Between Bone Mineral Density Values Research Articles

Risk of fracture prevention in spina bifida patients: correlation between bone mineral density, vitamin D, and electrolyte values.

The aim of our study was to investigate the relationship between bone mineral density (BMD), vitamin D, and electrolyte blood values in patients with spina bifida, to find a possible therapeutic regimen and an intervention to reduce the risk of fractures in this population. BMD values were measured in 49 patients (32 females, 17 males; aged 14.1 ± 3.86 years; range 5-20 years) using dual-energy X-ray absorptiometry (DEXA) and were analyzed based on sex, the level of spinal involvement, vitamin D, and electrolyte values, physical activity, body mass index (BMI), and ambulatory status [patients were divided into three subgroups: full-time wheelchair (FTWC), limited ambulator (LA), and full-time ambulator (FTA)]. These data were analyzed considering sex-, age-, and BMD-matched values and compared with those of normal population. BMD was significantly lower in these patients compared with that in the general healthy population (Z-score: -1.2 ± 1.8); in particular, females had Z-score values significantly lower that of the males (Z-score: -2.43 ± 2.02; P < 0.0004). In FTWC subgroup, Z-score was lower than that of the other two subgroups (P < 0.009). Vitamin D values were significantly lower compared with those in the general healthy population (vitamin D spina bifida group: 14.6 ± 8.7 mg/dL; normal subjects: 35 ± 9.8 mg/dL; P < 0.001). Subjects with spina bifida showed hypophosphatemia (<3 mg/dL) because of the lower levels of vitamin D (3.1 ± 0.9 mg/dL; P < 0.001). Spina bifida patients showed lower BMD, vitamin D, and electrolyte values than the healthy population; hence, they have an increase risk of developing pathological fractures. Vitamin D supplementation for a longer time period could reduce this risk.

Association of bone mineral density with postural stability and the fear of falling in Spanish postmenopausal women

ObjectiveThe purpose of our study was to investigate the relationship between bone mineral density (BMD) and postural stability and the fear of falling in a 50- to 65-year-old postmenopausal population. Study designA cross-sectional, observational study was conducted on 118 postmenopausal women. According to their BMD values, participants were divided into two groups: BMD>−2.0SD (n=95) and ≤−2.0SD (n=23). Main outcome measuresPostural stability, assessed with a resistive multi-sensor platform, fear of falling (FoF) and the history of falls in the last 12 months were investigated. ResultsWomen with BMD≤−2.0SD reported a significantly increased FoF when compared to women with BMD>−2.0SD (P=0.024, η2=0.045, 1−β=0.624). In the postural stability analysis, the group with BMD≤−2.0SD showed, under the eyes-open condition, statistically significantly higher values for the velocity (VEO) (P=0.040, η2=0.037, 1−β=0.539) and the anteroposterior mean displacement of the center of pressure (YEO; P=0.017, η2=0.049, 1−β=0.669). No significant differences between groups were observed in the history of falls or in the rest of the stabilometric analyses. ConclusionsIn Spanish postmenopausal women under 65 years, a BMD≤−2.0SD is significantly associated with postural instability (elevated VEO and XEO) and an increased FoF, which are two highly influential factors in the risk of falling.

Managing pediatric osteoporosis

Pediatric osteoporosis (PO) is a condition that is increasingly recognized, rarely due to primary genetic diseases of the bone, but more frequently a consequence of chronic illness and/or treatments [1,2]. Considering dual-energy x-ray absorptiometry as the gold standard to evaluate bone status, the relationship between bone mineral density (BMD) and risk of fracture in children is unknown; therefore, it is not possible to define thresholds below which there is an established increased risk. Furthermore, BMD measurements in children are affected by body size as the bone density value produced is an areal bone density (aBMD), failing to provide a volumetric BMD (vBMD). So, a child who is short for their age may receive an inappropriate diagnosis of osteoporosis [3]. Normal BMD values now exist for children aged 7 years and older [4], and there is also a position statement on bone densitometry in children, which states that PO diagnosis should be made on the basis of a low BMD or bone mineral content (z-score ≤-2.0, adjusted for age, gender and body size), and the presence of a clinically significant fracture history [5].

Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

To evaluate the longitudinal relationship between bone mineral density (BMD) and BMD changes and the progression of knee osteoarthritis (OA), as measured by cartilage outcomes. We used observational cohort data from the Vitamin D for Knee Osteoarthritis trial. Bilateral femoral neck BMD values as well as knee magnetic resonance imaging (MRI) scans in each subject were obtained at baseline and subsequently at 12 months and 24 months. The change in total cartilage volume and tibial and femoral cartilage thickness was measured by manual cartilage segmentation of 2 sequential knee MRI scans in each subject. Multivariable linear regression models were used to examine the associations of baseline BMD and BMD change with the cartilage outcomes, adjusting for baseline age, sex, body mass index, malalignment, and vitamin D treatment. Model fit and assumptions were validated. A total of 127 subjects were eligible for analysis. Longitudinal BMD loss was associated with loss of cartilage volume (β = 1.25 per 0.1 gm/cm(2) , P = 0.02) and loss of tibial cartilage thickness (β = 0.028, P = 0.03). BMD loss of a magnitude greater than the least significant change (<-4.7%) was associated with 1.02% cartilage volume loss per year (P = 0.005), 0.014 mm femoral cartilage thickness loss (P = 0.04), and 0.021 mm tibial cartilage thickness loss per year (P = 0.009). There were no significant associations between baseline BMD and any of the cartilage outcomes. Longitudinal BMD loss is associated with progressive cartilage loss in knees with OA. Further work to clarify the basis of this relationship could reveal novel therapeutic targets for knee OA.

Bone Mineral Density as a Predictor of Atherosclerosis and Arterial Wall Stiffness in Obese African-American Women

Bone demineralization is associated with higher cardiovascular event rates, possibly due to vascular calcification and accelerated atherosclerosis. African-Americans have less bone loss and less calcium content within atherosclerotic plaques. However, whether loss of bone mass is related to atherosclerosis has not been examined in African-Americans. The objective of this study was to evaluate possible associations between bone mineral density (BMD), carotid intimal-medial thickness (CIMT), and arterial stiffness. We studied 100 obese African-American women (BMI: 26.6 ± 6.2; age: 63 ± 14 years) referred for BMD estimation by dual-energy X-ray absorptiometry scan. BMD (g/cm²) was obtained at the lumbar spine (L1–L4), femoral neck, and total hip. Arterial stiffness was evaluated by the heart rate-corrected augmentation index (AI@75) and pulse wave velocity (PWV) using applanation tonometry. CIMT was measured by vascular ultrasound. Mean CIMT, AI@75, and PWV were 0.72 ± 0.14 mm, 28.8 ± 9.0%, and 8.9 ± 1.6 m/s, respectively. Mean BMD values at the lumbar spine, femoral neck, and hip were 0.96 ± 0.19, 0.80 ± 0.16, and 0.91 ± 0.17 g/cm². Older subjects had higher CIMT (r = 0.61, p < 0.001) and AI@75 (r = 0.42, p < 0.001). There was a significant correlation between AI@75 and CIMT (r = 0.45, p < 0.001). BMD was negatively correlated with AI@75 (lumbar: r = –0.22, p = 0.03; femoral neck: r = –0.24, p = 0.01; hip: r = –0.21, p = 0.03). BMD was unrelated to CIMT (lumbar: r = –0.09, p = 0.42; femoral neck: r = –0.15, p = 0.17; hip: r = –0.13, p = 0.23). On multivariate analysis, age (p < 0.001), hypertension (p = 0.02), and lumbar BMD (p = 0.01, R² = 0.30) were independent predictors of increased AI@75 after adjusting for age, height, and cardiovascular risk factors. These findings were unchanged upon substitution of femoral neck BMD (p = 0.05, R² = 0.28) into the model. There was a trend with hip BMD (p = 0.06, R² = 0.28) in the regression model. Age-matched comparison between normal BMD (n = 25) and osteoporotic patients (n = 34) demonstrated a significant difference in AI@75 (26.6 ± 8.9 vs. 31.6 ± 9.1%, p = 0.04). In summary, women with lower BMD had increased arterial stiffness. There was no relationship between BMD and atherosclerosis. In conclusion, age, hypertension, and BMD are independent predictors of higher arterial stiffness. Vascular changes are related to bone mineral loss, suggesting lower BMD may increase cardiovascular risk in African-Americans.

