BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patie...BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.展开更多
Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions...Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.展开更多
Purpose: Obtaining high peak bone mass (PBM) and maintaining bone mass is important for the prevention of osteoporosis. This study aimed to examine the regional differences in bone mineral density and factors associat...Purpose: Obtaining high peak bone mass (PBM) and maintaining bone mass is important for the prevention of osteoporosis. This study aimed to examine the regional differences in bone mineral density and factors associated with its acquisition from exercise. Design: The study population included 75 women of 18 - 22 years of age in East Japan and 104 women of 18 - 27 years of age in West Japan. The speed of sound (SOS) of the calcaneus was measured, and the young adult mean (%YAM) was calculated from the SOS. The subjects’ medical history, family history of osteoporosis, and exercise habits were examined using a self-administered questionnaire. Results: There were a significantly greater number of subjects with low %YAM in West Japan. The exercise history and exercise time were significantly higher in West Japan, and the exercise intensity score tended to be higher in East Japan during junior high and high school. A multiple regression analysis by region revealed that the following factors had a significant positive association with the SOS: exercise intensity at elementary school and outdoor sports at junior high school in East Japan;and exercise time at elementary school, muscle mass, and outdoor sports at junior high school in West Japan. On the other hand, exercise time in junior high school in West Japan showed a negative association with the SOS. Conclusions: Regional differences in bone mineral density existed, suggesting a trend toward lower bone mineral density in West Japan. Exercise history and time tended to be higher in West Japan, and exercise intensity scores tended to be higher in East Japan, suggesting that exercise intensity may be more important than exercise time for obtaining bone mineral density.展开更多
Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD an...Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD and T score were calculated by measuring the right heel bone using a quantitative-ultrasound densitometer. Body composition index of body weight, waist circumference (WC), waist height ratio (WtHR), body fat percentage (BFP) and visceral fat (VF) were measured using a bioelectrical impedance method. Results: The BMI, WC, and WtHR of the male osteoporosis group were lower than those of the normal bone mass (NBM) group (P Conclusion: BMI is positively correlated with BMD in Zhuang. BFP has a greater correlation with female BMD, and a small reduction in BFP can result in a significant decrease in BMD. BMD of male was positively correlated with abdominal obesity indicators (WC, WtHR, VF). However, abdominal obesity has no obvious effect on the promotion of BMD in women, and increased WtHR can lead to a decrease in BMD. Zhuang can appropriately increase the amount of fat within the normal weight range. At the same time, reasonable exercise and balanced nutrition to avoid excessive obesity or low body weight can reduce the incidence of osteoporosis and osteoporosis fractures.展开更多
BACKGROUND The inflammatory bowel diseases(IBD),Crohn’s disease(CD)and ulcerative colitis(UC)are chronic,immune-mediated disorders of the digestive tract.IBD is considered to be a risk factor for developing osteoporo...BACKGROUND The inflammatory bowel diseases(IBD),Crohn’s disease(CD)and ulcerative colitis(UC)are chronic,immune-mediated disorders of the digestive tract.IBD is considered to be a risk factor for developing osteoporosis;however current literature on this matter is inconsistent.AIM To assess prevalence and development of osteoporosis and low bone mineral density(BMD),and its risk factors,in IBD patients.METHODS Systematic review of population-based studies.Studies were identified by electronic(January 2018)and manual searches(May 2018).Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week,the European Crohn’s and Colitis Organisation congress,and Digestive Disease Week were screened.Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients.Studies on children under the age of 18 were excluded.Only population-based studies were included.All risk factors for osteoporosis and low BMD investigated in any included article were considered.Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale.RESULTS Twelve studies including 3661 IBD patients and 12789 healthy controls were included.Prevalence of osteoporosis varied between 4%-9%in studies including both CD and UC patients;2%-9% in studies including UC patients, and 7%-15% instudies including CD patients. Among healthy controls, prevalence ofosteoporosis was 3% and 10% in two studies. CD diagnosis, lower body massindex (BMI), and lower body weight were risk factors associated withosteoporosis or low BMD. Findings regarding gender showed inconsistent results.CD patients had an increased risk for osteoporosis or low BMD over time, whileUC patients did not. Increased age was associated with decreased BMD, and therewas a positive association between weight and BMI and BMD over time. Greatheterogeneity was found in the included studies in terms of study methodologies,definitions and the assessment of osteoporosis, and only a small number ofpopulation-based studies was available.CONCLUSIONThis systematic review found a possible increase of prevalence of osteoporosis inCD cohorts when compared to UC and cohorts including both disease types.Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBDpatients. The results varied considerably between studies.展开更多
BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely a...BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.展开更多
