Assessment Of Bone Quality Research Articles

MRI-Based Cervical VBQ Scores as Predictors of Cage Subsidence in Cervical Spine Surgery: A Meta-Analysis.

Study DesignSystematic review and meta-analysis.ObjectivePoor bone quality is a major risk factor for complications after cervical spine surgery. The MRI-based cervical vertebral bone quality (C-VBQ) score is a reliable tool for assessing bone quality. This study systematically evaluates, for the first time, the predictive value of C-VBQ for cage subsidence risk in cervical spine surgery patients using meta-analysis.MethodsWe conducted a comprehensive search of relevant literature in electronic databases up to October 16, 2024, to systematically assess the quality of included studies. Publication bias was evaluated by comparing C-VBQ between groups and calculating pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curves.Results7 studies involving 681 patients were included. Using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the studies were deemed high quality with low risk of bias. High C-VBQ scores were significantly associated with fusion subsidence, with a pooled odds ratio of 2.98 (95% CI: 1.68-5.30). The C-VBQ cut-off value was 2.94 ± 0.32, and the combined sensitivity and specificity for diagnosing postoperative complications were 0.78 and 0.87, respectively, with an area under the curve of 0.90 (95% CI: 0.87-0.92).ConclusionIn patients undergoing degenerative cervical spine surgery, higher C-VBQ scores were significantly associated with an increased risk of cage subsidence. The C-VBQ score is a reliable tool for preoperative bone quality assessment and serves as an independent predictor of cage subsidence risk following cervical spine surgery.

Bone quality assessment around dental implants in cone-beam computed tomography images: effect of scan mode and metal artefact reduction tool.

The purpose of this study was to evaluate how artefacts caused by titanium and zirconia dental implants affect the bone quality assessment in CBCT images. The effect of scan mode and the use of metal artefact reduction algorithm (MAR) on artefacts suppression were taken in consideration. Titanium and zirconia dental implants were installed in porcine bone samples and scanned with two CBCT devices with adjustments on scan mode and with the use of MAR. Control group consisted of bone sample without implant and scanned with full rotation scan mode without MAR. Artefacts extension was measured by deviation of gray values and bone quality around implants was measured by bone histomorphometry measurements (trabecular volume fraction, bone specific surface, trabecular thickness, and trabecular separation). Mean difference among groups was assessed by within ANOVA with Bonferroni correction. Correlation between bone quality measurements acquired in experimental and control groups were assessed by Spearman correlation test (α = 0.05). No statistical difference was found for artefacts extension in images acquired by half and full-rotation mode (p = 0.82). The application of MAR reduced artefacts caused by titanium and zirconia dental implants, showing no statistically significant difference to the control group (Titanium: p = 0.20; Zirconia: p = 0.31). However, bone quality measurements did not correlate to the control group (p < 0.05). Bone quality assessment was affected by the presence of artefacts caused by dental implants. Scan mode did not affect the appearance of artefacts and did not affect the bone qualitative measurements. MAR was able to decrease artefacts, however, it did not improve the accuracy of bone quality measurements.

Correlation Between CBCT and Torque-Based Measurements of Bone Density: A Study on Polyurethane Foam Blocks and Bovine Ribs.

To assess whether (and to what extent) average torque readings evaluating the bone density of polyurethane foam blocks and bovine ribs are correlated with that of gray values (GVs) measured via CBCT scans, both at the site of reading and at adjacent sites where bone is expected to engage the implant threads. Average torque readings were collected on blocks and ribs via CBCT scans that were then analyzed to measure the GVs of purposedly designed regions of interest (ROIs). The ROIs were shaped as concentric hollow cylinders centered on the sites of average torque measurements. The relation between average torque and GVs was investigated through correlation analyses. The correlation between average torque and GVs from blocks was strong (r = 0.94, r2 = 0.89, P < .001), which was independent of the ROI size. On the bovine ribs, the correlation was weak but significant (r = 0.23, P = .029); however, it become stronger when denser bone (average torque ≥ 7 Ncm) was tested (r = 0.41, P = .008). This result was independent from the distance of the site where the average torque had been read. Loss of average torque-GV interchangeability observed on bovine ribs was likely caused by intrinsic bone characteristics, such as an abundance of bone marrow and nonmineralized tissue, possibly having a confounding effect on GV measurements, especially at lower bone densities. Within the limitations of the study, average torque values were found to estimate physical bone density just as well as GVs from CBCT scans. In low-density bone, the assessment of mineral bone density was also found to possibly be more informative than GVs. Results of this study suggest that the micromotor may be presently regarded as a complementary tool to CBCT assessment of bone density and quality in the clinical setting.

