Bone Cross-sectional Area Research Articles

Brown adipose tissue and bone.

Brown adipose tissue (BAT) is capable of transforming chemically stored energy, in the form of triglycerides, into heat. Recent studies have shown that metabolically active BAT is present in a large proportion of adult humans, where its activity correlates with a favorable metabolic status. Hence, the tissue is now regarded as an interesting target for therapies against obesity and associated diseases such as type 2 diabetes, the hypothesis being that an induction of BAT would be beneficial for these disease states. Apart from the association between BAT activity and a healthier metabolic status, later studies have also shown a positive correlation between BAT volume and both bone cross-sectional area and bone mineral density, suggesting that BAT might stimulate bone anabolism. The aim of this review is to give the reader a brief overview of the BAT research field and to summarize and discuss recent findings regarding BAT being a potential player in bone metabolism.

EVALUATION OF DYNAMIC COMPRESSION MINIPLATES IN TREATMENT OF MANDIBULAR ANGLE FRACTURES USING TROCAR

Abstract: Introduction: Mandibular angle fractures (MAFs) account for 23% to 42% of all mandibular fractures. The frequent involvement of the angle in mandibular fractures can be attributed to its thin cross-sectional bone area and the presence of a third molar Objectives: The aim of this study was to evaluate clinically and radiologically the use of two dynamic compression miniplates in treatment of mandibular angle fractures using Trocar instrumentationMaterials and methods: The study was conducted on ten patients diagnosed with a single mandibular angle fracture indicated for open reduction and internal fixation. The fracture was exposed through transoral vestibular incision and reduced under general anesthesia. Third molar tooth in the fracture line was extracted. Temporary Maxillomandibular fixation was done using 26gauge stainless steel wires with arch bars. One dynamic compression miniplate was fixed on the external oblique ridge. The second miniplate was fixed on the lower border of the mandible using Trocar instrumentation. Results: Pain, edema and trismus decreased significantly over the follow up period. Maximum interincisal mouth opening and bone density along the fracture line increased significantly over the follow up period. Five patients had parasthesia of the inferior alveolar and mental nerve preoperatively. The parasthesia decreased progressively from the fourth week. Postoperative panorama radiographs showed adequate reduction and increase in bone density along the fracture line. No postoperative complication occurred. Conclusion: Two 2.0 mm dynamic compression miniplates are suitable for treatment of mandibular angle fractures using Trocar instrumentation. Key words: Dynamic compression miniplates, mandibular angle fractures, Trocar.

Changes over time in callus formation caused by intermittently administering PTH in rabbit distraction osteogenesis models.

BackgroundChanges over time in the callus during intermittent administration of parathyroid hormone (PTH) were studied in rabbit distraction osteogenesis models.MethodModels of distraction osteogenesis in Japanese white rabbits were created, and distraction osteogenesis (total length: 10.5 mm) was performed for 2 weeks. Simultaneously with the start of distraction, 30 rabbits received 4 weeks of subcutaneous administration of 30 μg/kg of PTH(1–34), teriparatide, (P-group: n = 15) or saline (N-group: n = 15) every other day. The tibias of five rabbits were dissected at 6, 8, and 10 weeks after surgery to perform bone mineral density (BMD), peripheral quantitative computed tomography (pQCT), and mechanical testing.ResultsThe mean BMD had no significant differences over time at 6, 8, and 10 weeks after surgery between the P-group and the N-group. On pQCT, the P-group had significant increases in total bone cross-sectional area of the callus compared to the N-group at 8 and 10 weeks after surgery. On mechanical testing, the P-group’s absorption energy had not changed at 6 weeks after surgery compared to the N-group, but it had significantly increased at 8 weeks. At 10 weeks after surgery, the N-group’s absorption energy rapidly increased, and the difference between the two groups disappeared.ConclusionThe intermittent administration of PTH(1–34), teriparatide, for 4 weeks every other day from the start of distraction had the potential to shorten the callus maturation period in the rabbit distraction osteogenesis models.

WS04.6 Children with cystic fibrosis: How compromised is bone?

