BMD Values Research Articles

Radiological Factors Associated with Bisphosphonate Treatment Failure and Their Impact on Fracture Healing in Postmenopausal Women with Osteoporotic Vertebral Fractures.

(1) Background: Bisphosphonate treatment failure is one of the most difficult clinical problems for patients with osteoporosis. This study aimed to analyze the incidence of bisphosphonate treatment failure, associated radiological factors, and effect of fracture healing in postmenopausal women with osteoporotic vertebral fractures (OVFs). (2) Methods: A total of 300 postmenopausal patients with OVFs who were prescribed bisphosphonate were retrospectively analyzed and divided into two groups according to the treatment response: response (n = 116) and non-response (n = 184) groups. The radiological factors and the morphological patterns of OVFs were included in this study. (3) Results: The initial BMD values of the spine and femur in the non-response group were significantly lower than those in the response group (all Ps < 0.001). The initial BMD value of the spine (odd ratio = 1.962) and the fracture risk assessment tool (FRAX) hip (odd ratio = 1.32) showed statistical significance in logistic regression analysis, respectively (all Ps < 0.001). (4) Conclusions: The bisphosphonate non-responder group showed a greater decrease in BMD over time than the responder group. The initial BMD value of the spine and the FRAX hip could be considered radiological factors influencing bisphosphonate non-response in the postmenopausal patients with OVFs. The failure of bisphosphonate treatment for osteoporosis has a possible negative on the fracture healing process in OVFs.

Carbon nanofiber nanomaterial modified polystyrene enzyme linked immunosorbent assay substrate for detecting osteoporosis

Osteoporosis (OS) develops without any pain or symptom, and it is usually identified when the weakened bone causes fracture. To overcome this issue, measuring bone density (BMD) helps to identify osteoporosis and its conditions. It was identified that when the level of anti-cyclic citrullinated peptide (anti-CCP) increases, values of BMD were decreased. This research was focused to quantify the level of anti-CPP on nanomaterial modified polystyrene ELISA substrate. ELISA wells were modified into amine-carbon nanofiber and then glutaraldehyde used as a linker to attach CCP. Anti-CCP antibody level was quantified on PS plate by secondary-antibody conjugated horseradish peroxidase. Carbon nanofiber improves the immobilization of CCP on PS well and attract higher number of anti-CCP antibody, which helps to reach the limit of detection at 10 pg/mL, which was four times lower limit of detection with conventional ELISA (40 pg/mL). Further, specific experiment was conducted with serum spiked anti-CCP antibody shows the absorbance increment in all the concentrations of anti-CCP antibody and control performances with relevant molecules did not increase the absorbance level confirms the selective and specific detection. This carbon nanofiber modified ELISA well quantifies anti-CCP level and helps to identify the condition of bone for diagnosing osteoporosis.

A cross-calibration study using a novel dual X-ray absorptiometry system for bone mineral density measurements with the European Spine Phantom.

For bone health assessment, dual-energy X-ray absorptiometry (DEXA) is recommended to measure bone mineral content and areal bone mineral density (aBMD) in the lumbar spine. However, intermachine differences were not taken into account when developing these recommendations. According to the International Society of Clinical Densitometry (ISCD), phantom-based cross-calibration is adequate after replacing the DEXA system from a different manufacturer. For different DEXA equipment, individual calibration equations were found to be necessary to fit the observed values with the given densities. The BMD European Spine Phantom (ESP) measurements (L1, L2, and L3) were assessed on 3 machines. We used the Welch test in the one-way analysis of variance (ANOVA) with a post-hoc Tamhane T2 test, linear regressions, and Bland-Altman analysis to assess the consistency of measurements and establish cross-calibration equations. The coefficients of variation (CV)% of the phantom BMD values measured using the 3 systems were less than 3.0%. The 3 DEXA systems were highly correlated with BMD in the lumbar spine, with correlation values ranging from 0.933 to 0.984 (P<0.0001). The cross-calibration regression models of the ESP measurements yielded the highest prediction accuracies with the lowest prediction errors (the standard error of the estimate ranged from 0.004 to 0.008 g/cm2; P<0.0001). After the regression equations were applied, the differences in BMD values among the 3 systems were negligible. In addition, the Bland-Altman plot showed that almost all data points were within the 95% limits of agreement. A strong agreement for BMD measurement was established between the 3 DEXA systems. Cross-calibration equations for the lumbar spine BMD values need to be applied to transform the Hologic Discovery A or GE Lunar iDXA measurements into SONIALVISION SMIT measurements to comply with the ISCD standards for patient continuity of care in assessment during clinical diagnosis.