UTE MRI technical developments and applications in osteoporosis: a review.

Osteoporosis (OP) is a metabolic bone disease that affects more than 10 million people in the USA and leads to over two million fractures every year. The disease results in serious long-term disability and death in a large number of patients. Bone mineral density (BMD) measurement is the current standard in assessing fracture risk; however, the majority of fractures cannot be explained by BMD alone. Bone is a composite material of mineral, organic matrix, and water. While bone mineral provides stiffness and strength, collagen provides ductility and the ability to absorb energy before fracturing, and water provides viscoelasticity and poroelasticity. These bone components are arranged in a complex hierarchical structure. Both material composition and physical structure contribute to the unique strength of bone. The contribution of mineral to bone's mechanical properties has dominated scientific thinking for decades, partly because collagen and water are inaccessible using X-ray based techniques. Accurate evaluation of bone requires information about its components (mineral, collagen, water) and structure (cortical porosity, trabecular microstructure), which are all important in maintaining the mechanical integrity of bone. Magnetic resonance imaging (MRI) is routinely used to diagnose soft tissue diseases, but bone is "invisible" with clinical MRI due to its short transverse relaxation time. This review article discusses using ultrashort echo time (UTE) sequences to evaluate bone composition and structure. Both morphological and quantitative UTE MRI techniques are introduced. Their applications in osteoporosis are also briefly discussed. These UTE-MRI advancements hold great potential for improving the diagnosis and management of osteoporosis and other metabolic bone diseases by providing a more comprehensive assessment of bone quantity and quality.

Effect of Bone Microstructure Derived From CBCT on the Accuracy of Robot-Assisted Implant Surgery: A Retrospective Study.

The aim of this study was to investigate the influence of bone microstructure on the accuracy of robot-assisted dental implant surgery. This retrospective study analyzed 52 patients who received robot-assisted implant surgery between January 2023 and October 2023. Cone beam computed tomography (CBCT) scans were used to evaluate bone microstructural parameters, including the bone volume (BV), tissue volume (TV), bone volume fraction (BV/TV), bone surface (BS), bone surface fraction (BS/BV), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). Preoperative and postoperative CBCT data were used to evaluate implant accuracy, and the relationship between bone microstructure parameters and implant deviation including platform deviation, apex deviation, and angular deviation was statistically analyzed. In robot-assisted implant surgery, BS/BV was a potential facilitator of several implant deviations, while BV/TV and Tb.Th were potential inhibitors of apex global deviation and angular deviation, respectively. Implant deviations were divided into two groups of large and small deviations by median, and the receiver operating characteristic (ROC) curve analysis showed that Tb.Th had the largest area under the ROC for predicting large apex global deviation, 0.711 (p < 0.001), with an optimal cutoff value > 0.179, a sensitivity and specificity of 70.37% and 76.92%. The study concluded that bone microstructure might affect the accuracy of dental implant placement in robotic surgeries. Incorporating bone quality assessments into preoperative planning may enhance the precision and outcomes of implant procedures, highlighting the potential for further refinement in robotic-assisted dental surgery techniques. ClinicalTrials.gov identifier: ChiCTR2400085813.

Impact of Lumbar Degenerative Changes on Vertebral Bone Strength: A Finite Element Analysis.