Objectives Bone disease is observed in at least 11% of CF patients. The underlying pathogenesis is multifactorial, including nutritional factors but also a direct impact of the CF transmembrane conductance regulator (CFTR) dysfunction. The objective was to compare bone microstructure between pediatric CF patients and healthy volunteers. Methods This is a cross-sectional study with bone geometry, volumetric density (vBMD) and microstructure assessement by DXA and high resolution scanner (HRpQCT) at the distal radius and tibia in children with CF compared to age- and gender-matched healthy volunteers (HV). Results Thirty four CF children (15 girls, 19 boys, 15±2 yrs, centile for weight −0.5±1.6 and height −0.6±1.2, 8 with a past of fracture) were included. Main respiratory parameters were: forced expiratory volume in one second: 89±21%; forced vital capacity: 95±17% and forced expiratory flow between 25–75% of FCV: 62±31%. Height, weight and lumbar spine areal BMD were not significantly different between CF and HV (respectively: 158±14 vs. 162±11 cm, 47±12 vs. 51±12 kg and 0.830±0.147 vs. 0.819±0.175 g/cm2). At the radius, bone geometry, vBMD and trabecular microstructure were not different between CF and HV. However, at the tibia, CF had smaller bone cross-sectional area than HV (619±153 vs. 696±122mm2 p = 0.01). vBMD, cortical thickness and trabecular microstructure were not impaired at the distal tibia. Conclusion In our study, bone microstructure in children with CF was rather reassuring. Given their mild lung disease and good nutritional status, it seems unlikely that CFTR defect plays by itself a major role in the bone disease observed in patients with CF.

Cystic fibrosis-related bone disease in children: Examination of peripheral quantitative computed tomography (pQCT) data

BackgroundThe investigation of skeletal health data beyond dual X-ray absorptiometry (DXA) is limited in young individuals with CF. We assessed volumetric bone mineral densities (BMD), and bone and muscle parameters using peripheral quantitative computed tomography (pQCT) in individuals with CF and controls, 7.00–17.99years. MethodsPeripheral QCT (XCT 3000, Stratec) measurements were made in 53 individuals with CF and 53 controls. Bone mineral content (BMC), total volumetric BMD (vBMD) and cross sectional area (CSA) of the bone were measured at the 4% and 66% sites of the non-dominant tibia and radius. Additionally, trabecular vBMD and bone strength index (BSIc) were measured at the 4% sites, and cortical vBMD, muscle CSA (mCSA) and strength strain index (SSI) were measured at the 66% sites. ResultsPre-pubertal males with CF had greater trabecular vBMD (p=0.01) and total vBMD (p=0.00) at 4% tibia, and greater total vBMD (p=0.02) at 4% radius. Pre-pubertal females with CF had greater total vBMD at 66% tibia (p=0.02) and radius (p=0.04), and cortical vBMD (p=0.04) at the radius. At puberty, the CF cohort had less BMC at 4% tibia (males, p=0.02; females, p=0.01), and smaller mCSA at 66% tibia (males, p=0.02; females, p=0.01). Pubertal CF females had a smaller bone CSA (p=0.01) at 4% tibia, and lower bone strength (SSI) at the tibia (p=0.00) and radius (p=0.05) sites. ConclusionsBone strength parameters were not compromised prior to puberty in this CF cohort. At puberty, the bone phenotype changed for this CF cohort, showing several deficits compared to the controls. However, bone strength was adapting to the mechanical demands of the muscle. Altered bone parameters and their implications for lowered bone strength with increased age may be greatly influenced by: the CF cohort remaining smaller for age and/or a reduced bone strain, secondary to reduced muscle force.

Pediatric reference values for tibial trabecular bone mineral density and bone geometry parameters using peripheral quantitative computed tomography.