Bone fragility, sarcopenia and cardiac calcifications in an elderly population: a preliminary study

Cardiovascular disease, osteoporosis and sarcopenia are very common age-related conditions. This study aimed at investigating the relationships of cardiac calcifications, as assessed by using GCCS with BMD, fragility fractures and sarcopenia in elderly subjects. In a cohort of 106 subjects (age 70.4 ± 5.8 yrs) we measured lumbar (BMD-LS), femoral BMD (femoral neck: BMD-FN, total femur: BMD-TH) and body composition (BMD-WB) with Dual-energy X-ray Absorptiometry (DXA) method. We also evaluated the presence of sarcopenia on the basis of the EWGSOP Consensus. All subjects, simultaneously, underwent to a transthoracic color doppler echocardiography exam to assess the presence of cardiac calcifications. The degree of non coronaric cardiac calcifications was evaluated using the Global Cardiac Calcium Score (GCCS). The degree of cardiac calcification assessed by GCCS was significantly higher in osteoporotic patients (p < 0.001). Furthermore, an inverse correlation emerged between BMD and GCCS, statistical significance was found at lumbar spine and femoral sub-regions in female population (p < 0.01). Moreover by dividing population according to the presence of fragility fractures, we observed that GCCS values were significantly higher in subjects with fractures in respect of non-fractured ones (p < 0.05). Multiple regression models showed that BMD-LS and BMD-FT were independently associated with cardiac calcification. GCCS values were significantly associated with BMI and ASMM in women (p < 0.01 and p < 0.05, respectively) and with handgrip strength in men (p < 0.05). Our data confirm the presence of a relationship between cardiac calcifications and decreased BMD values. It's also the first study that relates sarcopenia and valvular calcifications.

Associations between vitamin E status and bone mineral density in children and adolescents aged 8-19 years: Evidence based on NHANES 2005-2006, 2017-2018.

Bone mineral density (BMD) in adolescence is a crucial determinant in osteoporosis and fragility fractures in older age. Vitamin E is the most abundant lipid-soluble antioxidant present in the blood. However, the association of vitamin E status with BMD in children and adolescents remains unclear. We first measured the association of vitamin E status (serum α- and γ tocopherol) with BMD in children and adolescents with the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were performed to evaluate their relationship after adjusting for a large range of covariates. Stratified analyses and interaction tests were used to explore their effects on different genders, ages, and races/ethnicities. 13,606 children and adolescents from NHANES (2005-2006, 2017-2018) were included in our analysis. Compared with the lowest α-tocopherol quartile, individuals in the highest α-tocopherol quartile are likelier to be Non-Hispanic White and have a higher value of poverty income ratio (PIR). They have a lower value of serum phosphorus and lumbar spine BMD. Every 1umol/L increase in serum α- and γ- tocopherol, the lumbar spine BMD decreased by -0.0016 and -0.0068 g/cm2. Compared with the lowest quartile serum α- and γ- tocopherol concentration, individuals in the highest quartile have a -0.0223 and -0.0329 g/cm2 lower mean BMD, respectively. Interaction effects suggest that the negative effect is more prominent among female youth, individuals aged 8-13 years, non-Hispanic whites, Mexican Americans, and non-Hispanic blacks. Our study indicates serum α- and γ-tocopherol are negatively correlated with lumbar BMD. Age, gender, and race may have a modifying effect on this relationship. Our study has an important clinical implication. A higher vitamin E status for children and adolescents could not improve BMD, even decrease BMD. More prospective research with stronger evidence is needed to verify our findings and their underlying mechanisms.