Inverse association of serum long-acting natriuretic peptide and bone mineral density in renal transplant recipients

Our aim was to evaluate the relationship between bone mineral density (BMD) and fasting serum long-acting natriuretic peptide (LANP) concentration in renal transplant recipients. Fasting blood samples were obtained from 65 renal transplant recipients. BMD was measured using dual energy X-ray absorptiometry in lumbar vertebrae (L2-L4). Serum LANP levels were measured using a commercial enzyme immunoassay kit. Six patients (9.2%) had osteoporosis and 28 patients (43.1%) had osteopenia in renal transplant recipients. Increased serum LANP (p<0.001) was significantly correlated with low lumbar T-score cut-off points between groups (normal, osteopenia, and osteoporosis) in renal transplant recipients. Female patients had lower lumbar BMD than male renal transplant recipients (p=0.027). Univariate linear regression analysis indicated that lumbar BMD were positively correlated with height (p=0.038), body weight (p=0.003), and body mass index (BMI; p=0.019), whereas negatively correlated with LANP (p=0.004) among the renal transplant recipients. Multivariate forward stepwise linear regression analysis of the significant variables revealed that body weight (R(2) change=0.132; p=0.006) and LANP (R(2) change=0.093; p=0.008) were the independent predictors of lumbar BMD values in the renal transplant recipients. Serum LANP concentration correlates negatively with lumbar BMD values in renal transplant recipients.

Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis

To assess the relationship between bone mineral density (BMD) and varus deformity arising from bone structural changes caused by knee osteoarthritis (OA) in postmenopausal women. This cross-sectional study involved 135 consecutive postmenopausal female patients who had varus knee OA and a Kellgren-Lawrence grade > or = 2. Knee radiographs were obtained with the patient standing on one leg, and subjects were classified into 3 tertile groups according to femorotibial angle, which was taken as a measure of varus knee OA severity. We also measured the 3 subangles that make up the femorotibial angle, and focused on the varus inclination of the tibial plateau. BMD was measured in the lumbar spine, femoral neck, and medial and lateral tibial condyles using dual-energy X-ray absorptiometry. Differences between femorotibial angle tertile groups were assessed, and associations between femorotibial sub-angles and BMD values at various points were evaluated. After adjustment for age and body mass index, there was no significant association between the varus inclination of the tibial plateau and lumbar spine BMD. A weak but statistically significant negative correlation existed between varus inclination of the tibial plateau and BMD at the ipsilateral proximal femur and lateral tibial condyle. Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone.

Relationship Between Bone Mineral Density and Clinical Features in Women With Idiopathic Benign Paroxysmal Positional Vertigo

To evaluate the relationship between bone mineral density (BMD) and clinical features in women with idiopathic benign paroxysmal positional vertigo (IBPPV). Prospective study. Tertiary referral center. Patients with BMD measurements made after a diagnosis of IBPPV were included. The IBPPV (n = 78) and control groups (n = 177) were divided into ordinal age categories of similar size. Group A (n = 20) patients were aged 20 to 39 years, Group B (n = 21) patients were aged 40 to 49 years, Group C (n = 18) patients were aged 50 to 59 years, and Group D (n = 19) patients were aged 60 to 69 years. In each age range, the BMD values were compared according to the number of canalith repositioning maneuvers (CRMs) or the presence of recurrence. We divided all patients into 2 groups with the normal and abnormal BMD values and compared both groups based on the number of CRMs or the frequency of recurrence. The BMD value, the number of CRMs, and the presence of recurrence. In Groups A, B, and C, there was a significant difference in the BMD values between the control, 1-visit, and 2-or-more-visits subgroups. In Group D, the 2-or-more-visits subgroup had a lower BMD value than other subgroups. The difference in the number of CRMs between the normal and abnormal BMD groups was significant. In Groups A and B, there was a significant difference in the BMD values between the control, first-attack, and recurrent-attacks subgroups. In Groups C and D, the recurrent-attacks subgroup had lower BMD values than other subgroups. The difference in the frequency of recurrence between the normal and abnormal BMD groups was significant. Patients with IBPPV had lower BMD values compared with control subjects, and patients with low BMD values showed a significant increase in the number of CRMs required and the recurrence rate.

