Bone Mineral Density In Group Research Articles

Effect of Recombinant Human Parathyroid Hormone on Rotator Cuff Healing After Arthroscopic Repair

To assess the effect of teriparatide, a recombinant human parathyroid hormone, on rotator cuff healing after arthroscopic repair compared with patients who were not treated with teriparatide. This was a prospective propensity-matched study. Thirty-one patients who underwent arthroscopic rotator cuff repair for tears >2cm in size between January 2015 and June 2016 were recruited (group I). Daily subcutaneous injections of teriparatide 20μg were administered for 3months following surgery. In the same period, propensity score matching (1-to-4) was performed to generate an untreated control group undergoing rotator cuff repair alone (group II) with the same tear size. Magnetic resonance imaging evaluation of tendon healing was performed at least 1year postoperatively, as well as the range ofshoulder motion, American Shoulder and Elbow Surgeons score, Constant score, and simple shoulder test. There was no significant difference of the retraction size, the anterior to posterior dimension of torn rotator cuff, or the preoperative bone mineral density in groups I and II (P= .78, .87, and .96, respectively). The rate of retear was significantly lower in group I than in group II (16% vs 33.9%; P= .04). Range of motion and functional scores were not significantly different between the 2 groups (P > .05). Teriparatide, a recombinant human parathyroid hormone, can be a systemic treatment option that significantly enhances the tendon-to-bone healing after arthroscopic rotator cuff repair for patients with rotator cuff tears >2cm. Level III, case-control study.

The Correlation between Osteoporosis and Blood Circulation Function Based on Magnetic Resonance Imaging.

In order to investigate the relationship between changes in blood circulation and bone mineral density (BMD) loss, the characteristic parameters reflecting the function of tissue oxygen metabolism are obtained by means of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI), image processing and semi-quantitative analysis. The correlation and variance analysis of the characteristic parameters of different BMD groups are carried out, and the physiological parameters of bone marrow blood perfusion are obtained by dynamic enhanced MRI (DCE-MRI). Multivariate logistic regression analysis is carried out with the physiological parameters of blood oxygen metabolism function and bone marrow blood perfusion as independent variables and BMD as dependent variables. It is found that there are significant differences in oxygen metabolism between individual muscles in different BMD groups and between skeletal muscles of different types of muscle fibers. Age, total volume of bone marrow and oxygen metabolism ability of tibial anterior muscle have significant independent effects on osteoporosis. It shows that the changes of blood circulation in bone marrow and surrounding muscle tissue are indeed one of the causes of osteoporosis.

Discovery of potential biomarkers for osteoporosis using LC-MS/MS metabolomic methods.

Our study aimed to evaluate the association of metabolites with bone, trying to find new metabolic markers that are distinguishing for low bone mineral density (BMD). Our study recruited 320 participants, including 138 males and 182 postmenopausal females from the Shanghai area. Bone turnover markers (BTMs), including osteocalcin, PINP and β-CTX, and other biochemical traits were tested. BMD values of the lumber spine (L1-4), femoral neck and total hip were determined using dual-energy X-ray absorptiometry and the serum metabolome profiles including 221 metabolites from five groups (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids and hexose) were assessed by mass spectrometry. No visual separation in the metabolic profiles between different BMD groups was observed in principal component analysis (PCA) or partial least squares discriminant analysis (PLS-DA) models. We compared metabolites in three groups with different BMD levels in males and postmenopausal females separately and further filtering these metabolites via random forest-based feature selection, a commonly applied machine learning algorithm which could select the features with the greatest impact on osteoporosis, then metabolites with the highest importance (≥ 5%) (5 in males and 9 in postmenopausal females) were selected to construct better models for osteoporosis classification. After adding these selected metabolites to the model, the area under the curve (AUC) of receiver operating characteristic (ROC) curves increased significantly (BTMs: AUC 0.729, 95% CI 0.647-0.802, p < 0.0001, model 1: AUC = 0.828, 95% CI 0.754-0.888, p < 0.0001; model 1 versus model of BTMs: p = 0.0158) compared to the AUC of the BTM-only model in males. Similar results were also observed in postmenopausal females (BTMs: AUC = 0.638, 95% CI 0.562-0.708, p = 0.0025; model 2: AUC = 0.741, 95% CI 0.669-0.803, p < 0.0001; model 1 versus model of BTMs: p = 0.0182). Metabolites combined with traditional BTMs tend to better markers for distinguishing osteoporosis in both males and postmenopausal females than BTMs alone.