Relationship Between Weight-Adjusted Waist Index and Osteoporosis in the Senile in the United States from the National Health and Nutrition Examination Survey, 2017-2020

Background: Some studies suggested obesity may be beneficial in preventing bone loss through the negative relationship between body mass index (BMI) and osteoporosis in senile. However, using BMI to measure obesity is unconvincing due to confounding factors such as muscle mass were not taken into account, and few articles have yet taken a better way to evaluate the relationship between obesity and osteoporosis. Methodology: Using a cross-sectional sample of 1,979 participants aged ≥65 years from the National Health and Nutrition Examination Survey (NHANES) 2017 to 2020, we evaluated the relation of weight-adjusted waist index (WWI) with osteoporosis. WWI was calculated as waist (cm) divided by the square root of body weight (kg). Diagnosis of osteoporosis was described as follows: according to the updated reference for calculating bone mineral density T-Scores, we marked the BMD value as X, using the formula T femoral neck= (X g/cm2-0.888 g/cm2)/0.121 g/cm2, T lumbar spine= (X g/cm2- 1.065 g/cm2)/0.122 g/cm2, and defined those with a final T femoral neck <-0.25. T lumbar spine<-0.25 or patients with previously diagnosed OP in other hospitals as osteoporosis. Results: All the 1,979 participants were between 65 and 80 years, there were 379 (21.1%) with osteoporosis, 608 (30.7%) with WWI exceeding 12 (cm/√kg) (range 8.85-14.14), and 955 (48.3%) women. Furthermore, the relationship between WWI and osteoporosis was nonlinear with a threshold effect point. Odds of OP significantly increased with the increase of WWI (OR 2.33, 95% CI 11.48–3.38, P = 0.0001) at the right side of the threshold point (WWI≥12) according to the threshold effect study. Conclusions: Found a significant positive relationship between WWI and osteoporosis. Body fat management in the senile may be good to prevent osteoporosis if confirmed by other prospective studies analyzing the longitudinal risk of osteoporosis with obesity.

2D-3D reconstruction of the proximal femur from DXA scans: Evaluation of the 3D-Shaper software.

Introduction: Osteoporosis is currently diagnosed based on areal bone mineral density (aBMD) computed from 2D DXA scans. However, aBMD is a limited surrogate for femoral strength since it does not account for 3D bone geometry and density distribution. QCT scans combined with finite element (FE) analysis can deliver improved femoral strength predictions. However, non-negligible radiation dose and high costs prevent a systematic usage of this technique for screening purposes. As an alternative, the 3D-Shaper software (3D-Shaper Medical, Spain) reconstructs the 3D shape and density distribution of the femur from 2D DXA scans. This approach could deliver a more accurate estimation of femoral strength than aBMD by using FE analysis on the reconstructed 3D DXA. Methods: Here we present the first independent evaluation of the software, using a dataset of 77 ex vivo femora. We extend a prior evaluation by including the density distribution differences, the spatial correlation of density values and an FE analysis. Yet, cortical thickness is left out of this evaluation, since the cortex is not resolved in our FE models. Results: We found an average surface distance of 1.16mm between 3D DXA and QCT images, which shows a good reconstruction of the bone geometry. Although BMD values obtained from 3D DXA and QCT correlated well (r 2 = 0.92), the 3D DXA BMD were systematically lower. The average BMD difference amounted to 64mg/cm3, more than one-third of the 3D DXA BMD. Furthermore, the low correlation (r 2 = 0.48) between density values of both images indicates a limited reconstruction of the 3D density distribution. FE results were in good agreement between QCT and 3D DXA images, with a high coefficient of determination (r 2 = 0.88). However, this correlation was not statistically different from a direct prediction by aBMD. Moreover, we found differences in the fracture patterns between the two image types. QCT-based FE analysis resulted mostly in femoral neck fractures and 3D DXA-based FE in subcapital or pertrochanteric fractures. Discussion: In conclusion, 3D-Shaper generates an altered BMD distribution compared to QCT but, after careful density calibration, shows an interesting potential for deriving a standardized femoral strength from a DXA scan.

Exome-wide screening identifies novel rare risk variants for bone mineral density.