The purpose of this study was to establish reference data, in relation to age and body height, for tibial trabecular and cortical volumetric bone mineral density, bone mineral content, and cross-sectional bone geometry in healthy children and adolescents using peripheral quantitative computed tomography (pQCT). Over a 2-year period, 432 (207 male and 225 female) healthy children, with an age range of 5 to 19 years, from 6 different geographic areas in Belgium were recruited. Multislice pQCT scanning (XCT2000(®), Stratec Medizintechnik, Pforzheim, Germany) was performed at the distal metaphysis (at the 4% site) and the distal diaphysis (14 and 38% sites) of the tibia of the dominant leg. Gender-specific centile curves in relation to age and body height were generated with the LMS method for total and trabecular volumetric bone mineral density (at 4% site), bone mineral content, total bone cross-sectional area, periosteal circumference (all at 4, 14, and 38% site), cortical volumetric bone mineral density, endosteal circumference, and cortical thickness (at the 14 and the 38% site). These centile curves can be used for the interpretation of pQCT results at the 4, 14, and 38% site of the tibia in European children and adolescents, at least when a similar methodology is used.

Effect of dexamethasone on mandibular bone biomechanics in rats during the growth phase as assessed by bending test and peripheral quantitative computerized tomography.

Long-term glucocorticoid administration to growing rats induces osteopenia and alterations in the biomechanical behavior of the bone. This study was performed to estimate the effects of dexamethasone (DTX), a synthetic steroid with predominant glucocorticoid activity, on the biomechanical properties of the mandible of rats during the growth phase, as assessed by bending test and peripheral quantitative computed tomographic (pQCT) analysis. The data obtained by the two methods will provide more precise information when analyzed together than separately. Female rats aged 23 d (n=7) received 500μg.kg-1 per day of DXT for 4 weeks. At the end of the treatment period, their body weight and body length were 51.3% and 20.6% lower, respectively, than controls. Hemimandible weight and area (an index of mandibular size) were 27.3% and 9.7% lower, respectively. The right hemimandible of each animal was subjected to a mechanical 3-point bending test. Significant weakening of the bone, as shown by a correlative impairment of strength and stiffness, was observed in experimental rats. Bone density and cross-sectional area were measured by pQCT. Cross-sectional, cortical and trabecular areas were reduced by 20% to 30% in the DTX group, as were other cortical parameters, including the bone density, mineral content and cross-sectional moment of inertia. The "bone strength index" (BSI, the product of the pQCT-assessed xCSMI and vCtBMD) was 56% lower in treated rats, which compares well with the 54% and 52% reduction observed in mandibular strength and stiffness determined through the bending test. Data suggest that the corticosteroid exerts a combined, negative action on bone geometry (mass and architecture) and volumetric bone mineral density of cortical bone, which would express independent effects on both cellular (material quality) and tissue (cross-sectional design) levels of biological organization of the skeleton in the species.

History-dependent force, angular velocity and muscular endurance in ACTN3 genotypes.

This study aimed at determining the influence of the ACTN3 R577X polymorphism on muscle strength and muscle endurance in non-athletic young men. 266 healthy young men were included in this study. Each subject performed maximal isometric, concentric and eccentric contractions of the knee extensor muscles on an isokinetic dynamometer. Force depression, force enhancement and the fatigue index were derived from these data. In addition, handgrip strength, squat jump (SJ) and counter movement jump (CMJ) height were obtained. Our group included 83 RR (31 %), 131 RX (49 %) and 52 XX (20 %) individuals. The muscle bone cross-sectional area of the thigh was 5 % higher in RR compared to XX individuals (P = 0.033). RR genotypes showed 6 % higher handgrip strength compared to the XX group (P = 0.047). They also jumped 5 % higher in both the SJ and CMJ tests (P = 0.029; P = 0.031). No differences were found in force depression, force enhancement, isometric or eccentric strength. The relative concentric knee torque at 200°/s and at 300°/s was 7 and 8 % higher in RR compared to XX genotypes, respectively (P = 0.049; P = 0.048). Also, the fatigue index was found to be 4 % lower in XX genotypes (P = 0.037). Our findings are in agreement with the higher prevalence of the RR genotype in power-oriented activities. The better fatigue index of XX genotypes may be beneficial in endurance-type activities.

