Bone Mass Measurements Research Articles

Effects of Creatine Monohydrate Supplementation on Muscle, Bone and Brain- Hope or Hype for Older Adults?

Sarcopenia, generally characterized by the age-related reduction in muscle strength, lean/muscle mass and functional ability, is also associated with reduced bone mass and strength and impaired brain health and function. One potential intervention which has received much 'hype' over the past few decades to countermeasure these negative consequences of biological aging is creatine monohydrate supplementation. From a skeletal muscle perspective, the combination of creatine monohydrate supplementation and resistance training provides 'hope' for older adults as it improves measures of lean mass, regional (limb) muscle thickness, upper- and lower-body muscle strength and functional ability. Further, there is some evidence that creatine (supplementation or habitual diet) provides a ray of 'hope' for improving some aspects of cognitive function. The majority of research suggests that creatine is more 'hype' than 'hope' for improving measures of bone mass in older adults. Creatine monohydrate supplementation provides some anti-sarcopenic benefits for older adults.

Diabetes disrupts osteometric and trabecular morphometric parameters in the Zucker Diabetic Sprague-Dawley rat femur.

Type 2 diabetes mellitus is increasingly becoming more prevalent worldwide together with hospital care costs from secondary complications such as bone fractures. Femoral fracture risk is higher in diabetes. Therefore, this study aimed to assess the osteometric and microarchitecture of the femur of Zucker Diabetic Sprague-Dawley (ZDSD) femur. Ten-week-old male rats (n=38) consisting of 16 control Sprague-Dawley (SD) and 22 ZDSD rats were used. The rats were terminated at 20 weeks and others at 28 weeks of age to assess age, diabetes duration effects and its severity. Bilateral femora were taken for osteometry, bone mass measurements and micro-focus X-ray computed tomography scanning to assess the trabecular number (TbN), thickness (TbTh), spaces (TbSp), bone tissue volume to total volume (BV/TV) and volume (BV). Diabetic rats had shorter (except for 20-weeks-old), lighter, narrower, and less robust bones than SD controls that wered more robust. Although cortical area was similar in all diabatic and control rats, medullary canal area was the largest in ZDSD rats. This means that the diabetic rats bones were short, light and hollow. Diabetic rats aged 20 weeks had reduced BV, BV/TV, TbN with more spacing (TbSp). In contrast, the 28 weeks old diabetic rats only showed reduced BV and TbN. Discriminant function analysis revealed, for the first time, that osteometric parameters and TbTh, TbN, and TbSp were affected by diabetes. This knowledge is valuable in the management of diabetic complications.

Structural differences contributing to sex-specific associations between FN BMD and whole-bone strength for adult White women and men.

Hip areal BMD (aBMD) is widely used to identify individuals with increased fracture risk. Low aBMD indicates low strength, but this association differs by sex with men showing greater strength for a given aBMD than women. To better understand the structural basis giving rise to this sex-specific discrepancy, cadaveric proximal femurs from White female and male donors were imaged using nano-CT and loaded in a sideways fall configuration to assess strength. FN pseudoDXA images were generated to identify associations among structure, aBMD, and strength that differ by sex. Strength correlated significantly with pseudoDXA aBMD for females (R2 = 0.468, P < .001) and males (R2 = 0.393, P < .001), but the elevations (y-intercepts) of the linear regressions differed between sexes (P < .001). Male proximal femurs were 1045 N stronger than females for a given pseudoDXA aBMD. However, strength correlated with pseudoDXA BMC for females (R2 = 0.433, P < .001) and males (R2 = 0.443, P < .001) but without significant slope (P = .431) or elevation (P = .058) differences. Dividing pseudoDXA BMC by FN-width, total cross-sectional area, or FN-volume led to significantly different associations between strength and the size-adjusted BMC measures for women and men. Three structural differences were identified that differentially affected aBMD and strength for women and men: First, men had more bone mass per unit volume than women; second, different cross-sectional shapes resulted in larger proportions of bone mass orthogonal to the DXA image for men than women; and third, men and women had different proportions of cortical and trabecular bone relative to BMC. Thus, the proximal femurs of women were not smaller versions of men but were constructed in fundamentally different manners. Dividing BMC by a bone size measure was responsible for the sex-specific associations between hip aBMD and strength. Thus, a new approach for adjusting measures of bone mass for bone size and stature is warranted.

