Age-related Bone Mineral Density Research Articles

Perilla seed oil improves bone health by inhibiting bone resorption in healthy Japanese adults: A 12-month, randomized, double-blind, placebo-controlled trial.

Accumulating evidence suggests the beneficial effect of omega-3 polyunsaturated fatty acids (PUFAs) on bone mineral density (BMD). However, the effects of perilla (Perilla frutescens) seed oil (PO), a rich source of α-linoleic acid (LNA), on human bone have not yet been elucidated. This randomized, double-blind, placebo-controlled trial investigated the effects of long-term PO intake on bone health in Japanese adults. After screening for eligibility, 52 participants (mean age 54.2 ± 6.4 years) were randomly assigned to placebo (n=25) and PO (n=27) groups, which received 7.0 ml of olive oil and PO daily, respectively. At baseline and 12-month, quantitative ultrasound of the right calcaneus was measured with an ultrasound bone densitometer and percentage of the Young Adult Mean (%YAM) was calculated. Serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b), and bone alkaline phosphatase (BALP) were evaluated. In addition, PUFA levels in the erythrocyte plasma membrane (RBC-PM), serum biological antioxidant potential (BAP), and diacron reactive oxygen metabolites (d-ROM) were evaluated. Compared with the placebo group, %YAM levels increased and serum TRACP-5b levels decreased significantly in the PO group at 12-month, while serum BALP levels remained unchanged. Moreover, RBC-PM LNA levels and BAP/d-ROM ratios increased significantly in the PO compared with the placebo group. These results suggest that long-term PO intake may improve age-related BMD decline by suppressing bone resorption and increasing LNA levels.

COVID-19 illness and treatment decrease bone mineral density of surviving hospitalized patients.

The number patients surviving COVID-19 hospitalization is steadily increasing. Follow-up management for these patients relies on an understanding of the long-term effects of COVID-19. Specifically, there are insufficient data about the lasting effects of COVID-19 on bone health. We aim in this study to evaluate whether COVID-19 illness and treatment adversely affect the bone health of surviving patients. We assessed the bone mineral density (BMD) of hospitalized COVID-19 patients at diagnosis and at follow-up visits. Using the chest computed tomography (CT) scans of patients that were obtained for clinical management at diagnosis and follow-up visits, BMD was retrospectively measured by quantitative CT. The effect of COVID-19 severity markers and treatment-related factors on BMD were also assessed. BMD decreased by a mean of 8.6% (± 10.5%) from diagnosis to follow-up. The follow-up visits occurred at a mean of 81 (± 48) days after hospital discharge. The BMD decrease was significantly greater than expected for age-related annual BMD loss. The osteoporosis ratio increased two-fold after hospitalization for COVID-19 because of this substantial bone loss. On multivariable linear regression, only severity of COVID-19 pneumonia on initial chest CT and total steroid dose were predictive of change in BMD after COVID-19 hospitalization. Secondary osteoporosis may occur as a post-acute sequela of COVID-19. Therefore, the bone health status of patients surviving COVID-19 hospitalization should be monitored closely at follow-up visits, to facilitate the prevention and early treatment of osteoporosis complications.

Age-related trabecular bone loss is associated with a decline in serum Galectin-1 level

