Femoral Bone Mineral Density Research Articles

Site-Specific Differences in Bone Mineral Density of Proximal Femur Correlate with the Type of Hip Fracture.

The aim of this study was to investigate whether site-specific differences in bone mineral density (BMD) of proximal femur correlate with the type of hip fracture using quantitative computed tomography. Femoral neck (FN) fractures were classified as nondisplaced or displaced subtypes. Intertrochanteric (IT) fractures were classified as A1, A2, or A3. The severe hip fractures were identified as displaced FN fractures or unstable IT fractures (A2 and A3). In total, 404 FN fractures (89 nondisplaced and 317 displaced) and 189 IT fractures (76 A1, 90 A2, and 23 A3) were enrolled. Areal BMD (aBMD) and volumetric BMD (vBMD) were measured in the regions of total hip (TH), trochanter (TR), FN, and IT of the contralateral unfractured femur. IT fractures exhibited lower BMD than FN fractures (all p ≤ 0.01). However, unstable IT fractures had higher BMD compared with stable ones (p < 0.01). After adjusting for covariates, higher BMD in TH and IT were associated with IT A2 (A1 vs. A2: odds ratios (ORs) from 1.47 to 1.69, all p < 0.01). Low bone measurements were risk factors for stable IT fractures (IT A1 vs. FN fracture subtypes: ORs from 0.40 to 0.65, all p < 0.01). There are substantial site-specific differences in BMD between IT fractures A1 and displaced FN fractures. Higher bone density was associated with unstable IT fracture when compared with stable ones. The understanding of biomechanics of various fracture types could help to improve the clinical management of these patients.

Bone Mineral Density in Epileptic Children Getting Long Term Anti-epileptic Drugs

Background: Epilepsy is a common chronic neurological disorder with more than half of cases beginning in childhood. Most patients require long-term, and sometimes life-long, therapy with antiepileptic drugs (AEDs). AEDs are associated with significant side effects including radiological evidence of rickets, decreased bone mineral density (BMD), altered bone turnover, and increased risk of fracture.&#x0D; Aim of the Study: To assess the bone mineral density in epileptic children getting long term anti-epileptic drugs.&#x0D; Materials and Methods: This study was conducted in the Saleh Child Development and Disability Management Center (SCDDMC), of the Institute of Child and Mother Health (ICMH) Matuail, Dhaka. A total of 31 childrens age ranged 5-15 years diagnosed as epilepsy on the basis of both clinical examination and investigation (EEG) receiving antiepileptic drugs (AEDS) for at least two years were recruited in this study.&#x0D; Results: Almost two third (61.3%) children age group were in 5 to 10 years and 12(38.7%) in 10 to 15 years. Around three fourth (74.2%) children were male and 8(25.8%) were female. More than two third (67.7%) children had adequate sun exposure and more than three fourth (77.4%) children got adequate calcium and vit.D rich food. Majority (83.9%) of the patients got phenobarbitone (PB) followed by 17(54.8%) got combination, 13(41.9%) got valproic acid (VPA), 11(35.5%) got Nitrazipum (NTZ). More than one third (38.7%) children got mono therapy, 19(61.3%) got polytherapy. Majority of the children (96.8%) had serum calcium normal. The mean serum calcium was 9.22±0.78 mg/dl. The mean BMD of spine was 0.66±0.14. The mean BMD of neck left femur was 0.66±0.15. The mean BMD of neck right femur 0.66±0.15. More than two third (67.7%) children had low (&lt;-1SD) BMD Z score. Almost two third (60.0%) children had mono therapy showed BMD Z score normal (&gt;-1SD) and 6(28.6%) had BMD Z score low (&lt;-1SD). Almost three fourth (71.4%) children got poly therapy showed low BMD and 4(20.0%) got poly therapy showed normal BMD Z score. No significant association was found between BMD score and type and duration of therapy.&#x0D; Conclusion: AEDs decreased bone mineral density due to long term use as mono-therapy or polytherapy. The assessment of BMD among children with epilepsy receiving long term AEDs is essential.