BACKGROUND Little is known about inflammatory bowel disease(IBD)burden and its impact on bone mineral density(BMD)among adult patients in Saudi Arabia.To the best of our knowledge,our study is the only study to give a...BACKGROUND Little is known about inflammatory bowel disease(IBD)burden and its impact on bone mineral density(BMD)among adult patients in Saudi Arabia.To the best of our knowledge,our study is the only study to give an update about this health problem in adult Saudi patients with IBD.IBD is a great risk factor for reduced BMD due to its associated chronic inflammation,malabsorption,weight loss and medication side effects.Consequently,screening for reduced BMD among patients with IBD is of utmost importance to curb and control anticipated morbidity and mortality among those patients.AIM To assess the relationship between IBD and BMD in a sample of adult Saudi patients with IBD.METHODS Ninety adult patients with IBD-62 Crohn’s disease(CD)and 28 ulcerative colitis(UC)-were recruited from King Fahad Specialist Hospital gastroenterology clinics in Buraidah,Al-Qassim.All enrolled patients were interviewed for their demographic information and for IBD-and BMD-related clinical data.All patients had the necessary laboratory markers and dual-energy x-ray absorptiometry scans to evaluate their BMD status.Patients were divided into two groups(CD and UC)to explore their clinical characteristics and possible risk factors for reduced BMD.RESULTS The CD group was significantly more prone to osteopenia and osteoporosis compared to the UC group;44%of the CD patients had normal BMD,19%had osteopenia,and 37%had osteoporosis,while 78%of the UC patients had normal BMD,7%had osteopenia,and 25%had osteoporosis(P value<0.05).In the CD group,the lowest t-score showed a statistically significant correlation with body mass index(BMI)(r=0.45,P<0.001),lumbar z-score(r=0.77,P<0.05)and femur z-score(r=0.85,P<0.05).In the UC group,the lowest t-score showed only statistically significant correlation with the lumbar z-score(r=0.82,P<0.05)and femur z-score(r=0.80,P<0.05).The ROC-curve showed that low BMI could predict the lowest t-score in the CD group with the best cut-off value at≤23.43(m/kg2);area under the curve was 0.73(95%CI:0.59–0.84),with a sensitivity of 77%,and a specificity of 63%.CONCLUSION Saudi patients with IBD still have an increased risk of reduced BMD,more in CD patients.Low BMI is a significant risk factor for reduced BMD in CD patients.展开更多
Objective:Many factors affect intraoperative blood loss(BL)in mini-invasive posterior lumbar interbody fusion(PLIF)procedures,but only few has examined.Specifically,the impact of bone mineral density(BMD)levels on int...Objective:Many factors affect intraoperative blood loss(BL)in mini-invasive posterior lumbar interbody fusion(PLIF)procedures,but only few has examined.Specifically,the impact of bone mineral density(BMD)levels on intraoperative BL.This study aims to examine the correlation between these two factors.Methods:Retrospective review of 120 patients with low back disorders who were scheduled to undergo mini-invasive PLIF from October 2018 to October 2019 was performed.Patients were divided into two groups based on BMD of the lumbar spine:normal group and abnormal group(osteoporosis and osteopenia).Comparison of age,gender,BMD,BL,BMI,prothrombin time,activated partial thromboplastin time,haemoglobin concentration,intraoperative mean arterial pressure,platelet count,and operative time(OT)between the two groups,and correlation analysis of BMD and BL were conducted.Results:The mean BL of patients in the abnormal group was remarkably higher than that in the normal group:357.22±152.55 ml and 259.37±125.90 ml respectively(p<0.001).The partial correlation coefficient between BL and BMD was0.45(p<0.001).The results of univariate regression analysis demonstrated that only BMD,gender,and OT were related to BL(BMD,r=0.427,p<0.001;gender,r=0.211,p=0.024;OT,r=0.318,p=0.001).While multivariate linear regression analysis demonstrated that patients with lower BMD and longer OT had a higher amount of intraoperative BL(p<0.001).Conclusions:BMD is an important factor influencing intraoperative BL in mini-invasive PLIF.It should be assessed routinely as a part of the preoperative examination to improve preoperative assessment and ensure patient safety.展开更多
BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk...BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.展开更多
Objective:To evaluate the effects of calcium supplementation on bone mineral density in children.Methods:The PubMed,Embase,and Cochrane library were systematically searched.The retrieve inception date was between Octo...Objective:To evaluate the effects of calcium supplementation on bone mineral density in children.Methods:The PubMed,Embase,and Cochrane library were systematically searched.The retrieve inception date was between October 2001 and October 2019.Two reviewers independently performed the data extraction and assessed methodology quality.Studies were limited to randomized clinical trials comparing calcium supplement with a placebo for bone mineral density in children.A meta-analysis was performed to calculate standard mean difference(SMD)and 95%confidence interval(CI).Results:A total of 6 randomized controlled trials involving 408 participants(calcium supplementation group:198;placebo group:210)were finally included in this study.The meta-analysis revealed that,compared with placebos,calcium supplementation had no effect on the bone mineral densities[the whole-body:SMD with CI=0.43(-0.05-0.91),P=0.08,I2=75%;the 2nd-4th lumbar vertebrae:SMD with 95%CI=0.27(−0.17 to 0.70),P=0.07,I2=0%)].Sensitivity analysis revealed that the results of the whole-body bone mineral density were unstable and that the bone density of the 2nd-4th lumbar spine was robust.Conclusions:The results of this meta-analysis suggested that calcium supplementation did not improve bone mineral density in children.However,there continues to be a need for more high-quality studies to verify this fact in the future.展开更多
BACKGROUND The National Institute for Health and Care Excellence(NICE)guidelines have advised further research is required into investigating the added prognostic value of bone mineral density(BMD)in the assessment of...BACKGROUND The National Institute for Health and Care Excellence(NICE)guidelines have advised further research is required into investigating the added prognostic value of bone mineral density(BMD)in the assessment of fracture risk with the Fracture Risk Assessment Tool(FRAX)score.AIM To investigate the significance of BMD in fracture neck of femur patients and compare it to the outcome of the FRAX score.METHODS Inclusion criteria for this study were all patients who underwent dual-energy Xray absorptiometry(DXA)scan following fracture neck of femur between 2015 and 2017.Analysis of BMD,FRAX scores and patient demographic data was undertaken.RESULTS A total of 69 patients were included in the study,mean age 74.1 years.There was no significant difference between mean BMD of the femoral neck in males(0.65)as compared to females(0.61)(P=0.364).Analyses showed no significant correlation between BMD and menopause age(rs=-0.28,P=0.090).A significant difference was seen of the femoral neck BMD between the different fracture pattern types(P=0.026).A stronger correlation was observed between BMD of femoral neck and FRAX major score(rs=-0.64,P<0.001)than with BMD of lumbar spine and FRAX major score(rs=-0.37,P=0.003).CONCLUSION This study demonstrated that BMD of the femoral neck measured by DXA scan is of added prognostic value when assessing patients for risk of fracture neck of femur in combination with the FRAX predictive scoring system.展开更多