Can bone mass measured via bioelectrical impedance analysis be used to diagnose sarcopenia?

The simplification of diagnostic criteria is critical to promoting interventions for sarcopenia. This study aimed to evaluate the relationship between sarcopenia and bone mass [measured by bioelectrical impedance analysis (BIA)], as well as to identify new indicators associated with this disease. Basic interviews and measurement of physical function were performed on 474 community-dwelling older adults (aged 77.1 ± 7.6 years), including older adult patients with sarcopenia, in Wakasa Town, Fukui Prefecture. The findings led to 363, 71, and 40 participants being classified as 'normal', 'pre-sarcopenia', and 'having sarcopenia', respectively. An Ordinal Logistic Regression Analysis showed that age, bone mass phase angle (lower limb), Fat-free Mass Index, and leg muscle score were aggravating factors for sarcopenia in both men and women. A receiver operating characteristic analysis of bone mass and sarcopenia status showed that the area under the curve and cut-off value, as well as its sensitivity and specificity, in men were 0.915 [95% confidence interval (CI): 0.853-0.977], 2.2 kg, 81%, and 87%, respectively, and 0.913 (95% CI: 0.858-0.968), 1.6 kg, 91%, and 88%, respectively, in women. This study revealed that the BIA method of measuring bone mass has excellent accuracy in detecting sarcopenia in both males and females.

Age-related variations in trunk composition and patterns of regional bone and soft tissue changes in adult Caucasian women by DXA.

We explored the regional variations in body composition with advancing age in healthy Caucasian females living in the Mediterranean area. The objectives of this study were to establish body composition values for the trunk in healthy women of a Greek origin and to evaluate the effects of aging on the distribution of truncal bone mass, fat mass (FM) and lean mass (LM). Body composition of the trunk and detailed analysis of its anatomical components-the ribs, the thoracic spine, the lumbar spine and the pelvis, and FM and LM ratios--were calculated in 330 women aged 20-85years, using DXA. Peak bone mineral density (BMD) of the trunk was attained between ages 30 and 33. The overall truncal BMD reduction with age was 20.7% (p < 0.001). Peak %LM of the trunk was achieved at age 20. The overall reduction of %LM with age for the trunk was 9.8% (p < 0.001). Peak %FM of the trunk was attained between ages 68 and 73, and the overall %FM reduction with age was 2.8% (p > 0.05). Multiple comparative analyses showed that the 51-60years age group was the landmark age for significant changes of truncal bone mass measures across all age groups (p = 0). For truncal LM and FM metrics, multigroup comparative analysis showed the turning point of significant changes in soft tissue was the 41-50 age bracket (p = 0 and p = 0, respectively). In Greek women, truncal %LM exceeded by far %FM across all ages (p = 0). Our results suggest that aging affects body composition of the trunk in ambulatory healthy women of a Greek origin differently, leading to menopausal loss of bone mass, senior adulthood loss of lean mass, and middle-age storage of fat mass. In adult women, these age-related associations between bone and soft tissue metrics on DXA exams carry implications for the attainment of optimal peak values and shifts in body composition overtime, impacting lifelong skeletal health.

Association of insulin resistance with bone mineral density in a nationwide health check-up population in China.

