Bone Mineral Density Of Lumbar Vertebrae Research Articles

Radiomics and stacking regression model for measuring bone mineral density using abdominal computed tomography.

Measurement of bone mineral density (BMD) is the most important method to diagnose osteoporosis. However, current BMD measurement is always performed after a fracture has occurred. To explore whether a radiomic model based on abdominal computed tomography (CT) can predict the BMD of lumbar vertebrae. A total of 245 patients who underwent both dual-energy X-ray absorptiometry (DXA) and abdominal CT examination (training cohort, n = 196; validation cohort, n = 49) were included in our retrospective study. In total, 1218 image features were extracted from abdominal CT images for each patient. Combined with clinical information, three steps including least absolute shrinkage and selection operator (LASSO) regression were used to select key features. A two-tier stacking regression model with multi-algorithm fusion was used for BMD prediction, which can integrate the advantages of linear model and non-linear model. The prediction results of this model were compared with those using a single regressor. The degree-of-freedom adjusted coefficient of determination (Adjusted-R2), root mean square error (RMSE), and mean absolute error (MAE) were used to evaluate the regression performance. Compared with other regression methods, the two-tier stacking regression model has a higher regression performance, with Adjusted-R2, RMSE, and MAE of 0.830, 0.077, and 0.06, respectively. Pearson correlation analysis and Bland-Altman analysis showed that the BMD predicted by the model had a high correlation with the DXA results (r = 0.932, difference = -0.01 ± 0.1412 mg/cm2). Using radiomics, the BMD of lumbar vertebrae could be predicted from abdominal CT images.

Osteodensitometric Characteristics of Bone Tissue in Women with Normal Body Weight

The aim of the study was to investigate age-related changes in bone mineralization indicators in the lumbar vertebrae in women with normal body weight living in the conditions of the Northern region.Material and methods. A complex somatometric examination and quantitative assessment of the bone tissue mineral density in the lumbar vertebrae were performed according to dual-energy X-ray absorptiometry of a group of Slavic women (n=127) with a normal body weight (BMI values from 18.5 to 24.9 kg/m2) aged 20 to 87 years, permanently residing in the Republic of Karelia. Statistical processing of the material was performed using the program "STATISTICA 6.0".Results. The BMI values in women increased significantly every decade of life. Direct correlations of mineral bone density (MBD) with the body length (r=0.46, p<0.001), with the body surface area (r=0.46, p<0.001), with absolute muscle mass (MM) (r=0.39, p<0.001), and with body mass (r=0.29, p<0.001) were revealed. No significant correlation with the adipose mass was found. The incidence of low MBD of the lumbar vertebrae was 48%: osteopenia was in 29%, osteoporosis was in 19% of women. The analysis of the component composition of the body in women with different levels of bone mass showed significant differences in the absolute content of muscle mass.Conclusion. In women with a normal BMI, body weight and muscle mass play an essential role in maintaining lumbar vertebrae bone mineral density.

Effect of Low Dietary Vitamin D Fed Prior to and During Pregnancy and Lactation on Maternal Bone Mineral Density, Structure, and Strength in C57BL/6 Mice.

ABSTRACTSeveral studies have shown that diets containing lower vitamin D than in the AIN-93G diet do not compromise bone structure, bone mineral density (BMD), and/or bone strength in male and female mice. This study determined if a diet containing low vitamin D from prepregnancy through to the end of lactation maintained these bone outcomes to a similar extent as a high vitamin D diet. Mice were fed an AIN-93G diet with 25 (LD diet) or 5000 (HD diet) IU vitamin D/kg diet from premating through to lactation (n = 15/group). Of the major structure outcomes, only cortical area fraction of the distal femur was lower (P <0.05) with the LD diet. Lumbar vertebra BMD was lower (P <0.05) with LD whereas distal femur BMD and bone strength at 3 sites did not differ. Dams fed an LD diet premating through to the end of lactation had largely similar bone outcomes to dams fed a HD diet.