BackgroundSenile osteoporosis with age-related bone loss is diagnosed depending on radiographic changes of bone and bone mineral density (BMD) measurement. However, radiographic alterations are usually signs of medium-late stage osteoporosis. Therefore, biomarkers have been proposed as indicators of bone loss. In the current study, Galectin-1 (Gal-1) showed age-related decline in mice serum. The role of Gal-1 in osteoporosis has not been investigated so far. Hence, the current study illustrated the relationship of serum Gal-1 level with bone loss.MethodsWe employed 6- and 18-month-old mice to establish an animal model of age-related trabecular bone loss, whose bone density and microstructure were investigated by micro-CT. ELISA was used to measure the levels of Gal-1 in serum. The correlation analysis was performed to illustrate the relationship between serum Gal-1 levels and trabecular bone loss. In addition, immunohistochemistry was used to investigate the abundance of Gal-1 in bone marrow of mice. ELISA and western blot were performed to measure the secretion ability and protein expression of Gal-1 in bone marrow stromal cells (BMSC), hematopoietic stem cells (HSC) and myeloid progenitor (MP) respectively. Flow cytometry was used to measure BMSC number in bone marrow. Finally, male volunteers with age-related BMD decrease were recruited and the relationship between serum Gal-1 and BMD was analyzed.ResultsGal-1 showed age-related decline in mice serum. Serum Gal-1 was positively associated with BV/TV of femur, tibia and L1 vertebrae in mice. BMSC secreted more Gal-1 compared with HSC and MP. BMSC number in bone marrow was significantly lower in aged mice compared with young mice. Significant attenuation of Gal-1 protein expression was observed in BMSC and HSC from aged mice compared with young mice. Further, we found a decline in serum Gal-1 levels in men with age-related BMD decrease. There was positive correlation between BMD and serum Gal-1 levels in these men.ConclusionsAge-related trabecular bone loss is associated with a decline in serum Gal-1 level in mice and men. Our study suggested Gal-1 had great potential to be a biomarker for discovering BMSC senescence, diagnosing early osteoporosis and monitoring trabecular bone loss.

Quantitating Age-Related BMD Textural Variation from DXA Region-Free-Analysis: A Study of Hip Fracture Prediction in Three Cohorts.

ABSTRACTThe risk of osteoporotic fracture is inversely related to bone mineral density (BMD), but how spatial BMD pattern influences fracture risk remains incompletely understood. This study used a pixel‐level spatiotemporal atlas of proximal femoral BMD in 13,338 white European women (age 20–97 years) to quantitate age‐related texture variation in BMD maps and generate a “reference” map of bone aging. We introduce a new index, called Densitometric Bone Age (DBA), as the age at which an individual site‐specific BMD map (the proximal femur is studied here) best matches the median aging trajectory at that site in terms of the root mean squared error (RMSE). The ability of DBA to predict incident hip fracture and hip fracture pattern over 5 years following baseline BMD was compared against conventional region‐based BMD analysis in a subset of 11,899 women (age 45–97 years), for which follow‐up fracture records exist. There were 208 subsequent incident hip fractures in the study populations (138 femoral necks [FNs], 52 trochanteric [TR], 18 sites unspecified). DBA had modestly better performance compared to the conventional FN‐BMD, TR‐BMD, and total hip (TOT)‐BMD in identifying hip fractures measured as the area under the curve (AUC) using receiver operating characteristics (ROC) curve analysis by 2% (95% confidence interval [CI], −0.5% to 3.5%), 3% (95% CI, 1.0% to 4.0%), and 1% (95% CI, 0.4% to 1.6%), respectively. Compared to FN‐BMD T‐score, DBA improved the ROC‐AUC for predicting TR fractures by ~5% (95% CI, 1.1% to 9.8%) with similar performance in identifying FN fractures. Compared to TR‐BMD T‐score, DBA improved the ROC‐AUC for the prediction of FN fractures by ~3% (95% CI, 1.1% to 4.9%), with similar performance in identifying TR fractures. Our findings suggest that DBA may provide a spatially sensitive measure of proximal femoral fragility that is not captured by FN‐BMD or TR‐BMD alone. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Effects of vegetarian diet on bone mineral density

Factors, such as hormonal changes in postmenopausal women, natural aging degeneration, race, gender, body size, lifestyle, physical activity, sunlight, dietary intake, medications, or other environmental issues, can affect the rate of bone formation or reabsorption, cause changes in bone mineral content, and influence the development of osteoporosis. Do vegetarian diets adversely affect bone mineral density (BMD)? Among postmenopausal Buddhists, long-term practitioners of vegan vegetarian were found to have a higher risk exceeding the lumbar fracture threshold and a lower level of hip BMD after controlling for other variables. However, results of several prospective longitudinal studies failed to show a harmful effect of vegetarianism on bone health. In the Taiwanese adult population, researchers also did not find that a vegetarian diet significantly affects age-related BMD decline. Due to the various levels of nutrients in the diet (such as protein, alkali, calcium, Vitamin K, and phytoestrogens) and major lifestyle factors (such as smoking and physical exercise), determining the impact of a vegetarian diet on bone health is very complex. Good-quality vegetarian food can provide a healthy foundation for building and maintaining healthy bones and preventing fractures.