Objective:To explore the characteristics of bone mineral density(BMD)and treatment inChinese patients with complete androgen insensitivity syndrome(CAIS).Methods:Fourteen cases of CAIS were studied retrospectively thr...Objective:To explore the characteristics of bone mineral density(BMD)and treatment inChinese patients with complete androgen insensitivity syndrome(CAIS).Methods:Fourteen cases of CAIS were studied retrospectively through analyzing and compa-ring BMD of pre-and post-gonadectomy with healthy Chinese men and women.BMD at the lum-bar spine and the femur were measured by dual energy X-ray absorptiometry(DXA).Results:There were 10 cases of CAIS having pre-gonadectomy DXA,in which 6 cases hadvery significantly reduced lumbar 2-4 BMD[(0.92±0.08)g/cm^2]comparing with both healthymen and women(P<0.01),5 cases had significantly reduced femur neck BMD[(0.89±0.12)g/cm^2]comparing with healthy men(P<0.05).There were 7 cases having 12 post-gonadectomyDXA,in which all lumbar 2-4 BMD[(0.954-0.06)g/cm^2]were reduced very significantly com-paring with both healthy men and women(P<0.01),femur neck BMD[(0.91±0.08)g/cm^2]were also reduced significantly comparing with healthy men(P<0.01)and women(P<0.05).Conclusion:There were different degrees of osteopenia in patients of CAIS,especially inlumbar vertebra.This suggests that both estrogen and androgen play important roles in the ac-quirement and maintenance of peak bone mass.展开更多
Background:Growing pain (GP) is the most common form of nonspecific, recurrent leg pain in children aged 4 - 12 years. The exact etiology of GP is not known. However, some studies have found an association between vit...Background:Growing pain (GP) is the most common form of nonspecific, recurrent leg pain in children aged 4 - 12 years. The exact etiology of GP is not known. However, some studies have found an association between vitamin D and Bone Mineral Status (BMD) status with GP in their study. Objectives: To assess the serum level of vitamin D, and BMD and to determine their association with growing pain in children. Methods: This cross-sectional analytical study was conducted in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). Sixty children between the age of 6 - 12 years were included in the study from March 2020 to August 2021. Children who fulfilled the Evans criteria of GP were enrolled as cases and thirty age and sex matched healthy children were recruited as the control in the study. Informed written consent was obtained from patients and parents. Serum 25-hydroxy-vitamin-D levels and BMD were performed among cases and controls and subsequently compared to see their association in growing pain. A preformed semi-structured questionnaire was completed for each participant which included socio-demographic, clinical and laboratory characteristics. Appropriate statistical tests were applied for data analysis and performed by SPSS version 22. A p-value less than 0.05 was considered as significant at a 95% confidence interval. Results: In this study, 96.7% of growing pain patients had hypovitaminosis D and among them,<span style="font-family: "> the majority (86.7%) was vitamin D deficient. There was a significant association between vitamin D with GP compared to healthy control. BMD was significantly lower in the lumbar vertebra (L1 -<span style="font-family: "> L4) and femoral neck region (both right and left) among GP children compared to the control group. Conclusion: From this study, it may be concluded that the majority of children with GP had hypovitaminosis D and low BMD status compared to the control. Vitamin D deficiency and low BMD status were significantly associated with children with growing pain. Institutional Review Board (I.R.B.) Clearance Certificate (NO. BSMMU/2020/4503 Date: 15/03/2020) was provided from the office of the Registrar, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.展开更多
Aim: In vitro studies have shown that iron promotes osteoclast differentiation and bone-resorbing activity by enhancing mitochondrial biogenesis, whereas it suppresses osteoblastogenesis. In postmenopausal women, seru...Aim: In vitro studies have shown that iron promotes osteoclast differentiation and bone-resorbing activity by enhancing mitochondrial biogenesis, whereas it suppresses osteoblastogenesis. In postmenopausal women, serum ferritin increases by 2 - 3 times due to the lack of a major mechanism of iron excretion, while menstrual blood decreases. Based on this observation, it has been hypothesized that in addition to estrogen deficiency, increased iron as a result of menopause could contribute to bone loss in postmenopausal women. So our aim was to investigate the association between serum ferritin levels and bone mineral density (BMD) in elderly women at various skeletal sites. Methods: Retrospective analysis of the medical records of 71 postmenopausal women having a mean age of (66 ± 7) years (range 60 - 83 years) was done. The collected data included age of menopause, past medical history, smoking habits, physical activity, and medication use. BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry, and other biochemical markers including, serum ferritin, 25 hydroxyvitamin D3, serum alkaline phosphatase, and parathyroid hormone were assayed. Results: We found that serum ferritin levels are significantly related to BMD of the total hip and lumbar vertebrae [with a p value of (0.01) and ( Conclusion: This study suggests a positive association between serum ferritin levels and BMD in elderly women without hematologic disorders. Further study is warranted to verify the effects of iron on bone metabolism.展开更多
BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To inv...BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients.展开更多
Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data f...Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data from more than two hundred subjects were retrospectively studied. For each subject, a DXA (GE Lunar Prodigy) scan of the forearm was performed, and bone mineral density (BMD) value was measured at the location of ultra-distal radius, X-ray digital image of the same forearm was taken on the same day, and ISV value over the same location of ultra-distal radius was calculated. Pearson’s correlation coefficients were calculated to examine the correlation between BMD and ISV of the trabecular bones located at the same ultra-distal radius. ISV values changed with subjects’ age were also reported. Results: The results show that ISV value was highly correlated with the DXA-measured BMD of the same trabecular bone located at the ultra-distal radius. The correlation coefficient between ISV and BMD with the 95% confident was 0.79 ± 0.09. They also demonstrated that the age-related changes in trabecular bone health and differentiated age patterns in males and females, respectively. The results showed that the decrease in BMD was accompanied by a decrease in the initial slope of variogram (ISV). Conclusions: This study suggests that ISV might be used to quantitatively evaluate trabecular health for osteoporosis and bone disease diagnosis.展开更多
Background and objective: The aim of this study was to evaluate the association between dietary intake and bone mineral density in children with juvenile idiopathic arthritis (JIA). Methods: A cross-sectional study ca...Background and objective: The aim of this study was to evaluate the association between dietary intake and bone mineral density in children with juvenile idiopathic arthritis (JIA). Methods: A cross-sectional study carried out in Morocco between May 2010 and June 2011, covering out patients with JIA. The characteristics of patients were collected. The nutritional status was assessed by a food questionnaire including data of food intake during 7 consecutive days using 24-hour dietary recall. Food intake was quantified using the software Bilnut (Bilnut version 2.01, 1991). Bone mineral density (BMD in g/cm2) was measured by DXA method (X-ray absorptiometry) on a Lunar Prodigy. Results: The study consisted of 33 patients with JIA (4 - 16 years old). The median age of patients was 10.4 ± 4.3 years. Median disease duration was 2 (1 - 4.5) years. The group of patients with low dietary intake of proteins was associated with low BMD (p = 0.03). Low BMD was related with low intake of magnesium (p = 0.007) and vitamin C (p = 0.04) in children aged between 4 and 9 years. Low intake of vitamin E and folate was associated with high BMD in the other range of children (p < 0.001). Conclusion: This study suggests that low intake of protein and of some micronutrients (magnesium, vitamin C, vitamin E and folate) influence bone mass in children with JIA. Prospective studies with a larger number of patients seem to be necessary in order to confirm our findings.展开更多
Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients ...Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients with nonfunctional adenoma and 255 healthy controls were enrolled in this study between December 2007 and May 2008.展开更多
Persistent generalized low bone mineral density (BMD) has been reported in patients with adolescent idiopathic scoliosis (AIS).However,the exact mechanisms and causes of the low BMD in AIS patients are largely unknown...Persistent generalized low bone mineral density (BMD) has been reported in patients with adolescent idiopathic scoliosis (AIS).However,the exact mechanisms and causes of the low BMD in AIS patients are largely unknown.The purpose of this study was to examine the relationship between the receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) levels in osteoblasts (OBs) from AIS patients with low BMD and with comparison made between the patients and controls.Twenty AIS patients and eight age-matched controls were included in the present study.The BMD of lumbar spine and proximal femur was measured in all subjects.OBs from the cancellous bone of each subject was harvested and primarily cultured.The mRNA and protein expression of RANKL and OPG in OBs was detected by RT-PCR and Western blotting.The results showed BMD was lower in AIS patients than in controls.A significantly higher mRNA and protein expression of RANKL was observed in OBs from AIS patients,while no significant difference was found in the expression of OPG between AIS patients and controls.As a result,RANKL/OPG ratio in patients with AIS was remarkably higher than controls.Our study preliminarily demonstrated expression of RANKL was higher in OBs from AIS patients with low BMD as compared with controls,suggesting the unbalanced RANKL/OPG ratio caused by an over-expression of RANKL in OBs may be responsible for the low BMD in AIS patients.展开更多
Cone beam computed tomography(CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. Howe...Cone beam computed tomography(CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. However, there is no consensus regarding the accuracy of the determination of the gray scales in these exams. This study aims to provide a literature review concerning the reliability of CBCT to determine bone mineral density. The gray values obtained with CBCT show a linear relationship with the attenuation coefficients of the materials, Hounsfield Units values obtained with medical computed tomography, and density values from dual energy X-ray absorciometry. However, errors are expected when CBCT images are used to define the quality of the scanned structures be-cause these images show inconsistencies and arbitrari-ness in the gray values, particularly when related to abrupt change in the density of the object, X-ray beam hardening effect, scattered radiation, projection data discontinuity-related effect, differences between CBCTdevices, changes in the volume of the field of view(FOV), and changes in the relationships of size and position between the FOV and the object evaluated. A few methods of mathematical correction of the gray scales in CBCT have been proposed; however, they do not generate consistent values that are independent of the devices and their configurations or of the scanned objects. Thus, CBCT should not be considered the ex-amination of choice for the determination of bone and soft tissue mineral density at the current stage, par-ticularly when values obtained are to be compared to predetermined standard values. Comparisons between symmetrically positioned structures inside the FOV and in relation to the exomass of the object, as it occurs with the right and left sides of the skull, seem to be viable because the effects on the gray scale in the re-gions of interest are the same.展开更多
基金Supported by Social Development Projects of Nantong,No.MS22021008 and No.QNZ2022005.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.