Insulin resistance (IR) is closely associated with cardio-metabolic diseases. However, the impact of IR on bone mass remains obscure. The present study is to evaluate the association between the triglyceride-glucose (TyG) indicated IR and bone mass in a nationwide health check-up population in China. We conducted a retrospective cross-sectional study including 788,247 participants and a longitudinal cohort study in 8770 participants who had repeated measurements of TyG index and bone mass in at least a 2-year follow-up period. The restricted cubic splines and logistic models were used to analyze the association between IR and bone mass in the cross-sectional study. The Cox model was applied to evaluate the relationship between baseline IR and the subsequent incidence of low bone mass and osteoporosis in the longitudinal study. In the cross-sectional study, the TyG index had positive correlations with low bone mass, osteoporosis, or both after adjusting for confounding factors (all P<0.001). In the longitudinal cohort study, the baseline TyG index was significantly associated with the incidence of low bone mass, osteoporosis, or both during the follow-up period, with hazard ratios (HRs) of 1.56 (95% confidence interval [CI]: 1.25, 1.93, P<0.05), 1.66 (95%CI: 1.06, 2.59, P<0.05), and 1.55 (95%CI: 1.27, 1.88, P<0.05) after adjusting for confounding factors, respectively. These results suggest that IR indicated by TyG is significantly associated with an increased risk of low bone mass and osteoporosis. Therefore, bone mass monitoring and early prevention strategies may be needed in individuals with IR to prevent the occurrence of low bone mass and osteoporosis.

Vitamin D status, including serum levels and sun exposure are associated or correlated with bone mass measurements diagnosis, and bone density of the spine

BackgroundOsteoporosis is a health complication worldwide, especially in developing countries. The prevalence was reported to be 18.3% globally. While the effect of biochemical factors on fracture risk/odds has been documented, the association/correlation between serum 25(OH)D levels, vitamin D dietary intake, and sun exposure with bone mineral density (BMD) remains controversial. This study aimed to evaluate the association and correlation between vitamin D status, including serum levels, dietary intakes, and sun exposure with BMD. We hypothesized that vitamin D-related factors would have different correlations/associations with BMD, which would help better evaluate future studies’ results.MethodsA total of 186 individuals were included in this study (winter 2020). BMD was measured by Dual-energy X-ray absorptiometry. Blood serum levels of 25(OH)D, phosphorus, calcium, parathyroid hormone (PTH), and calcitonin were tested using standard lab tests. Valid and reliable questionnaires were used for sun exposure assessment and dietary intakes.ResultsThere was a significant protective association between spine BMD (classifications, two groups) (OR = 0.69, 95%CI: 0.50–0.94; p-value = 0.023), BMD diagnosis (classifications, two groups) (OR = 0. 69, 95%CI: 0.49–0.87; p-value = 0.036) and sun exposure. There was a significant and moderate correlation between Spine measurements (Spine BMD: Pearson correlation coefficient = 0.302, p-value = 0.046; Spine T-score: Pearson correlation coefficient = 0.322, p-value = 0.033, Spine Z-score: Pearson correlation coefficient = 0.328, p-value = 0.030) and serum 25(OH)D. In addition, participants with osteopenia and osteoporosis significantly consume a higher amount of soluble fiber than the normal BMD group. There was no significant correlation between vitamin D intake and BMD.ConclusionIn conclusion, serum 25(OH)D levels and sun exposure are correlated and associated with BMD. However, prospective studies are needed to investigate the association between dietary vitamin D intake and BMD.

The study of bone mass measurement by clavicle radiogrammetry in a comparison to the dual energy x-ray absorptiometry examination