The Relationship Between Dual Energy X-Ray Absorptiometry (DXA) and DXA With Laser (DXL) Measurements in Children

The present study was designed to examine the relationship between bone mineral density (BMD) measurements performed using conventional dual energy X-ray absorptiometry (DXA) in total body (TB), spine, and hip and the more recent technique of DXA with laser (DXL) in the calcaneus in a young population and to explore the diagnostic capacity of the heel DXL. One hundred and twelve persons, 2.2–20.6 yr of age, were studied using the 2 techniques. Significant correlations were observed between the heel BMD and BMD values in TB ( r = 0.73, p < 0.001), TB head excluded(HE) ( r = 0.83, p < 0.001), spine ( r = 0.72, p < 0.001), and hip ( r = 0.90, p < 0.001). The relationships between DXA and DXL measurements with 95% tolerance intervals are presented. Using heel DXL measurements to predict the lowest DXA quartiles at all the other measured sites revealed sensitivity levels of 0.9 (TB, spine, hip) and 1.0 (TB HE) and specificity levels of 0.86 (TB), 0.94 (TB HE), 0.92 (spine), and 0.95 (hip). We conclude that BMD values obtained with DXA and DXL correlate well and that the DXA and DXL techniques effectively identify the same individuals with low BMD. The DXL, which is portable, easy to use and gives a low radiation dose, can be useful for assessing bone mass in a young population.

A comparison of bone mineral density in the spine, hip and jaws of edentulous subjects

The aim was to investigate the relationship between bone mineral density (BMD) of the jaws (mandible and maxilla) and other skeletal sites. In addition, the influence of gender, smoking and the number of years without natural teeth were examined. 18 edentulous patients (9 females, 9 males) with a mean age of 67.1 (sd 12.6) years had DXA scans to assess the BMD of the lumbar spine and hip, together with the ramus, body and symphysis of the mandible and the anterior of the maxilla. BMD values for the ramus were similar to those for the femur but significantly lower than the lumbar spine. The body and anterior mandible had higher values and the anterior maxilla lower values than both the femur and ramus. The ramus BMD showed moderately strong relationships with the standard measures of BMD in the spine and hip, but the BMD of other areas of the jaws showed no relationship with skeletal sites. The BMD for both the hip and the ramus showed an inverse relationship with increasing age. There was no statistically significant relationship between BMD of hip, spine and jaw and either years edentulous or cigarette years. (207) Although the ramus of the mandible may show correlation of BMD with skeletal sites, the areas of the jaws where implants may be placed do not. Therefore BMD of the skeletal sites could not be used to predict BMD of the jaws. The BMD of the jaws as measured by DXA showed no relationship with either years edentulous or cigarette smoking.

Low Bone Mineral Density and Fractures in Long-Term Hemodialysis Patients: A Meta-Analysis