Protocol for a randomized study of the efficacy of ibandronic acid plus eldecalcitol in patients with gastric cancer after gastrectomy: A comparative study of different routes of administration of ibandronic acid

Background: Patients who undergo gastrectomy for gastric cancer are susceptible to osteoporosis. To prevent a decrease in bone mineral density, an appropriate prophylaxis is considered important to adjust the post-gastrectomy condition. In this study, we will compare two different routes of administration of ibandronic acid (oral or intravenous) plus eldecalcitol as a potentially more suitable treatment for patients at a high risk of fragile fracture. Protocol: This study protocol describes a randomized, active-controlled, non-blind, single-center, phase II trial. For patients in the investigational arm (Group A), sodium ibandronate hydrate will be administered intravenously once a month with daily oral intake of eldecalcitol; for those in the control arm (Group B), sodium ibandronate hydrate will be administered orally once a month with daily oral intake of eldecalcitol. We will recruit patients aged 45–85 years who have undergone gastrectomy for gastric cancer and are at a risk of fragility fractures. The study will include patients with existing vertebral fractures and/or femoral proximal fractures, or with lumbar and/or proximal femur bone mineral density of less than 80% of the young adult mean. The primary outcome of this study will be the change in lumbar bone mineral density. We will also evaluate the changes in femur bone mineral density, bone metabolism markers, health-related quality of life as evaluated using the EuroQol 5 Dimension (EQ-5D), and digestive symptoms as evaluated using the Gastrointestinal Symptom Rating Scale after 52 weeks of treatment. Conclusions: We believe that appropriate treatments that are adjusted to the condition of patients after gastrectomy are important for the prevention of bone mineral loss. Registration: This study was accepted by the Japan Registry of Clinical Trials (jRCT1041200059, November 6, 2021).

A Fracture Risk Assessment Tool for High Resolution Peripheral Quantitative Computed Tomography.

Most fracture risk assessment tools use clinical risk factors combined with bone mineral density (BMD) to improve assessment of osteoporosis; however, stratifying fracture risk remains challenging. This study developed a fracture risk assessment tool that uses information about volumetric bone density and three-dimensional structure, obtained using high-resolution peripheral quantitative compute tomography (HR-pQCT), to provide an alternative approach for patient-specific assessment of fracture risk. Using an international prospective cohort of older adults (n = 6802) we developed a tool to predict osteoporotic fracture risk, called μFRAC. The model was constructed using random survival forests, and input predictors included HR-pQCT parameters summarizing BMD and microarchitecture alongside clinical risk factors (sex, age, height, weight, and prior adulthood fracture) and femoral neck areal BMD (FN aBMD). The performance of μFRAC was compared to the Fracture Risk Assessment Tool (FRAX) and a reference model built using FN aBMD and clinical covariates. μFRAC was predictive of osteoporotic fracture (c-index = 0.673, p < 0.001), modestly outperforming FRAX and FN aBMD models (c-index = 0.617 and 0.636, respectively). Removal of FN aBMD and all clinical risk factors, except age, from μFRAC did not significantly impact its performance when estimating 5-year and 10-year fracture risk. The performance of μFRAC improved when only major osteoporotic fractures were considered (c-index = 0.733, p < 0.001). We developed a personalized fracture risk assessment tool based on HR-pQCT that may provide an alternative approach to current clinical methods by leveraging direct measures of bone density and structure. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Abstract #1400160: Early Onset Osteoporosis Associated with Novel Mutation of WNT1 Gene

