Bone Mineral Density Index Research Articles

Assessment of aging characteristics of female condylar trabecular structure by cone-beam computed tomography.

This study was performed to analyze the aging-related changes of the female condylar bone mineral density (BMD) and trabecular structure by cone-beam computed tomography (CBCT), and determine whether the condylar structure shows obvious changes after menopause. The CBCT images of 160 female patients who met the inclusion criteria for the study were collected and divided into four groups by age (20-29 years, 30-39 years, premenopausal, and postmenopausal groups). Computer processing software CT-Analyser (Version 1.15.2.2+; SkyScan, Antwerp, Belgium) was used to measure the condylar BMD and related indexes, namely the bone volume/tissue volume ratio (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular structure model index (SMI), and bone surface area/volume ratio (BS/BV). SPSS 12.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the radiographic findings and statistical differences. No significant differences were found between the bilateral condyles in each group (P > 0.05). BV/TV, Tb.N, and Tb.Th of the condyle decreased with age, and the postmenopausal group showed significantly different values for each index compared with the other groups (P < 0.01). Tb.Sp, SMI, and BS/BV of the condyle increased with age, and the postmenopausal group showed significantly different values for each index compared with the other groups (P < 0.01). With increasing age, the female condylar bone volume decreases, the Tb.N and Tb.Th decrease, the gap between the trabecular bone increases, and plate-like trabecular bone gradually transforms into a rod-like form. These changes are much more obvious in postmenopausal women.

Serum 25-hydroxy Vitamin D levels as an Indicator of Bone Mineral Density in Osteoporosis

Serum 25-hydroxy Vitamin D levels as an Indicator of Bone Mineral Density in Osteoporosis

Normocalcemic primary hyperparathyroidism — «new era» in diagnosis of an old disease

During the last century, primary hyperparathyroidism (PHPT) passed from the category of rare severe diseases to a common endocrine disorder with a prevalence of mild forms. Over the last 10—20 years, widespread screening for osteoporosis has led to the «new era» in diagnosis of PHPT when patients are diagnosed at the stage of an isolated elevated parathyroid hormone with stable normal serum calcium levels and the absence of secondary causes of hyperparathyroidism. This phenomenon was called normocalcemic primary hyperparathyroidism (nPHPT); according to the literature data, its prevalence varies from 0.4 to 16.7% due to the lack of unified diagnostic criteria. The clinical picture and natural history of the disease are poorly explored, and it is still unclear if nPHPT is a separate disease entity or if it is an early stage of hypercalcemic PHPT. A number of studies have shown that complications of nPHPT (osteoporosis and urolithiasis) are similar to those of the symptomatic form of PHPT despite stable normocalcemia. However, these patients were often referred to specialized metabolic centers due to a decrease in the bone mass or nephrolithiasis, therefore the rate of complications in them may be overestimated. There are also controversial data on an increased risk of cardiovascular diseases due to metabolic disorders in this pathology.&#x0D; As a new clinical nosology, normocalcemic PHPT was first officially recognized at the Third International Workshop on Management of Asymptomatic PHPT in 2008, but there have been yet no common recommendations for its treatment. Some studies have shown a response to medical therapy and improved indicators of bone mineral density after parathyroidectomy in these patients. According to the experts of the Fourth International Workshop in 2014, nPHPT remains one of the key topics for further research.

Antiosteoporotic activity of Salvadora persica sticks extract in an estrogen deficient model of osteoporosis

ObjectivesThe effect of Salvadora persica sticks on prevention of tooth decay is well established, but the effect of S. persica stick extract (SPE) on the prevention/treatment of osteoporosis has not been studied. The purpose of this study is to provide baseline information of the effectiveness of SPE on ovariectomized (OVX) rat model of osteoporosis. MethodsSPE was administered at 50, 150, and 300 mg/d orally to OVX rats for 16 weeks. Serum osteocalcin, alkaline phosphatase, calcium, and phosphorus, and urinary deoxypyridinoline, calcium, and phosphorus were measured. Bone mineral density (BMD), 3-point bending test, and histomorphometric characteristics of the femoral bone were also examined. ResultsSPE at doses of 150 and 300 mg/d, but not 50 mg/d, significantly prevented bone loss in OVX rats as proved by decreased biochemical markers of bone resorption and increased BMD and biomechanical indices of the femoral bone. ConclusionsThis study confirms a dose-dependent protective action of SPE on rat OVX model of osteoporosis. This effect needs further investigation at the molecular and clinical levels to provide a natural and cost-effective alternative for the management of postmenopausal osteoporosis.