The Association between Dehydroepiandrosterone Sulfate (DHEA-S) and Bone Mineral Density in Korean Men and Women.

BackgroundThe relationship between dehydroepiandrosterone sulfate (DHEA-S) and bone mineral density (BMD) is controversial. And findings of most studies that have investigated this relationship are restricted to postmenopausal women. In this study, we investigated the relationship between serum DHEA-S and BMD in both men and women.MethodsThis cross-sectional study evaluated a total of 294 healthy Korean participants through a medical examination program. And a subgroup of 154 participants was subjected to a longitudinal analysis. We measured BMD by dual energy X-ray absorptiometry and assayed DHEA-S by a chemiluminescent immunoassay.ResultsWe evaluated the association between serum DHEA-S concentration and BMD at the femur trochanter after adjusting for cofounders such as age, body mass index, lifestyle factors, serum cortisol level, serum insulin-like growth factor 1 (IGF-1) level, and sex. Through our longitudinal study, we found that the changes in BMD at the total spine, at the femur neck, and at the femur trochanter were all smaller in the ΔDHEA-S <0 group than in the ΔDHEA-S >0 group.ConclusionsWe found that there was a positive correlation between serum DHEA-S and femur BMD, which suggests that controlling serum DHEA-S levels may retard age-related BMD reduction in Koreans.

Higher serum ferritin level and lower femur neck strength in women at the stage of bone loss (≥ 45 years of age): The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV)

ABSTRACTPurpose: Despite the clear effect of iron on bone metabolism, most clinical studies related to bone health have only focused on bone mineral density (BMD). In the present study, we investigated the relationship between serum ferritin and composite indices of femur neck strength via a population-based, cross-sectional study using the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Our study series included 693 women at the stage of bone loss (≥ 45 years of age), defined based on the observed patterns of age-related BMD changes in the KNHANES. Geometric bone structure properties, including hip axis length (HAL) and femur neck width (FNW), were measured using hip dual-energy X-ray absorptiometry scans and were combined with BMD, body weight, and height to create composite indices of femur neck strength relative to load in three different failure modes: compression (CSI), bending (BSI), and impact strength indices (ISI). Results: After adjustment for age, body mass index (BMI), lifestyle factors, serum 25-hydroxyvitamin D, calcium and phosphorus intake, diabetes, and menopause status, multiple regression analyses revealed that serum ferritin was inversely associated with the BMD values at the lumbar spine and femur neck, and the femur neck cortical thickness. Importantly, in all adjustment models, higher serum ferritin was consistently associated with the lower values for all three femur neck composite indices, such as CSI, BSI, and ISI.Conclusions: These data provide the first clinical evidence that increased total body iron stores reflected by higher serum ferritin may be associated with the decrease of bone strength relative to load.

Severity and pattern of bone mineral loss in endocrine causes of osteoporosis as compared to age-related bone mineral loss