Decreases in bone mineral density at cortical and trabecular sites in the tibia and femur during the first year of spinal cord injury

BackgroundDisuse osteoporosis occurs in response to long-term immobilization. Spinal cord injury (SCI) leads to a form of disuse osteoporosis that only affects the paralyzed limbs. High rates of bone resorption after injury are evident from decreases in bone mineral content (BMC), which in the past have been attributed in the main to loss of trabecular bone in the epiphyses and cortical thinning in the shaft through endocortical resorption. MethodsPatients with motor-complete SCI recruited from the Queen Elizabeth National Spinal Injuries Unit (Glasgow, UK) were scanned within 5weeks of injury (baseline) using peripheral Quantitative Computed Tomography (pQCT). Unilateral scans of the tibia, femur and radius provided separate estimates of trabecular and cortical bone parameters in the epiphyses and diaphyses, respectively. Using repeat pQCT scans at 4, 8 and 12months post-injury, changes in BMC, bone mineral density (BMD) and cross-sectional area (CSA) of the bone were quantified. ResultsTwenty-six subjects (5 female, 21 male) with SCI (12 paraplegic, 14 tetraplegic), ranging from 16 to 76years old, were enrolled onto the study. Repeated-measures analyses showed a significant effect of time since injury on key bone parameters at the epiphyses of the tibia and femur (BMC, total BMD, trabecular BMD) and their diaphyses (BMC, cortical BMD, cortical CSA). There was no significant effect of gender or age on key outcome measures, but there was a tendency for the female subjects to experience greater decreases in cortical BMD. The decreases in cortical BMD in the tibia and femur were found to be statistically significant in both men and women. ConclusionsBy carrying out repeat pQCT scans at four-monthly intervals, this study provides a uniquely detailed description of the cortical bone changes that occur alongside trabecular bone changes in the first year of complete SCI. Significant decreases in BMD were recorded in both the cortical and trabecular bone compartments of the tibia and femur throughout the first year of injury. This study provides evidence for the need for targeted early intervention to preserve bone mass within this patient group.

Fundamental differences in axial and appendicular bone density in stress fractured and uninjured Royal Marine recruits — A matched case–control study

Stress fracture is a common overuse injury within military training, resulting in significant economic losses to the military worldwide. Studies to date have failed to fully identify the bone density and bone structural differences between stress fractured personnel and controls due to inadequate adjustment for key confounding factors; namely age, body size and physical fitness; and poor sample size. The aim of this study was to investigate bone differences between male Royal Marine recruits who suffered a stress fracture during the 32weeks of training and uninjured control recruits, matched for age, body weight, height and aerobic fitness. A total of 1090 recruits were followed through training and 78 recruits suffered at least one stress fracture. Bone mineral density (BMD) was measured at the lumbar spine (LS), femoral neck (FN) and whole body (WB) using Dual X-ray Absorptiometry in 62 matched pairs; tibial bone parameters were measured using peripheral Quantitative Computer Tomography in 51 matched pairs. Serum C-terminal peptide concentration was measured as a marker of bone resorption at baseline, week-15 and week-32. ANCOVA was used to determine differences between stress fractured recruits and controls. BMD at the LS, WB and FN sites was consistently lower in the stress fracture group (P<0.001). Structural differences between the stress fracture recruits and controls were evident in all slices of the tibia, with the most prominent differences seen at the 38% tibial slice. There was a negative correlation between the bone cross-sectional area and BMD at the 38% tibial slice. There was no difference in serum CTx concentration between stress fracture recruits and matched controls at any stage of training. These results show evidence of fundamental differences in bone mass and structure in stress fracture recruits, and provide useful data on bone risk factor profiles for stress fracture within a healthy military population.

안면골격 유형에 따른 하악 전치 치조골의 형태 차이: Cone-beam CT를 이용한 정량적 평가

Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume (mm³) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors’ axis: the cross sectional area of total bone (mm²), the area of the cancellous bone (mm²) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor’ axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.

Sex- and age-related differences in mid-thigh composition and muscle quality determined by computed tomography in middle-aged and elderly Japanese.