Perinatal infection may worse the state of maternal bone

To compare structural condition of the bone tissue in the women with verified perinatal infection (vPI) and in healthy pregnant women in the dynamics of gestation. a prospective study in the dynamics of gestation has been performed in 363 pregnant women, 235 of them (group I – main group) with vPI. decrease in bone mineral density (BMd) have been identified already in the 2nd trimester. 128 healthy pregnant women formed control group (group II). ultrasound densitometry was used for the assessment of the structural state of bone tissue. BMd indexes matched normal only in 18.29 % (subgroup IB) of the pregnant women with vPI in the 2nd trimester of pregnancy. osteopenia was diagnosed in 71.91 % (subgroup Ia) in terms of BdI (78.07 ± 1.16) %, z-criterion – (–1.20 ± 0.04) Sd. at 9.78 % of the women under observation (subgroup IC: z-criterion (–2.65 ± 0.24) Sd, BdI – (56.35 ± 2.21) %) osteoporosis was diagnosed. BdI in vPI patients and normal values of BMd (sub- group IB) was (86.45 ± 0.74) %, z-criterion – (–0.90 ± 0.04) Sd. In the dynamics of gesta- tion there were significant losses of BMd in both groups, at vPI BMd losses were more pro- nounced. Probably, the syndrome of systemic inflammatory response may cause BMd loss or exacerbate an existing bone pathology.

Effects of Titanium Mesh Cage End Structures on the Compressive Load at the Endplate Interface: A Cadaveric Biomechanical Study.

BackgroundThis study aimed to evaluate whether obliquely angled and ring-shaped titanium mesh cage (TMC) end structures can improve the compressive load on the endplate interface in anterior cervical corpectomy and fusion (ACCF).Material/MethodsA total of 23 volunteers underwent cervical lateral x-ray. The oblique angle of the superior endplate was measured, which was used to construct the gradient of the TMC end. Forty-two fresh cadaveric vertebral bodies were harvested and randomly distributed among four TMC groups with different ends. The baseline indicators of bone mineral density and anteroposterior and transverse dimensions were recorded. The superior endplate was placed at an angle of 12° when performing uniaxial compression testing. The maximum loads of the four TMCs were assessed.ResultsThere were no significant differences among the groups regarding the baseline indicators. The conventional TMC had the lowest maximum load (1362.3±221.78 N, p<0.05), whereas the TMC with an obliquely end ring had the highest maximum load (2095.82±285.64 N, p<0.05). The maximum loads of the TMCs with oblique footprints and flat end ring were much higher than that of the conventional TMC (p<0.05) but significantly lower than that of the TMC with the obliquely end ring (p<0.05), with average values of 1806.91±246.98 N and 1725.3±213.33 N, respectively.ConclusionsBoth the ring shape and oblique angle of the TMC end contributed to an increase in compressive force and are advocated for use in TMC structure optimization to decrease the incidence of TMC subsidence in ACCF.

Cortical porosity not superior to conventional densitometry in identifying hemodialysis patients with fragility fracture.