Abstract P002: Associations Of Bone Fracture Outcomes With Body Compositions Measurements In A Fragility Fracture Clinic Population

Introduction: While preoperative bone health optimization is typical in the fragile population, objective assessment is limited. Among the aged, localized discordance in bone loss is prevalent and may not be assessed properly with traditional diagnostic measures. Etiology for bone loss discordance is unknown, but may be attributed to aging, disease state, habitus, or activity. This study investigated the association between body composition measures and common fragility fractures. Hypothesis: We hypothesized that each different fracture outcome would associate differently with measures of body composition. Methods: The Fragility Fracture Clinic at the University of Michigan provides comprehensive care to promote bone health, accelerate healing, and reduce fracture risk in those with and at-risk for fractures. Participants (N=344) included those who enrolled at the clinic between 2013 and 2020 and received an abdomen and/or pelvis computed tomography (CT) scan up to 120 days prior to initial enrollment date. Fracture categorizations included acute vs. non-acute, intensity (high vs. low energy), and location (thoracic vs. lumbar vertebral). Retrospective CT-scans were obtained from the University of Michigan Picture Archive and Communication System. Analytic Morphomics was used to obtain granular vertebral-indexed measurements of vertebral bone density, fascia, adipose tissue, muscle, vasculature, and interior body dimensions. Relevant measures include bone mineral density (BMD) [vertebral body trabecular bone density in Hounsfield Units (HU)], lower muscle group density in HU (DMG) (cross sectional area of DMG in HU range of 31-100), cortical bone density [anterior cortical half-maximum (in HU)], and fascial width (in mm). Measurements were divided by their standard deviation to ease interpretation of odds ratios. Multivariable logistic regression was used to evaluate the relationship between body measures and fracture type. Coefficients are reported as odds ratio (OR) and 95% confidence interval (CI). An alpha level of 0.05 determine statistical significance. Results: Associations were observed between acute fracture and BMD at L3 [OR 0.58, 95% CI 0.36-0.85]; high energy fracture and DMG at L3 [OR 2.08, 1.05-4.64]; low energy fracture and BMD at T8 [OR 0.39, 0.17-0.81]; thoracic vertebral fractures and BMD at T11 [OR 0.39, 0.17-0.81], cortical bone density at T11 [OR 0.64, 0.40-0.95], and fascial width at L4 [OR 0.67, 0.43-0.98]; lumbar vertebral fracture and BMD at L3 [OR 0.44, 95% CI 0.20-0.88]. Conclusion: Body composition measures uniquely associated with fracture outcomes. Lower vertebral trabecular bone density was associated with acute, high energy, thoracic vertebral, and lumbar vertebral fractures; lower lean muscle with high energy fractures; cortical bone density and facial (i.e. visceral cavity) width with thoracic vertebral fractures.

The Association of Lumbar Disc Herniation with Lumbar Volumetric Bone Mineral Density in a Cross-Sectional Chinese Study.

Little is known about the effect of lumbar intervertebral disc herniation (LDH) on lumbar bone mineral density (BMD), and few previous studies have used quantitative computed tomography (QCT) to assess whether the staging of LDH correlates with lumbar vertebral trabecular volumetric bone mineral density (Trab.vBMD). To explore the relationship between lumbar Trab.vBMD and LDH, seven hundred and fifty-four healthy participants aged 20–60 years were enrolled in the study from an ongoing study on the degeneration of the spine and knee between June 2014 and 2017. QCT was used to measure L2–4 Trab.vBMD and lumbar spine magnetic resonance images (MRI) were performed to assess the incidence of disc herniation. After 9 exclusions, a total of 322 men and 423 women remained. The men and women were divided into younger (age 20–39 years) and older (age 40–60 years) groups and further into those without LDH, with a single LDH segment, and with ≥2 segments. Covariance analysis was used to adjust for the effects of age, BMI, waistline, and hipline on the relationship between Trab.vBMD and LDH. Forty-one younger men (25.0%) and 59 older men (37.3%) had at least one LDH segment. Amongst the women, the numbers were 46 (22.5%) and 80 (36.4%), respectively. Although there were differences in the characteristics data between men and women, the difference in Trab.vBMD between those without LDH and those with single and ≥2 segments was not statistically significant (p > 0.05). These results remained not statistically significant after further adjusting for covariates (p > 0.05). No associations between lumbar disc herniation and vertebral trabecular volumetric bone mineral density were observed in either men or women.

Comprehensive Interventions Including Vitamin D Effectively Reduce the Risk of Falls in Elderly Osteoporotic Patients