Background: Clavicle radiogrammetry test related to chest radiography has been found to be useful in evaluation of osteoporosis. The diagnosis of osteoporosis was based on the measurement of bone mineral density (BMD) with dual energy x-ray absorptiometry. Objectives: The aim of this study was to evaluate bone mass measurement using clavicle radiograms to differentiate the goal standards related to the dual energy x-ray absorptiometry methods. Materials and methods: The population sample consisted of a 100 healthy Thai adult volunteers, (50 women, 50 men) aged from 24 to 76 years. The study subjects were divided as normal bone mass group, T-score ≥ -1.0 and the low bone mass group, T-score ≤ -1.0. Subsequently, posteroanterior (PA) chest radiographs were taken. Measurements of the clavicle radiograms were evaluated, and the images at the midshaft of both clavicles were calculated. An independent t-test was used to examine the differences between the normal and the low bone mass of each gender and two separate BMD sites. The confidence interval was 95% at level of significance 0.05. Pearson’s correlation was used to measure the strength and direction of linear relationship between the bone mass measurement using the dual energy x-ray absorptiometry (DEXA) test and clavicle radiogrammetry test. Results: The results showed 18 women and 28 men maintained a normal BMD, while 32 women and 22 men had low bone mass density. The average clavicle thickness measurements of the normal bone mass of the women group were lower than the normal bone mass measurements of men. Conversely, the low bone groups of women measurements were higher than low bone mass in the men’s group. A greater diminishing of cortical thickness of clavicle was found in the low bone mass than normal group for both genders. The average cortical thickness of clavicle in the low bone mass of women decreased by 17.8% (5.31 mm/6.46 mm) compared to normal women, while in men, which were fewer, 16.13% (7.07 mm/8.43 mm) between groups, respectively. The average measurements of the clavicle periosteal width and combined cortical thickness of clavicle showed a positive correlation with BMD, whereas, the clavicle endosteal width showed a negative correlation with BMD. Conclusion: Using the radiogrammetric method to measure the clavicle cortex thickness on the chest x-ray images showed a gradual thinning of the cortex with aging. By comparison, the measurements of clavicle cortex thickness showed a moderate relationship with BMD performed by DEXA in the assessment of osteoporosis.

Relation between Biochemical Parameters and Bone Density in Postmenopausal Women with Osteoporosis.

Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry (DXA) is an accurate non-invasive system measuring bone density, with a low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using the DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase, and magnesium were measured by an autoanalyzer, and serum levels of vitamin D were measured by high-performance liquid chromatography (HPLC). The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium did not show a significant difference between the two groups (P-value > 0.05). In the control group, the relationship between alkaline phosphatase and bone mineral content (BMC) and bony area (BA) in the spine was significant with a correlation coefficient of - 0.402 and 0.258, respectively (P-value < 0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus (correlation = 0.368; P value = 0.038). There was a significant relationship between the Z-score with calcium (correlation = 0.358; P value = 0.044). There was no significant relationship between the values of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium parameters and bone density (spine and hip) in postmenopausal women with osteopenia or osteoporosis.

Increased Dietary Protein to Energy Ratio in Pre-Weaning Lambs Increases Average Daily Gain and Cortical Bone Thickness in the Tibia

The objective of this study was to examine if diets differing in crude protein (CP) to metabolizable energy (ME) ratio (CP:ME) pre-weaning altered peripheral quantitative computed tomography (pQCT) measures of bone mass and strength in lambs. The left hind leg of lambs were available at the completion of a trial designed to examine the effect that altering the CP:ME ratio in milk replacer had on growth and body composition of pre-weaned lambs reared artificially. Treatments consisted of either normal commercial milk replacer (CMR, n = 10) containing 240 g/kg CP and 21.89 MJ/kg ME, high protein milk replacer (HPM, n = 9) containing CMR with additional milk protein concentrate to reach 478.7 g/kg CP and 19.15 MJ/kg ME or a mix of normal milk replacer and milk protein concentrate adjusted twice-weekly to match optimal CP:ME requirements (MB, n = 8) based on maintenance plus 300 g/d liveweight gain. At 22 kg live weight, lambs were euthanized and the tibia including the surrounding muscle was collected and scanned using pQCT at the mid-diaphysis. Lambs on the HPM and MB diets had a greater average daily gain (p &lt; 0.01). There were limited differences in bone morphology and muscle mass, though notably the higher protein diets (MB and HPM) were associated with greater cortical thickness (p &lt; 0.05) and, therefore, potentially greater peak bone mass at maturity This finding demonstrates that pre-weaning diets, and the protein content in particular, may influence the developmental potential of long bones and attainment of peak bone mass at maturity.