BMD is highly heritable and a major predictor of osteoporotic fractures, but its genetic basis remains unclear. We aimed to identify rare risk variants contributing to BMD. Utilizing the newly released UK Biobank 200,643 exome dataset, we conducted a gene-based exome-wide association study in males and females, respectively. First, 100,639 males and 117,338 females with BMD values were included in the polygenic risk scores (PRS) analysis. Among individuals with lower 30% PRS, cases were individuals with top 10% BMD, and individuals with bottom 10% BMD were the controls. Considering the effects of vitamin D (VD), individuals with the highest 30% VD concentration were selected for VD-BMD analysis. After quality control, 741 males and 697 females were included in the BMD analysis, and 717 males and 708 females were included in the VD-BMD analysis. The variants were annotated by ANNOVAR software, then BMD and VD-BMD qualified variants were imported into the SKAT R-package to perform gene-based burden tests, respectively. The gene-based burden test of the exonic variants identified genome-wide candidate associations in ANKRD18A (P = 1.60 × 10-5, PBonferroni adjust = 2.11 × 10-3), C22orf31 (P = 3.49 × 10-4, PBonferroni adjust = 3.17 × 10-2), and SPATC1L (P = 1.09 × 10-5, PBonferroni adjust = 8.80 × 10-3). For VD-BMD analysis, three genes were associated with BMD, such as NIPAL1 (P = 1.06 × 10-3, PBonferroni adjust = 3.91 × 10-2). Our study suggested that rare variants contribute to BMD, providing new sights for broadening the genetic structure of BMD.

Vertebral Fractures in Acromegaly: A Systematic Review.

Acromegaly is characterized by a very particular alteration of bone microarchitecture, leading to increased vertebral fragility. However, due to inconsistent and insufficient evidence, no guidelines are available for the evaluation of this osteopathy. We performed a literature review of studies published between 1968 and January 2022 on the PubMed and SCOPUS databases using the terms "acromegaly" and "vertebral fractures". Twenty-four studies were found eligible for inclusion, published between June 2005 and November 2021. Included studies evaluated acromegaly patients, who were assessed for the presence of vertebral fractures. We excluded case reports, reviews, meta-analyses, letters to the editor, articles not written in English, and research performed on the same set of patients without significant differences in study design. Risk of bias was avoided by following the ROBIS risk of bias recommendations. We executed rigorous data collection, and the results are depicted as a narrative overview, but also, as statistical synthesis. Limitations of the evidence presented in the study include study heterogeneity, small sample sizes, and a small number of prospective studies with short follow-up. Data regarding vertebral fractures (VFs) in acromegaly and their influencing factors are variable. Twenty-four studies were included, nine out of which had a prospective design. The smallest group of acromegaly patients had 18 subjects and the largest included 248 patients. Prevalence ranges between 6.5% and 87.1%, although most studies agree that it is significantly higher than in controls. VFs also have a higher incidence (between 5.6% and 42%) and are more frequently multiple (between 46.15% and 71%). Evidence shows that disease activity and active disease duration are influencing factors for the prevalence and incidence of VFs. Nonetheless, hypogonadism does not seem to influence the frequency of VFs. While reports are conflicting regarding the use of bone mineral density in acromegaly, evidence seems to be slightly in favor of it not being associated with VFs. However, trabecular bone score is significantly lower in fractured patients, although no prospective studies are available. Vertebral fractures evaluation should be performed with regularity in all acromegalic patients, especially in the presence of active disease. Disease activity is an important determinant of vertebral fracture incidence and prevalence, although hypogonadism is less so. To clarify the predictive value of both BMD and TBS for vertebral fractures, additional, larger, prospective studies are necessary.

Reference values of bone mineral density of proximal femur for Southeast Asian children and adolescents.

Proximal femur scans of 170 boys and 191 girls obtained from DXA (Lunar Prodigy Pro, GE, and software enCORE version 7.53) were un-analyzed and then re-analyzed with the upgraded software enCORE version 17 SP2 for BMD assessment. The bone mineral apparent density of the femoral neck (FNBMAD) was calculated. Sex and Tanner stage-specific BMD normative data were generated. BMD values of the femoral neck and total hip increased with age and pubertal progression. FNBMAD values were not markedly influenced by age and puberty. Using multiple linear regression analysis, age and weight affected FNBMD and total hip BMD in boys and girls, but height and Tanner stage only influenced girls. Age did not significantly influence FNBMAD in either sex. Tanner stage weakly influenced FNBMAD only in boys. We established normative reference data for BMD of the proximal femur measured by DXA in Thai children aged 5 to 18years. Our reference data will help clinicians and researchers assess and interpret the BMD of the proximal femur for Southeast Asian children.