文摘Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.
文摘Purpose: Obtaining high peak bone mass (PBM) and maintaining bone mass is important for the prevention of osteoporosis. This study aimed to examine the regional differences in bone mineral density and factors associated with its acquisition from exercise. Design: The study population included 75 women of 18 - 22 years of age in East Japan and 104 women of 18 - 27 years of age in West Japan. The speed of sound (SOS) of the calcaneus was measured, and the young adult mean (%YAM) was calculated from the SOS. The subjects’ medical history, family history of osteoporosis, and exercise habits were examined using a self-administered questionnaire. Results: There were a significantly greater number of subjects with low %YAM in West Japan. The exercise history and exercise time were significantly higher in West Japan, and the exercise intensity score tended to be higher in East Japan during junior high and high school. A multiple regression analysis by region revealed that the following factors had a significant positive association with the SOS: exercise intensity at elementary school and outdoor sports at junior high school in East Japan;and exercise time at elementary school, muscle mass, and outdoor sports at junior high school in West Japan. On the other hand, exercise time in junior high school in West Japan showed a negative association with the SOS. Conclusions: Regional differences in bone mineral density existed, suggesting a trend toward lower bone mineral density in West Japan. Exercise history and time tended to be higher in West Japan, and exercise intensity scores tended to be higher in East Japan, suggesting that exercise intensity may be more important than exercise time for obtaining bone mineral density.
文摘Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD and T score were calculated by measuring the right heel bone using a quantitative-ultrasound densitometer. Body composition index of body weight, waist circumference (WC), waist height ratio (WtHR), body fat percentage (BFP) and visceral fat (VF) were measured using a bioelectrical impedance method. Results: The BMI, WC, and WtHR of the male osteoporosis group were lower than those of the normal bone mass (NBM) group (P Conclusion: BMI is positively correlated with BMD in Zhuang. BFP has a greater correlation with female BMD, and a small reduction in BFP can result in a significant decrease in BMD. BMD of male was positively correlated with abdominal obesity indicators (WC, WtHR, VF). However, abdominal obesity has no obvious effect on the promotion of BMD in women, and increased WtHR can lead to a decrease in BMD. Zhuang can appropriately increase the amount of fat within the normal weight range. At the same time, reasonable exercise and balanced nutrition to avoid excessive obesity or low body weight can reduce the incidence of osteoporosis and osteoporosis fractures.
文摘BACKGROUND The inflammatory bowel diseases(IBD),Crohn’s disease(CD)and ulcerative colitis(UC)are chronic,immune-mediated disorders of the digestive tract.IBD is considered to be a risk factor for developing osteoporosis;however current literature on this matter is inconsistent.AIM To assess prevalence and development of osteoporosis and low bone mineral density(BMD),and its risk factors,in IBD patients.METHODS Systematic review of population-based studies.Studies were identified by electronic(January 2018)and manual searches(May 2018).Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week,the European Crohn’s and Colitis Organisation congress,and Digestive Disease Week were screened.Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients.Studies on children under the age of 18 were excluded.Only population-based studies were included.All risk factors for osteoporosis and low BMD investigated in any included article were considered.Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale.RESULTS Twelve studies including 3661 IBD patients and 12789 healthy controls were included.Prevalence of osteoporosis varied between 4%-9%in studies including both CD and UC patients;2%-9% in studies including UC patients, and 7%-15% instudies including CD patients. Among healthy controls, prevalence ofosteoporosis was 3% and 10% in two studies. CD diagnosis, lower body massindex (BMI), and lower body weight were risk factors associated withosteoporosis or low BMD. Findings regarding gender showed inconsistent results.CD patients had an increased risk for osteoporosis or low BMD over time, whileUC patients did not. Increased age was associated with decreased BMD, and therewas a positive association between weight and BMI and BMD over time. Greatheterogeneity was found in the included studies in terms of study methodologies,definitions and the assessment of osteoporosis, and only a small number ofpopulation-based studies was available.CONCLUSIONThis systematic review found a possible increase of prevalence of osteoporosis inCD cohorts when compared to UC and cohorts including both disease types.Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBDpatients. The results varied considerably between studies.
文摘BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.
基金Sulaiman Al Rajhi University,Saudi Arabia,from the Annual Budget of their Research Unit.