Canonical WNT signaling plays a significant role in bone development and maintenance of bone mass. WNT1 gene mutations have been associated with osteogenesis imperfecta type XV in homozygotes and early onset osteoporosis in heterozygotes. We present a case of early onset osteoporosis associated with a novel mutation of the WNT1 gene. A 56-year-old female presented for evaluation of early onset osteoporosis. History was significant for hypothyroidism as well as chronic inflammatory demyelinating polyneuropathy on IVIG infusions. She was diagnosed with low bone density in the setting of a vertebral compression fracture from a diving accident when she was 24. She had mild scoliosis, brittle teeth and 10 fractures as a child and young adult including rib fractures, pelvic fracture and compression fracture of the spine, some of which occurred in the setting of low impact trauma. Her family history was notable for possible osteoporosis in her grandmother. Initial evaluation demonstrated PTH 75 (18 - 80 PG/ML), Calcium 9.5 (8.5 - 10.5 MG/DL ), Albumin 4.1 (3.5 - 5.0 G/DL ), 25-hydroxy vitamin D 44.6 (30.0-100.0 ng/mL), Phosphorus 3.6 (2.4 - 4.8 MG/DL), creatinine 0.59 (0.44 - 1.03 MG/DL), TSH 1.24 (0.350 - 5.500 uIU/ML ), 24-hour urine calcium 133 (50 - 300 MG/24H), late night salivary cortisol 0.066 (less than 0.112 ug/dL), tryptase 6.1 (< 11.0 mcg/L), tissue transglutaminase IgA antibody 2.5 (0-20 units), hemoglobin A1c 4.1 (4.3 - 5.6 % ), IGF-1 112 (50 - 317 ng/mL), Alkaline Phosphorus 62 (34 - 104 IU/L). Dual-energy X-ray absorptiometry (DEXA) scan at the age of 50 showed bone mineral density (BMD) 0.828 g/cm2 with T score of -2.0 at lumbar spine, BMD of 0.593 g/cm2 with T score of -2.3 at left femoral neck and BMD of 0.707 g/cm2 with T score of -1.9. She sustained a low trauma spine fracture at L1 at the age of 55. Subsequent DEXA scan at age 55 showed significant decline of BMD with T score of -3.3 at lumbar spine and T score of -3.0 at the left femoral neck. Due to suspicion for osteogenesis imperfecta, a genetic panel was sent which showed a heterozygous variant in WNT1 gene, c.581T >G (p.L194R). She was treated with oral alendronate 70 mg once weekly for less than one year which was stopped due to gastrointestinal side effects. Follow-up is planned for discussion of additional therapeutic options. Heterozygous mutations in WNT1 have been described in the literature as a cause of early onset osteoporosis. The currently described variant mutation in the WNT1 gene has not been previously reported in literature. In silico analysis using SIFT and PolyPhen2 predict this variant to be deleterious/possibly damaging. Genetic testing and evaluation of bone density in other family members may help further support the clinical importance of this mutation.

Quadriceps Performance and Running Biomechanics Influence Femur BMD Changes after ACL Reconstruction in Collegiate Athletes.

Reduced bone mineral density of the distal femur (BMD DF ) can persist long term after anterior cruciate ligament reconstruction (ACLR), even in athletes who return to high levels of competition. These deficits may have implications for the onset and progression of knee osteoarthritis. It is unknown if clinically modifiable factors are associated with losses in BMD DF . This study evaluated the potential influence of knee extensor peak torque (PT), rate of torque development (RTD), as well as peak knee flexion (PKF) angle and peak knee extensor moment (PKEM) during running, on longitudinal changes in BMD DF post-ACLR. After ACLR, 57 Division I collegiate athletes underwent serial whole-body dual-energy x-ray absorptiometry (DXA) scans between 3 and 24 months post-ACLR. Of these, 43 athletes also had isometric knee extensor testing (21 female, 105 observations), and 54 had running analyses (26 female, 141 observations). Linear mixed-effects models, controlling for sex, assessed the influence of surgical limb quadriceps performance (PT and RTD), running mechanics (PKF and PKEM), and time post-ACLR on BMD DF (5% and 15% of femur length). Simple slope analyses were used to explore interactions. Athletes with RTD less than 7.20 (N·m)·kg -1 ·s -1 (mean) at 9.3 months post-ACLR demonstrated significant decreases in 15% BMD DF over time ( P = 0.03). Athletes with PKEM during running less than 0.92 (N·m)·kg -1 (-1 SD below mean) at 9.8 months post-ACLR demonstrated significant decreases in 15% BMD DF over time ( P = 0.02). Significant slopes were not detected at -1 SD below the mean for PT (1.75 (N·m)·kg -1 , P = 0.07) and PKF (31.3°, P = 0.08). Worse quadriceps RTD and running PKEM were associated with a greater loss of BMD DF between 3 and 24 months post-ACLR.

Association between inflammatory markers and bone mineral density: a cross-sectional study from NHANES 2007–2010

PurposeMonocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) are acknowledged as novel inflammatory markers. However, studies investigating the correlation between inflammatory markers and osteoporosis (OP) remain scarce. We aimed to investigate the relationship between NLR, MLR, PLR and bone mineral density (BMD).MethodsA total of 9054 participants from the National Health and Nutrition Examination Survey were included in the study. MLR, NLR and PLR were calculated for each patient based on routine blood tests. Given the complex study design and sample weights, the relationship between inflammatory markers and BMD was evaluated through weighted multivariable-adjusted logistic regression and smooth curve fittings. In addition, several subgroup analyses were conducted to assess the robustness of the outcomes.ResultsThis study observed no significant relationship between MLR and lumbar spine BMD (P = 0.604). However, NLR was positively correlated with lumbar spine BMD (β = 0.004, 95% CI: 0.001 to 0.006, P = 0.001) and PLR was negatively linked to lumbar spine BMD (β = − 0.001, 95% CI: − 0.001 to − 0.000, P = 0.002) after accounting for covariates. When bone density measurements were changed to the total femur and femoral neck, PLR was still significantly positively correlated with total femur (β = − 0.001, 95% CI: − 0.001, − 0.000, P = 0.001) and femoral neck BMD (β = − 0.001, 95% CI: − 0.002, − 0.001, P < 0.001). After converting PLR to a categorical variable (quartiles), participants in the highest PLR quartile had a 0.011/cm2 lower BMD than those in the lowest PLR quartile (β = − 0.011, 95% CI: − 0.019, − 0.004, P = 0.005). According to subgroup analyses stratified by gender and age, the negative correlation with PLR and lumbar spine BMD remained in males and age < 18 groups, but not in female and other age groups.ConclusionsNLR and PLR were positively and negatively correlated with lumbar BMD, respectively. And PLR might serve as a potential inflammatory predictor of osteoporosis outperforming MLR and NLR. The complex correlation between the inflammation markers and bone metabolism requires further evaluation in large prospective studies.

Association between dietary intake of α-tocopherol and cadmium related osteoporosis in population ≥ 50years.

To analyze the association between α-tocopherol intake and cadmium (Cd) exposure and osteoporosis in population ≥ 50years. Sociodemographic data, physical examination, andlaboratory indicators including serum Cd level and dietary α-tocopherol intake of 8459 participants were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. The associations between α-tocopherol intake, serum Cd levels and osteoporosis were evaluated using univariate and multivariate logistic regression analyses, with the estimated value (β), odds ratios (ORs) and 95% confidence intervals (CIs). We further explored the impact of α-tocopherol intake on Cd exposure and the bone mineral density (BMD) in total femur and femur neck. A total of 543 old adults suffered from osteoporosis. The serum Cd level (0.52 μg/L vs. 0.37 μg/L) and α-tocopherol intake (5.28mg vs. 6.50mg) were statistical different in osteoporosis group and non-osteoporosis group, respectively. High level of Cd exposure was related to the increased risk of osteoporosis [OR = 1.60, 95% CI (1.15-2.21)]. In the total femur, α-tocopherol intake may improve the loss of BMD that associated with Cd exposure [β = - 0.047, P = 0.037]. Moreover, high α-tocopherol intake combined with low Cd exposure [OR = 0.54, 95% CI (0.36-0.81)] was linked to the decreased risk of osteoporosis comparing with low α-tocopherol intake combined with high Cd exposure. High α-tocopherol intake may improve the Cd-related osteoporosis and loss of BMD that could provide some dietary reference for prevention of osteoporosis in population ≥ 50years old.

Risk Factors Associated with Intraoperative Iatrogenic Fracture in Patients Undergoing Intramedullary Nailing for Atypical Femoral Fractures with Marked Anterior and Lateral Bowing.

Background and objectives: Iatrogenic fractures are potential complications during intramedullary (IM) nailing for atypical femoral fractures (AFFs). The risk factors associated with iatrogenic fractures remain unclear, although excessive femoral bowing and osteoporosis are hypothesized to be contributing factors. The present study aimed to determine the risk factors for the occurrence of iatrogenic fractures during IM nailing in patients with AFFs. Materials and Methods: This retrospective cross-sectional study evaluated 95 patients with AFF (all female; age range: 49-87 years) who underwent IM nailing between June 2008 and December 2017. The patients were divided into two groups: Group I (with iatrogenic fracture: n = 20) and Group II (without iatrogenic fracture: n = 75). Background characteristics were retrieved from medical records and radiographic measurements were obtained. Univariate and multivariate logistic regression analyses were performed to identify risk factors for the occurrence of intraoperative iatrogenic fractures. Receiver operating curve (ROC) analysis was conducted to determine a cut-off value for the prediction of iatrogenic fracture occurrence. Results: Iatrogenic fractures occurred in 20 (21.1%) patients. The two groups exhibited no significant differences regarding age and other background characteristics. Group I exhibited significantly lower mean femoral bone mineral density (BMD) and significantly greater mean lateral and anterior femoral bowing angles than Group II (all p < 0.05). There were no significant differences in AFF location, nonunion, and IM nail diameter, length, or nail entry point between the two groups. In the univariate analysis, femoral BMD and lateral bowing of the femur differed significantly between the two groups. On multivariate analysis, only lateral bowing of the femur remained significantly associated with iatrogenic fracture occurrence. The ROC analysis determined a cut-off value of 9.3° in lateral bowing of the femur for prediction of iatrogenic fracture occurrence during IM nailing for AFF treatment. Conclusions: The lateral bowing angle of the femur is an important predictive factor for intraoperative iatrogenic fracture occurrence in patients undergoing IM nailing for AFF treatment.