Hemodialysis (HD) patients face increased fracture risk, which is further associated with elevated risk of hospitalization and mortality. High-resolution peripheral computed tomography (HR-pQCT) has advanced our understanding of bone disease in chronic kidney disease by characterizing distinct changes in both the cortical and trabecular compartments. Increased cortical porosity (Ct.Po) has been shown to be associated with fracture in patients with osteopenia or in postmenopausal diabetic women. We tested whether the degree of Ct.Po identifies hemodialysis patients with prevalent fragility fractures in comparison to bone mineral density (BMD) assessed by dual X-ray absorptiometry (DXA). We performed a post-hoc analysis of a cross-sectional study in 76 prevalent hemodialysis patients. Markers of mineral metabolism, coronary calcification score, DXA-, and HR-pQCT-data were analyzed, and Ct.Po determined at radius and tibia. Ct.Po was significantly higher in patients with fracture but association was lost after adjusting for age and gender (tibia p = 0.228, radius p = 0.5). Instead, femoral (F) BMD neck area (p = 0.03), F T-score neck area (p = 0.03), radius (R) BMD (p = 0.03), R T-score (p = 0.03), and cortical HR-pQCT indices such as cortical area (Ct.Ar) (tibia: p = 0.01; radius: p = 0.02) and cortical thickness (Ct.Th) (tibia: p = 0.03; radius: p = 0.02) correctly classified patients with fragility fractures. Area under receiver operating characteristic curves (AUC) for Ct.Po (tibia AUC: 0.711; p = 0.01; radius AUC: 0.666; p = 0.04), Ct.Ar (tibia AUC: 0.832; p<0.001; radius AUC: 0.796; p<0.001), and F neck BMD (AUC: 0.758; p = 0.002) did not differ significantly among each other. In conclusion, measuring Ct.Po is not superior to BMD determined by DXA for identification of HD patients with fragility fracture.

Вікові та статеві особливості показників мінеральної щільності кiсткової тканини щурів

In vivo assessment of bone mineral density (BMD) and bone mineral content (BMC) indices gives an objective description of the possible rates of bone loss during aging and various diseases, as well as response to treatment by various drugs, affecting bone metabolism. This study was conducted on 376 Wistar rats of both genders, divided into 12 age groups using the method of dual-energy X-ray absorptiometry. Studying the parameters of BMD and BMC depending on age and sex has found no bone mass opeak) in rats of both sexes. Bone mineral density indices were increased in both male and female rats during growing, more pronounced in males. These differences are noted in all age groups of animals. Moreover, we have established age and gender particularities of BMC indices in different parts of the skeleton. In female rats, a significant increase of BMD and BMC parameters have been detected in age from 1.5 to 2 months (33%), from 2 to 3 months - by 12.5%. In males, the increase of BMD indices was found to happen 1 month later and it was less pronounced (from 2 to 3 months - 27%, from 4 to 5 months - 5%). In other age periods, the dynamics of BMD indices had only an upward trend, but significant differences different groups were not established. Our results of BMD and BMC indices and their age and gender features can be used for further research in osteology as reference data for modeling of experimental osteoporosis in rats and study of response to the use of different antiosteoporotic drugs.

The association between markers for lipid metabolism and bone mineral density indicators in postmenopausal women with obesity

The association between markers for lipid metabolism and bone mineral density indicators in postmenopausal women with obesity

Zoledronic Acid and Its Calcium-contain Complexes in Treatment of Experimental Osteoporosis in Wistar Female Rats

The aim was to assess the composition, stability and biological activity of the complexes that are formed in the solution on the interaction of calcium ions with Zolendronic acid (Zol) and study their effects on bone mineral density (BMD) indexes in female rats with experimental osteoporosis. 40 reproductive Wistar rats with systemic osteoporosis which was modeled by oophorectomy were under the study. Animals were divided into 4 groups (I – did not receive any treatment with bisphosphonates, only sufficient consumption of calcium and vitamin D (Ca-D); II – receive single dose of Zol and Ca-D; III – soluble calcium complexes of Zol (Ca-Zol) without additional use of Ca-D; IV – soluble calcium complexes of Zol with Ca-D). BMD and bone mineral content (BMC) of total body and spine were measured before treatment, after 1 and 3 months of observation by X-ray densitometer Prodigy. Our study showed the significant positive changes in total body BMD in 1 and 3 months and spine BMD in 3 months of observation 2d group. Analysis of BMD in rats of 3d group has not shown any significant changes of spine and total body in 1 and 3 months after its injection. However, the administration of complexes calcium and Zol with Ca-D has positive effects on total body BMDs in 1 and 3 months’ follow-up and spine BMD in 3 months of observation. Analysis of BMC indices in rats of 4th group showed the positive changes in spine and total body indexes in 1 and 3 month of follow-up, however it was not found any significant differences with animal of 2d group. Conclusion investigated soluble complexes of calcium and Zol in combination with Ca-D supplementation showed positive effect on BMD and BMC indices however did not have any benefits in comparison standard administration of Zol with Ca-D supplementation.