Bone fragility and sarcoidosis: An underestimated relationship.

Sarcoidosis is a chronic multisystem inflammatory disease which may affect any organ. Also bone can be involved both directly and indirectly. Data on BMD values and fragility fractures in sarcoidosis patients are few and heterogeneous. This study aimed to characterized the presence of fracture and the relative risk factors in patients with sarcoidosis. In this single center cross-sectional study we evaluated 252 sarcoidosis patients (54.7 ± 12.1 years) compared to sex-and age matched healthy controls. We measured BMD at lumbar spine, at femoral neck and at total hip. Moreover, the presence of fragility fractures was collected during osteoporosis visit and all radiological images were examined for the presence of any vertebral fracture according to Genant's method's. Lung function measurements, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, and diffusion capacity for carbon monoxide (DLCO) were assessed. Bone Mineral Density T-scores were lower in patients affected by sarcoidosis with respect to those obtained in healthy controls, but the difference was statistically significant only for BMD-LS (p < 0.01) and BMD-TH (p < 0.05). Moreover, BMD values at all skeletal sites were significantly associated with DLCO (%) (p < 0.05). The prevalence of fragility fracture was higher in patients with sarcoidosis than in healthy controls (30.6 vs. 12.3%). The patients with ≥3 vertebral fracture had lower values of FVC (%), FEV1 (%), and DLCO (%). Multiple regression analyses showed that BMI was positively associated with fragility fracture, while BMD-TH, DLCO(%) and therapy use was negatively associated. Vertebral fractures represent a frequent complication in patients with sarcoidosis. Furthermore, the number of vertebral fractures was linked with a worsening in pulmonary functional tests. Therefore, the degree of severity of the sarcoidosis disease appears to be the main determinant of bone fragility.

PSAT156 Abaloparatide Implementation and Follow-Up: Real-World Results of a Pharmacist-Run Anabolic Osteoporosis Clinic

Abstract Introduction Osteoporosis, the most common bone disorder worldwide, is associated with increased morbidity and mortality. Available treatments include antiresorptive agents and anabolic therapies. Anabolic therapies are indicated in patients at high risk of osteoporotic fracture. There are challenges to utilizing anabolic therapies, however, including providing training on injection technique, addressing patient concerns about medication safety, and completion of medication prior authorizations. Pharmacist involvement could help ensure the safe and effective use of anabolic therapy. Objective To describe the 4-year, real-world results of a pharmacist-run abaloparatide osteoporosis clinic. Methods The primary study endpoint was the comparison of DXA T-scores and BMD values of the total hip, femoral neck, spine, and 1/3 radius (wrist) at baseline, after abaloparatide therapy, and following 1 year of follow-up antiresorptive therapy. The secondary end point was the number of documented fractures. Each patient served as his/her own control. Paired T-tests were performed to compare mean differences in pre- and post- T-scores and BMD values. Results Between April 2017 and October 2021, 146 patients were referred for abaloparatide therapy, with 91 patients (62.3%) initiating therapy. Eighteen patients refused to begin therapy because of concerns of adverse drug reactions, lack of interest in treating their osteoporosis, or because of the route of drug administration. Other consenting patients did not initiate therapy due to high monthly co-pay costs (15), insurance preferring teriparatide (1), insurance refusing coverage of any anabolic therapy (1), and contraindication to abaloparatide therapy (10). The average age at initiation of therapy was 66.7 (+ 7.7) years, 97.8% were women, 98.9% were Caucasian, mean BMI was 25.2 (+ 6.0), 56% had a history of osteoporotic fracture, baseline T-Scores of the femoral neck and spine were -2.5 (+ 0.7), and -2.4 (+ 1.3), respectively, and 49.5% of patients were osteoporosis drug naïve. There were significant improvements in T-scores and BMD at the spine, total hip and femoral neck during an average of 12 + 2 months (range 9–18 months) of abaloparatide therapy, and a significant decrease in T-score at the 1/3 radius. All patients received follow-up antiresorptive therapy, with 84.1% of patients receiving denosumab. After 1 year of antiresorptive therapy, significant increases in T-scores and BMD were seen at the total hip and lumbar spine, with nonsignificant changes in the femoral neck and 1/3 radius. There was one reported fracture during the evaluation period. Eighteen patients (19.8%) discontinued therapy due to an ADR. Conclusion Abaloparatide is effective in increasing BMD and T-scores and in preventing osteoporosis-related fractures. The fact that 37.7% of referred patients did not initiate therapy, indicates that significant barriers to anabolic osteoporosis treatment remain. Noteworthy, however, is the achieved 72.5% persistence rate of the patients initiating abaloparatide at this pharmacist-run anabolic osteoporosis clinic. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Phenotypes of body composition in patients with systemic sclerosis