Assessing the bone condition in patients with spinal disease is clinically valuable. However, evaluating bone strength in the presence of spine degenerative changes is challenging. Quantitative computed tomography (QCT) and finite element analysis (FEA) have been proposed as methods for more accurate bone quality assessment. This study investigates the relationship between bone strength predicted by FEA and other relevant biological parameters. This retrospective cross-sectional study included 127 patients with spinal disease who underwent preoperative CT scans between 2014 and 2020. Baseline patient characteristics, volumetric bone mineral density (vBMD) measured by QCT, and vertebral bone strength predicted by FEA were collected. The degree of degeneration was evaluated by classifying osteophyte formation, disc height narrowing, vertebral sclerosis, and spondylolisthesis into a grading scale ranging from 0 to 2. Multiple linear regression analysis was conducted to assess the effect of each factor on bone strength predicted by FEA. Of 127 patients, 120 patients (median age was 62 years) were included. The median vBMD and vertebral strength were 114.3 mg/cm3 and 7892.9 N, respectively. After adjusting for age, sex, body mass index, smoking status, diabetes mellitus, vBMD, and degenerative changes, multiple linear regression analysis revealed that sex, vBMD, and degree of degeneration independently increased the vertebral strength measured by FEA. This study suggests that in patients with spinal disease, vertebral bone strength is affected not only by sex and bone mineral density but also by degenerative changes. Thus, bone strength could be predicted more accurately in patients with spinal disease using FEA.

Anti-osteoporotic effects and good biocompatibility of novel bioactive carbon quantum dots invitro and in ovariectomized mice.

Osteoporosis is a prevalent condition among the elderly, and current treatments are limited by their side effects. This study aimed to develop a safe nanocarbon material with anti-osteoporotic properties. A promising candidate, carbon quantum dots (CQDs), was synthesized using a single-step liquid-phase pulse method and characterized by transmission electron microscopy (TEM). To evaluate the biocompatibility and anti-osteoporotic effects of CQDs, they were administered at a dose of 276μg/mL or a placebo to an osteoporotic mouse model (n= 16) for 3months. Biocompatibility was assessed through monitoring weight changes, general health, blood tests, and H&E staining of visceral organs. To assess bone quality, imaging, histological analysis, and biomechanical tests were performed. The results showed that CQDs significantly inhibited osteoclastic activity, leading to improved bone mass and mechanical strength without obvious toxicity. These findings suggest CQDs as a promising candidate for safer osteoporosis therapies.

Textural and geometric measures derived from digital tomosynthesis discriminate women with and without vertebral fracture.

Textural and geometric measures derived from digital tomosynthesis discriminate women with and without vertebral fracture.

Alcohol Abuse and Collagen Disruption

Study Design. Single-center cross-sectional analysis of a prospectively maintained database. Background Context. Alcohol abuse, defined by the NIAAA as excessive consumption leading to health risks, contributes significantly to tissue degeneration through the damaging effects of acetaldehyde. Collagen type I, a critical structural protein in skin and bone, degrades in parallel across tissue types. Recent studies have linked dermal ultrasound (US) echogenicity to bone quality, but evidence supporting its utility as a biomarker for tissue degeneration remains limited. This study hypothesizes that alcohol abuse correlates with increased dermal US echogenicity, decreased skin thickness (ST), and poor tissue quality, supporting the potential use of US for preoperative bone quality assessment. Objective. To investigate the relationship between skin US parameters and alcohol abuse in lumbar fusion patients. Methods. Patients undergoing lumbar fusion surgery with alcohol abuse (NIAAA criteria: &gt;14 drinks/week in males, &gt;8 in females) were included. Preoperative US measurements at two lumbar locations assessed echogenicity in the average dermal (AD), upper dermal (UD), and lower dermal (LD) layers. ST was measured at three dermal sites. Wilcoxon rank sum, Fisher’s Exact tests, and regression analyses adjusted for age, sex, and BMI were used (P&lt;0.05). Results. Among 459 patients (50.5% male; median age 63.67 y; BMI 28.74 kg/m²), females exhibited higher US echogenicity (e.g., AD median 121 vs. 111.75, P&lt;0.0001), while males had greater ST (2.97 vs. 2.65 mm, P&lt;0.0001). Alcohol abuse was associated with increased LD echogenicity (14.86; P=0.038) and decreased ST (−0.35; P=0.034). Conclusion. Alcohol abuse correlates with dermal layer degradation, as indicated by increased echogenicity and reduced ST. These findings highlight the potential utility of skin US as a preoperative biomarker for bone quality in lumbar fusion patients, warranting further investigation to enhance clinical applications.