Status of bone strength and factors associated with vertebral fracture in postmenopausal women with type 2 diabetes.

The aim of this study was to assess the status of bone mass, microarchitecture, and factors associated with vertebral fracture in postmenopausal women with type 2 diabetes mellitus (T2DM). We consecutively enrolled 285 women (aged 60.7 ± 6.9 y) with T2DM who underwent bone mineral density (BMD) and trabecular bone score (TBS) assessment using dual-energy x-ray absorptiometry; T8-S1 lateral spine radiographs; laboratory evaluation; and interviews regarding clinical risk factors based on the fracture risk assessment tool (FRAX). Low bone mass and deteriorated bone microarchitecture were observed in 63.2% and 72.6% of women with T2DM, respectively. TBS was correlated with lumbar spine, femoral neck, and total hip BMD. Significant differences in TBS were observed between the normal BMD, osteopenia, and osteoporosis groups. Age, vertebral fracture, and bone-specific alkaline phosphatase significantly differed among groups with different T scores or those classified by TBS categories. Bone-specific alkaline phosphatase was inversely correlated with BMD and TBS but positively with glycated hemoglobin. BMD showed a weaker correlation with vertebral fracture than TBS, TBS and BMD, FRAX, and TBS-adjusted FRAX. Low bone mass and deteriorated TBS were noted in approximately two-thirds of T2DM women and was also associated with vertebral fracture. In addition to aging, poor glycemic control may play an important role in bone remodeling, which may be associated with changes in bone strength in T2DM women. Bone strength together with clinical risk factors has the strongest association with fracture, and may potentially be useful to identify women with T2DM at risk.

The Effect of an Exercise Intervention During Early Lactation on Bone Mineral Density During the First Year Postpartum.

During lactation, women may lose up to 10% of bone mineral density (BMD) at trabecular-rich sites. Previous studies show that resistance exercise may slow BMD; however, the long-term effects of exercise on BMD during lactation have not been reported. To evaluate the effect of two 16-week exercise interventions (4- to 20-wk postpartum) in lactating women at 1-year postpartum on lumbar spine, total body, and hip BMD. To increase sample size at 1-year postpartum, two 16-week exercise interventions were combined for analysis. At 4-week postpartum, 55 women were randomized to intervention group (weight bearing aerobic exercise and resistance exercise) or control group (no exercise) for 16-week, with a 1-year postpartum follow-up. BMD was measured by dual-energy X-ray absorptiometry. Repeated-measures analysis of covariance was used to test for time and group differences for BMD controlling for prolactin concentration and dietary calcium at 1-year postpartum. Change in lumbar spine BMD was significantly different over time and between groups from 4-week to 1-year postpartum, when controlling for prolactin concentration and dietary calcium. There were no significant differences between groups in total body and hip BMD. These results suggest that resistance exercise may slow bone loss during lactation, resulting in higher BMD levels at 1-year postpartum.

Association between metabolic profiles in urine and bone mineral density of pre- and postmenopausal Chinese women

In the present study, we aimed to characterize the pathological development of menopausal osteoporosis, as well as to explore potential biomarkers and metabolic pathways involved in osteoporosis. Urine samples from 322 female participants categorized by menopause status and different bone conditions were collected and analyzed based on a gas chromatography-mass spectrometry (GC-MS) approach. Multivariate and univariate statistical analyses were carried out for urinary metabolomic profile characterization and comparison. Seventeen metabolites in the low bone mineral density (BMD) groups were clearly differentiated from those in normal BMD groups. Among these 17 differentiating metabolites, taurine, β-alanine, and 5-hydroxycaproic acid were found to be potential biomarkers of osteoporosis. The taurine metabolic pathway and the β-alanine metabolic pathway were found to be related to menopause and bone loss. Based on the GC-MS metabolomic platform, four typical pathological phases during the progression of postmenopausal osteoporosis were described. Several differentiating metabolites and metabolic pathways were found to be closely related to the pathology of postmenopausal osteoporosis. Our results provided a solid foundation for further studies on early diagnosis and pathomechanistic evaluation.