Early Changes in the Bone Mineral Density on Dual-energy X-ray Absorptiometry Scan of Patients Undergoing Primary Cemented Total Knee Arthroplasty: A Prospective Cohort Study

Background: The known risk factors of osteoarthritis (OA) knee are aging and obesity while the risk factors of osteoporosis are aging and low body weight, so the relationship between all three is complex. Currently, the dual-energy X-ray absorptiometry (DXA) test is the gold standard in osteoporosis diagnostics. Many epidemiologic studies have revealed increased bone mineral density (BMD) in individuals with OA knee. The impact of total knee arthroplasty (TKA) on BMD levels is not fully understood. Concern has been raised regarding the increased risk of femoral and spine fractures early after TKA. Hence, we conducted this study to measure the BMD changes in the hip and spine in patients receiving TKA. Materials and Methods: It was a prospective interventional cohort study conducted from December 2018 to December 2020. The study included 43 patients admitted for elective TKA after applying the relevant inclusion and exclusion criteria. Patients were analyzed with DXA scans both preoperatively and 6 months postoperatively. Results: When we studied all the patients as one single sample, the initial observation was that at the 6-month follow-up, the patients showed a statistically significant improvement in the femur BMD score while the change in spine BMD was statistically insignificant. However, when subsets of the study sample, i.e. preoperatively normal, osteopenic, and osteoporotic patients, underwent further analysis, we found that out of 18 patients having normal BMD preoperatively, one patient developed osteopenia and another developed osteoporosis upon postoperative follow-up DXA scan. Similarly, one out of the eight patients, having osteoporosis preoperatively, improved a grade to osteopenia upon postoperative follow-up DXA scan. However, these changes were not statistically significant. Conclusions: we conclude that there is no statistically significant change in both the femur and the spine BMD at least 6-month follow-up postprimary TKA.

Intraoperative physician assessment of bone: correlation to bone mineral density.

Intuitively, intraoperative physician assessment (IPA) would be an excellent measure of bone status gained through haptic feedback during bone preparation. However, no studies have evaluated the orthopedic surgeon's ability to do so. This study's purpose, in patients undergoing total knee arthroplasty (TKA), was to relate IPA with (1) the lowest bone mineral density (BMD) T-score at routine clinical sites; and (2) with distal femur BMD. Seventy patients undergoing TKA by 3 surgeons received pre-operative DXA. Intraoperatively, bone quality was assessed on a 5-point scale (1 excellent to 5 poor) based on tactile feedback to preparation. Demographic data, DXA results, and IPA score between surgeons were compared by factorial ANOVA. Lowest T-score and distal femur BMD were associated with IPA using Spearman's correlation. The mean (SD) age and BMI were 65.8 (7.6) years and 31.4 (5.1) kg/m2, respectively. Patient demographic data, BMD, and IPA (mean [SD] = 2.74 [1.2]) did not differ between surgeons. IPA correlated with the lowest T-score (R = 0.511) and distal femur BMD (R = 0.603-0.661). Based on the lowest T-score, no osteoporotic patients had an IPA above average, and none with normal BMD was classified as having poor bone. IPA is highly correlated with local (distal femur) and overall BMD. This study supports the International Society for Clinical Densitometry position that surgeon concern regarding bone quality should lead to bone health assessment. As IPA is comparable between surgeons, it is logical this can be widely applied by experienced orthopedic surgeons. Future studies evaluating IPA at other anatomic sites are indicated.

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

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

Changes in bone quality after switching from a TDF to a TAF based ART: A pilot randomized study.