Sex- and age-related differences in mid-thigh composition and muscle quality remain unclear. The present study aimed to clarify these differences using computed tomography in middle-aged and elderly Japanese. A total of 2310 participants (age 40-89 years), who were randomly selected from the local residents, underwent computed tomography examination of the right mid-thigh. Thigh circumference and cross-sectional areas of the thigh, muscle, quadriceps, non-quadriceps, fat, and bone were measured. Knee extension strength and muscle quality index (knee extension strength/quadriceps cross-sectional area) were also assessed. Sex- and age-related differences in these indices were analyzed. The thigh cross-sectional area in men and women decreased by 0.6% and 0.5%/year, respectively, because of a decrease in muscle cross-sectional area (men 75.2%, women 40.6%), fat cross-sectional area (men 24.4%, women 59.6%) and bone cross-sectional area (men 0.5%, women -0.2%). Muscle cross-sectional area in men and women decreased by 0.6% and 0.4%/year, respectively, because of a decrease in quadriceps cross-sectional area (men 65.6%, women 81.6%) and non-quadriceps cross-sectional area (men 34.4%, women 18.4%). Muscle quality in men and women decreased by 0.4% and 0.3%/year, respectively. Thigh cross-sectional area decreased with age mainly because of a decrease in muscle cross-sectional area in men and fat cross-sectional area in women. The rate of decrease in muscle cross-sectional area was 1.5-fold higher in men than in women. Muscle cross-sectional area decreased with age mainly because of a decrease in quadriceps cross-sectional area, especially in women. Decrease in muscle quality with age was similar in both sexes.

Past sporting activity during growth induces greater bone mineral content and enhances bone geometry in young men and women

We aimed to determine the effect of past sporting activity on bone mineral content (BMC), areal bone mineral density (aBMD) in the lumbar spine and proximal femur, and bone geometry of the mid femur in young men and women. We assessed 142 subjects, comprising 79 young men (21.2±0.8years) and 63 premenopausal young women (21.4±0.6years). The subjects were classified into three groups, two on the basis of the age of starting to participate in sport [elementary school starters (6-12years), junior high school to university starters (13-22years)], and the third group had no participation in sport. We measured BMC and aBMD by dual-energy X-ray absorptiometry (DXA) in the lumbar spine and proximal femur, and bone geometric characteristics of the mid femur by magnetic resonance imaging (MRI), and calculated the osteogenic index (OI) of previous sporting activity. The OI correlated significantly with many MRI-determined measures of bone geometry; DXA-measured BMC and aBMD were effective indicators of previous sporting activity in both sexes. The female elementary school starters had significantly greater femoral mid-diaphyseal perimeters (vs the no-sport group), bone cross-sectional area (vs the 13-22-year-old starters and the no-sport group), and maximum and minimum second moment of area at the mid-diaphysis point of the femur (vs the no-sport group). The OI is a proven practicable and useful index. DXA- and MRI-determined geometric characteristics showed that high-impact, weight-bearing exercise before and in early puberty induces greater total proximal femur BMC and enhances femoral mid-diaphyseal size and shape, and that these benefits persisted in young adult women.

Bone strength is related to muscle volume in ambulant individuals with bilateral spastic cerebral palsy

ObjectiveThe aim of this study is to investigate how bone strength in the distal femur and proximal tibia are related to local muscle volume in ambulant individuals with bilateral spastic cerebral palsy (CP). MethodsTwenty-seven participants with CP (mean age: 14.6±2.9years; Gross Motor Function Classification System (GMFCS) levels I-III) and twenty-two typically developing (TD) peers (mean age: 16.7±3.3years) took part in this study. Periosteal and medullary diameter in the distal femur and cortical bone cross-sectional area (CSA) and thickness (CT) in the distal femur and proximal tibia were measured along with nine lower limb muscle volumes using MRI. Additionally, the polar section modulus (Zp) and buckling ratio (BR) were calculated to estimate bone bending strength and compressional bone stability respectively in the distal femur. The relationships of all measured parameters with muscle volume, height, age, body mass, gender, and subject group were investigated using a generalized linear model (GZLM). ResultsIn the distal femur, Zp was significantly positively related to thigh muscle volume (p=0.007), and height (p=0.026) but not significantly related to subject group (p=0.076) or body mass (p=0.098). BR was not significantly different between groups and was not related to any of the variables tested. Cortical bone CSA was significantly lower in the CP group at both the distal femur (p=0.002) and proximal tibia (p=0.009). It was also positively associated with thigh muscle volume (p<0.001) at the distal femur, and with subject height (p=0.005) at the proximal tibia. ConclusionsBending and compressional strength of the femur, estimated from Zp and cortical bone CSA respectively, is associated with reduced thigh muscle volume. Increasing muscle volume by strength training may have a positive effect on bone mechanics in individuals with CP.