Background. Systemic sclerosis (SSc) is an autoimmune inflammatory disease of connective tissue with a polysyndromic clinical picture. One of the factors that significantly affect the quality of life of such patients is the involvement of the musculoskeletal system. A small number of studies were aimed at studying osteoporosis and body composition in patients with SSc, however, the clinical heterogeneity of the disease, a small number of patients included in the studies do not allow to draw unambiguous conclusions about the frequency of various phenotypes of body composition, their relationship and factors affecting their occurrence.Aim. To study the body composition and to establish the frequency of isolated and combined pathological phenotypes in women with SSс and to determine the factors associated with the muscle mass.Materials and methods. 85 postmenopausal women (46 with SSc, 39 without rheumatic pathology) were included. Questionnaires, anthropometric measurements, assessment of nutritional status by MNA, dual-energy X-ray absorptiometry of the whole body, lumbar spine, femoral neck and total hip were carried out. Correlation and univariate linear regression analyses were performed to identify factors related to appendicular muscle mass.Results. Normal body composition was found in 13.0% of patients with SSс and 25.6% — in the control, isolated and combined pathological phenotypes were detected in 34.8% and 52.2% women with SSс and in 61.5% and 12.8% in the group without rheumatic diseases, respectively. Combined pathological phenotypes, phenotypes with the presence of sarcopenia and/or osteoporosis were significantly more often in SSc patients (p&lt; 0.001), but the frequency of obesity did not differ (69.6% and 64.1%, respectively). Negative correlations were revealed between the value of appendicular muscle mass and the presence of osteolysis of the nail phalanges (Rs=-0.23), the cumulative dose of glucocorticoids (GC) (Rs=-0.43) and direct — with the value of the femoral neck BMD (Rs=0.47), nutritional status by MNA (Rs=0.51), BMI (Rs=0.70), the circumference of the shoulder of the non-dominant arm (Rs=0.68), waist (Rs=0.66), hips (Rs=0.72) and lower leg of the non-dominant leg (Rs=0.81), p&lt; 0.05. Univariate linear analysis confirmed the presence of positive associations between the appendicular muscle mass and proximal hip BMD, BMI, shoulder circumferences, waist, hips and lower leg (p&lt; 0.001), and negative associations with the Rodnan skin score (p=0.012) and the cumulative dose of GC (p=0.001).Conclusion. 87% of patients with SSc had pathological phenotypes of body composition, among them combined phenotypes were significantly more common than in people without rheumatic diseases. BMD in the proximal hip, BMI, circumference of the shoulder, waist, hips and lower leg were positively, and the Rodnan skin score and cumulative dose of GC were negatively associated with the appendicular muscle mass.

Bone Mineral Density as an Individual Prognostic Biomarker in Patients with Surgically-Treated Brain Metastasis from Lung Cancer (NSCLC).