The association between bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) and fracture in patients with stage 5 chronic kidney disease (CKD) is unclear. We performed a meta-analysis to determine whether BMD by DXA was associated with fractures. We included published reports of completed studies that enrolled patients with stage 5 CKD; measured BMD by DXA at the spine, femoral neck, or radius; and reported on fractures. To compare mean BMD values between the fracture and nonfracture groups, we used the standardized mean difference as an effect measure. We synthesized study results using a random-effects meta-analysis model and tested for heterogeneity using Cochran Q test. Our results are unadjusted for confounders. Our outcome was fractures, either morphometric spine or clinical nonspine fractures. We identified 1,774 potentially relevant articles, retrieved 105 reports for evaluation, and included 6 cross-sectional studies with 683 subjects. The studies reported on 75 morphometric spine fractures and 79 clinical fractures. BMD was measured at the spine, femoral neck, and ultradistal, one third, and midradius. Mean age ranged from 60.5 +/- 14.3 to 73.6 +/- 6.3 years, and mean duration of dialysis therapy ranged from 36.8 +/- 3.1 to 87.1 +/- 60.2 months. For all BMD sites except the femoral neck, subjects with fractures had significantly lower BMD than subjects without fractures. For example, the pooled standardized mean difference was -0.44 (95% confidence interval, -0.80 to -0.08) in the 5 studies that examined associations between spine BMD and fracture. There was important heterogeneity in the association between BMD and fractures. This was a meta-analysis of cross-sectional observational studies and reports an unadjusted association between BMD and fracture. Our meta-analysis suggests that BMD is lower in patients with stage 5 CKD who have fractures. Future studies need to determine whether this association is independent of confounding factors, measurement of BMD is useful for predicting future fracture risk, and fractures may be prevented by treatments that preserve BMD.

Is Osteoporosis Generalized or Localized to Central Skeleton in Ankylosing Spondylitis?

Osteoporosis at the lumbar spine and at the femur is a well-established complication in ankylosing spondylitis (AS), but the exact mechanism and the distribution of osteoporosis are not known absolutely. To determine whether the osteoporosis is generalized or localized to central skeleton and to examine the relation between bone mineral density (BMD) and disease activity and radiologic progression in patients with AS. In this study, 26 patients with AS and 33 healthy controls matched for age and sex were recruited to the study. Hip and forearm BMD were measured by dual energy X-ray absorptiometry (DEXA). Laboratory and clinical disease activity parameters were documented, and anteroposterior sacroiliac radiographs were taken to determine the radiologic progression. The urine deoxypyridinoline levels of the patients with AS were statistically significantly higher (P = 0.02) and the serum osteocalcin levels were significantly lower with respect to controls (P = 0.03). The femoral neck and femur BMD values and T scores were significantly lower in patients with AS compared with the controls (P = 0.019, 0.003, 0.01, and 0.01, respectively). The differences in BMD values and T scores of the distal 1/3 radius between 2 groups were not statistically significant. The relation between BMD and disease activity, and radiologic progression in patients with AS could not detected. Sparing of distal regions such as the as radius suggests that osteoporosis might be due to localized effects of inflammatory activity or immobility rather than a systemic effect. Both increased resorption and decreased formation might be involved in the pathogenesis of osteoporosis. Radius BMD may not be appropriate to evaluate bone loss in patients with AS.

Low Femoral Bone Mineral Density and Quantitative Ultrasound Are Risk Factors for New Osteoporotic Fracture and Total and Cardiovascular Mortality: A 5-Year Population-Based Study of Brazilian Elderly Women