Correlations of Serum Hormones and Bone Mineral Density with Fracture and Balance Ability of Postmenopausal Patients and Effects of Calcitriol.

BackgroundThe aim of this study was to analyze the correlations of serum hormones and bone mineral density (BMD) with fracture and balance ability of postmenopausal patients and effects of calcitriol on them.Material/MethodsThe clinical data of 164 postmenopausal female patients with osteoporosis (OP) treated in our hospital were retrospectively analyzed.ResultsThe incidence rates of OVCF, balance index score (BIS), front-back ratio (FBR), and right-left ratio (RLR) in the normal BMD group, reduced BMD group, and OP group showed increasing trends, and there were statistically significant differences in comparisons among groups (p<0.05). The levels of serum estradiol (E2) and progesterone (P) in the OVCF group were lower than those in the non-OVCF group, and there were statistically significant differences in comparisons between the 2 groups (p<0.05). However, there was no statistically significant difference in the comparison of serum luteinizing hormone (LH) level between the 2 groups (p>0.05). BIS, FBR, and RLR were negatively correlated with E2 and testosterone (T) (p<0.05). With the prolongation of calcitriol treatment time, BIS, FBR, and RLR gradually decreased, but T value gradually increased. At 6 months and 12 months after intervention, BIS, FBR, and RLR had significant differences compared to those before the experiment (p<0.05). (5) Total hip BMD, height, age, and body mass index (BMI) were the independent factors affecting SDI.ConclusionsHip BMD, age, height, and BMI are significantly correlated with OVCF. Calcitriol treatment can increase lumbar BMD and improve balance ability, and these effects become more obvious with prolongation of intervention time.

Magnetic Susceptibility and Fat Content in the Lumbar Spine of Postmenopausal Women With Varying Bone Mineral Density.

Osteoporosis is a systemic disease characterized by low bone mass with increased fracture risk. Quantitative imaging biomarkers are important for accurately predicting fracture risk in patients with osteoporosis. To prospectively study the changes of magnetic susceptibility and fat content in the lumbar spine of postmenopausal females with varying bone mineral density (BMD), and investigate their application to osteoporosis assessment. Cohort. In all, 108 postmenopausal females (58.2 ± 6.7 [range 45-79] years old). Quantitative computed tomography (QCT) performed on a 64-detector CT scanner; quantitative susceptibility mapping (QSM) and mDixon quant MR imaging performed using a 3.0T imaging system with a 16-channel posterior coil. QCT, QSM, and mDixon were performed in 108 postmenopausal females to measure vertebral BMD, susceptibility, and proton-density fat fraction (PDFF). Mean vertebral QSM and PDFF were compared among three BMD cohorts (normal, osteopenic, and osteoporotic). Receiver operating characteristic analyses were performed to evaluate the performance of QSM, PDFF, and QSM+PDFF for assessing osteoporosis. Parameters were compared using Kruskal-Wallis test and Pearson test. Compared with that of the normal BMD group (-17.0 ± 43.6 ppb), vertebral QSM was significantly increased in osteopenia (30.8 ± 47.0 ppb, P < 0.001), and further increased in osteoporosis (82.0 ± 39.9 ppb, P < 0.001). QSM was negatively correlated with BMD (r = -0.70, P < 0.001) and positively correlated with PDFF (r = 0.64, P < 0.001). Compared with the area under the curve (AUC) of PDFF, the AUC of QSM was higher in differentiating between normal and osteoporosis (P = 0.44), and between osteopenia and osteoporosis (P = 0.13), but without statistical significance. The AUC of QSM+PDFF was significantly higher than that of PDFF for differentiating between osteopenia and osteoporosis (0.82 vs. 0.70, P = 0.039). The combination of vertebral susceptibility and fat content may be a promising marker for assessing postmenopausal osteoporosis. 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1020-1028.

