources and internationalrecommendations, which identify the main mechanisms and risk factors that contribute to the development of osteoporosis in patients with type 1 and 2 diabetes mellitus; methods for the timely diagnosis of osteoporosis are indicated, methods for correcting the condition of patients with diabetes mellitus, which can help prevent the development of osteoporosis in this group of patients, are given. The current recommendations for the treatment of osteoporosis in men and women are presented. Conclusions. Taking into account the data of the analysis of literary sources, osteoporosis can be considered one of the complications of diabetes mellitus. Today, densitometry and fracture risk assessment FRAX are quite sensitive methods for early diagnosis of osteoporosis in patients with type 1 diabetes mellitus, but not sufficient for patients with type 2 diabetes mellitus, therefore there is a need to determine the trabecular bone index during densitometry, as well as additional actions when assessing the risk of fractures on the FRAX scale. Therapy of patients with osteoporosis with concomitant diabetes mellitus should be based on the achievement of target glycemic levels and the use of bisphosphonates with target level of calcium and vitamin D.

Estimation of bone mineral density and algorithms of 10-year risk of osteoporotic fractures in women

Osteoporosis is the fourth most common after cardiovascular, cancer and endocrine diseases. With an increase in life expectancy, it becomes one of the main causes of deterioration in health and an increase in mortality. Aim of the study. Assess bone mineral density using ultrasonic densitometry and the risk of osteoporotic fractures among women in Cherkasy region. Materials and methods. The study was based on a survey of 43 women in the Odessa region, the average age of the subjects was 56,4±9,9 years, the average body weight was 73,5±11,6 kg, height 164,9±5,9 cm, the average BMI was 27,1±4,3. All women were divided into groups by age with a ten-year interval and by densitometry indices. Results. Decreased bone density was found in 58,1 % of subjects, osteoporosis - 2 (4,8%). Women with osteopenia and osteoporosis have an increased risk of fractures and significantly reduced ultrasound densitometry compared to respondents with normal BMD. The structure of concomitant pathology was dominated by diseases of the circulatory system (22 cases;51,2 %) and digestive organs (12; 27,9 %). More than half of women (26; 60,5 %) had a total of 50 comorbidities, with an average of 1.2 cases of comorbidity. Conclusions. Most women had osteopenic manifestations. Age significantly correlates with BMD parameters. The number of women with changes in the structure of bone tissue increases with age. Algorithms for assessing the 10-year risk of FRAX and Q-Fracture fractures are significantly correlated with densitometry. The combination of ultrasonic densitometry with algorithms for assessing the risk of osteoporotic fractures increases the diagnosis of osteoporosis.

Ability of radiofrequency echographic multispectrometry to identify osteoporosis status in elderly women with type 2 diabetes

Background Patients with type 2 diabetes (T2DM) have an increased or normal BMD; however fragility fractures represent one of the most important complications of T2DM. Aims This study aimed to evaluate whether the use of the Radiofrequency Echographic multi spectrometry (REMS) technique may improve the identification of osteoporosis in T2DM patients. Methods In a cohort of 90 consecutive postmenopausal elderly (70.5 ± 7.6 years) women with T2DM and in 90 healthy controls we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using a dual-energy X-ray absorptiometry device; moreover, REMS scans were also carried out at the same axial sites. Results DXA measurements were all higher in T2DM than in non-T2DM women; instead, all REMS measurements were lower in T2DM than in non T2DM women. Moreover, the percentage of T2DM women classified as “osteoporotic”, on the basis of BMD by REMS was markedly higher with respect to those classified by DXA (47.0% vs 28.0%, respectively). On the contrary, the percentage of T2DM women classified as osteopenic or normal by DXA was higher with respect to that by REMS (48.8% and 23.2% vs 38.6% and 14.5%, respectively). T2DM women with fragility fractures presented lower values of both BMD-LS by DXA and BMD-LS by REMS with respect to those without fractures; however, the difference was significant only for BMD-LS by REMS (p < 0.05). Conclusions Our data suggest that REMS technology may represent a useful approach to enhance the diagnosis of osteoporosis in patients with T2DM.

Ascending Aortic Calcification as a Potential Predictor for Low Bone Mineral Density: A Pilot Study

Background. Identifying the factors related to low bone mineral density (BMD) can have significant implications for preventing hip fractures. The correlation between ascending aortic calcification and BMD has never been reported. Therefore, the purpose of the current study is to confirm the hypothesis that ascending aortic calcification can be used as a predictive factor for low BMD and to find a radiographic sign to show it. Method. Plain film and computed tomography (CT) images of the thorax were obtained from 91 patients with hip fractures. Using the images, the calcification line of the ascending aorta adjacent to the aortic arch was evaluated. A prominent calcification line confirmed by both plain film and CT was classified as +2. A line which was ambiguous on plain film but confirmed by CT was classified as +1. Cases with no calcification were categorized as 0 (control). We compared the classified score with the BMD and calculated the kappa coefficient to measure intraobserver reliabilities for this radiographic finding. Results. Twenty-eight patients showed a +2 line, twenty-four patients showed a +1 line, and thirty-nine patients showed 0 lines. The median BMD of each group was 0.37 for the +2 line, 0.45 for the +1 line, and 0.51 for the 0 line. The BMD for the +2 group was significantly lower than the others. The kappa coefficient was approximately 0.6 ( p < 0.01 ). Conclusion. The imaging finding of calcification of the ascending aorta might be considered as a potential surrogate marker of low BMD. In such subjects, BMD might be ordered for the confirmation of diagnosis of osteoporosis. Mini-Abstract. The Aortic Arch Tail Sign, a calcification line on the ascending aorta, was relevant to low BMD in the current study. BMD can be ordered for the confirmation of diagnosis of osteoporosis in a subject incidentally found to have ascending aorta calcification on X-ray or CT.