The effect of the root dilaceration on the treatment duration and prognosis of unilateral impacted immature maxillary central incisors

This study aimed to investigate the effect of root dilaceration on the closed-eruption technique treatment and prognosis on impacted immature maxillary central incisors. In this retrospective study, we compared the age at the beginning of the treatment, the treatment duration, root development, and alveolar bone mass after the closed-eruption technique between the impacted immature maxillary central incisors with dilacerated roots (group 1) and those with straight roots (group 2). The mean age at the time of the surgery of group 1 was 0.9 years younger than that of group 2 (P= 0.008). The mean traction time was greater in group 1 (8.0 ± 1.8 months), with a difference of 1.4 months than in group 2 (6.6 ± 2.1 months) (P= 0.042). The measurements of lingual bone thickness at the alveolar crest (C) showed significant differences between the 2 groups (P= 0.025). No significant differences were found in other treatment duration or measurements of root development and alveolar bone mass between the 2 groups. Patients with impacted immature incisors with dilacerated roots were younger at the beginning of the closed-eruption treatment and had a longer traction time than those with impacted immature incisors having straight roots. The root dilaceration had little or no effect on root development and alveolar bone mass after the closed-eruption treatment. The closed-eruption treatment of impacted immature incisors with root dilaceration is suggested to commence as early as possible.

Epidemiology of injuries in elite Korean adolescent football (soccer) athletes: A prospective cohort study

Abstrct Objectives This study attempted to analyze the injury patterns during training by sex and determine whether cardiopulmonary function and bone mineral density (BMD) were related to the patterns of injuries in elite adolescent footballers. Methods Since 2021, data for consisted of 96 adolescent football athletes (52 men and 44 women) who underwent intensive training in Korea and participated in competitions. For cardiopulmonary function, minute ventilation (VE), volume oxygen maximum (VO2max), and ventilation threshold (VT) were measured. BMD was measured measure systemic BMD and bone mass. The injury incidence rates (IIR) per 1000 training of hours. χ2 tests were performed to compare injury patterns between sex. Simple linear regression was used to evaluate the relationship between variables. Results The overall IIR was 4.80 (4.32–5.32) per 1000 h of training. Female had a higher rate than male (p=0.008). We observed differences in injury severity between men and women (p=0.040). Both the cardiopulmonary function and BMD were related to IIR in all athletes. The body regions with the most injuries were the lower extremities (52.05%), trunk (23.84%), upper extremities (16.71%), and head and neck (7.40%). Cardiopulmonary function and BMD were not related to the location of the injury. However, Cardiopulmonary function and BMD were related to the IIR of severe and ligament injury. Conclusion The sex was found to affect rate and severity of injury. Cardiopulmonary function and BMD were related to the injury patterns. Our findings can help promote the performance improvement of elite football athletes and the development of injury prevention program.

The interplay between BMU activity linked to mechanical stress, specific surface and inhibitory theory dictate bone mass distribution: Predictions from a 3D computational model

Bone mechanical and biological properties are closely linked to its internal tissue composition and mass distribution, which are in turn governed by the purposeful action of the basic multicellular units (BMUs). The orchestrated action of osteoclasts and osteoblasts, the resorbing and forming tissue cells respectively, in BMUs is responsible for tissue maintenance, repair and adaptation to changing load demands through the phenomenon known as remodelling. In this work, a computational mechano-biological model of bone remodelling based on the inhibitory theory and a new scheme of bone resorption introduced previously in a 2D model, is extended to a 3D model of the real external geometry of a femur under normal walking loads. Starting from a uniform apparent density (ratio of tissue local mass to total local volume) distribution, the BMU action can be shown to lead naturally to an internal density distribution similar to that of a real bone, provided that the initial density value is high enough to avoid unrealistic final mass deposition in zones of high energy density and excessive damage. Physiological internal density values are reached throughout the whole 3D geometry, and at the same time a ‘boomerang’-like relationship between apparent and material density (ratio of tissue mass to tissue volume) emerges naturally under the proposed remodelling scheme. It is also shown here that bone-specific surface is a key parameter that determines the intensity of BMU action linked to the mechanical and biological requirements. Finally, by engaging in simulations of bone in disuse, we were able to confirm the appropriate selection of the model parameters. As an example, our results show good agreement with experimental measurements of bone mass on astronauts a fact that strengthens our belief in the insightful nature of our novel 3D computational model.