ObjectiveTo evaluate the effects of different intervention measures to prevent falls in elderly osteoporotic patients.MethodsA randomized controlled trial was conducted in our outpatient ward from August 2014 to September 2015. A total of 420 patients over 60 years of age were assigned to four groups. NA VitD group took 800 mg calcium and 800 IU non‐active vitamin D. P‐NA VitD group took 800 mg calcium, 800 IU non‐active vitamin D, and received physical exercise. A VitD group took 800 mg calcium and 0.5 μg active vitamin D. P‐A VitD took 800 mg calcium, 0.5 μg active vitamin D, and received physical exercise. Physical exercise includes guidance in improving muscle strength and balance ability. Short physical performance battery (SPPB), grip strength, modified falls efficacy scale (MFES), blood calcium, and 25‐hydroxyl vitamin D were measured before interventions and at 3, 6, and 12 months after interventions. Bone mineral density (BMD) was detected before interventions and at 12 months after interventions. The incidence of falls and fractures, adverse events, and drug reactions were recorded for 12 months.ResultsA total of 420 patients were allocated in the four groups: 98 cases into the NA VitD group (11 males, 87 females), 97 cases into the P‐NA VitD group (13 males, 84 females), 99 cases in the A VitD group (15 males, 84 females), and 98 cases into the P‐A VitD group (11 males, 87 females). At 6 months after interventions, the SPPB of A VitD group significantly increased from 6.9 ± 1.9 to 8.0 ± 2.4 (P < 0.05), and the SPPB of A VitD group significantly increased from 7.2 ± 2.1 to 8.6 ± 1.7 (P < 0.05). At 6 months after interventions, MFES of P‐NA VitD group 7.0 ± 1.6 to 7.6 ± 1.6 (P < 0.05), and MFES of P‐A VitD group significantly increased from 6.7 ± 1.6 to 7.5 ± 1.6 (P < 0.05). At 12 months after interventions, SPPB of all groups, grip strength, and MFES of P‐NA VitD group, A VitD group, P‐A VitD group were significantly improved (P < 0.05). The BMD of lumbar vertebrae of A VitD group significantly increased from 0.742 ± 0.042 to 0.776 ± 0.039, and P‐A VitD group significantly increased from 0.743 ± 0.048 to 0.783 ± 0.042 (P < 0.05). No serious adverse events occurred during the 12 months of follow‐up.ConclusionActive vitamin D is better than non‐active vitamin D to improve physical ability and the BMD of lumbar vertebrae and reduce the risk of falls.

Computed tomography-based opportunistic osteoporosis assessment: a comparison of two software applications for lumbar vertebral volumetric bone mineral density measurements

We aimed to compare two volumetric bone mineral density (vBMD) analysis programs, regarding (I) agreement of vBMD values based on mono- and dual-energy computed tomography (MECT and DECT) scans and (II) suitability for analyzing DECT data obtained at different energies. We retrospectively analyzed two abdominal CT datasets: one performed in a MECT scan (vertebrae L1-L3) and one in a DECT scan (vertebrae L1-L4). Each dataset included different individuals [MECT 15 patients (45 vertebrae) and DECT 12 patients (48 vertebrae), respectively]. vBMD analysis was conducted using Philips IntelliSpace (IP) and Mindways qCT Pro (MW). Regarding the DECT scans, vBMD analysis was done at three different energies: 80, 150 and synthetic 120 kVp and for MECT scan at 120 kVp. For comparison of vBMD results between different software (aim 1) MECT 120 kVp and DECT synthetic 120 kVp data was used. For analyzing suitability of using different DECT energies for vBMD assessment (aim 2) all three DECT energies were used and results from each software was analyzed separately. vBMD assessed with MW and IP, respectively correlated significantly for both the MECT (r=0.876; P<0.001) and DECT (r=0.837; P<0.001) scans, but the vBMD values were lower in using IP for vBMD assessment (8% and 14% lower for MECT and DECT, respectively; P=0.001). Regarding the different DECT energies, using MW for vBMD assessment showed significant correlations in vBMD results between 120 kVp and the two other energies (r=0.988 and r=0.939) and no significant differences in absolute vBMD values (P>0.05). The IP analysis as well showed significant correlation between 120 kVp and the other energies (r=0.769 and r=0.713, respectively), but differences in absolute vBMD values between the energies (P≤0.001). We show that the correlations between the vBMD derived from the two investigated software solutions were generally good but that absolute vBMD value did differ and might impact the clinical diagnosis of osteoporosis. Though small, our study data indicate that vBMD might be assessed in energies other than 120 kVp when using MW but not when using IP.