Prediction of subsequent vertebral fracture after percutaneous vertebral augmentation using MRI-based vertebral bone quality and CT-based Hounsfield units: a retrospective cross-sectional study

Subsequent vertebral fracture (SVF) is a common and refractory complication after percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF). Computed tomography (CT)-based Hounsfeld units (HU) and magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score can evaluate osteoporosis quantitatively, hyperlipidemia(HLP) might affect measurement result of VBQ score. The primary objective of this study is to compare the predictive capabilities of HU and VBQ for SVF, and to clarify the impact of hyperlipidemia on the predictive abilities. This study included consecutive 341 patients with OVCF who were treated with PVA from March 1, 2020, to December 31, 2022. A multivariate logistic regression analysis was used to determine the relationship between HU and VBQ and SVF. ROC curves were plotted to calculate area under curve (AUC), and hoc analysis and Youden index was used to determine cut-off values of HU and VBQ. Compared with the non-SVF group, VBQ (4.69 ± 0.35 vs. 4.14 ± 0.41, P < 0.001) was higher and HU (58.2 ± 13.81 vs. 81.2 ± 16.68, P < 0.001) was lower in the SVF group. On multivariate logistic regression analysis, higher VBQ (odds ratio (OR) = 23.47,P < 0.001) and lower HU (OR = 0.93,P < 0.001) are independent predictors for SVF. The AUC using VBQ for predicting SVF was 0.84, the cut-off was 4.28. The AUC using HU for predicting SVF was 0.85, the cut-off was 64.40. In the HLP group, the AUC of VBQ was comparable with that of HU for SVF prediction, however, the sensitivity was lower in the HLP group (0.50 vs. 0.83). Furthermore, the AUC value of VBQ with HLP was lower than that of VBQ without HLP (0.78 vs. 0.90, P = 0.017). These findings demonstrated that both VBQ and HU can accurately predict the occurrence of SVF after PVA. HLP might cause a false increase of VBQ value, using HU could better assess bone quality and predict SVF occurrence when HLP is present.

The Use of Bone Biomarkers, Imaging Tools, and Genetic Tests in the Diagnosis of Rare Bone Disorders.

Rare bone diseases are clinically and genetically heterogenous. Despite those differences, the underlying pathophysiology is not infrequently different. Several of these diseases are characterized by abnormal bone metabolism and turnover with subsequent abnormalities in markers of bone turnover, rendering them useful adjuncts in the diagnostic process. As most rare bone diseases are inherited, genetic testing for implicated pathogenic variants, where known, is another relevant tool that can aid in diagnosis. While some skeletal disorders can be localized or monostotic, others can involve multiple skeletal sites and warrant imaging tools to localize them and determine the severity of disease and/or presence of complications as well as to assess bone quality and the potential risk of fractures. Rare bone disorders pose a great challenge in their diagnosis, ultimately resulting in delayed diagnosis, higher risk of complications and a poor quality of life in affected individuals. In this review we discuss the biochemical and radiological tools that can be utilized to diagnose selected orphan bone disorders, the clinical utility and limitations of these diagnostic tools, and areas where future research is warranted.

Hounsfield Unit Utilization in Cervical Spine for Bone Quality Assessment: A Scoping Review.