Assessment of Total Procollagen Type 1 Intact N-terminal Propeptide, C-telopeptide of type 1 collagen, Bone Mineral Density and its Relationship to Body Mass Index in Men with Type 2 Diabetes

Background: Type 2 diabetes negatively affects the biochemical parameters of bone turnover more than obesity and is associated with an increased risk of osteoporosis and fragility fractures. Obesity and type 2 diabetes (T2DM) are linked to increased fracturing risk; however, the effect of obesity on diabetes-related bone deficit is unknown. Objective: The goal of this research is to compare the indications, bone density, and bone turnover in T2DM men and a control group, and to investigate the effect of body mass index on bone turnover levels. Subjects, Material and Method: This case-control study was conducted on 120 men whose ages were from 40 - 69 years. They were grouped into two categories: T2DM (n=80) and healthy control (n=40). Serum samples from both groups were analyzed for blood glucose, Calcium and Albumin, by using (Cobas c111), PTH by (Cobas e 411), P1NP and CTX-1 levels in the serum using ELISA kits. Participants underwent (DEXA) measuring Bone Mass Density (BMD) at the lumbar spine. Results: The control (obese and non-obese) participants had statistically significant higher levels of CTX-1 and P1NP than the patients (obese and non-obese) (P-value = 0.000). There was no significant differences in Spine BMD, T-score (p-value = 0.27 and 0.37 respectively). Conclusion: Men with T2DM had a low bone turnover level and deteriorated bone quality compared to controls. The obese healthy controls can maintain healthy bone metabolism if T2DM is prevented.

Using linear and natural cubic splines, SITAR, and latent trajectory models to characterise nonlinear longitudinal growth trajectories in cohort studies

BackgroundLongitudinal data analysis can improve our understanding of the influences on health trajectories across the life-course. There are a variety of statistical models which can be used, and their fitting and interpretation can be complex, particularly where there is a nonlinear trajectory. Our aim was to provide an accessible guide along with applied examples to using four sophisticated modelling procedures for describing nonlinear growth trajectories.MethodsThis expository paper provides an illustrative guide to summarising nonlinear growth trajectories for repeatedly measured continuous outcomes using (i) linear spline and (ii) natural cubic spline linear mixed-effects (LME) models, (iii) Super Imposition by Translation and Rotation (SITAR) nonlinear mixed effects models, and (iv) latent trajectory models. The underlying model for each approach, their similarities and differences, and their advantages and disadvantages are described. Their application and correct interpretation of their results is illustrated by analysing repeated bone mass measures to characterise bone growth patterns and their sex differences in three cohort studies from the UK, USA, and Canada comprising 8500 individuals and 37,000 measurements from ages 5–40 years. Recommendations for choosing a modelling approach are provided along with a discussion and signposting on further modelling extensions for analysing trajectory exposures and outcomes, and multiple cohorts.ResultsLinear and natural cubic spline LME models and SITAR provided similar summary of the mean bone growth trajectory and growth velocity, and the sex differences in growth patterns. Growth velocity (in grams/year) peaked during adolescence, and peaked earlier in females than males e.g., mean age at peak bone mineral content accrual from multicohort SITAR models was 12.2 years in females and 13.9 years in males. Latent trajectory models (with trajectory shapes estimated using a natural cubic spline) identified up to four subgroups of individuals with distinct trajectories throughout adolescence.ConclusionsLME models with linear and natural cubic splines, SITAR, and latent trajectory models are useful for describing nonlinear growth trajectories, and these methods can be adapted for other complex traits. Choice of method depends on the research aims, complexity of the trajectory, and available data. Scripts and synthetic datasets are provided for readers to replicate trajectory modelling and visualisation using the R statistical computing software.