Monitoring early developed low bone mineral density in HIV-infected patients by intact parathyroid hormone and circulating fibroblast growth factor 23.

HIV-infected patients have a high prevalence of low bone mineral density (BMD), but BMD changes remain unclear. This cross-sectional retrospective observational study aimed to characterize the prevalence and associated factors of low BMD in HIV patients. Between 1 January 2015 and 31 December 2016, all patients aged 20 years or greater who sought for HIV care were included. BMD was measured by dual-energy X-ray absorptiometry. Multivariable analyses of the association with HIV disease status, treatment and anthropometric parameters were performed. Circulating fibroblast growth factor 23 and intact parathyroid hormone were measured. A total of 137 patients was included; their median age was 39 years old; 97.8% were treated with combination antiretroviral therapy (cART); Body mass index (BMI) was 21.97kg/m2. Sixty-one patients (44.5%) showed low BMD (osteopenia and osteoporosis) based on the WHO criteria. The median BMD was -0.80g/cm2 (IQR, -1.5 to -0.2). The prevalence rate of low BMD was 37% in those who were aged 20-29 years, 45.2% in those who were aged 30-39 years, 45.2% in those who were aged 40-49 years, 45.8% in those who were aged 50-59 years, and 53.8% in those who were aged ≧60 years. More than half of patients (50.4%, 69/137) were younger than 40 years. Compared with normal BMD group, the low BMD group has a higher proportion of secondary hyperparathyroidism (18.0% vs 5.3%, p: 0.026) and a lower median C-terminal FGF23 level (48.92 vs 62.61pg/ml, p: 0.008). Univariate and multivariate analyses of the factors associated with low BMD. We found that only serum intact-parathyroid hormone (iPTH)>69pg/ml (OR, 3.86; 95% CI, 1.14-13.09) was statistically significant associated with low BMD in multivariate analysis. This cohort-based survey showed a high prevalence of low BMD among HIV-infected adults which included young-age patient in an university hospital. Secondary hyperparathyroidism was significantly associated with low BMD. There was no association between FGF23 and low BMD.

Evaluation of bone mineral density and its correlation with homocysteine and other biochemical bone markers in postmenopausal women

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Osteoporosis is more common in post-menopausal women. Early detection of bone loss by bone mineral density helps to confirm the diagnosis of osteoporosis and assesses the future risk of osteoporotic fractures. Recent studies have revealed the association between increased plasma concentrations of homocysteine (Hcy), and reduced bone mineral density. Nevertheless, inconsistencies persist in the literature. Thus, the need for this study arose to investigate the possible relationship between serum Hcy status and bone mineral density on a group of post-menopausal women.&lt;strong&gt; &lt;/strong&gt;The objective of the study was to assess bone mineral density (BMD) in postmenopausal women and to correlate the same with biochemical bone markers like homocysteine, serum alkaline phosphatase (ALP), calcium and phosphorous levels.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; One hundred (100) postmenopausal women were recruited to enter this cross-sectional study. Out of which 86 postmenopausal females, were grouped into osteopenic and osteoporotic based on low t –scores. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DEXA) and serum Hcy, serum ALP, calcium and phosphorus levels were estimated. The relationship of Hcy with BMDand other biochemical markers was estimated using Pearson’s correlation.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Serum Hcy levels were significantly higher in osteoporotic women when compared to other BMD groups, and were inversely correlated with BMD. No statistical difference was seen with other biochemical bone markers like calcium, Phosphorus and ALP.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study shows that Hcy status is associated with BMD in osteoporotic postmenopausal women. BMD evaluation in postmenopausal women with high Hcy levels may have prognostic and therapeutic potentials, which needs to be explored through further Prospective studies.&lt;/p&gt;