Background:Data are scant on bone health in endocrinopathies from India. This study evaluated bone mineral density (BMD) loss in endocrinopathies [Graves’ disease (GD), type 1 diabetes mellitus (T1DM), hypogonadotrophic hypogonadism (HypoH), hypergonadotropic hypogonadism (HyperH), hypopituitarism, primary hyperparathyroidism (PHPT)] as compared to age-related BMD loss [postmenopausal osteoporosis (PMO), andropause].Materials and Methods:Retrospective audit of records of patients >30 years age attending a bone clinic from August 2014 to January 2016 was done.Results:Five-hundred and seven records were screened, out of which 420 (females:male = 294:126) were analyzed. A significantly higher occurrence of vitamin D deficiency and insufficiency was noted in T1DM (89.09%), HyperH (85%), and HypoH (79.59%) compared to age-related BMD loss (60.02%; P < 0.001). The occurrence of osteoporosis among females and males was 55.41% and 53.97%, respectively, and of osteopenia among females and males was 28.91% and 32.54%, respectively. In females, osteoporosis was significantly higher in T1DM (92%), HyperH (85%), and HypoH (59.26%) compared to PMO (49.34%; P < 0.001). Z score at LS, TF, NOF, and greater trochanter (GT) was consistently lowest in T1DM women. Among men, osteoporosis was significantly higher in T1DM (76.67%) and HypoH (54.55%) compared to andropause (45.45%; P = 0.001). Z score at LS, TF, NOF, GT, and TR was consistently lowest in T1DM men. In GD, the burden of osteoporosis was similar to PMO and andropause. BMD difference among the study groups was not significantly different after adjusting for body mass index (BMI) and vitamin D.Conclusion:Low bone mass is extremely common in endocrinopathies, warranting routine screening and intervention. Concomitant vitamin D deficiency compounds the problem. Calcium and vitamin D supplementations may improve bone health in this setting.

Femoral Strength Changes Faster With Age Than BMD in Both Women and Men: A Biomechanical Study.

Although a large number of studies have addressed the age-related changes in bone mineral density (BMD), there is a paucity of data for the assessment of femoral strength loss with age in both genders. We determined the variation of strength with age in femurs of women and men by mechanical tests on a cohort of 100 cadaveric femurs. In addition, the age-related neck BMD loss in our cadaveric cohort was found to be similar with BMD loss of four published population-based studies. Given the strong correlation found in our cadaveric study between BMD and femoral strength, we also estimated the femoral strength of the four populations based on their reported neck BMDs. Our study showed that men's femurs in our cadaveric cohort were stronger than women's femurs by about 800 N at the same BMD level, and by 1750 N at the same age. The strength differences were not explained satisfactorily by the size difference between men's and women's bones. Similar to the findings of clinical studies, the BMD values of men at all ages were larger than that of women. The age-related loss rates in BMD and strength were not statistically different between the two genders of our cadaveric cohort. After normalization, strength decreased more than 40% faster than BMD. On average, men reached a certain BMD value about 16 years later than women, and for strength about 23 years later, which may explain the higher rate of hip fracture in postmenopausal women. In patient population cohorts men reached a similar BMD value about 16 to 25 years later than women, whereas for estimated strength, sometimes more than 40 years later.

한국 남성의 연령에 따른 부위별 골밀도 변화 및 골 소실률

국민건강영양조사 제 5기 1 2차년도에 참여한 남성을 대상으로 연령에 따른 부위별 골밀도 변화, 골 소실률에 대해서 알아보고자 시도 하였다. 연령에 따른 골밀도 변화를 가장 잘 보여 주기 위해 Cubic regression을 사용하였고, 척추, 대퇴경부, 대퇴골 전자부, Ward 부위 골밀도 차이는 분산분석을 이용하여 분석하였다. 연구결과, 요추, 대퇴골 전체, 대퇴경부, 대퇴골 전자부, Ward 부위의 최대 골밀도는 20-24세였으며, 75-79세에서 골 소실률이 가장 높았다. 따라서, 남성에서는 75세 이상에서 골다공증의 집중적인 관리가 필요할 것이며, 남성에서의 골다공증 진단기준은 국제 임상 골밀도 학회(The International Society for Clinical Densitometry; ISCD)의 지침을 따르는 방안을 고려해 봐야 할 것이다. This study examined the age-related bone mineral density (BMD), accumulated bone loss rate (ABLR) at different skeletal sites in Korean men using the data from the Korea National Health and Nutrition Examination Survey (KNHANES)(the 1st (2010), 2nd (2010) and the year at the 5th survey). The cubic regression model was found to be the best for describing the age-related changes in BMD. The lumbar spine, total hip, femoral neck, trochanter, Ward's triangle in the bone mineral density difference were analyzed by ANOVA. The peak BMD was at 20-24 years at the lumbar spine, total hip, femoral neck, trochanter, Ward's triangle, and the 75-79 years of age group had the highest Accumulated Bone Loss Rate. Therefore, intensive management will be necessary for men over 75 years, and a diagnosis of osteoporosis in Korean men should be made according to The International Society for Clinical Densitometry; ISCD.