Taro (Colocasia esculenta) flour intake enable bone integrity in male rats

Objetivo: A proposta deste estudo foi investigar a composição óssea em ratos tratados com dieta suplementada com farinha de taro (Colocasia esculenta) até eles completarem 90 dias de idade. Métodos: No momento do desmame, os ratos foram divididos em grupo controle (C, n = 11) e experimental (T, n = 12) – composto por animais tratados com farinha de taro até os 90 dias de idade. Ingestão alimentar, massa e comprimento corporal foram avaliados semanalmente ao longo de todo o período experimental. Dimensões ósseas, bem como a densidade mineral óssea (DMO), conteúdo mineral ósseo (CMO), área óssea total e propriedades biomecânicas foram determinadas no final de 90 dias. Resultados: Grupo T apresentou elevados valores (P&lt;0.05) para massa e comprimento corporal; DMO, CMO e área óssea da coluna vertebral; DMO na quarta vértebra lombar; massa femoral, distância entre as epífises, largura do ponto médio da diáfise, DMO, força máxima e concentrações séricas de osteocalcina, quando comparado ao grupo controle. Conclusões: A ingestão da farinha de taro apresentou efeito positivo na saúde óssea.

Treatment of chronic thoracolumbar osteoporotic fractures combined with kyphosis with cement-injectable cannulated pedicle screw and multiple level Schwab grade Ⅰ osteotomy

To evaluate the effectiveness of cement-injectable cannulated pedicle screw combined with multiple level Schwab grade Ⅰ osteotomy for chronic thoracolumbar osteoporotic fractures with kyphosis. The clinical data of 27 patients with symptomatic chronic thoracolumbar osteoporotic fractures combined with kyphosis treated between June 2015 and June 2017 were retrospectively analysed. Among them, there were 8 males and 19 females, with an average age of 69.5 years (range, 56-81 years). The damage segment (kyphosis vertex) included T 11 in 4 cases, T 12 in 12 cases, L 1 in 10 cases, and L 2 in 1 case. The disease duration ranged from 3 to 21 months, with an average of 12.5 months. The T value of lumbar vertebral bone mineral density ranged from -4.9 to -2.5, with an average value of -3.61. The American Spinal Injury Association (ASIA) classification was used to evaluate spinal cord injury, there were 1 case of grade D and 26 cases of grade E. The visual analogue scale (VAS) score, Oswestry disability index (ODI), kyphosis Cobb angle of fracture site, and sagittal vertical axis (SVA) data were obtained before operation, at 2 weeks after operation, 3 months after operation, and last follow-up, to evaluate the quality of life and improvement of sagittal spine parameters. No complications related to pedicle screw and bone cement occurred. The incisions healed by first intention in 26 cases, and 1 incision healed after dressing change due to poor blood glucose control. There were no complications such as bedsore, hypostatic pneumonia, or deep venous thrombosis. All patients were followed up 8-24 months, with an average of 16.6 months. The VAS score, ODI score, Cobb angle, and SVA were significantly improved when compared with those before operation ( P<0.05). There was no significant difference in Cobb angle between each time point after operation ( P>0.05); the VAS score and ODI score at 3 months after operation and last follow-up were significantly better than those at 2 weeks after operation ( P<0.05), and the ODI score at last follow-up was further improved when compared with the score at 3 months ( P<0.05), but there was no significant difference in VAS score ( P>0.05); SVA at last follow-up was significantly worse than that at 2 weeks and 3 months after operation ( P<0.05), but there was no significant difference between at 2 weeks and 3 months after operation ( P>0.05). During the follow-up period, there was no complication such as pedicle screw loosening, breakage or cutting, adjacent vertebral fracture, proximal junctional kyphosis, and so on. For the chronic thoracolumbar osteoporotic fractures combined with kyphosis, the cement-injectable cannulated pedicle screw and multiple level Schwab grade Ⅰ osteotomy has the advantages of less operation trauma, quick recovery, and remarkable effectiveness.

Density and Fat Fraction of the Psoas, Paraspinal, and Oblique Muscle Groups Are Associated With Lumbar Vertebral Bone Mineral Density in a Multi-Ethnic Community-Living Population: The Multi-Ethnic Study of Atherosclerosis.