Bone mineral density (BMD) is an essential indicator of bone strength and plays a crucial role in the clinical management of various spinal pathologies. Hounsfield units (HUs) calculated from computed tomography (CT) scans are a well-established, effective, and non-invasive method to determine bone density in the lumbar spine when juxtaposed to dual-energy X-ray absorptiometry (DEXA) scans, the gold standard for assessing trabecular bone density. Only recently have studies begun to investigate and establish HUs as a reliable and valid alternative for bone quality assessment in the cervical spine as well. In addition, multiple recent studies have identified cervical HUs as an accurate predictor of cage subsidence, an undesired complication of anterior cervical discectomy and fusion (ACDF) of anterior cervical corpectomy and fusion (ACCF) procedures. Subsidence involves migration of the spinal fusion cage into vertebral bodies, causing a loss of disk space, negatively altering spine alignment, and possibly necessitating further unwanted surgical intervention. Using the PRISMA-ScR checklist and the registered scoping review protocol (INPLASY2024100126), this review explores the current research on the use of cervical spine HU measurements as both a determinant of BMD and as a prognosticator of postoperative subsidence following cervical spine procedures (i.e., ACDFs and ACCFs) with the aim of improving clinical and surgical outcomes.

Impact of bone quality on surgical decision-making in total hip arthroplasty: a qualitative analysis in the UK

IntroductionFor total hip arthroplasty (THA) to be successful, surgeons need to make several decisions ranging from implant choice to impaction force. It is unclear, however, whether and how bone quality...

Individuals with heterogenous trabecular bone texture by clinical magnetic resonance imaging have lower bone strength and stiffness by quantitative computed tomography-based finite element analysis.

Opportunistic screening is essential to improve the identification of individuals with osteoporosis. Our group has utilized image texture features to assess bone quality using clinical MRIs. We have previously demonstrated that greater heterogeneity of MRI texture related to history of fragility fractures, lower bone density, and worse microarchitecture. The present study investigated relationships between MRI-based texture features and biomechanical properties of bone using CT-based finite element analyses (FEAs). We hypothesized that individuals with greater texture heterogeneity would have lower stiffness and failure load. Thirty individuals included in this prospective study had CT and MRI of L1 and L2 vertebrae. Using T1-weighted MR images, a gray-level co-occurrence matrix was generated to characterize the distribution and spatial organization of voxelar signal intensities to derive the following texture features: contrast (variability), entropy (disorder), angular second moment (ASM; uniformity), and inverse difference moment (IDM; homogeneity). Features were calculated in five directions relative to the image plane. Whole-bone stiffness and failure load were calculated from phantom-calibrated lumbar QCT. Mean age of subjects was 59 ± 11yr (57% female). Individuals with lower vertebral stiffness had greater texture heterogeneity; specifically, higher contrast (r = -0.54, p< .01), higher entropy (r = -0.52, p< .01), lower IDM (r = 0.54, p< .01) and lower ASM (r = 0.51, p< .01). Lower vertebral failure load and lower vBMD were similarly associated with greater texture heterogeneity. Relationships were unchanged when using the average of texture in all directions or the vertical direction in isolation. In summary, individuals with more heterogeneous MRI-based trabecular texture had lower stiffness and failure load by FEA, and lower vBMD by central quantitative CT. These results-the first relating MRI-based texture features and biomechanical properties of bone-provide further support that MRI-based texture measurements can be used to opportunistically detect skeletal fragility.