Metabolomic profiles associated with bone mineral density in US Caucasian women

BackgroundIndividuals’ peak bone mineral density (BMD) achieved and maintained at ages 20–40 years is the most powerful predictor of low bone mass and osteoporotic fractures later in life. The aim of this study was to identify metabolomic factors associated with peak BMD variation in US Caucasian women.MethodsA total of 136 women aged 20–40 years, including 65 subjects with low and 71 with high hip BMD, were enrolled. The serum metabolites were assessed using a liquid chromatography-mass spectrometry (LC-MS) method. The partial least-squares discriminant analysis (PLS-DA) method and logistic regression models were used, respectively, to examine the associations of metabolomic profiles and individual metabolites with BMD.ResultsThe low and high BMD groups could be differentiated by the detected serum metabolites using PLS-DA (Ppermutation = 0.008). A total of 14 metabolites, including seven amino acids and amino acid derivatives, five lipids (including three bile acids), and two organic acids, were significantly associated with the risk for low BMD. Most of these metabolites are novel in that they have never been linked with BMD in humans earlier. The prediction model including the newly identified metabolites significantly improved the classification of the groups with low and high BMD. The area under the receiver operating characteristic curve without and with metabolites were 0.88 (95% CI: 0.83–0.94) and 0.97 (95% CI: 0.94–0.99), respectively (P for the difference = 0.0004).ConclusionMetabolomic profiling may improve the risk prediction of osteoporosis among Caucasian women. Our findings also suggest the potential importance of the metabolism of amino acids and bile acids in bone health.

Influence of gait on bone strength in turkeys with leg defects.

Leg problems have become more frequent in fast-growing turkeys. The objective of this study was to evaluate the effects of common leg defects on kinetic parameters of gait and biomechanical properties of bone. Nine hundred, day-old, male, Large White turkeys were raised in 48 floor pens. At 42 d of age, turkeys were divided into four categories of leg condition as determined by visual evaluation: Normal, Crooked toes, Shaky legs, and Valgus. Fifteen toms were selected from each group and trained to walk on a pressure sensitive walkway. Gait kinetic data were collected at 92, 115 and 144 d of age. At 145 d of age, turkeys were sacrificed and bones were collected and frozen until analysis. Morphological measurements of femur, tibia and tarsus-metatarsus were recorded. Bone mineral density (BMD) and content (BMC) were obtained using DEXA. Bone strength of tibias was evaluated using a four-point bending test and femurs with a torsion test. ANOVA was used to detect differences among groups, and Tukey's test used for mean separation. There were no differences in BW among different leg conditions. Gait parameters changed as turkeys aged, and age-group interactions were observed on peak vertical force (PVF), contact time, step length (SL) and bipedal cycle. No differences (P > 0.05) were detected in morphological measurements of femur or tibia. Relative asymmetry of femur length was lower (P < 0.05) in Normal and Valgus turkeys than in toms with Crooked toes. There were no differences (P > 0.05) among groups for femur BMD, BMC or strength. Tibia BMD and the area moment of inertia of turkeys with Crooked toes were lower (P < 0.05) than in toms with Valgus. With all four leg conditions, femur strength was positively correlated with PVF and negatively correlated with SL; BMD and BMC were correlated with tibia strength and gait kinetic parameters. In conclusion, only crooked toes caused consistent differences in gait patterns, bone properties and bone strength, but in general, gait kinetics was correlated with bone biomechanics in turkeys.

Transcriptomic Data Identified Key Transcription Factors for Osteoporosis in Caucasian Women.

Osteoporosis is a prevalent bone metabolic disease, mainly caused by excessive bone resorption (by osteoclasts) over bone formation (by osteoblasts). Identifying the key transcription factors and understanding the regulatory network influencing osteoclastogenesis will be helpful to explore the potential biological mechanism for osteoporosis. In our study, peripheral blood monocyte (PBM) was used as a cell model for bone mineral density (BMD) research. PBMs serve as progenitors of osteoclasts and produce important cytokines for osteoclastogenesis. In our study, via exon arrays, gene expression profiles of PBMs were analyzed between high versus low hip BMD groups. Transcription factors for differentially expressed genes were then predicted based on the enrichment analysis. We found that 591 genes were differentially expressed between the two BMD groups (nominally significant, raw p value < 0.05). For high BMD subjects, 482 genes were up-regulated and 109 genes were down-regulated. We then found 29 potential transcription factors for up-regulated genes and nine transcription factors for down-regulated genes. Among these transcription factors, HMGA1 and NFKB2 were differentially expressed between high versus low BMD groups. In addition, their regulation types with their target genes were consistent with the information from public databases. Our findings of key transcription factors and their target genes for osteoporosis were further validated by GWAS analysis. Overall, we predicted important transcription factors for osteoporosis. We were also able to infer the regulatory mechanism that exists between transcription factors and target genes in bone metabolism.

Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density.

Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD). Twenty-one human L2 vertebral bodies from donors between 19 and 96years of age were used for in vitro experiments. BMD was measured using quantitative computed tomography (QCT). Two pedicle screws were inserted in each specimen and unilaterally augmented with bone cement. Fatigue testing was performed using a cranio-caudal sinusoidal, cyclic load (0.5Hz) with increasing compression force (100N + 0.1N/cycles). Results were evaluated for the BMD groups: normal: BMD > 120mg/cm3, osteopenic: BMD 80-120mg/cm3, and osteoporotic: BMD < 80mg/cm3 bone mass. There was a significant correlation between fatigue force and BMD for the non-augmented and augmented screws (non-augmented R2 = 0.839, p < 0.001; augmented R2 = 0.551, p < 0.001). There was a significantly increased fatigue strength of the augmented screws over the non-augmented screws in the osteoporotic group (p = 0.001), while the differences in the other groups were not significant (normal p = 0.818/osteopenic p = 0.132). The benefit of pedicle screw cement augmentation significantly depends on the bone mineral density and has the greatest extent of increased fatigue strength in osteoporotic vertebrae. Preoperative measurement of the BMD is strongly recommended to predict the benefit of augmentation and reinforce the decision for cement augmentation. These slides can be retrieved under Electronic Supplementary Material.

Bone Mineral Density in Collegiate Dance Majors Compared to Healthy Controls.

The bone mineral density (BMD) status of dancers is currently unknown. Some research indicates that female dancers have no difference or higher BMD than non-dancers. Other evidence indicates they have lower BMD, predisposing them to osteoporosis and fractures later in life. These differences among studies may be due to differences in dancer type, age, level, and lack of control of confounding variables. Few studies have been completed on college-level dancers. To evaluate BMD in female college-level dance majors. 20 female multi-genre collegiate dance majors and 12 female non-dancer control subjects participated in the study. Each participant underwent three consecutive dual energy x-ray absorptiometry scans to determine BMD of the total body, dual femurs, and lumbar spine. Statistical analysis was completed by an independent samples t-test. The lumbar spine demonstrated a significant difference between groups (p=0.011), with dancers showing greater BMD (1.32±0.10 vs 1.21±0.12 g/cm2). There was no significant difference between groups for total body or dual femur BMD (p=0.104 and 0.175, respectively). College-level dancers may have higher BMD of their lumbar spine than non-dancers, but not in other areas. This area may have increased BMD due to loading from dance activity and warrants further investigation.

Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio.

Plasma aldosterone/renin ratio (ARR) is a useful method for primary aldosteronism (PA) screening. However some confounders, such as medications and dietary, affect plasma renin and aldosterone levels, resulting in false-negative or -positive plasma ARR. This study investigated the association between postmenopausal osteoporosis (PMO) and plasma ARR. Bone mineral density (BMD) was measured by dual-energy X-ray-absorptiometry (DXA) in 324 normotensive postmenopausal women. Based on clinical characteristics and BMD, 186 and 96 subjects were diagnosed as PMO and osteopenia respectively, and the remaining 42 subjects were grouped as normal BMD. Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), parathyroid hormone (PTH), bone alkaline phosphatase (BALP) and 25-Hydroxyvitamin D(25-(OH)D) were determined. Subjects with PMO showed significantly higher levels of PAC (121.0 ± 78.8 vs. 81.8 ± 71.5 pg/ml, p < 0.01 and 121.0 ± 78.8 vs. 91.7 ± 56.2 pg/ml, p < 0.01) and ARR (32.0 ± 53.6 vs. 9.0 ± 9.3 pg/μU, p < 0.01 and 32.0 ± 53.6 vs. 16.3 ± 32.1 pg/μU, p < 0.01) compared to women with normal BMD and osteopenia, respectively. Using ARR ≥ 37.0 pg/μU as the cutoff for positive screening, more false-positive was found in the PMO group when compared to the normal BMD group (24 vs. 2%) and osteopenia group (24 vs. 7%), respectively. PAC was negatively associated with lumbar spine BMD T-score (r = -0.239, p < 0.001), femur neck BMD T-score (r = -0.234, p < 0.001) and total hip BMD T-score (r = -0.228, p < 0.001). PTH was positively associated with PAC (r = 0.119, p < 0.05) and ARR (r = 0.136, p < 0.05). PAC and ARR are elevated in women with PMO, which might increase the risk of false-positive for case detection of PA.