Simple SummaryBone mineral density (BMD) has been shown to be a relevant imaging biomarker for various chronic debilitating diseases. The present study investigated the prognostic value of preoperative BMD values in patients with surgically-treated brain metastasis (BM) related to non-small-cell lung cancer (NSCLC). BMD values were measured in the first lumbar vertebra (L1) in preoperative CT scans and referenced to age-adjusted reference values. Pathologic BMDs were found to exhibit an impaired median overall survival and increased 1-year mortality in the study cohort, and could therefore aid as easily accessible and relevant biomarkers for prognostic assessment and treatment guidance.Patients with BM are in advanced stages of systemic cancer, which may translate into significant alterations of body composition biomarkers, such as BMD. The present study investigated the prognostic value of BMD on overall survival (OS) of 95 patients with surgically-treated BM related to NSCLC. All patients were treated in a large tertiary care neuro-oncological center between 2013 and 2018. Preoperative BMD was determined from the first lumbar vertebrae (L1) from routine preoperative staging computed tomography (CT) scans. Results were stratified into pathologic and physiologic values according to recently published normative reference ranges and correlated with survival parameters. Median preoperative L1-BMD was 99 Hounsfield units (HU) (IQR 74–195) compared to 140 HU (IQR 113–159) for patients with pathological and physiologic BMD (p = 0.03), with a median OS of 6 versus 15 months (p = 0.002). Multivariable analysis revealed pathologic BMD as an independent prognostic predictor for increased 1-year mortality (p = 0.03, OR 0.5, 95% CI 0.2–1.0). The present study suggests that decreased preoperative BMD values may represent a previously unrecognized negative prognostic factor in patients of BM requiring surgery for NSCLC. Based on guideline-adherent preoperative staging, BMD may prove to be a highly individualized, readily available biomarker for prognostic assessment and treatment guidance in affected patients.

IMPACT OF WHOLE-BODY ELECTROMYOSTIMULATION AND RESISTANCE TRAINING ON BONE MINERAL DENSITY IN WOMEN AT RISK OF OSTEOPOROSIS

In recent years, there has been an increasing interest in physical activity programs for older adults. Questions have been raised about the efficacy of programs regarding real effects on life. The purpose of the study is to compare the impact of ten weeks of Whole-Body Electromyostimulation (WB-EMS) and resistance training (RT) programs on one mineral density (BMD) and T-score values in women at risk of osteoporosis. The WB-EMS was carried out once per week (total: ten sessions), the RT was carried out twice per week (total: 20 sessions). Twenty-eight elderly women participated in the study, nine in a WB-EMS group (weight: 69.84±10.29kg; BMI: 25.04±4.18 kg/m2), eight in a RT group (weight: 74.16±4.19kg; BMI: 27.35±2.76 kg/m2), and ten in a control group (CG) (weight: 79.72±15.61kg kg; BMI 28.58±5.70 kg/m2). A dual-energy X-ray absorptiometry scanner (DXA) was used to assess body composition, BMD, and T-score values. To identify the statistical significance of the differences between pre-test and post-test in all groups, the parametric t-test was used. Statistical significance was set at p ≤ 0.05. Although no significant differences were found in either BMD or T-score values, the study appeared to elicit some positive behaviour that could have an impact for more than ten weeks. The present study was designed to determine the effect of RT and WB-EMS on selected parameters in groups of women at risk of osteoporosis. Even though the results were not statistically significant, we consider the impact of programs on the level of BMD and T-score beneficial. Results show that the RT method is more practical. More tested subjects of the RT reported the same or higher level of BMD in the post-test compared to the WB-EMS method (RT 50% vs WB-EMS 44.7%). It was impossible to further investigate the significant relationships between selected parameters and intervention because the sample size was too small. Therefore, a further study with more focus on the duration of intervention and an increase in sample size is suggested.

Opportunistic osteoporosis screening using chest CT with artificial intelligence.

To explore the value of the attenuation values of all thoracic vertebrae and the first lumbar vertebra measured by artificial intelligence on non-enhanced chest CT to do osteoporosis screening. On base of images of chest CT, using artificial intelligence (AI) to measure the attenuation values (HU) of all thoracic and the first vertebrae of patients who underwent CT examination for lung cancer screening and dual-energy X-ray absorptiometry (DXA) examination during the same period. The patients were divided into three groups: normal group, osteopenia group, and osteoporosis group according to the results of DXA. Clinical baseline data and attenuation values were compared among the three groups. The correlation between attenuation values and BMD values was analyzed, and the predictive ability and diagnostic efficacy of attenuation values of thoracic and first lumbar vertebrae on osteopenia or osteoporosis risk were further evaluated. CT values of each thoracic vertebrae and the first lumbar vertebrae decreased with age, especially in menopausal women and presented high predictive ability and diagnostic efficacy for osteopenia or osteoporosis. After clinical data correction, with every 10 HU increase of CT values, the risk of osteopenia or osteoporosis decreased by 32 ~ 44% and 61 ~ 80%, respectively. And the combined diagnostic efficacy of all thoracic vertebrae was higher than that of a single vertebra. The AUC of recognizing osteopenia or osteoporosis from normal group was 0.831and 0.972, respectively. The routine chest CT with AI is of great value in opportunistic screening for osteopenia or osteoporosis, which can quickly screen the population at high risk of osteoporosis without increasing radiation dose, thus reducing the incidence of osteoporotic fracture.