Different Relationships Between Body Compositions and Bone Mineral Density According to Gender and Age in Korean Populations (KNHANES 2008–2010)

Fat and muscle are linked to bone metabolism. The objective of the study was to investigate the association of fat mass (FM) and lean mass (LM) with bone mineral density (BMD) according to gender and age. This was a population-based, cross-sectional study from Korea National Health and Nutrition Examination Surveys. 15,036 Koreans (6692 men and 8344 women) aged 10-95 years. BMD and body compositions were measured using dual-energy X-ray absorptiometry. BMD was determined at the femoral neck, total hip, and lumbar spine. Body compositions included total FM (TFM), percentage FM (PFM), truncal FM (TrFM), total LM (TLM), and appendicular skeletal muscle mass/weight (ASM/Wt). We categorized each man and woman into one of three age groups, based on changes in age-related BMD and the hormonal status. In all gender and age groups, TFM, PFM, and TrFM associated inversely with BMD (P < .001-.034), whereas TLM and ASM/Wt associated positively (P < .001-.037) after adjusting for confounders. The negative contribution of FM (P < .001-.034), and the positive contribution of LM (P < .001-.035) on BMD were significantly stronger in men than in women. The associations were strongest in men of growing age (P = .003-.040). When we subdivided the subjects into four groups based on the median values of PFM and TLM, FM had a greater effect than LM on BMD in men (P < .001-.006). These results demonstrate that the effects of FM and LM on BMD may be based on gender and age.

Quantification of the relative contribution of estrogen to bone mineral density in men and women

BackgroundThe study quantified the relative contributions of estrogen (E2) and total testosterone (TT) to variation in bone mineral density in men and women.MethodsThis was a cross-sectional study which involved 200 men and 415 women aged 18 to 89 years. BMD at the lumbar spine (LS) and femoral neck (FN) was measured by DXA. Serum levels of E2 and TT were measured by electrochemiluminescence immunoassays. The association between E2, TT, and BMD was analyzed by the multiple linear regression model, adjusting for age and BMI. The contribution of each hormone to the variation in BMD was quantified by the bootstrap method.ResultsIn women, higher serum levels of E2, but not TT, were significantly associated with greater BMD at the FN (P = 0.001) and LS (P < 0.0001). In men, higher serum levels of E2 were independently associated with greater FNBMD (P = 0.008) and LSBMD (P = 0.086). In the multiple linear regression model, age, body weight and E2 accounted for 50-55% variance in FNBMD, and 25% (in men) and 48% (in women) variance in LSBMD. Variation in E2 accounted for 2.5% (95% CI 0.4 - 7.8%) and 11.3% (95% CI 8.1 - 15.3%) variation in FNBMD in men and women, respectively. Moreover, E2 contributed 1.2% (95% CI 0.1 - 5.8%) and 11.7% (95% CI 8.5 - 15.9%) variation in LSBMD in men and women, respectively.ConclusionsEstrogen is more important than testosterone in the determination of age-related bone mineral density men and women of Vietnamese background. However, the relative contributions of estrogen to bone mineral density in men are likely modest.