Relationship between Helicobacter pylori infection and bone mineral density: a retrospective cross-sectional study

BackgroundHelicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders. Our aim is to investigate the association between H. pylori infection and bone mineral density.MethodsThis retrospective cross-sectional study was performed by using the data from the health examination database in a medical center of southern Taiwan in 2013. We investigated the relationship between sex, age, body mass index (BMI), waist circumstance, lipid profile, H. pylori infection, the findings of upper gastrointestinal endoscopy and bone mineral density (BMD). Because of nonrandomized assignment and strong confounding effect of age on BMD, the 1:1 propensity score match was applied for age adjustment. The simple and multiple stepwise logistic regression analysis were performed to assess the risk factors of decreased BMD in these well-balanced pairs of participants.ResultsOf the 867 subjects in final analysis with the mean age of 55.9 ± 11.3 years, 381 (43.9%) subjects had H. pylori infection, and 556 (64.1%) subjects had decreased BMD. In decreased BMD group, the portion of woman was higher than a normal BMD group (37.2% versus 29.6%, P = 0.023), the age was significantly older (59.4 ± 9.8 versus 49.8 ± 11.3, p < 0.001) and BMI was significantly lower (24.7 ± 3.5 versus 25.4 ± 3.7, p = 0.006) than the normal BMD group. The prevalence of H. pylori infection was 39.9% and 46.2% in the normal BMD group and the decreased BMD group respectively (P = 0.071). The multivariate analysis which was used for these possible risk factors showed that only advanced age (OR 1.09, 95% CI 1.08–1.11, P < 0.001), and low BMI (OR 0.91, 95% CI 0.87–0.95, P < 0.001) were independently significantly associated with decreased BMD in this nonrandomized study. In the propensity score-matched participants, the multiple stepwise logistic regression analysis revealed H. pylori infection (OR 1.62, 95% CI 1.12–2.35, P = 0.011) and low BMI (OR 0.92, 95% CI 0.87–0.97, P = 0.001) were independently significantly associated with decreased BMD.ConclusionsH. pylori infection and low BMI were independently significantly associated with decreased BMD in selected propensity score-matched populations after age adjustment.

Effects of Curcumin on Bone Loss and Biochemical Markers of Bone Turnover in Patients with Spinal Cord Injury.

Osteoporosis is one of the most common problems of patients with spinal cord injuries (SCIs). The current study aimed to evaluate the antiosteoporotic effects of curcumin on densitometry parameters and biomarkers of bone turnovers among patients with SCI. The current controlled clinical trial was conducted among 100 patients with SCI referred to an outpatient clinic of rehabilitation in Ilam City, Iran, in 2013-2015. The intervention group received 110/mg/kg/day curcumin for 6 months and the control group received placebo. Bone mineral density (BMD) was measured in all patients. The level of procollagen type I N-terminal propeptide, serum carboxy-terminal telopeptide of type I collagen, osteocalcin, and bone-specific alkaline phosphates were compared before and after study. BMD indicators of lumbar, femoral neck, and total hip in the control group significantly decreased compared with the beginning of study. However, in the curcumin group, a significant increase was observed in BMD indicators of lumbar, femoral neck, and hip at the end of study compared with the beginning. There was also a significant difference between interventional and control groups for the mean BMD of femoral neck and hip at the end of study (0.718 ± 0.002 g/cm2 vs. 0.712 ± 0.003 g/cm2 and 0.742 ± 0.031 g/cm2 vs. 0.692 ± 0.016 g/cm2, respectively). Curcumin, via modulation of densitometry indices and bone resorption markers, showed inhibitory effects on the process of osteoporosis. Treatment with curcumin was significantly associated with a decrease in the osteoporosis progression and bone turnover markers of patients with SCI after 6 months.