Association between SNPs and haplotypes in the METTL21C gene and peak bone mineral density and body composition in Chinese male nuclear families.

The methyltransferase-like 21C gene (METTL21C), which is mainly expressed in muscle, can promote the differentiation of myoblasts to myotubes and reduce glucocorticoid-induced apoptosis of osteocytes. The purpose of this study was to explore the association between single nucleotide polymorphisms of METTL21C and peak bone mineral density (BMD), body mass index, total fat mass (TFM), and total lean mass (TLM) in Chinese young men. Fifteen tagging single nucleotide polymorphisms were genotyped, and haplotype blocks were derived in 400 Chinese male nuclear families. The peak BMD of the lumbar and hip, TFM, and TLM were measured by dual-energy X-ray absorptiometry. The association analyses were performed by a quantitative transmission disequilibrium test. Both TLM and TFM had a significant positive effect on peak BMD, but the positive regulation of TLM was stronger than that of TFM. After 1000 permutations, significant within-family associations were found between rs9585961 and lumbar spine BMD and femoral neck BMD, rs9518810 and femoral neck BMD, and rs599976 and body mass index, TFM, and percentage fat mass (all P<0.05). The association analyses with haplotypes showed that haplotype AG in block1 was significantly associated with TFM (P=0.031) and haplotype CAG in block2 was significantly associated with lumbar spine BMD (P=0.020). Our study, for the first time, demonstrates that the polymorphisms and haplotypes of METTL21C contribute to the peak BMD and TFM in Chinese males, which suggests that as a quantitative trait locus with potential pleiotropy it may have an influence on osteoporosis and obesity.

Marrow Fat Quality Differences by Sex in Healthy Adults

Several studies have demonstrated the relationship between bone marrow adiposity (BMAT) and bone mass. 1H magnetic resonance spectroscopy is a noninvasive technique able to assess both BMAT quantity and quality. The aim of our study was to perform quantitative and qualitative analyses of BMAT and to investigate its association with bone mineral density (BMD) in healthy nonobese volunteers. Fifty-one healthy volunteers, 21 men and 30 women, underwent 1.5 T 1H magnetic resonance spectroscopy of the lumbar spine. BMD was determined by dual-energy X-ray absorptiometry of the lumbar spine. Correlation analysis was performed to evaluate association among lipids fractions, BMD, and age. The female and male volunteers had similar body mass index and BMD (p > 0.05). Our data demonstrated an inverse correlation of BMD and BMAT with age, with a stronger correlation of saturated lipids (r = 0.701; p < 0.0001) compared with unsaturated lipids (UL) (r = 0.278; p = 0.004). Importantly, female subjects had the highest amount of UL (confidence interval: 0.685%–1.722%; p < 0.001). Our study reports that men and women with similar BMD and body mass index have striking differences in bone marrow lipids composition, namely women have higher UL than men. In addition, we believe that our study brings new insights to the complex network involving BMAT and other factors that influence bone integrity.