Prospective and cross-sectional studies have confirmed a significant association between bone mineral density (BMD) measurements and fracture risk. However, the relationship among incident fracture risk, mortality, BMD, and quantitative ultrasound is controversial and less studied. At baseline, 275 postmenopausal elderly women were evaluated by clinical questionnaire regarding fracture risk factors and had radiological analysis of the spine, spine and femur dual energy x-ray absorptiometry, and calcaneous quantitative ultrasound measurements. Five years later, 42 (15.3%) women had died, 25 (9.1%) were lost to follow-up, and 208 (75.6%) continued the study. Specific questionnaire items regarding fracture risk were reevaluated, and thoracic and lumbar spine x-rays were taken to identify new fractures. Causes of mortality in this population were also assessed. All reported deaths were confirmed by review of death certificates or hospital records and were classified according to International Classification of Diseases, 10th Revision (ICD-10) code. After adjustments for age, weight, body mass index, smoking status, previous fracture, physical activity, drug use, and presence of chronic diseases, each 1 standard deviation (SD) reduction in stiffness index (SI) at baseline was significantly associated with future fracture (hazard ratio [HR] = 2.23; 95% confidence interval [CI], 1.30-3.83) and total mortality 5 years later (HR = 1.57; 95% CI, 1.10-2.47). Femoral neck and trochanter BMD values at baseline were also related to new fracture (HR = 2.01; 95% CI, 1.27-3.18 and HR = 1.62; 95% CI, 1.08-2.42, respectively) and total mortality (HR = 1.44; 95% CI, 1.06-2.22 and HR = 1.59; 95% CI, 1.07-2.36, respectively). Cardiovascular mortality was associated with decreased baseline femur BMD (HR = 1.28; 95% CI, 1.08-2.26) and lower SI values (HR = 1.54; 95% CI, 1.08-2.79). Our results demonstrate that low femoral BMD and low SI are able to predict fracture risk and are related to non-cause-specific and cardiovascular mortality, independently of other factors associated with osteoporosis, death, or aging.

Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea

The objectives of this population-based study were to investigate the potential association between bone mineral density (BMD) and serum lipid profiles and to compare the effects of serum lipids on BMD at various skeletal sites in pre- and post-menopausal women. In July and August of 2004, BMD was measured at a variety of skeletal sites [lumbar spine (L1-4), femoral neck, trochanter, Ward's triangle, shaft and proximal total hip] using the GE/Bravo Lunar DPX dual-energy X-ray absorptiometer in a South Korean population-based sample of 375 pre-menopausal and 355 post-menopausal rural women aged 19-80 years. The levels of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were inversely associated with BMD in both pre- and post-menopausal women. In the pre-menopausal women, correlations were shown only for lumbar 1-4 (TC: r=-0.12, P<0.05; LDL-C: r=-0.12, P<0.05), whereas in the post-menopausal women, no correlation was evident for the lumbar sites. In the post-menopausal subjects, the TC levels showed significant correlations with the BMD values at the trochanter (r=-0.15, P<0.01), shaft (r=-0.16, P<0.001) and proximal total hip (r=-0.15, P<0.01) sites, while the LDL-C levels showed significant correlations with the BMD values at the neck (r=-0.13, P<0.05), trochanter (r=-0.21, P<.001), shaft (r=-0.20, P<0.001) and proximal total hip (r=-0.20, P<0.001) sites. The levels of triglyceride (TG) were shown to have a significant positive correlation with BMD values at the trochanter site (r=0.11, P=0.05) in the post-menopausal women; by contrast, subjects in a higher quartile of TG levels show lower lumbar BMD values in the pre-menopausal women. The levels of high-density lipoprotein cholesterol (HDL-C) were not associated with BMD values at any of the sites in the pre- and post-menopausal subjects. Our data indicate a relationship between BMD values and serum lipid levels and suggest differences between pre- and post-menopausal women in terms of the effects of serum lipids on BMD at various skeletal sites.

Tumor necrosis factor α, CYP 17, urokinase, and interleukin 10 gene polymorphisms in postmenopausal women: correlation to bone mineral density and susceptibility to osteoporosis

Objective:Osteoporosis is a common disorder with a strong genetic component. We investigated the correlations between bone mineral density (BMD) and four gene polymorphisms (−308G>A tumor necrosis factor α (TNF-α), −34T>C CYP 17, *141T>C urokinase, and −627C>A interleukin 10 (IL-10) promoter), and their relationship to osteoporosis in postmenopausal women. Study design:These polymorphisms were determined using polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) analysis. BMD of the lumbar spine and proximal femur were measured using dual-energy X-ray absorptiometry. Results:The prevalence of each genotype was as follows: (1) 79.3% A/A, 16.6% A/G, and 4.1% G/G in −308G>A TNF-α; (2) 18.9% T/T, 52.1% T/C, and 29% C/C in −34T>C CYP 17; (3) 86.4% C/C and 13.6% C/T in *141T>C urokinase; (4) 46.2% A/A, 45% A/C, and 8.8% C/C in −627C>A IL-10 promoter. Subjects with genotype C/C in −627C>A IL-10 promoter had lower BMD values and a significantly greater risk for osteoporosis (OR 8.1, 95% CI 1.5–42.8) at the lumbar spine compared with subjects with genotype A/C in −627C>A IL-10 promoter, after adjustment for potential confounders. Conclusion:The RsaI IL-10 promoter gene polymorphism is associated with reduced BMD and predisposes women to osteoporosis at the lumbar spine.