文摘BACKGROUND Little is known about inflammatory bowel disease(IBD)burden and its impact on bone mineral density(BMD)among adult patients in Saudi Arabia.To the best of our knowledge,our study is the only study to give an update about this health problem in adult Saudi patients with IBD.IBD is a great risk factor for reduced BMD due to its associated chronic inflammation,malabsorption,weight loss and medication side effects.Consequently,screening for reduced BMD among patients with IBD is of utmost importance to curb and control anticipated morbidity and mortality among those patients.AIM To assess the relationship between IBD and BMD in a sample of adult Saudi patients with IBD.METHODS Ninety adult patients with IBD-62 Crohn’s disease(CD)and 28 ulcerative colitis(UC)-were recruited from King Fahad Specialist Hospital gastroenterology clinics in Buraidah,Al-Qassim.All enrolled patients were interviewed for their demographic information and for IBD-and BMD-related clinical data.All patients had the necessary laboratory markers and dual-energy x-ray absorptiometry scans to evaluate their BMD status.Patients were divided into two groups(CD and UC)to explore their clinical characteristics and possible risk factors for reduced BMD.RESULTS The CD group was significantly more prone to osteopenia and osteoporosis compared to the UC group;44%of the CD patients had normal BMD,19%had osteopenia,and 37%had osteoporosis,while 78%of the UC patients had normal BMD,7%had osteopenia,and 25%had osteoporosis(P value<0.05).In the CD group,the lowest t-score showed a statistically significant correlation with body mass index(BMI)(r=0.45,P<0.001),lumbar z-score(r=0.77,P<0.05)and femur z-score(r=0.85,P<0.05).In the UC group,the lowest t-score showed only statistically significant correlation with the lumbar z-score(r=0.82,P<0.05)and femur z-score(r=0.80,P<0.05).The ROC-curve showed that low BMI could predict the lowest t-score in the CD group with the best cut-off value at≤23.43(m/kg2);area under the curve was 0.73(95%CI:0.59–0.84),with a sensitivity of 77%,and a specificity of 63%.CONCLUSION Saudi patients with IBD still have an increased risk of reduced BMD,more in CD patients.Low BMI is a significant risk factor for reduced BMD in CD patients.
基金The study was funded by Zhejiang Provincial Nature Science Foundation of China(LY17H060006)Zhejiang Provincial Medical and Health Science Project(2017198461).
文摘Objective:Many factors affect intraoperative blood loss(BL)in mini-invasive posterior lumbar interbody fusion(PLIF)procedures,but only few has examined.Specifically,the impact of bone mineral density(BMD)levels on intraoperative BL.This study aims to examine the correlation between these two factors.Methods:Retrospective review of 120 patients with low back disorders who were scheduled to undergo mini-invasive PLIF from October 2018 to October 2019 was performed.Patients were divided into two groups based on BMD of the lumbar spine:normal group and abnormal group(osteoporosis and osteopenia).Comparison of age,gender,BMD,BL,BMI,prothrombin time,activated partial thromboplastin time,haemoglobin concentration,intraoperative mean arterial pressure,platelet count,and operative time(OT)between the two groups,and correlation analysis of BMD and BL were conducted.Results:The mean BL of patients in the abnormal group was remarkably higher than that in the normal group:357.22±152.55 ml and 259.37±125.90 ml respectively(p<0.001).The partial correlation coefficient between BL and BMD was0.45(p<0.001).The results of univariate regression analysis demonstrated that only BMD,gender,and OT were related to BL(BMD,r=0.427,p<0.001;gender,r=0.211,p=0.024;OT,r=0.318,p=0.001).While multivariate linear regression analysis demonstrated that patients with lower BMD and longer OT had a higher amount of intraoperative BL(p<0.001).Conclusions:BMD is an important factor influencing intraoperative BL in mini-invasive PLIF.It should be assessed routinely as a part of the preoperative examination to improve preoperative assessment and ensure patient safety.
文摘BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.
文摘Objective:To evaluate the effects of calcium supplementation on bone mineral density in children.Methods:The PubMed,Embase,and Cochrane library were systematically searched.The retrieve inception date was between October 2001 and October 2019.Two reviewers independently performed the data extraction and assessed methodology quality.Studies were limited to randomized clinical trials comparing calcium supplement with a placebo for bone mineral density in children.A meta-analysis was performed to calculate standard mean difference(SMD)and 95%confidence interval(CI).Results:A total of 6 randomized controlled trials involving 408 participants(calcium supplementation group:198;placebo group:210)were finally included in this study.The meta-analysis revealed that,compared with placebos,calcium supplementation had no effect on the bone mineral densities[the whole-body:SMD with CI=0.43(-0.05-0.91),P=0.08,I2=75%;the 2nd-4th lumbar vertebrae:SMD with 95%CI=0.27(−0.17 to 0.70),P=0.07,I2=0%)].Sensitivity analysis revealed that the results of the whole-body bone mineral density were unstable and that the bone density of the 2nd-4th lumbar spine was robust.Conclusions:The results of this meta-analysis suggested that calcium supplementation did not improve bone mineral density in children.However,there continues to be a need for more high-quality studies to verify this fact in the future.