Low vertebral bone mass is a major risk factor for vertebral compression fractures. Although sarcopenia has been shown to be associated with low bone mineral density (BMD), it is not known whether trunk musculature is directly associated with lumbar BMD, and whether exercise modifies this association. Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we sought to determine the association of muscle density and fat fraction of the psoas, paraspinal, and oblique muscle groups with L3 lumbar volumetric BMD, and whether these associations were modified by exercise. We obtained L3 vBMD measurements, and fat and muscle measurements (in Hounsfield units [HU]) from abdominal computed tomography (CT) scans spanning the L2 -L4 intervertebral disc spaces. Muscle density was defined as the mean HU value for a muscle group area. Fat fraction was calculated as the mean HU value for the muscle group fat area/total muscle group area (cm2 ). Exercise data were self-reported (MET-minute/week). We utilized multivariable linear regression to evaluate these associations, stratified by gender, and adjusting for demographics, body mass index (BMI), smoking status, impaired fasting glucose, and corticosteroid and anti-resorptive medication use. Among 1923 MESA participants, mean ± standard deviation (SD) age was 62 ± 10 years, 49% were female, 40% white, 21% black, 26% Hispanic/Latino, and 13% Chinese. In fully adjusted analysis, for every 1-SD higher psoas fat fraction, there was a 3.19-SD lower L3 vBMD in men and 4.3-SD lower L3 vBMD in women (p < 0.001). For every 1-SD higher psoas density, there was a 0.2-SD higher L3 vBMD (p < 0.001) in men and 0.19-SD higher L3 vBMD (p < 0.001) in women. Findings were similar for paraspinal and oblique muscles. Intentional exercise did not modify these associations. In men and women, trunk muscle density was positively associated with higher lumbar BMD, suggesting a local association. Future studies are warranted to determine the temporality of this association. © 2022 American Society for Bone and Mineral Research (ASBMR).

Effects of Teriparatide versus Salmon Calcitonin Therapy for the Treatment of Osteoporosis in Asia: A Meta-analysis of Randomized Controlled Trials

The objective of this meta-analysis was to compare the efficacy and safety of teriparatide versus salmon calcitonin for the treatment of osteoporosis in Asian patients and to investigate whether the results of global studies could be applicable to Asian patients. PubMed, OVID, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE up to December 2018 were searched. Eligible randomized controlled trials (RCTs) that compared teriparatide versus salmon calcitonin in Asian osteoporosis population were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for data synthesis, and Cochrane Collaboration software Review Manager 5.3 was used to analyze the pooled data. Three RCTs involving 529 patients were included (mean age 68.7 yr; 93.4% females; mean follow-up 6 months); outcome measures included bone mineral density (BMD) of the femoral neck, total hip and lumbar spine; bone markers and adverse events. We found that the period of 6-months of teriparatide treatment was helpful for the improvement of the BMD of lumbar vertebra, however, the improvement of BMD was not significant in the femoral neck and total hip joint. There was a positive correlation between bone-specific alkaline phosphatase (BSAP) and osteocalcin (OCN) and the response of Asian patients to subcutaneous injection of 20 micrograms per day of teriparatide. The proportion of the occurrence of adverse effects was more obvious in the teriparatide group compared with salmon calcitonin, but there was no significant difference. Results suggested that the use of teriparatide could improve the lumbar BMD by shortterm (six months) application in Asian osteoporosis patients, which is beneficial to the patients who cannot tolerate adverse events of long-term treatment. The BSAP and OCN bone markers could be useful to monitor the responses of Asian osteoporosis patients to teriparatide treatment. Finally, both of teriparatide and salmon calcitonin were well tolerated by Asian patients.

SAT-LB68 A Rare De Novo Mutation in LRP5 Gene in an Adolescent Female With Juvenile Onset Primary Osteoporosis

Background: Juvenile onset of primary osteoporosis is a rare skeletal disorder with a highly heterogenous clinical presentation and complex poorly understood genetic etiology. Low-density lipoprotein receptor-related protein 5 (LRP5), a Wnt-β-catenin pathway receptor involved in bone mineral density (BMD) regulation, has been reported in children with primary osteoporosis mainly due to missense and frame-shift mutations. To our knowledge, there is only one report of in-frame deletions in exon 21 possibly being implicated in pregnancy related osteoporosis (1). We report the first case of a rare heterozygous de novo in-frame deletion in exon 21 of LRP5 gene in a girl with juvenile onset primary osteoporosis. Clinical Case: A 7.5 yo previously healthy European-African-American female born to non-consanguineous family, was noted to have left ankle and bilateral wrists fractures during sport activities occurring over the span of 1 y. On exam, she was of normal stature, had normal sclerae and vision, but was found to have hypermobile joints. Initial blood work revealed an elevated iPTH 72 pg/mL (9-59), normal Ca 9.6 mg/dL (8.9-10.4), and low 25OH-Vitamin D 17 ng/mL (30-100), which normalized with supplementation to 30.4 ng/mL. By 10.5 yo, she had sustained multiple sports related and pathologic fractures of long bones with progressive bone pain and functional ambulatory impairment. Radiographic evaluation showed osteopenia, multiple healed long bone fractures with presumed non-ossifying fibroma in the distal right femoral metaphysis, and subtle height loss of T4-5 vertebrae. CT bone densitometry at 12 yo showed low mean cancellous lumbar vertebral BMD of 190 mg/cm3 (ref. 285 ± 45) and normal cortical BMD of the femoral midshaft of 1977 mg/cm3 (ref. 2000 ± 60). Genetic testing for Osteogenesis Imperfecta returned negative for COL1A1 and COL1A2 mutations. Whole exome sequencing (WES) revealed a rare, de novo heterozygous mutation in exon 21 that involved deletion of nucleotides 4454 to 4465 resulting in an in-frame deletion of amino acid 1485 to 1488. This mutation is predicted to be deleterious by in silico analysis. Conclusion: We present the first case of a young female with progressive pathologic fractures, functional ambulatory impairment, and low BMD in childhood, consistent with juvenile onset primary osteoporosis. WES revealed a rare de novo heterozygous in-frame deletion mutation in LRP5, providing a plausible biological mechanism for her clinical presentation, and further contributing to the increasing genetic heterogeneity of juvenile onset primary osteoporosis and LRP5-related bone disorders. Reference: (1) Cook, F., Mumm, S., Whyte, M., Wenkert, D. Pregnancy-associated osteoporosis with a heterozygous deactivating LDL receptor-related protein 5 (LRP5) mutation and a homozygous methylenetetrahydrofolate reductase (MTHRF) polymorphism. JBMR. 2014;29 (4): 922-8.