Osteoporosis and pain severity in reproductive age patients with breast cancer

Aim. To analyze the relationship of osteoporosis in reproductive age patients with breast cancer with the pain severity and osteoporosis diagnosis improvement in these patients to improve their quality of life.Methods. The study included 63 women aged 30 to 50 years. The studied group consisted of 33 women with confirmed diagnosis of breast cancer, control group - 30 healthy, same age women of comparison group. The examination included a blood test for osteocalcin, calcitonin, alkaline phosphatase, parathyroid hormone, thyroid stimulating hormone, calcium and phosphorus. The pain severity was evaluated by McGill pain questionnaire and pain syndrome classification. Osteodensitometry was performed to all patients of studied and control groups. All patients with «breast cancer» diagnosis were examined prior to specific treatment administration and 6 months after treatment course completion. 12 patients were examined also after neoadjuvant chemotherapy.Results.Osteopenia (initial changes of bone tissue) was revealed in 3 (10%) cases in the control group. There was no cases of osteoporosis in the control group. Clinical manifestations in the form of the 1st level pain syndrome in healthy women was registered in 6 (20%) cases. Osteoporosis develops more often in patients who underwent complex treatment with ovarian function blocking, i.e. the artificial menopause advent. Osteoporosis in breast cancer patients after combined treatment was detected in 69.7% of cases, and pain - in 75.8% of cases. Bone mineral density indicators during treatment and after it were significantly different compared to those before treatment (pConclusion. In breast cancer in reproductive age patients after the complex treatment, osteoporosis and pain often develop, therefore such patients need to undergo osteodensitometry for timely osteoporosis diagnosis and treatment correction.

Does Salivary Calcium and Phosphate Concentrations Adequately Reflect Bone Mineral Density in Patients with Chronic Periodontitis?

Periodontitis is the inflammation of the periodontal supporting tissues. The response of periodontal tissues to local bacteria leads to bone resorption and destruction of periodontal junction. Given the possible association between periodontitis and low bone mineral density, the aim of present study was to find if measurement of salivary biomarkers as a less invasive method, can provide an appropriate screening method for assessment of bone mineral density in patients with chronic periodontitis? A case-control study was conducted on 53 people, including 28 patients with severe chronic periodontitis and 25 healthy people between April 2014 to March 2015 in Zahedan (southeast of Iran). Following Periodontal examination, salivary samples were collected, and the concentration of salivary calcium and phosphate were measured and reported as mg/dl. Bone mineral density of participants was measured using dual energy x-ray absorptiometry and reported as gr/cm2. No significant association was found between concentrations of salivary calcium and phosphate levels with bone mineral density in either healthy people or in patients with severe chronic periodontitis, despite a significant bone density reduction (in the femur neck and lumbar spine L2-L4) in the periodontitis group compared to healthy people (P=0.006, and P=0.009 respectively). Concentration of salivary calcium and phosphate do not appear to be good indicators of bone mineral density. Further prospective studies with larger sample size are recommended.

Bone Mineral Density and Cognitive Decline in Elderly Women: Results from the InCHIANTI Study.

Osteoporosis and cognitive impairment, which are highly prevalent conditions in elderly populations, share several risk factors. This study aims at evaluating the association of bone mineral density (BMD) with prevalent and incident cognitive impairment after a 3-year follow-up. We studied 655 community-dwelling women aged 65+ participating in the InCHIANTI study, who had been followed for 3years. Total, trabecular, and cortical BMD were estimated by peripheral quantitative computed tomography using standard transverse scans at 4 and 38% of the tibial length. Cognitive performance was evaluated using the Mini-Mental State Examination and the Trail Making Tests (TMT) A and B; a MMSE score <24 was adopted to define cognitive impairment. The TMT A-B score was calculated as the difference between TMT-A and TMT-B times (ΔTMT). The association of cognitive performance after 3years with baseline indices of BMD was assessed by logistic and linear regression analyses. Cortical, but not trabecular, BMD was independently associated with incident cognitive impairment (OR 0.93, 95% CI 0.88-0.98; P=0.012), worsening cognitive performance (OR 0.96, 95% CI 0.92-0.98; P=0.039), and worsening performance in ΔTMT (OR 0.96, 95% CI 0.92-0.99; P=0.047). Increasing cortical BMD tertiles was associated with decreasing probability of incident cognitive impairment (P for linear trend =0.001), worsening cognitive performance (P=0.013), and a worsening performance below the median value (P for linear trend <0.0001). In older women, low BMD might represent an independent and early marker of subsequent cognitive impairment. Physicians should assess and monitor cognitive performance in the routine management of elderly women with osteoporosis.