Characteristics of total body and appendicular bone mineral content and density in Japanese collegiate Sumo wrestlers

The purpose of this study was to explore the characteristics of total body and appendicular bone mineral content (BMC, kg) and bone mineral density (BMD, g/cm2) in Japanese collegiate Sumo wrestlers. A total of 54 male college Sumo wrestlers were recruited for the study and assigned to two groups according to their body weight (middleweight, 85–115 kg, n = 23 and heavyweight, > 115 kg, n = 31). The BMC, BMD, fat mass, and lean soft tissue mass (LSTM) values were measured using dual-energy X-ray absorptiometry for the total body and appendicular regions. Heavyweight Sumo wrestlers had significantly higher body weight, fat mass, and LSTM compared to middleweight Sumo wrestlers. The mean total body and regional BMC values were significantly higher in heavyweight than in middleweight Sumo wrestlers. The total body and leg BMD was significantly higher in heavyweight than in middleweight Sumo wrestlers, and was significantly correlated with body weight, but not arm BMD. The present study indicates that BMC and BMD might not sharply elevate among even heavyweight athletes, although heavier Sumo wrestlers had a greater BMC and BMD.

Effect of obesity on fragility fractures, BMD and vitamin D levels in postmenopausal women. Influence of type 2 diabetes mellitus

AimsTo see the effects of obesity on risk fracture, bone density (BMD), and vitamin D levels in a group of postmenopausal women, and consider how comorbid type 2 diabetes mellitus (T2DM) modifies them.Methods679 postmenopausal women were grouped into obese and non-obese. Obese women were grouped into those with T2DM and those without. 25(OH)-vitamin D, PTH and BMD were measured, and prevalent fragility fractures were gathered.ResultsObese women had higher prevalence of T2DM, than non-obese women. Levels of 25(OH)-vitamin D were lower and those of PTH higher in obese women, BMD values were higher in obese women. Diabetic-obese women had a higher prevalence of non-vertebral fractures than non-diabetic-obese. Multivariate logistic regression model showed association of fragility fractures with age, total hip BMD, BMI and T2DM. Obese women have higher BMD and lower 25(OH)-vitamin D values (and higher PTH) than non-obese, without diabetes.ConclusionsT2DM confers an increased risk of non-vertebral fractures in postmenopausal obese women.

Poster 124: Intrinsic Anthropometric Factors are Associated with Bone Stress Injuries in Collegiate Distance Runners: New Risk Metrics &amp; Screening Tools?

Poster 124: Intrinsic Anthropometric Factors are Associated with Bone Stress Injuries in Collegiate Distance Runners: New Risk Metrics &amp; Screening Tools?

Correlation of serum cornitine levels with bone mineral density among Indian male tobacco users.

It is of interest to assess levels of serum cornitine in male tobacco users and also find its correlation with bone mineral density. Assessment for serum cotinine levels was done using commercially available Enzyme Linked Immunosorbent Assay (ELISA Kit). While bone mineral density was measured using bone densitometry through ultrasound in the wrist region. Karl Pearson's coefficient was used to assess correlation between BMD values and serum cotinine (ng/ml) levels. Inter group BMD association was measured using Chi square test. The present study showed that the first 3 groups had a low BMD level compared to control group, indicative of osteopenia. BMD values were lesser for chewers from group II as compared to smokers from group I and individuals using both smoked and smokeless form of tobacco from Group III. In group III (both forms of tobacco), osteopenic individuals were more. Thus, data shows effect of tobacco usage on bone mineral density. Smokeless form of tobacco has relatively serious effects on bone density.