The association between higher serum ferritin level and lower bone mineral density is prominent in women ≥45 years of age (KNHANES 2008–2010)

Data gathered from a nationally representative cohort demonstrate that higher serum ferritin levels are significantly associated with lower bone mass at various skeletal sites and the increased prevalence of osteoporosis and fractures, especially in women ≥45 years of age. Despite extensive in vitro and in vivo studies showing the detrimental effects of iron on bone metabolism, the clinical studies relating to osteoporosis-related phenotypes have not been evaluated extensively. In the present study, we investigated and compared the association between serum ferritin and bone mineral density (BMD), depending on the stratified age groups in both genders. This is a population-based, cross-sectional study from the Korea National Health and Nutrition Examination Surveys, including 14,017 Koreans (6,817 men and 7,200 women) aged 10-80 years. BMD was measured using dual X-ray absorptiometry, and osteoporosis was diagnosed by the World Health Organization definition. Initially, we divided the subjects into three age groups, based on the patterns of age-related BMD changes in this national cohort (i.e., ≤24, 25-44, and ≥45 years old). Serum ferritin concentrations were inversely associated with BMD values at all measured sites after adjustment for confounders, only in women ≥45 years of age (P = 0.041 to <0.001). Furthermore, when we divided these women into serum ferritin quartiles, the odds for prevalent osteoporosis and fractures were 1.55-fold (95 % CI = 1.09-2.23) and 1.52-fold (95 % CI = 1.02-2.27) higher, respectively, in subjects in the highest quartile compared with those in the lowest quartile. These results provide the first clinical evidence that the associations between serum ferritin level and bone parameters could be the most prominent in women ≥45 years of age.

Age-Related Bone Mineral Density Patterns in Koreans (KNHANES IV)

Bone loss is considered to begin with menopause in women and later in life in men; however, several recent studies have reported that bone loss began in young adults. There are still discordant results concerning age-related changes in bone mineral density (BMD), especially in nonvertebral bone. The objective of the study was to investigate the age-related changes in BMD in Korean youth. This was a population-based, cross-sectional study from the Fourth Korea National Health and Nutrition Examination Surveys. A total 10,575 Korean (4,731 males and 5,844 females) aged 10-80 yr were included. BMD at the spine and hip was measured using dual X-ray absorptiometry. Age-related bone loss at the femoral neck in males occurred continuously with temporary acceleration phase after achieving peak bone mass (PBM). In contrast, age-related bone loss at total hip in both sexes and femoral neck in females showed three obvious phases: acceleration, consolidation, and then the second acceleration phase after reaching PBM. Interestingly, this pattern of bone loss was more significant in the total hip and thus showed the acceleration phase until the late 20s and the consolidation phase until the late 40s. Early accelerated loss of BMD was not observed at the lumbar spine in each sex. Although body mass index and body fat percentage were more related with BMD than other clinical parameters, they could not explain the early accelerated loss of BMD at the femur. There was an accelerated bone loss at the femur in both sexes during early adulthood and more than 60% of the bone loss before age 50 yr occurred during this period.

Common Genetic Variants Are Associated with Accelerated Bone Mineral Density Loss after Hematopoietic Cell Transplantation

BackgroundBone mineral density (BMD) loss commonly occurs after hematopoietic cell transplantation (HCT). Hypothesizing that genetic variants may influence post-HCT BMD loss, we conducted a prospective study to examine the associations of single nucleotide polymorphisms (SNP) in bone metabolism pathways and acute BMD loss after HCT.Methods and FindingsWe genotyped 122 SNPs in 45 genes in bone metabolism pathways among 121 autologous and allogeneic HCT patients. BMD changes from pre-HCT to day +100 post-HCT were analyzed in relation to these SNPs in linear regression models. After controlling for clinical risk factors, we identified 16 SNPs associated with spinal or femoral BMD loss following HCT, three of which have been previously implicated in genome-wide association studies of bone phenotypes, including rs2075555 in COL1A1, rs9594738 in RANKL, and rs4870044 in ESR1. When multiple SNPs were considered simultaneously, they explained 5–35% of the variance in post-HCT BMD loss. There was a significant trend between the number of risk alleles and the magnitude of BMD loss, with patients carrying the most risk alleles having the greatest loss.ConclusionOur data provide the first evidence that common genetic variants play an important role in BMD loss among HCT patients similar to age-related BMD loss in the general population. This infers that the mechanism for post-HCT bone loss is a normal aging process that is accelerated during HCT. A limitation of our study comes from its small patient population; hence future larger studies are warranted to validate our findings.