Are bone turnover markers associated with volumetric bone density, size, and strength in older men and women? The AGES-Reykjavik study.

Association between serum bone formation and resorption markers and bone mineral, structural, and strength variables derived from quantitative computed tomography (QCT) in a population-based cohort of 1745 older adults was assessed. The association was weak for lumbar spine and femoral neck areal and volumetric bone mineral density. The aim of this study was to examine the relationship between levels of bone turnover markers (BTMs; osteocalcin (OC), C-terminal cross-linking telopeptide of type I collagen (CTX), and procollagen type 1N propeptide (P1NP)) and quantitative computed tomography (QCT)-derived bone density, geometry, and strength indices in the lumbar spine and femoral neck (FN). A total of 1745 older individuals (773 men and 972 women, aged 66-92years) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik cohort were studied. QCT was performed in the lumbar spine and hip to estimate volumetric trabecular, cortical, and integral bone mineral density (BMD), areal BMD, bone geometry, and bone strength indices. Association between BTMs and QCT variables were explored using multivariable linear regression. Major findings showed that all BMD measures, FN cortical index, and compressive strength had a low negative correlation with the BTM levels in both men and women. Correlations between BTMs and bone size parameters were minimal or not significant. No associations were found between BTMs and vertebral cross-sectional area in women. BTMs alone accounted for only a relatively small percentage of the bone parameter variance (1-10%). Serum CTX, OC, and P1NP were weakly correlated with lumbar spine and FN areal and volumetric BMD and strength measures. Most of the bone size indices were not associated with BTMs; thus, the selected bone remodeling markers do not reflect periosteal bone formation. These results confirmed the limited ability of the most sensitive established BTMs to predict bone structural integrity in older adults.

Bone mineral density and fracture risk in patients with type ii diabetes mellitus (review)

The purpose of a literature review was to analyze the peculiarities of bone tissue organization in patients with diabetes mellitus (DM) II type by evaluating bone mineral density (BMD) and fracture risk. Review consists of three sections, which are the results of studies BMD and fracture risk in patients with type II diabetes, as well as pathogenesis of disorders in bone tissue in case of the said disease. During study of men and women with DM type II we revealed differences in BMD parameters in different segments of the skeleton. Most researchers have concluded that for DM type II BMD increased in the axial skeleton. There were positive correlation between body mass index and femoral neck BMD in women with DM type II. Potential factors affecting an increasing BMD in cases of DM type II include obesity, hyperinsulinemia, increased levels of androgens associated with obesity in women. However there are some works in which there were revealed no changes in BMD compared to healthy individuals or proven reducing of this parameter. On the one hand, the discrepancy of the indeces can be explained by population characteristics, on the other hand - the study was conducted in patients of different age and disease duration, and on different bone densitometers. Not in all cases they took into account comorbidities and features of the metabolic background of the organism. It was determined that gender features also appear on the BMD index. Either in the population or in patients with DM type II it was fixed lower skeletal mineralization in women comparing to men which one may explain by the increased risk of fracture in women. However despite on the high rates of BMD fracture risk in patients with DM type II is increased compared to healthy people indicating the need to consider other factors, for instance: risk of falls, mi­croarchitecture and features of bone remodeling, etc.