A cross-sectional study exploring useful indicators for low bone mineral density in male alcoholic patients.

BackgroundAlcohol dependence induces low bone mineral density (BMD), predicting osteoporosis, while low and moderate alcohol consumption may even increase BMD. In recent years, undercarboxylated osteocalcin (ucOC) and tartrate-resistant acid phosphatase-5b (TRACP-5b), bone turnover markers, have gained special interest as useful indicators of low BMD. However, it remains unclear whether other alcohol-related variables (eg, duration of abstinence and continuous drinking) are linked to aberrant BMD. In addition, no previous study has investigated whether ucOC or TRACP-5b is clinically useful to predict low BMD not only in the general population, but also in alcohol-dependent subjects.Patients and methodsWe recruited 275 male alcohol-dependent subjects and collected information about their drinking habits, comorbid diseases, smoking history and walking exercise behavior. BMD in each subject was determined by ultrasonography. Serum liver enzymes (AST, ALT, ALP, ChE, γ-GTP and LDH), ucOC and TRACP-5b were measured in all subjects. T-scores were calculated according to BMD for all subjects.ResultsThe mean T-scores of our subjects were negatively shifted compared to the general population (−0.75±1.36 SD). We divided our subjects into a normal BMD group (n=137) and a low BMD group (n=138) according to their T-scores (T-score ≥−1 SD, normal BMD; T-score <−1 SD, low BMD). Multivariate logistic regression analysis showed that body mass index (BMI) was negatively associated with low BMD (95% CI: 0.75–0.90). By contrast, long abstinence period (95% CI: 1.40–4.21), smoking (95% CI: 1.30–5.56), hypertension (95% CI: 1.04–3.76), lactate dehydrogenase (LDH) (95% CI: 1.00–1.01) and ucOC (95% CI: 1.04–1.22) were positively associated with low BMD.ConclusionIn alcohol-dependent males, smoking habits and higher ucOC are associated with low BMD. Our study suggests that smoking cessation may prevent lower BMD, and ucOC may predict lower BMD in alcohol-dependent individuals.

Glenoid neck Hounsfield units on computed tomography can accurately identify patients with low bone mineral density

Osteoporosis is a costly and morbid disease with the first presentation often with a fragility fracture. The purpose of this study was to assess whether Hounsfield unit (HU) measurements on shoulder computed tomography could identify patients at risk of osteoporosis and aid in its diagnosis. We identified patients who had both a computed tomography scan of the glenoid and a dual-energy x-ray absorptiometry scan. Dual-energy x-ray absorptiometry results and HU measurements of the patients' glenoid were recorded. Differences in HU measurements between patients with normal and abnormal central bone mineral density (BMD) were assessed. Correlations were calculated, and receiver operating characteristics were examined. A total of 51 glenoids met the criteria. The mean glenoid HU measurement was 140.6 (95% confidence interval [CI], 120.1-161.1) in the osteoporotic group, 168.1 (95% CI, 152.7-183.5) in the osteopenic group, and 233.2 (95% CI, 210.1-256.4) in the normal BMD group (P < .001). There was a significant correlation between mean glenoid HU measurement and patients' t scores in the femoral neck (r = 0.581), total hip (r = 0.524), and lumbar spine (r = 0.345). The area under the receiver operating characteristic curve was 0.918. With 197 HUs used as the cutoff for diagnosis of abnormal BMD, the positive predictive value was 96.6%. With 257.1 HUs used as the cutoff, the negative predictive value was 100%. A patient with an HU measurement below 197 has a 97% chance of having low BMD, and a patient with a measurement over 257 likely has normal BMD. In patients with measurements between these values, a definitive diagnosis should be aggressively pursued. Opportunistic screening for a modifiable disease that has significant morbidity and mortality rates at no additional cost, radiation, or time is of great value.