Age-related bone mineral density, osteoporosis rate and risk of vertebral fracture in mainland Chinese women with type 2 diabetes mellitus

Few data are available regarding bone mineral density (BMD) and the risk of vertebral fracture among mainland Chinese women with type 2 diabetes mellitus (T2DM). A decrease in the bone projective area (BPA) can be an indirect marker reflecting compressed vertebral fracture. We investigated age-related BMD, BPA, and the prevalence of osteoporosis in women with T2DM in mainland China. BMD and BPA of the posteroanterior lumbar spine (L1-L4) and hip were measured by dual-energy X-ray absorptiometry in 1253 women with T2DM and 1194 control subjects without diabetes aged 40-80 yr. BMD of the lumbar spine and hip decreased with age. BMD of the lumbar spine was higher in T2DM than controls (p<0.05-0.001), as was BPA at some vertebral bodies (p<0.05-0.001), whereas no significant intergroup differences in BPA were observed at the hip. The prevalence of osteoporosis in the women with T2DM increased with age: 0-2.58% at age 40-49 yr, 6.94-28.4% at age 50-59 yr, 32.7-76.7% at age 70-80 yr, with the range reflecting differences between skeletal sites. In subjects over 60 yr, the rates of osteoporosis at posteroanterior spine were significantly lower in T2DM patients than in controls (p<0.05-0.001). In conclusion, women with T2DM had higher BMD and lower risk of osteoporosis. Higher BPA of the vertebrae indicated that women with T2DM in mainland China would have a lower risk of vertebral fracture than non-diabetic women.

Establishment of BMD reference databases for the diagnosis and evaluation of osteoporosis in central southern Chinese men

Osteoporosis in men is an increasingly important public health problem. This study was designed to establish bone mineral density (BMD) reference databases for central southern Chinese men at multiple skeletal sites. We recruited 2433 native Chinese males for BMD assessment. Of these, 1537 were healthy volunteers (age range, 15-85 years), and 896 were suspected to have osteoporosis. BMD values were measured at the posteroanterior (PA) and lateral spine, hip, and distal forearm using a Delphi A absorptiometer. The quadratic regression model provided the best fit for age-related changes in BMD in the spine and hip. The cubic regression model was the best for describing age-related BMD changes in the distal forearm. Peak BMD in the lumbar spine, femoral neck, and total hip occurred at 15-19 years. Peak BMD at the distal forearm occurred at 40-44 years. The prevalence of primary osteoporosis in subjects ranging from 50-85 years was 4.3%-27.7% at various skeletal sites. Compared to the databases established here, the Hologic databases led to significantly higher osteoporosis detection rates. The BMD reference databases established for central southern Chinese men provide the most reliable diagnostic standards for osteoporosis detection in men of central south China.

Osteoporosis in a female population from Bratislava – age-related BMD changes

We analysed 498 women (n=498) in a Bratislava (BA) population aged 21 to 90. We measured bone mineral density (BMD) in the proximal femur with one densitometric instrument (DXA Osteocore II, France; dual energy X-ray absorptiometry), applying BMD and T-score values in three standard regions of interest: Neck (ROI1), Ward's area (ROI2), Trochanter (ROI3). Measured values of T-score in ROI1, ROI2 had normal distribution and a lognormal distribution of frequency in ROI3. Using chi2-test (chi-square goodness-of-fit statistics), we determined the distribution of the frequency of T-score values and the percentage of osteoporosis incidence in the Bratislava female population. The osteoporosis incidence, according to T-score values measured in ROI1 was 2.40%, in ROI2 16.34% and in ROI3 3.83%. Following the division of women into ten-year intervals, the statistically significant sample averages of T-score values were decreasing in relation to age only for ROI2. Osteoporosis incidence in age intervals was rising with age for ROI2, for ROI1 the number of osteoporotic patients in the 61 to 70-year interval was lower than in the 41 to 50-year interval, and for ROI3 the number of osteoporotic patients in the 51 to 60-year interval was lower than in the 41 to 50-year interval. Except in the above-mentioned intervals, T-score values decreased in relation to age also in ROI1 and ROI3. According to the analysis of variance, the age category explains 9.6% of the overall variability of T-score values for ROI1, 24.7% for ROI2 and 11.70% for ROI3. As in ROI2 (Ward's area) a greater fraction of trabecular bone is measured in comparison with ROI1 and ROI3, ROI2 reflects best the age-related BMD changes. In ROI1 and ROI3 the relation was distorted by a greater fraction of cortical bone in comparison with ROI2 and by osteoarthritis.