文摘BACKGROUND The National Institute for Health and Care Excellence(NICE)guidelines have advised further research is required into investigating the added prognostic value of bone mineral density(BMD)in the assessment of fracture risk with the Fracture Risk Assessment Tool(FRAX)score.AIM To investigate the significance of BMD in fracture neck of femur patients and compare it to the outcome of the FRAX score.METHODS Inclusion criteria for this study were all patients who underwent dual-energy Xray absorptiometry(DXA)scan following fracture neck of femur between 2015 and 2017.Analysis of BMD,FRAX scores and patient demographic data was undertaken.RESULTS A total of 69 patients were included in the study,mean age 74.1 years.There was no significant difference between mean BMD of the femoral neck in males(0.65)as compared to females(0.61)(P=0.364).Analyses showed no significant correlation between BMD and menopause age(rs=-0.28,P=0.090).A significant difference was seen of the femoral neck BMD between the different fracture pattern types(P=0.026).A stronger correlation was observed between BMD of femoral neck and FRAX major score(rs=-0.64,P<0.001)than with BMD of lumbar spine and FRAX major score(rs=-0.37,P=0.003).CONCLUSION This study demonstrated that BMD of the femoral neck measured by DXA scan is of added prognostic value when assessing patients for risk of fracture neck of femur in combination with the FRAX predictive scoring system.
文摘Objective:To explore the characteristics of bone mineral density(BMD)and treatment inChinese patients with complete androgen insensitivity syndrome(CAIS).Methods:Fourteen cases of CAIS were studied retrospectively through analyzing and compa-ring BMD of pre-and post-gonadectomy with healthy Chinese men and women.BMD at the lum-bar spine and the femur were measured by dual energy X-ray absorptiometry(DXA).Results:There were 10 cases of CAIS having pre-gonadectomy DXA,in which 6 cases hadvery significantly reduced lumbar 2-4 BMD[(0.92±0.08)g/cm^2]comparing with both healthymen and women(P<0.01),5 cases had significantly reduced femur neck BMD[(0.89±0.12)g/cm^2]comparing with healthy men(P<0.05).There were 7 cases having 12 post-gonadectomyDXA,in which all lumbar 2-4 BMD[(0.954-0.06)g/cm^2]were reduced very significantly com-paring with both healthy men and women(P<0.01),femur neck BMD[(0.91±0.08)g/cm^2]were also reduced significantly comparing with healthy men(P<0.01)and women(P<0.05).Conclusion:There were different degrees of osteopenia in patients of CAIS,especially inlumbar vertebra.This suggests that both estrogen and androgen play important roles in the ac-quirement and maintenance of peak bone mass.
文摘Background:Growing pain (GP) is the most common form of nonspecific, recurrent leg pain in children aged 4 - 12 years. The exact etiology of GP is not known. However, some studies have found an association between vitamin D and Bone Mineral Status (BMD) status with GP in their study. Objectives: To assess the serum level of vitamin D, and BMD and to determine their association with growing pain in children. Methods: This cross-sectional analytical study was conducted in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). Sixty children between the age of 6 - 12 years were included in the study from March 2020 to August 2021. Children who fulfilled the Evans criteria of GP were enrolled as cases and thirty age and sex matched healthy children were recruited as the control in the study. Informed written consent was obtained from patients and parents. Serum 25-hydroxy-vitamin-D levels and BMD were performed among cases and controls and subsequently compared to see their association in growing pain. A preformed semi-structured questionnaire was completed for each participant which included socio-demographic, clinical and laboratory characteristics. Appropriate statistical tests were applied for data analysis and performed by SPSS version 22. A p-value less than 0.05 was considered as significant at a 95% confidence interval. Results: In this study, 96.7% of growing pain patients had hypovitaminosis D and among them,<span style="font-family: "> the majority (86.7%) was vitamin D deficient. There was a significant association between vitamin D with GP compared to healthy control. BMD was significantly lower in the lumbar vertebra (L1 -<span style="font-family: "> L4) and femoral neck region (both right and left) among GP children compared to the control group. Conclusion: From this study, it may be concluded that the majority of children with GP had hypovitaminosis D and low BMD status compared to the control. Vitamin D deficiency and low BMD status were significantly associated with children with growing pain. Institutional Review Board (I.R.B.) Clearance Certificate (NO. BSMMU/2020/4503 Date: 15/03/2020) was provided from the office of the Registrar, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
文摘Aim: In vitro studies have shown that iron promotes osteoclast differentiation and bone-resorbing activity by enhancing mitochondrial biogenesis, whereas it suppresses osteoblastogenesis. In postmenopausal women, serum ferritin increases by 2 - 3 times due to the lack of a major mechanism of iron excretion, while menstrual blood decreases. Based on this observation, it has been hypothesized that in addition to estrogen deficiency, increased iron as a result of menopause could contribute to bone loss in postmenopausal women. So our aim was to investigate the association between serum ferritin levels and bone mineral density (BMD) in elderly women at various skeletal sites. Methods: Retrospective analysis of the medical records of 71 postmenopausal women having a mean age of (66 ± 7) years (range 60 - 83 years) was done. The collected data included age of menopause, past medical history, smoking habits, physical activity, and medication use. BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry, and other biochemical markers including, serum ferritin, 25 hydroxyvitamin D3, serum alkaline phosphatase, and parathyroid hormone were assayed. Results: We found that serum ferritin levels are significantly related to BMD of the total hip and lumbar vertebrae [with a p value of (0.01) and ( Conclusion: This study suggests a positive association between serum ferritin levels and BMD in elderly women without hematologic disorders. Further study is warranted to verify the effects of iron on bone metabolism.