Comparative analysis of MRI-based VBQ and EBQ score for predicting cage subsidence in PILF surgery

Background contextAs lumbar degenerative diseases become more prevalent in an aging population, there is an increasing demand for surgical interventions, such as posterior lumbar interbody fusion (PLIF). However, cage subsidence (CS), observed in 23.9–54% of cases postoperatively, remains a significant complication. Several factors, including age, bone quality, and endplate damage, contribute to the risk of CS, with bone quality being among the most critical determinants. Although DEXA and QCT are widely employed to assess bone density, their routine use in preoperative evaluations is restricted by cost considerations and radiation exposure. Recent studies suggest that MRI-based vertebral body quality (VBQ) and endplate bone quality (EBQ) score offer a viable, non-invasive alternative for evaluating bone quality; however, there is limited research comparing their predictive value for CS.MethodsIn this retrospective study, 165 patients undergoing single-level PLIF surgery were included. MRI-based VBQ and EBQ score were calculated using T1-weighted images, and preoperative QCT was employed as a clinical standard. Cage subsidence was assessed based on postoperative imaging at 12-month follow-up. Statistical analyses, including t-tests, chi-square tests, and ROC curve analyses, were used to evaluate the predictive accuracy of VBQ and EBQ for CS.ResultsThe study’s findings demonstrated that both VBQ and EBQ scores were significantly correlated with QCT measurements, thereby validating their utility as indicators of bone quality. ROC analysis revealed that VBQ had superior predictive value for CS (AUC = 0.814) compared to EBQ (AUC = 0.719), with both scores demonstrating significant clinical utility in identifying patients at risk for CS. Notably, VBQ exhibited a stronger correlation with preoperative clinical outcomes compared to EBQ, underscoring its greater reliability as a predictor.ConclusionsThis study highlights the effectiveness of MRI-based VBQ and EBQ score as practical, non-invasive tools for assessing bone quality preoperatively, with VBQ demonstrating superior predictive performance for CS risk. The findings underscore the potential of integrating these MRI-based assessments into routine preoperative planning to improve patient outcomes and minimize complications associated with PLIF surgery.

Assessment Of Jaw Bone Quality And Quantity In Edentulous Patients Using Cone Beam Computed Tomography – A Cross-Sectional Study.

Assessment Of Jaw Bone Quality And Quantity In Edentulous Patients Using Cone Beam Computed Tomography – A Cross-Sectional Study.

Assessing bone quality in hounsfield units using computed tomography: what value should be used to classify bone as normal or osteoporotic?

The purpose of this study was to investigate threshold values for classifying bone as normal or osteoporotic based on Computed Tomography (CT) Hounsfield Units (HU) and to determine if clinically applicable values could be derived to aid spine surgeons evaluating bone quality using CT. This literature review was completed using PubMed and Ovid (MedLine), using syntax specific to bone quality and CT. The included articles were original clinical studies assessing bone quality and utilized composite L1-L4 HU values compared against dual-energy X-ray absorptiometry (DEXA) values. Extracted data study descriptors, CT measurement technique, and CT threshold values. CTs were measured from L1-L4 using either axial or sagittal images, and must classify their bone quality findings for any of the following 3 categories: normal, osteopenia, or osteoporosis. This review located 34 studies measuring bone density using CT with threshold values, of which, 10 were included in the final review. Number of patients ranged from 74 to 283 and cohort ages from 20s to 70.6 years. CT threshold values for assessing normal and osteoporotic bone quality ranged from 150 to 179 and 87 to 155, respectively. From combining values across studies, a HU value of ≥ 170 HU was associated with normal bone and ≤ 115 HU with osteoporosis. There is variation in HU values used to differentiate normal from compromised bone quality, even after limiting studies. For patients with HU values between or near 170 or 115 HU, a DEXA scan may be warranted for further evaluation. With ongoing investigation in this area, threshold values for classifying bone quality using CT will be continually refined.

A Comparison of Deep Learning vs. Dental Implantologists in Cone-Beam Computed Tomography-Based Bone Quality Classification.