The impact of tenofovir disoproxil fumarate (TDF) antiretroviral (ART) regimens on bone health has been characterized mostly by bone mineral density (BMD), but recently also by bone quality (BQ). The aim of this pilot study is to assess the changes in BMD and BQ after switch from TDF to tenofovir alafenamide (TAF) ART. HIV individuals receiving TDF-based ART were randomized to switch to Bictegravir-TAF-Emtricitabine or to remain in the same regimen. At baseline and 24-weeks after randomization, participants underwent bone mineral density (BMD) by DXA and BQ assessment using bone microindentation, a validated technique that measures bone tissue quality expressed as bone material strength index (BMSi). A panel of plasma bone turnover biomarkers were measured by ELISA at the same time-points. Values are expressed as median [interquartile range] and non-parametric tests were used where appropriate. A total of 24 HIV individuals were included in the study, 19 of which were men (80%). Median age at baseline was 43 years (IQR 38-54). Half of individuals were allocated in the TDF group while the other half changed to TAF treatment. No differences at baseline between both groups were detected in any parameter. Non-significant changes nor in lumbar or femoral BMD at week 24 was found in any regimen. In contrast, there was an increase in BMSi in the TAF arm at 24 weeks, and thus an improvement in BQ[81.6 (79-83) to 86 (80-88) (+5.1%);p=0.041], whereas the TDF arm remained stable from 82 (76-85) at baseline to 82 (73-83);p=0.812. Hence, at week 24 there were significant differences in BQ between arms (p=0.049). A reduction in bone formation markers was found at week 24 in both regimens: N-terminal propeptide of type-1 collagen decreased a 20% (-35 - -0.6); p=0.031 with TAF and -16% (-25 - -5); p=0.032 with TDF. Also a decrease in bone resorption marker C-telopeptide with TAF was detected [-10% (-19 - -5);p=0.028] but not with TDF (p=0.232), suggesting a less metabolically active bone after switching to TAF. A bone quality improvement was found after switching from a TDF to a TAF based ART independently of BMD, suggesting that the bone health benefits of TAF may extend beyond BMD. Future research should be directed to confirm these findings and to identify the underlying mechanisms of ART related bone toxicity.

Bone mineral density and normal-weight obesity syndrome: beyond body weight and body mass index.

This study aimed to evaluate, for the first time, the bone profile of adult women and men with and without normal-weight obesity (NWO) syndrome and its association with bone health-related nutrient intake, anthropometry, and body composition. This was a cross-sectional study of adults aged between 20 and 59years with normal body weight, separated according to body fat (BF) percentage into NWO and non-NWO syndrome groups. BF > 30% and > 19% were considered high for women and men, respectively. Socioeconomic, physical activity, food consumption, anthropometric, and body composition data were evaluated. Student's t-test or Mann-Whitney test and Pearson's χ2 or Fisher's exact tests were applied for comparisons. Multiple linear regression models were developed, with bone parameters as the dependent variables and anthropometric, body composition, and food consumption data as the main independent variables. The sample consisted of 224 adults (69.2% women) with a median (interquartile range) age of 23 (21-25) years, 71% of whom had NWO syndrome. Compared with women, a higher percentage of men had a lower-than-expected spinal bone mineral density (BMD) Z-score for age (10%; p = 0.0214). Bone parameters were similar between groups. Spinal BMD was negatively associated with male sex and positively associated with body weight. The femoral BMD was negatively associated with BF percentage and positively associated with body mass index. The negative association of BMD with BF percentage may suggest a higher risk of bone alterations in individuals with NWO syndrome and should be monitored over time.

Effect of pulmonary function on bone mineral density in the United States: results from the NHANES 2007–2010 study

Based on the data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010, this study explored whether there is a correlation between PF (1st second forceful expiratory volume as a percentage of expected value (FEV1(% predicted)), (one-second rate (FEV1/FVC)), and bone mineral density. We evaluated the relationship between PF and BMD in 6327 NHANES subjects (mean age 44.51 ± 15.64 years) from 2007 to 2010. The bone mineral density of the whole femur was measured by dual-energy X-ray absorptiometry (DXA). After adjusting for a wide range of confounders, we examined the relationship between PF and total femur BMD using a multiple linear regression model. Correction of race, age, alcohol consumption, body mass index (BMI), height, poor income ratio (PIR), total protein, serum calcium, serum uric acid, cholesterol, serum phosphorus, blood urea nitrogen, FEV1(% predicted), and femur BMD were positively correlated (β = 0.032, 95% CI: 0.010-0.054, P = 0.004). FEV1/FVC was positively correlated with spine BMD (β = 0.275 95%CI: 0.102-0.448, P = 0.002). Our study shows that PF is positively associated with BMD in the US population. A variety of factors such as race and age influence this relationship. the relationship between PF and BMD needs to be further investigated, including specific regulatory mechanisms and confounding factors.