Compromised bone microarchitecture and estimated bone strength in young adults with cystic fibrosis.

Young adults with cystic fibrosis (CF) are at risk for low bone density and fractures, but the underlying alterations in bone microarchitecture that may contribute to their increased fracture risk are currently unknown. The main goal of this study was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) to characterize the bone microarchitecture, volumetric bone mineral density (vBMD), and estimated strength of the radius and tibia in young adults with CF compared with healthy volunteers. This was a cross-sectional study at an outpatient clinical research center within a tertiary academic medical center. Thirty young adults with CF, 18 to 40 years of age, were evaluated and compared with 60 healthy volunteers matched by age (±2 years), gender, and race. The primary outcomes were HR-pQCT-derived cortical and trabecular vBMD, bone microarchitecture, and estimates of bone strength. At the radius and tibia, young adults with CF had smaller bone cross-sectional area and lower vBMD. Cortical and trabecular microarchitecture were compromised at both sites, most notably involving the trabecular bone of the tibia. These differences translated into lower estimated bone strength both at the radius and tibia. After accounting for body mass index differences, young adults with CF had lower bone area and estimated bone strength at the radius and had compromised trabecular microarchitecture and lower total and trabecular vBMD and estimated bone strength at the tibia. Alterations in trabecular bone density and microarchitecture and estimated strength measures of the tibia were also greater than expected based on dual-energy x-ray absorptiometry-derived areal BMD differences. Young adults with CF have compromised bone microarchitecture and lower estimated bone strength at both the radius and tibia, even after accounting for their smaller body size. These skeletal deficits likely explain the higher fracture risk observed in young adults with CF.

Influence of physical activity on bone strength in children and adolescents: a systematic review and narrative synthesis.

A preponderance of evidence from systematic reviews supports the effectiveness of weight-bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone strength. Thus, our systematic review extended the scope of the previous review by including all PA intervention and observational studies, including organized sports participation studies, with child or adolescent bone strength as the main outcome. We also sought to discern the skeletal elements (eg, mass, structure, density) that accompanied significant bone strength changes. Our electronic-database, forward, and reference searches yielded 14 intervention and 23 observational studies that met our inclusion criteria. We used the Effective Public Health Practice Project (EPHPP) tool to assess the quality of studies. Due to heterogeneity across studies, we adopted a narrative synthesis for our analysis and found that bone strength adaptations to PA were related to maturity level, sex, and study quality. Three (of five) weight-bearing PA intervention studies with a strong rating reported significantly greater gains in bone strength for the intervention group (3% to 4%) compared with only three significant (of nine) moderate intervention studies. Changes in bone structure (eg, bone cross-sectional area, cortical thickness, alone or in combination) rather than bone mass most often accompanied significant bone strength outcomes. Prepuberty and peripuberty may be the most opportune time for boys and girls to enhance bone strength through PA, although this finding is tempered by the few available studies in more mature groups. Despite the central role that muscle plays in bones' response to loading, few studies discerned the specific contribution of muscle function (or surrogates) to bone strength. Although not the focus of the current review, this seems an important consideration for future studies.