Bone quality assessment is crucial for pre-surgical implant planning, influencing both implant design and drilling protocol selection. The Lekholm and Zarb (L&Z) classification, which categorizes bone quality into four types based on cortical bone width and trabecular bone density using cone-beam computed tomography (CBCT) data, lacks quantitative guidelines, leading to subjective interpretations. This study aimed to compare the performance of deep learning (DL)-based approaches against human examiners in assessing bone quality, according to the L&Z classification, using CBCT images. A dataset of 1100 CBCT cross-sectional slices was classified into four bone types by two oral and maxillofacial radiologists. Five pre-trained DL models were trained on 1000 images using MATLAB®, with 100 images reserved for testing. Inception-ResNet-v2 achieved the highest accuracy (86.00%) with a learning rate of 0.001. The performance of Inception-ResNet-v2 was then compared to that of 23 residency students and two experienced implantologists. The DL model outperformed human assessors across all parameters, demonstrating excellent precision and recall, with F1-scores exceeding 75%. Notably, residency students and one implantologist struggled to distinguish bone type 2, with low recall rates (48.15% and 40.74%, respectively). In conclusion, the Inception-ResNet-v2 DL model demonstrated superior performance compared to novice implantologists, suggesting its potential as an supplementary tool for cross-sectional bone quality assessment.

Evaluation of black Cumin (Bunium persicum), Ajwain (Carum copticum) and Fenugreek (Trigonella foenum-graecum) dietary supplementation on growth performance, blood metabolites, ileal digestibility, bone strength and in broilers

ABSTRACT This study aimed to evaluate the effects of herbal plants (HP) consisting of black Cumin (Bunium persicum), Ajwain (Carum copticum) and Fenugreek (Trigonella foenum-graecum) on broiler performance and health. A total of 360 broilers were allocated into four groups consisting of control diet (A) or supplemented with a mixture of Ajwain, Fenugreek and black Cumin seeds at the rate of 1.5 (B), 3 (C) and 4.5 g/kg (D). Results showed that feed intake was significantly (P < 0.05) higher in Group-C during the 6th week. Weight gain in Group-C was also significantly (P < 0.05) higher in 6th weeks compared to other groups. FCR was significantly (P < 0.05) improved in Group-C at week 6. The apparent ileal digestibility of crude protein and fat was highest in Group-C, showing significant (P < 0.05) improvements. Blood analysis revealed lower total cholesterol and LDL levels in Group-B and -C, while HDL was significantly (P < 0.05) higher in group-C. Bone quality assessments indicated that the tibiotarsal index was significantly (P < 0.05) higher in Group-C, suggesting enhanced bone strength. In conclusion, dietary inclusion of PFAs, particularly at 3 g/kg, significantly improved growth performance, nutrient digestibility, blood biochemistry and bone quality in broilers.

Impaired Bone Tissue Quality Associated with Inflammation in HIV-Immunological Non-Responders: A Cross-Sectional Analysis.

People with HIV (PWH) with poor immune response despite adequate antiretroviral treatment (ART) are susceptible to non-AIDS-related health issues. This study seeks to evaluate bone quality in Immunological Non-Responders (INRs) in comparison to those with proper immune response (IRs) using in vivo microindentation to quantify bone quality, in addition to conventional bone mineral density (BMD) evaluations. A cross-sectional study was conducted at Hospital del Mar in Barcelona from January 2019 to June 2023. Participants were matched in a 1:2-ratio (INRs:IR) based on age, sex, body mass index (BMI), and ART. Participants underwent bone quality assessment using in vivo microindentation, BMD and analysis of bone turnover and inflammation markers. Statistical analyses involved multivariable regression to adjust for potential confounding variables. A total of 159 PWH were included, 53 INRs and 106 IRs. INRs had worse bone quality, with lower median Bone Material Strength index (BMSi) compared to IRs (79 (76-87) vs. 86 (82-89); p<0.001), and similar BMD. INRs shown increased high-sensitive C-Reactive Protein levels with lower 25-(OH)-Vitamin D3. A significant negative correlation between inflammation and bone quality was found, especially noticeable in INRs. Multivariable linear regression shown that INR status is a major predictor of decreased bone quality, regardless of conventional risk factors. INRs condition is significantly associated with higher inflammatory levels, which may contribute to a deleterious effect on bone quality as measured by in vivo microindentation. Further studies are needed to confirm these results and to focus on non-AIDS comorbidities in this subgroup of PWH.