Seropositive for hepatitis B and C viruses is associated with the risk of decreased bone mineral density in adults: An analysis of studies from the NHANES database.

Some studies had reported that patients with viral hepatitis are at increased risk of reduced bone mineral density and even osteoporosis. However, the interaction between reduced bone mineral density (BMD) and viral hepatitis remains inconclusive. Therefore, our study collected hepatitis test results and bone mineral density from respondents in the NHANES database. The aim of this study was to investigate whether there is an association between hepatitis and a decrease in bone mineral density. The respondents with both hepatitis- and BMD-related indicators from the NHANES database in the United States from 2005-2010, 2013-2014, to 2017-2020 were collected for this study. BMD were compared between respondents who were positive and negative for respondents related to hepatitis B and C. BMD was measured using dual-energy X-ray absorptiometry of the femur and lumbar spine. Finally, multiple regression analysis was performed between hepatitis B surface antigen (HBsAg) and hepatitis C RNA (HCV-RNA) and BMD in the respondents. A total of 15,642 respondents were included in the hepatitis B surface antigen-related survey. Of these, 1,217 respondents were positive for hepatitis B surface antigen. A total of 5111 hepatitis C RNA-related responders were included. Hepatitis C RNA-positive had 268 respondents. According to the results of the multiple regression analysis, the femoral BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.018 (-0.026, -0.009) (P < 0.01). Moreover, spinal BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.020 (-0.030, -0.010) (P < 0.01). According to the results of multiple regression analysis for hepatitis C RNA, HCV-RNA (+) respondents had significantly lower BMD compared to HCV-RNA (-) respondents: -0.043 (-0.059, -0.026) (P < 0.01). During the analysis of respondents in the NHANES database in the United States, positive tests for hepatitis B surface antigen and hepatitis C RNA were found to be associated with a reduction in BMD. Positive serology for these hepatitis indicators may increase the risk of reduced BMD. Of course, this conclusion still needs to be further confirmed by more large clinical trials.

Association of bone mineral density with trichlorophenol: a population-based study

BackgroundTrichlorophenols (TCPs) are metabolites of several organochlorine chemicals, including chlorobenzene, hexachlorocyclohexane, and chlorophenoxy acid, present in air, surface water, soil, and sediment. Many studies have shown that endocrine disruptors (EDs)may contribute to decreased bone mass and the increased risk of osteoporosis. However, the relationship between TCP and bone mineral density (BMD) has not been studied yet.MethodsWe conducted a cross-sectional study by using data from the 2005–2010 National Health and Nutrition Examination Survey (NHANES). TCP levels were measured in urine samples from 3385 participants and bone mineral density was obtained by dual X-ray absorptiometry (DXA) lumbar spine and femur scanning. Multiple regression analysis, stratified analysis, curve fitting analysis, and trend tests were used to assess the relationship between TCP and BMD.ResultAfter adjusting for confounding factors, the results of multiple regression analysis only showed that ln-2,4,5-TCP was negatively associated with BMD of lumbar spine. In stratified analyses, Male, Menstruating Female and Menopausal Female were divided into three groups for analysis. The results showed that ln-2,4,5-TCP and ln-2,4,6-TCP were not statistically associated with BMD in total femur, femoral neck, femoral tuberosity, intertrochanteric femur and lumbar spine, which was also confirmed by curve fitting analyses and trend tests.ConclusionThis study demonstrated that 2,4,5-TCP and 2,4,6-TCP in urine samples were not significantly associated with BMD in the US population. Therefore, 2,4,5-TCP and 2,4,6-TCP may not be detrimental to BMD.