Bone mass measurement by DXA should be interpreted with caution in the CKD population with vascular calcification

BackgroundKDIGO guidelines suggest the use of dual-energy X-ray absorptiometry (DXA) to assess bone mineral density (BMD) in patients with CKD 3a-5D. Previous studies have demonstrated an association between trabecular bone mass loss and coronary artery calcification (CAC) progression. This study aimed to prospectively investigate the relationship between BMD changes, quantified by DXA, and CAC progression in the non-dialyzed CKD population. MethodsIn this post hoc study, BMD by DXA was measured at the lumbar spine and total hip at baseline and 12-months. Patients were categorized according to BMD changes into 3 different groups: LOSS, UNCHANGED and GAIN. CAC quantification was obtained by multislice computed tomography at baseline and 12-months. Results87 patients (55.6 ± 10.7 years, 62% males, 30% diabetic, eGFR = 39.2 ± 18.1 mL/min/1.73m2) were enrolled. CAC was found in 41 (47%) of the patients at baseline and CAC progression in 25 (64%) of them. Considering the lumbar spine and total hip BMD changes together, 24%, 48%, and 25% of the patients were in the LOSS, UNCHANGED and GAIN groups, respectively. Compared to the UNCHANGED or LOSS groups, the GAIN group had an increase in calcium score (p = 0.04) and a higher proportion of patients with CAC progression (p = 0.01). In the logistic regression analysis, CAC progression was 4.5 times more likely to be in the GAIN group. ConclusionsThe association between the increase in BMD values and the progression of vascular calcification was the result of two concomitant processes overlapping, leading to a misinterpretation of DXA results. Thus, the use of DXA for the evaluation of bone mass, especially at the lumbar spine, must be applied with restraint and its results very carefully interpreted in CKD patients.

Evaluation of Clinical and Laboratory Factors Affecting Bone Mineral Density Measurements in Patients with Kidney Transplant

Histological evidence of osteodystrophy and osteopenia is encountered in most patients who have undergone successful renal transplantation. Renal transplantation may be beneficial for correcting uremia-related problems in end-stage renal disease patients; however, its benefit is limited in bone metabolism disorders. The present study aims to evaluate bone mass measurements and investigate the influencing factors in patients with renal transplant. One hundred and eighteen patients (83 males and 35 females) with a mean age of 40.2 ± 11.8 yr (range 20-67) were included in the present study. The laboratory and the clinical data of the patients were retrospectively analyzed. The association between bone mineral density (BMD) measurements and the demographic characteristics of the patients, serum creatinine, parathormone, calcium, phosphorous, alkaline phosphatase, 25-hydroxyvitamin D and the glomerular filtration rate were evaluated. Of the patients, 23.7% (n =28) had normal, 48.3% (n = 57) had osteopenic and 28% (n = 33) had osteoporotic BMD values. A significant positive correlation was determined between the body mass index (BMI) and the BMD measurement results (p = 0.001; r = 0.385). A negative correlation was determined between the BMD values and the serum parathormone (p = 0.012; r = -0.237). BMD values were significantly lower in the group that had not received mammalian target of rapamycin (mTOR) inhibitor (p = 0.026).Conclusion: BMI values, mTOR inhibitor treatment and serum parathormone levels had an effect on the BMD measurement values.

Adolescent female handball players present greater bone mass content than soccer players: A cross-sectional study.