Prediction of bone mineral density from computed tomography: application of deep learning with a convolutional neural network.

To investigate whether a deep learning model can predict the bone mineral density (BMD) of lumbar vertebrae from unenhanced abdominal computed tomography (CT) images. In this Institutional Review Board-approved retrospective study, patients who received both unenhanced CT examinations and dual-energy X-ray absorptiometry (DXA) of the lumbar vertebrae, in two institutions (1 and 2), were included. Supervised deep learning was employed to obtain a convolutional neural network (CNN) model using axial CT images, including the lumbar vertebrae as input data and BMD values obtained with DXA as reference data. For this purpose, 1665 CT images from 183 patients in institution 1, which were augmented to 99,900 (= 1665 × 60) images (noise adding, parallel shift and rotation were performed), were used. Internal (by using data of 45 other patients in institution 1) and external validations (by using data of 50 patients in institution 2) were performed to evaluate the performance of the trained CNN model. Correlations and diagnostic performances were evaluated with Pearson's correlation coefficient (r) and area under the receiver operating characteristic curve (AUC), respectively. The estimated BMD values, according to the CNN model (BMDCNN), were significantly correlated with the BMD values obtained with DXA (r = 0.852 (p < 0.001) and 0.840 (p < 0.001) for the internal and external validation datasets, respectively). Using BMDCNN, osteoporosis was diagnosed with AUCs of 0.965 and 0.970 for the internal and external validation datasets, respectively. Using deep learning, the BMD of lumbar vertebrae could be predicted from unenhanced abdominal CT images. • By applying a deep learning technique, the bone mineral density (BMD) of lumbar vertebrae can be estimated from unenhanced abdominal CT images. • A strong correlation was observed between the estimated BMD and the BMD obtained with DXA. • By using the estimated BMD, osteoporosis could be diagnosed with high performance.

Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short-Bowel Syndrome.

Osteoporosis has scarcely been prospectively investigated in short-bowel syndrome (SBS). This prospective study was designed to evaluate incretins, adipokines, bone mass, and lipid deposits from marrow adipose tissue (MAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver (IHLs). The study comprised 2 groups matched by gender, height, and age: the control group (CG) (9 males, 9 females) and the SBS group (SBSG) (6 males, 5 females). The SBSG was evaluated twice in an interval of 1 year (SBSG0 and SBSG1 ). The biochemical evaluation included incretins, leptin, and adiponectin. Dual-energy x-ray absorptiometry and magnetic resonance were, respectively, used to measure BMD and lipid deposits. Bone mineral density (BMD) was lower in the SBSG than in the CG, but there was no difference between SBSG0 and SBSG1 . There was no difference in MAT, SAT, and VAT, but IHL was lower in CG than in SBSG0 and SBSG1 . A negative correlation between MAT and third lumbar vertebrae BMD was found in the CG but not in SBSG0 or SBSG1 . There was a negative association between IHL and bone mass considering all participants (CG and SBSG0 ) (R2 = 0.38; P < .05). Appropriate nutrition assistance recovers body composition, reverts the relationship of bone mass and MAT, and mitigates bone loss in SBS. In spite of this, osteoporosis seems to be an early and persistent complication in SBS. Curiously, SBS seems to be a highly vulnerable condition for the development of hepatic steatosis and shows an association between bone mass and IHL.