Rubiadin Regulates Bone Metabolism in Ovariectomized Rat Model by Inhibition of osteoclast formation and differentiation

AbstractThe present study investigated the effect of rubiadin from morinda officinalis on bone metabolism in an ovariectomized rat model. Results from the MTT test showed that the best drug concentration was 0.6 mg for 24 h (P&gt;0.05). Compared with the Control group, the femoral bone mineral density in the experimental group treated with rubiadin was significantly higher (P&lt;0.05). After the intervention of rubiadin, the level of P1NP in serum increased, the level of β‐CTX decreased, and the level of estradiol increased. The up‐regulated genes C−C motif chemokine ligand 2 (CCL2), Inhibitor of Nuclear Factor Kappa B Kinase Subunit Beta (IKBKB), C1q, C6, Suppressor of cytokine signaling1 (SOCS1/3) and Dickkopf‐3 (DKK3) were screened from the data. Down regulated genes wnt6, Sfrp5, COL4A6, Ig like R. The differential genes were detected by RT‐PCR. Compared with the Control group, CCL2 and SOCS3 were significantly up‐regulated in the experimental group (P&lt;0.05), and COL4A6 and LILRB3a were significantly down regulated in the experimental group (P&lt;0.05). Western blot test results showed that the expression of LILRB3a protein was significantly reduced, while the expression of SOCS3 protein was significantly increased, indicating that rubiadin could significantly increase the expression of SOCS3 protein and reduce the expression of LILRB3a protein. In conclusion, rubiadin inhibits the formation and differentiation of osteoclasts by affecting the expression of CCL2 and SOCS3, COL4A6 and LILRB3a genes. Therefore, rubiadin can be of therapeutic importance for the treatment of osteoporosis.

Low Bone Density and High Sclerostin in Non-Functioning Pituitary Adenoma

Purpose: Sclerostin reduces bone formation by inhibiting the Wnt signaling pathway in bone tissue. This study evaluated the serum sclerostin level in non-functioning pituitary adenoma (NFPA) patients and analyzed its relationship with bone metabolism. Method: The data of the patients who applied to the Dicle University Endocrinology, diagnosed with non-functioning pituitary adenoma, and the control group consisting of healthy individuals were included in the study. Serum sclerostin levels and DXA analysis parameters were evaluated and compared with healthy control groups. Results: The study consisted of 39 patients (F / M: 27/12) with NFPA (patient group) and 43 control groups (F / M: 26/17). There was no difference in terms of gender, age, height, weight and serum calcium, phosphorus, creatinine, 25-OH vitamin D, parathyroid hormone levels. Serum sclerostin levels (32.31 ± 1.53 ng / ml) in the patient group was found to be significantly higher than the control group (22.45 ± 8.9 ng / ml) (p < 0.001). BMD (Patients groups vs control group); total lumbar BMD (0.951-1.56 gr / cm2) (p < 0.001), femoral neck BMD (0.752-1.15 g / cm2) (p < 0.001), femoral total BMD (0.995- 1.63 gr / cm2) (p < 0.001), were found to be statistically significantly lower. Conclusion: This study provides the first evidence that serum sclerostin levels were increased in non-functioning pituitary adenomas, which showed that bone parameters were negatively affected.

Denervation impacts muscle quality and knee bone mineral density after spinal cord injury

Cross-sectional study. To compare muscle size, body composition, bone mineral density (BMD), and metabolic profiles in denervated versus innervated individuals with spinal cord injury (SCI). Hunter Holmes McGuire Veterans Affairs (VA) Medical Center. Body composition, bone mineral density (BMD), muscle size, and metabolic parameters were collected in 16 persons with chronic SCI (n = 8 denervated, n = 8 innervated) using dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), and fasting blood samples. BMR was measured by indirect calorimetry. Percent differences of the whole thigh muscle cross-sectional area (CSA; 38%), knee extensor CSA (49%), vasti CSA (49%), and rectus femoris CSA (61%) were smaller in the denervated group (p < 0.05). Leg lean mass was also lower (28%) in the denervated group (p < 0.05). Whole muscle intramuscular fat (IMF%; 15.5%), knee extensor IMF% (22%), and % fat mass (10.9%) were significantly greater in the denervated group (p < 0.05). Knee distal femur and proximal tibia BMD were lower in the denervated group, 18-22% and 17-23%; p < 0.05. Certain indices of metabolic profile were more favorable in the denervated group though were not significant. SCI results in skeletal muscle atrophy and dramatic changes in body composition. Lower motor neuron (LMN) injury results in denervation of the lower extremity muscles which exacerbates atrophy. Denervated participants exhibited lower leg lean mass and muscle CSA, greater muscle IMF, and reduced knee BMD compared to innervated participants. Future research is needed to explore therapeutic treatments for the denervated muscles after SCI.