The effects of once-weekly teriparatide on hip geometry assessed by hip structural analysis in postmenopausal osteoporotic women with high fracture risk

Weekly administration of teriparatide has been shown to reduce the risk of vertebral and non-vertebral fractures in patients with osteoporosis at higher fracture risk in Japan. However, its efficacy for hip fracture has not been established. To gain insight into the effect of weekly teriparatide on the hip, hip structural analysis (HSA) based on dual-energy X-ray absorptiometry (DXA) was performed using the data of 209 postmenopausal osteoporotic women who had participated in the original randomized, multicenter, double-blind, placebo-controlled trial assessing the effects of once-weekly 56.5μg teriparatide for 72weeks. The DXA scans, obtained at baseline, 48weeks and 72weeks, were analyzed to extract bone mineral density (BMD) and cross-sectional geometrical indices at the narrowest point on the neck (NN), the intertrochanteric region (IT), and the proximal shaft. Compared with placebo after 72weeks, the teriparatide group showed significantly higher BMD, average cortical thickness, bone cross-sectional area, and section modulus, and lower buckling ratio at both the NN and IT regions. No significant expansion of periosteal diameter was observed at these regions. There were no significant differences in BMD and HSA indices at the shaft region. The results indicate that overall structural strength in the proximal femur increased compared to placebo, suggesting that once-weekly teriparatide effectively reverses changes in hip geometry and strength with aging.

Sex differences in quadriceps muscle and femoral bone cross sectional areas in adolescent and mature volleyball athletes

F. Eckstein 1 , H. Boeth 2 , G. Diederichs 3 , S. Cotofana 1 , M. Hudelmaier 1 , W. Wirth 1 , M. HofmannAmtenbrink 4 , G. Duda 5 ; 1 Paracelsus Med. Univ., Salzburg, AUSTRIA, 2 Julius Wolff Inst., Charite – Univ.smedizin Berlin, Ctr. for Sports Sci. and Sports Med. Berlin, Berlin, GERMANY, 3 Dept. of Radiology, Charite Univ.smedizin Berlin, Berlin, GERMANY, 4 Mat Search Consulting Hofmann, Pully, Switzerland, Pully, SWITZERLAND, 5 Julius Wolff Inst., Charite – Univ.smedizin Berlin, Ctr. for Sports Sci. and Sports Med., Berlin, GERMANY.

Effects of strength and endurance training intervention on thigh intermuscular and subcutaneous adipose tissue in sarkopenic women

Effects of strength and endurance training intervention on thigh intermuscular and subcutaneous adipose tissue in sarkopenic women

Effect of increased axial rotation angle on bone mineral density measurements of the lumbar spine

Background contextOsteoporosis frequently occurs in elderly people and is commonly associated with neuromuscular diseases or severe cerebral palsy. Osteoporosis can cause pain via compression fractures or secondary neurologic deficits; thus, accurate evaluation of bone mineral density (BMD) is essential for the prevention and treatment of osteoporosis. However, spinal axial rotation caused by scoliosis may affect the outcome of BMD tests, such that BMD measurements may be significantly greater than actual BMD in patients with severe scoliosis of the spine. PurposeWe investigated the effect of axial rotation angle on BMD measurements of the phantom spine. Study design/settingInvestigation for the effect of axial rotation with aluminum phantom spine. MethodsA GE-Lunar Aluminum Spine Phantom was used to assess BMD. Bone mineral content (BMC), BMD, and cross-sectional area were measured 100 times at L1–L4 using a GE Lunar Prodigy Vision system. Dual-energy X-ray absorptiometry was performed at axial rotation angles of 0° to 25° (5° intervals). ResultsCross-sectional area decreased and BMD values increased as the axial rotation angle increased, whereas BMC did not change significantly. A fitting function was obtained to evaluate the relationships among axial rotation angle, cross-sectional area, and BMD. We obtained an equation to estimate BMD at L1–L4: 1.000−0.001674x+0.0001043x2−0.000005333x3, where x denotes the axial rotation angle. We found that the observed BMD needed adjustment when the angle was more than 5°. ConclusionsBone mineral density values may be overestimated in patients with even slight (>5°) axial rotation. When osteoporosis is suspected in a clinical setting, the degree of axial rotation should be measured on a lumbar spine X-ray.