Assessment of femur and tibia subchondral parts mineral bone density in gonarthrosis

Objective. To assess association between bone mineral density (BMD) of parts of femur and tibia gonarthrosis stage. Material and methods. 53 female with bilateral gonarthrosis aged 42 to 84 years with body mass index from 21,2 to 43 kg/m2 were included. Knee joints X-ray examination, densitometry of lumbar spine, femoral neck and condyles of femur and tibia were performed. Subchondral BMD assessment was done in 5 regions of knee. Results. Increase of gonarthrosis stage was accompanied by rise of subchondral tibia BMD values. Increase of medial femur condyles BMD was associated with knee joint space decrease, presence of subchondral osteosclerosis and marginal osteophytes so as knee varus deformity. Subchondral femur BMD values correlated only with the presence of marginal osteophytes.

Low bone mineral density is related to echogenic carotid artery plaques: a population-based study.

In a 1994-1995 cross-sectional, population-based study of 2,543 men and 2,726 postmenopausal women aged 55-74 years in Tromsø, Norway, the authors assessed a possible relation between bone mineral density (BMD) and the prevalence of carotid artery plaques, with an emphasis on plaque morphology. BMD measurements of the forearm and ultrasonography of the carotid artery were performed. Study participants were divided into quartiles with respect to sex-specific BMD values. Prevalent plaques were categorized into four groups ranging from low echogenicity to high echogenicity. For echogenic plaques, a significant inverse correlation with BMD was found (p for linear trend=0.007 after adjustment for age, sex, and cardiovascular risk factors). For predominantly echogenic plaques, a similar but weaker association was indicated (p = 0.08); for predominantly echolucent and echolucent plaques, no significant associations were observed (p > or = 0.3). Subjects whose BMD values were in the highest quartile had a statistically significant lower risk of echogenic plaques than subjects whose BMD values were in the lowest quartile (odds ratio=0.51, 95% confidence interval: 0.31, 0.83). This study indicates that low bone mass is associated with an increased risk of echogenic calcified atherosclerotic plaques but not with a risk of echolucent plaques.

Bone Mineral Density in Patients on Maintenance Hemodialysis and Effect of Chronic Hepatitis C Virus Infection

Objective: To determine the prevalence of osteopenia and osteoporosis in HD patients at our center; to investigate whether HCV infection affects BMD in hemodialysis patients; to test for correlations between bone mineral density (BMD) and clinical and laboratory parameters in this population. Subjects and Methods: The study involved 76 end‐stage renal disease patients. Forty‐three (56.6%) patients were tested negative for anti‐HCV antibodies and HCV‐RNA. Thirty‐three (43.4%) of them had positivity of anti‐HCV antibodies and permanent or intermittent HCV‐RNA positivity at least for two years. Mean HD duration was 86.4 months. Patients completed a standard questionnaire that listed age, sex, occupation, education level; cause of renal failure, smoking history, dialysis duration, and sports activities engaged in during life, and pathologic bone fractures. The women answered additional items about age at menarche, number of pregnancies and menopausal status. Each subject underwent a baseline physical examination, including measurement of body weight and height for calculation of body mass index. The results of laboratory tests that had been done at monthly visits in the previous year were retrospectively evaluated, and mean levels for the year were used for correlation testing. Bone mineral density was measured in the spine, femoral neck and forearm. Relationships between BMD values and chronic HCV infection, laboratory results and clinical parameters were analyzed. Results: In the 43 patients who were negative for anti‐HCV antibodies and HCV‐RNA, spine BMD testing showed osteopenia in 16 (37.2%) cases and osteoporosis in 7 (16.3%) cases. The corresponding values for the neck of the femur were 14 (32.6%) and 6 (14.0%), and for the forearm were 19 (44.2%) and 15 (34.9%). In the 33 anti‐HCV antibodies and HCV‐RNA positive patients; spine BMD testing showed osteopenia in 10 (30.3%) cases and osteoporosis in 7 (21.2%) cases. The corresponding values for the neck of the femur were 17 (51.5%) and 4 (12.1%), and for the forearm were 4 (12.1%) and 25 (75.8%). Bone mineral density decreased as dialysis duration increased (p < 0.05). There was no statistical difference between BMD measurements of chronic HCV infection positive and negative group. Conclusion: However the mean BMD values for all three sites in the 76 HD patients were low HCV infection may not be a risk factor for low BMD in this population.