文摘BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients.
文摘Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data from more than two hundred subjects were retrospectively studied. For each subject, a DXA (GE Lunar Prodigy) scan of the forearm was performed, and bone mineral density (BMD) value was measured at the location of ultra-distal radius, X-ray digital image of the same forearm was taken on the same day, and ISV value over the same location of ultra-distal radius was calculated. Pearson’s correlation coefficients were calculated to examine the correlation between BMD and ISV of the trabecular bones located at the same ultra-distal radius. ISV values changed with subjects’ age were also reported. Results: The results show that ISV value was highly correlated with the DXA-measured BMD of the same trabecular bone located at the ultra-distal radius. The correlation coefficient between ISV and BMD with the 95% confident was 0.79 ± 0.09. They also demonstrated that the age-related changes in trabecular bone health and differentiated age patterns in males and females, respectively. The results showed that the decrease in BMD was accompanied by a decrease in the initial slope of variogram (ISV). Conclusions: This study suggests that ISV might be used to quantitatively evaluate trabecular health for osteoporosis and bone disease diagnosis.
文摘Background and objective: The aim of this study was to evaluate the association between dietary intake and bone mineral density in children with juvenile idiopathic arthritis (JIA). Methods: A cross-sectional study carried out in Morocco between May 2010 and June 2011, covering out patients with JIA. The characteristics of patients were collected. The nutritional status was assessed by a food questionnaire including data of food intake during 7 consecutive days using 24-hour dietary recall. Food intake was quantified using the software Bilnut (Bilnut version 2.01, 1991). Bone mineral density (BMD in g/cm2) was measured by DXA method (X-ray absorptiometry) on a Lunar Prodigy. Results: The study consisted of 33 patients with JIA (4 - 16 years old). The median age of patients was 10.4 ± 4.3 years. Median disease duration was 2 (1 - 4.5) years. The group of patients with low dietary intake of proteins was associated with low BMD (p = 0.03). Low BMD was related with low intake of magnesium (p = 0.007) and vitamin C (p = 0.04) in children aged between 4 and 9 years. Low intake of vitamin E and folate was associated with high BMD in the other range of children (p < 0.001). Conclusion: This study suggests that low intake of protein and of some micronutrients (magnesium, vitamin C, vitamin E and folate) influence bone mass in children with JIA. Prospective studies with a larger number of patients seem to be necessary in order to confirm our findings.
文摘Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients with nonfunctional adenoma and 255 healthy controls were enrolled in this study between December 2007 and May 2008.
基金supported by the National Natural ScienceFoundation of China (No.81101335)
文摘Persistent generalized low bone mineral density (BMD) has been reported in patients with adolescent idiopathic scoliosis (AIS).However,the exact mechanisms and causes of the low BMD in AIS patients are largely unknown.The purpose of this study was to examine the relationship between the receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) levels in osteoblasts (OBs) from AIS patients with low BMD and with comparison made between the patients and controls.Twenty AIS patients and eight age-matched controls were included in the present study.The BMD of lumbar spine and proximal femur was measured in all subjects.OBs from the cancellous bone of each subject was harvested and primarily cultured.The mRNA and protein expression of RANKL and OPG in OBs was detected by RT-PCR and Western blotting.The results showed BMD was lower in AIS patients than in controls.A significantly higher mRNA and protein expression of RANKL was observed in OBs from AIS patients,while no significant difference was found in the expression of OPG between AIS patients and controls.As a result,RANKL/OPG ratio in patients with AIS was remarkably higher than controls.Our study preliminarily demonstrated expression of RANKL was higher in OBs from AIS patients with low BMD as compared with controls,suggesting the unbalanced RANKL/OPG ratio caused by an over-expression of RANKL in OBs may be responsible for the low BMD in AIS patients.
文摘Cone beam computed tomography(CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. However, there is no consensus regarding the accuracy of the determination of the gray scales in these exams. This study aims to provide a literature review concerning the reliability of CBCT to determine bone mineral density. The gray values obtained with CBCT show a linear relationship with the attenuation coefficients of the materials, Hounsfield Units values obtained with medical computed tomography, and density values from dual energy X-ray absorciometry. However, errors are expected when CBCT images are used to define the quality of the scanned structures be-cause these images show inconsistencies and arbitrari-ness in the gray values, particularly when related to abrupt change in the density of the object, X-ray beam hardening effect, scattered radiation, projection data discontinuity-related effect, differences between CBCTdevices, changes in the volume of the field of view(FOV), and changes in the relationships of size and position between the FOV and the object evaluated. A few methods of mathematical correction of the gray scales in CBCT have been proposed; however, they do not generate consistent values that are independent of the devices and their configurations or of the scanned objects. Thus, CBCT should not be considered the ex-amination of choice for the determination of bone and soft tissue mineral density at the current stage, par-ticularly when values obtained are to be compared to predetermined standard values. Comparisons between symmetrically positioned structures inside the FOV and in relation to the exomass of the object, as it occurs with the right and left sides of the skull, seem to be viable because the effects on the gray scale in the re-gions of interest are the same.