A correlative study of liver fat content and bone mineral density in middle-aged and elderly people

Objective To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people. Methods Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis. Result Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD (r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant (r=-0.291, P<0.001), in males (r=-0.283, P=0.021) and in females (r=-0.210, P=0.025). Conclusion Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people. Key words: Fatty liver; Bone density; Tomography, X-ray computed; mDIXON-Quant technique

Analysis of bone mineral density and bone metabolism in elderly hip fracture patients of different genders

Objective To understand changes and characteristics of bone mineral density(BMD)and early-stage bone turnover biochemical markers in elderly hip fracture patients of different genders. Methods This was a retrospective cohort study.A total of 1 161 elderly patients with hip fractures hospitalized in Beijing Jishuitan Hospital from May 2015 to December 2017 were enrolled.Based on gender, patients were divided into the female group(n=831)and the male group(n=330). Clinical data, BMD, serum type I procollagen amino terminal propeptide(P1NP), and 25-hydroxyvitamin D3 [25-(OH)VD3], type I collagen cross-linked carboxy terminal peptide beta degradation products(β-CTX), osteocalcin(OC)and parathyroid hormone(PTH)were measured and compared between the two groups. Results Of the 1 161 elderly patients with hip fractures, 831 were female and 330 were male.The BMD of the lumbar vertebrae and the total hip in the female and male groups showed that 30.4%(353/1 161)and 6.8%(79/1 161)had T≥-1.0 SD respectively; 36.6%(425/1 161)and 44.7%(519/1 161)had -2.5 SD 0.05). The levels of tP1NP, β-CTX, OC and PTH in females were higher than those in males, and the level of 25-(OH)VD3 was lower than that in males(all P<0.05). As the T value decreased, β-CTX and OC increased and 25-(OH)VD3 decreased accordingly(all P<0.05). Conclusions With the increase of age, the BMD T value in elderly patients with hip fractures shows a downward trend, but its decline in women is faster and earlier.Overall, the BMD T value is not sensitive enough for osteoporosis diagnosis or hip fracture prediction in the elderly, especially in men.In the early stage of fractures, the bone turnover biochemical markers show varying degrees of change, and bone resorption and bone formation are both reduced.The significance of OC, β-CTX and VD levels in early bone metabolic abnormalities requires further study. Key words: Osteoporosis; Hip fractures; Bone density

The effects of polypharmacy on bone mineral density in middle-aged and elderly men

Background: Osteoporosis is a loss of bone density among aging adults that can cause fractures and disability. Drug-induced osteoporosis is a noteworthy health problem, but many physicians are unaware that many commonly prescribed medications contribute to significant bone loss and fractures. This study investigated the cumulative effects of concurrent polydrug use (≥ 5 medications) on bone mineral density (BMD) with inhibited and induced cytochrome P450 (CYP450) enzyme activity. Methods: This study enrolled 207 middle-aged and elderly male subjects who underwent two dual-energy X-ray absorptiometry (DXA) scans to measure lumbar vertebrae BMD between 2012 and 2018 and analyzed their prescribed medicines metabolized via the CYP450 system. Results: The inhibitory group (n = 66) included patients prescribed more drugs that inhibit CYP450 than those that induce CYP450, the inductive group (n = 72) included patients prescribed more medications that induce CYP450 than those that inhibit CYP450, and the reference group (n = 69) included patients administered with the equal number of prescription drugs that inhibit and induce CYP450 or used neither. The results indicated a significant increase in the risk of BMD loss in the inductive group compared to the reference group (OR = 3.63, 95% CI = 1.43-5.84) (p = 0.013). Conclusions: The prescription of drugs that induce CYP450 decreases the BMD in middle-aged and elderly males. A possible mechanism is that more CYP450 inducers in number would accelerate the metabolic rate of vitamin D and will eventually affect the function of parathyroid hormone in bone remodeling.