Age-Related Bone Mineral Density, Bone Loss Rate, Prevalence of Osteoporosis, and Reference Database of Women at Multiple Centers in China

Our study surveyed age-related bone mineral density (BMD), bone loss rate, and prevalence of osteoporosis in women at multiple research centers in China. Survey results were used to establish a BMD reference database for the diagnosis of osteoporosis in Chinese women nationwide. We used dual-energy X-ray absorptiometry bone densitometers to measure BMD at posteroanterior (PA) lumbar spine (L1–L4; n = 8142) and proximal femur (n = 7290) in female subjects of age 20–89 yr from Beijing, Shanghai, Guangzhou, Chengdu, Nanjing, and Jiaxing. A cubic regression-fitting model was used to describe the change of BMD with age at various skeletal sites. Peak BMD occurred between 30 and 34 yr of age for femur neck and total femur, and between 40 and 44 yr for spine and trochanter measurement sites. Young adult (YA) BMD values (mean and standard deviation [SD], calculated as the average BMD in the age range of 20–39, were 1.116 ± 0.12, 0.927 ± 0.12, 0.756 ± 0.11, and 0.963 ± 0.13 g/cm 2 at PA spine, femoral neck, trochanter, and total femur, respectively. The BMD of 85-yr-old women reflected a loss of 32% at the spine and 30–35% at femur measurement sites. The prevalence of osteoporosis, defined as a BMD of ≤−2.5 SDs from YA values established in this study, in female subjects of age 50 yr or older, was 28% for the spine, 15% for any femur site, and 31% for any spine or femur site. This study provides important information for formulating osteoporosis prevention and treatment strategies in Chinese women, and it establishes a reliable BMD reference database for the diagnosis of osteoporosis of Chinese women nationwide.

Race/ethnic differences in bone mineral density in men

The epidemiology of osteoporosis in male and minority populations is understudied. We compared BMD in 1,209 Black, Hispanic, and White men. Black men exhibited higher BMD than Hispanic or White men. Age-related BMD decreases were greatest among Hispanic men. Results may help explain variation in hip fracture rates by race/ethnicity. The epidemiology of osteoporosis in male and minority populations is understudied. To address this concern, we conducted a study of skeletal health in a diverse population of adult males. A total of 367 Black, 401 Hispanic, and 451 White men aged 30-79 years were randomly sampled from Boston, MA. Bone densitometry (bone area (BA), bone mineral content (BMC), and bone mineral density (BMD)) at the whole body, hip, lumbar spine, and forearm was performed. Multiple regression analyses on 1,209 men with available data were used to describe race/ethnic group-specific means (height- and age-adjusted) and age trends (height-adjusted) in BMC, BA, and BMD. Results were weighted to represent the Boston male population aged 30-79 years. Black men had greater BMC and BMD than Hispanic or White men. Femoral neck BMD was 5.6% and 13.3% higher in Black men than in Hispanic and White men, respectively. Differences between Hispanic and White subjects were restricted to the hip. Age-related declines in BMC and BMD were significantly steeper among Hispanic than Black or White men. Differences in BMC and BMD could explain variation in fracture rates among Black, Hispanic, and White men. The steeper age-related BMD decline in Hispanic men is of particular concern.