Osteoporosis is a systemic disease affecting half of women over the age of 50years. Considering that almost 90% of peak of bone mass is achieved until the second decade of life, ensuring a maximal bone mineral content acquisition may compensate for age-associated bone loss. Among several other factors, physical activity has been recommended to improve bone mass acquisition. However, it is unknown whether athletes involved with sports with different impact loading characteristics differ in regards to bone mass measurements. To compare the bone mass content, bone mass density and lean mass of young female soccer players (odd-impact loading exercise), handball players (high-impact loading exercises) and non-athletes. A total of 115 female handball players (15.5±1.3years, 165.2±5.6cm and 61.9±9.3kg) and 142 soccer players (15.5±1.5years, 163.7±6.6cm and 56.5±7.7kg) were evaluated for body composition using a dual-emission X-ray absorptiometry system, and 136 female non-athletes (data from NHANES) (15.1±1.32years, 163.5±5.8cm and 67.2±19.4kg) were considered as the control. Handball players presented higher bone mass content values than soccer players for upper limbs (294.8±40.2g and 270.7±45.7g, p<0.001), lower limbs (1011.6±145.5g and 967.7±144.3g, p=0.035), trunk (911.1±182.5g and 841.6±163.7g, p=0.001), ribs (312.4±69.9g and 272.9±58.0g, p<0.001), spine (245.1±46.8g and 222.0±45.1g, p<0.001) and total bone mass (2708.7±384.1g and 2534.8±386.0g, p<0.001). Moreover, non-athletes presented lower bone mass content for lower limbs (740.6±132.3g, p<0.001), trunk (539.7±98.6g, p<0.001), ribs (138.2±29.9g, p<0.001), pelvis (238.9±54.6g, p<0.001), spine (152.8±26.4g, p<0.001) and total bone mass (1987.5±311.3g, p<0.001) than both handball and soccer players. Handball players also presented higher bone mass density values than soccer players for trunk, ribs and spine (p<0.05) and handball and soccer players presented higher bone mass density than non-athletes for all measurements (p<0.005). Finally, the non-athletes' lower limb lean mass was lower than soccer and handball players values (p<0.05). Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than non-athletes. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.

Parathyroid Hormone-Related Changes of Bone Structure.

Parathyroid hormone (PTH) increases the release of serum calcium through osteoclasts, which leads to bone resorption. Primary, PTH stimulates osteoblasts leading to increase RANKL (receptor activator for nuclear factor kappa-B ligand) expression and thus differentiation of osteoclasts. In kidneys, PTH increases calcium and decrease phosphate reabsorption. In kidneys, PTH stimulates 1alpha-hydroxylase to synthesize active vitamin D. Primary hyperparathyroidism (PHPT) is characterized by skeletal or renal complications. Nowadays, the classical form of PHPT is less seen and asymptomatic or subclinical (oligo symptomatic) forms are more frequent. Previously, it was thought that cortical bone is preferably affected by PHPT and that predispose bones to fracture at sites with a higher amount of cortical bone. However, an increased risk of vertebral fractures has been found by most of the studies showing that also trabecular bone is affected. Bone Mass measurement (BMD) at all skeletal sites is advised, but another specific tool for fracture assessment is needed. Trabecular bone score (TBS), an indirect measure of trabecular bone, maybe a useful method to estimate fracture risk. TBS is associated with vertebral fractures in PHPT regardless of BMD, age, BMI and gender. Furthermore, there is an association between TBS and high resolution peripheral quantitative computed tomography (HR-pQCT) parameters in the trabecular and cortical compartment. However, studies considering the effect of PHPT treatment on TBS are more conflicting. Secondary hyperparathyroidism caused by vitamin D deficiency was associated with impaired bone microarchitecture in all age categories, as measured by TBS and Hr-pQCT with further improvement after treatment with vitamin D.

Fat mass as the main contributor to the Body Mass Index of obese patients in Banyumas Regency

Body Mass Index (BMI) measurement is the indicator most often used to identify whether a person is obese or not. However, BMI is not always synonymous with body fat mass because many other body components that play a role in determining BMI, such as muscle mass and bone mass. This study aims to determine whether the BMI of obese patients can represent body fat mass. This study was a cross-sectional study. A total of 76 obese women aged 18-34 years were taken by consecutive sampling. The examination of height and weight were performed to determine the BMI. Meanwhile, the measurements of fat mass, muscle mass, and bone mass were carried out using a bioelectric impedance analyzer (BIA). Analysis of data used Pearson correlation test and Multiple Linear Regression analysis. The level of significance was at p&lt;0.05. The results of the Pearson correlation test showed that there was a significant correlation between fat mass, muscle mass, bone mass, and BMI (p=0.000). Multivariate test using Multiple Linear Regression analysis showed that only fat mass has a significant relationship with BMI (p=0.000), R square=0.978, and the regression equation BMI = -2.860+0.807 fat mass. The main contributor to the BMI of obese patients in Banyumas was fat mass. For every 1% increase in fat mass, the BMI will increase by 0.807