Bone mineral density and prevalent vertebral fractures in men and women.

To test the hypothesis that the association between bone mineral density (BMD) and estimated volumetric BMD and prevalent vertebral fractures differs in men and women, we studied 317 Caucasian men and 2,067 Caucasian women (average age 73 years). A total of 43 (14%) men and 386 (19%) women had a vertebral fracture identified on lateral spine radiographs using vertebral morphometry. Hip and spine areal BMD was about 1/3 standard deviation lower among men and women with a vertebral fracture. A 0.10 g/cm(2) decrease in areal BMD was associated with 30-40% increased odds of having a fracture in men and 60-70% increased likelihood in women. Low bone mineral apparent density (BMAD) was also associated with 40-50% increased odds of a vertebral fracture in both genders. The probability of a man having a fracture was observed at higher absolute areal BMD values than observed for women (P=values for interaction of BMD x gender: trochanter, P=0.05; femoral neck, P=0.10; total hip, P=0.09). In contrast, the probability of fracture was similar in men and women across the range of estimated volumetric BMD (BMAD). In conclusion, low BMD and low BMAD are associated with increased odds of vertebral fracture in both men and women. Measures of bone mass that partially correct for gender differences in bone size may yield universal estimates of fracture risk. Prospective studies are needed to confirm this observation.

Bone mineral density and importance of a gluten-free diet in patients with celiac disease in childhood.

Celiac disease (CD), a common cause of malabsorption, is known to be associated with disorders of the skeleton, but there are conflicting data about the effect of diet on bone metabolism. The aims of this study were to investigate the prevalence of osteopenia; to identify the relationship between bone mineral density (BMD), serum calcium, and parathyroid hormone levels; and to determine the effect of gluten-free diet on BMD in children with celiac disease. The study included 32 patients with CD (group 1) and 82 healthy controls (group 2). The patients with CD were evaluated under 2 subgroups, ie, 16 patients with recent diagnosis (group 1a) and 16 patients who follow their diet strictly (group 1b). BMD values and concentrations of calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone were determined on entry to the study and at 12 months in celiac patients. These values were compared with those of healthy control participants. BMD and bone mineral content values in patients with recent diagnosis were found to be significantly lower than the control group. The BMD values in patients with recent diagnosis were significantly increased after a gluten-free diet for 1 year. Osteopenia was found more commonly in patients with recent diagnosis than patients in whom a gluten-free diet had been instituted. At 1-year follow-up, osteopenia was not resolved with the gluten-free diet, and this was especially true in patients without gastrointestinal manifestation. In patients with recent diagnosis (group 1a), the mean calcium level was found to be lower than the patients who follow their diet strictly (group 1b). There was a positive correlation between calcium level and BMD and bone mineral content. BMD is almost invariably low in newly diagnosed celiac patients in childhood. We therefore recommend that BMD should be evaluated in patients with CD. Strict gluten avoidance promoted a significant increase in BMD. However, values still remained markedly low after 1 year of follow-up in some patients. These patients should be followed for longer periods of time with yearly BMD evaluation, as 1 year of diet therapy was found to be insufficient for osteopenia to be resolved.