Homeostasis-based aging model for trabecular changes and its correlation with age-matched bone mineral densities and radiographs

PurposeThis paper aims (1) to propose a novel bone adaptation model for age-related trabecular changes by adopting two implicit parameters in optimization, (2) to compare the simulated bone volume fraction (BV/TV) with the reported bone mineral density (BMD), and (3) to review the simulated trabecular architectures with the age-matched radiographs. Materials and methodsThe proposed model simulated the trabecular changes for an age span of 32–80 years. Quantitative comparison was conducted in terms of BMD and other morphometric indices. Then, two radiologists scored the simulated trabecular architectures using the age-matched radiographs. This protocol was approved by the hospital institutional review board. ResultsThe simulated BV/TV was well correlated with BMD reported in the literature (R2=0.855; p<0.05). In comparison with age-matched radiographs, the consensus scores of agreement of the trabeculae were higher in age groups over the 50s, and the means of the Ward's triangle areas were strongly correlated with those in the age-matched radiographs (R2=0.982; p<0.05). ConclusionThe proposed model could reflect the targeted trabecular changes in proximal femur with age. With further follow-up measurements, this research would contribute to the development of patient-specific models that assist radiologists in predicting skeletal integrity with aging.

Low bone mineral density and fat-free mass in younger patients with a femoral neck fracture.

Reduced bone mineral density (BMD) together with muscle wasting and dysfunction, that is sarcopenia, emerges as a risk factor for hip fracture. The aim of this study was to examine body composition and BMD and their relationship with trauma mechanisms in young and middle-aged patients with femoral neck fracture. Altogether, 185 patients with femoral neck fracture aged 20-69 were included. BMD, body composition and fat-free mass index (FFMI) were determined by dual-X-ray absorptiometry (DXA), and trauma mechanisms were registered. Ninety per cent of the whole study population had a femoral neck BMD below the mean for age. In the young patients (< 50 years), 27% had a Z-score of BMD ≤ -2 SD. More than half of the middle-aged patients (50-69 years) had osteopenia, that is T-score -1 to -2.5, and 35% had osteoporosis, that is T-score < -2.5, at the femoral neck. Patients with low-energy trauma, sport injury or high-energy trauma had a median standardised BMD of 0.702, 0.740 vs. 0.803 g/cm(2) (P = 0.03), and a median FFMI of 15.9, 17.7 vs. 17.5 kg/m(2) (P < 0.001), respectively. FFMI < 10th percentile of an age- and gender-matched reference population was observed in one-third. A majority had low BMD at the femoral neck, and one-third had reduced FFMI (i.e. sarcopenia). Patients with fracture following low-energy trauma had significantly lower femoral neck BMD and FFMI than patients with other trauma mechanisms. DXA examination of both BMD and body composition could be of value especially in those with low-energy trauma.

Peripheral quantitative computed tomography (pQCT) reveals low bone mineral density in adolescents with motor difficulties.

This is the first reported study to describe local bone mineral density, assess parameters of fracture risk and report history of fractures in adolescents with motor difficulties. Motor difficulties evidenced by poor coordination in adolescence should be considered a new risk factor for below-average bone strength and structure and fracture risk. Adolescents with motor difficulties are characterised by poor coordination and low levels of physical activity and fitness. It is possible these deficits translate into below-average bone strength and structure. The objectives of this study were to describe local bone mineral density (BMD), assess parameters of fracture risk (stress-strain index, SSI) and report history of fractures in this group. Thirty-three adolescents (13 females), mean age of 14.3 (SD = 1.5) years, with motor difficulties underwent peripheral quantitative computed tomography (pQCT) measurements at proximal (66 %) and distal (4 %) sites of the non-dominant radius (R4 and R66) and tibia (T4 and T66). One sample t test was used to compare Z-scores for total BMD, trabecular density, cortical density and stress strain index (SSI) against standardized norms. Significant differences were present at R4 total density mean Z-score = -0.85 (SD = 0.7, p < 0.001), R66 cortical density mean Z-score = -0.74 (SD = 1.97, p = 0.038), R66 SSI mean Z-score = -1.00 (SD = 1.08, p < 0.001) and T66 SSI mean Z-score = -0.70 (SD = 1.15, p < 0.001). There was a higher incidence of fractures (26.9 %) compared to the normal population (3-9 %). Motor difficulties in adolescence should be considered a risk factor for below-average bone strength and structure and fracture risk. Strategies are needed to improve bone health in this high-risk-group.