Relationship between quantitative parameters of lumbar vertebral perfusion and bone mineral density (BMD) in postmenopausal women.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a noninvasive method to evaluate the microcirculation of bone marrow in local tissue, which will be a new tool for the diagnosis of osteoporosis. To investigate the relationship between quantitative perfusion parameters (Ktrans, Kep and Ve) and bone mineral density (BMD) in postmenopausal women. The subjects were divided into 3 groups according to T value: normal bone mass group (T value ≥-1.0); bone loss group (-2.5 < T <-1.0); and osteoporosis group (T ≤-2.5). Ktrans, Kep and Ve of the lumbar spine were measured using quantitative DCE-MRI. The relationship between these parameters and age was analyzed. Bone mineral density of the lumbar spine and femoral neck gradually decreased with age. The values of Ktrans, Kep and Ve significantly decreased with age. The values of Ktrans, Kep and Ve of the lumbar vertebrae in the osteoporosis group were lower than those in the bone loss and normal bone mass group. Bone mineral density was positively correlated with the Ktrans and Ve of the lumbar vertebrae. The incidences of bone loss and osteoporosis increased with age. The measurement of BMD was conducive to early diagnosis of osteoporosis. Ktrans, Kep and Ve values of the lumbar vertebra decreased with age, and have a positive correlation with lumbar BMD. The value of DCE-MRI may play a role in the diagnostic algorithm of osteoporosis.

Effect of co-administration of alendronate and allan sodium phosphate for the management of osteoporosis

Purpose: To study the therapeutic effect of combination of alendronate and allan sodium phosphate on osteoporosis.Methods: Patients diagnosed with osteoporosis (100) were randomly assigned to control and study groups (50 subjects/group). The control group received conventional calcium treatment (calcium carbonate D3) after surgery. They consisted of 21 males and 29 females aged 62 to 78 years. The observation group consisted of 22 males and 28 females aged 63 to 77 years (mean age = 68.90 ± 6.43 years), and were treated with sodium alendronate and allan sodium phosphate. Bone mineral density (BMD), bone pain score, clinical effectiveness and levels of calcium, phosphorus, osteocalcin, collagen N-terminal peptide (NTX) and urinary calcium/creatinine were determined using ELISA kits.Results: After 1 year of treatment, lumbar vertebral and femoral neck BMD significantly increased in both groups. The study group had significantly higher BMD than the controls (p &lt; 0.05). Blood calcium levels increased significantly after 1 year in both groups. The treatment led to a higher level of osteocalcin in the study group than in the control group (p &lt; 0.05). However, the treatment brought about significantly lower NTX level in the study group than in controls.Conclusion: The results indicate that combined administration of sodium alendronate and allan sodium phosphate is effective for the treatment of osteoporosis.Keywords: Osteoporosis, Allan sodium phosphate, Alendronate, Apoptosis-related factors, Calcium

Abstract P135: Bone Mineral Density is Associated With Vascular Endothelial Function and Arterial Stiffness in Apparently Normal Population From China

Objective: To evaluate the relation of vascular parameters with bone mineral density (BMD) in the apparently normal population. Background: Vascular parameters including brachial arterial flow-mediated vasodilatation (FMD), brachial ankle pulse wave velocity (ba-PWV) and ankle brachial index (ABI), are reported associated with bone health. However, prior investigations have been limited to highly selected samples. Methods: We studied 165 individuals without a history of cardiovascular disease in the Chinese Arteriosclerosis Series Evaluation-She Minority Study (CASE-SMS) cohort (mean age 46.94±11.23 years, 59.4% women). BMD was quantified by dual-energy X-ray absorptiometry (DXA). Results: Age-adjusted analysis showed there was no difference in FMD, ba-PWV, ABI, lumbar vertebra BMD and left hip BMD between male, premenopausal female and postmenopausal female (all p&gt;0.05). Multivariable linear analysis showed that FMD (B=0.005, p=0.016) and ba-PWV (B=-0.009, p=0.014) were both associated with lumbar vertebra BMD independently of each other. Multivariable logistic analysis showed FMD and ba-PWV were both related to low BMD in total (FMD OR 0.860, 95% CI 0.802 to 0.922, p&lt;0.001; ba-PWV OR 1.494, 95% CI 1.275 to 1.751, p&lt;0.001), male (FMD OR 0.861, 95% CI 0.757 to 0.979, p=0.022; ba-PWV OR 1.523, 95% CI 1.190 to 1.951, p=0.001), premenopausal female (FMD OR 0.842, 95% CI 0.734 to 0.966, p=0.014; ba-PWV OR 1.421, 95% CI 1.063 to 1.899, p=0.018) and postmenopausal female population (FMD OR 0.825, 95% CI 0.715 to 0.952, p=0.008; ba-PWV OR 1.740, 95% CI 1.187 to 2.551, p=0.004). In all the analyses, ABI was not associated with BMD (all p&gt;0.05). Conclusion: There was no difference in FMD, ba-PWV, ABI, lumbar vertebra BMD and left hip BMD between male, premenopausal female and postmenopausal female after adjusting for age. FMD and ba-PWV were independently associated with lumbar vertebra BMD and low BMD. However, ABI was not associated with BMD.