Bone Mineral Quantity Research Articles

Clinical Devices for Bone Assessment.

Although it has been over 30years since the first recorded use of quantitative ultrasound (QUS) technology to predict bone strength, the field has not yet reached its maturity. Among several QUS technologies available to measure cortical or cancellous bone sites, at least some of them have demonstrated potential to predict fracture risk with an equivalent efficiency compared to X-ray densitometry techniques, and the advantages of being non-ionizing, inexpensive, portable, highly acceptable to patients and repeatable. In this Chapter, we review instrumental developments that have led to in vivo applications of bone QUS, emphasizing the developments occurred in the decade 2010-2020. While several proposals have been made for practical clinical use, there are various critical issues that still need to be addressed, such as quality control and standardization. On the other side, although still at an early stage of development, recent QUS approaches to assess bone quality factors seem promising. These include guided waves to assess mechanical and structural properties of long cortical bones or new QUS technologies adapted to measure the major fracture sites (hip and spine). New data acquisition and signal processing procedures are prone to reveal bone properties beyond bone mineral quantity and to provide a more accurate assessment of bone strength.

Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy.

ObjectiveHuman immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) have been associated with reduced bone mineral density (BMD) in persons with HIV (PWH). BMD provides information only about bone mineral quantity. Trabecular bone score (TBS) is a noninvasive tool that estimates bone microarchitecture. The aim of this study is to measure BMD and TBS of Chinese PWH after one-year ART.MethodsWe designed a retrospective study of adult Chinese PWH. Patients with a dual-energy X-ray absorptiometry (DXA) scan prior to ART initiation, and again 48 weeks later were included. Information regarding demographic and clinical history, HIV treatment history, BMD and TBS were collected. We analyzed differences in BMD and TBS over 48 weeks and associations between key risk factors and changes in BMD and TBS.ResultsOur study included 233 ​PWH (mean age ​= ​36.6 ​± ​11.1 years). Before ART initiation, 19.3% of PWH had normal BMD but abnormal TBS. Both BMD and TBS decreased after one-year ART. TDF and LPV/r-containing regimens were associated with greater declines in BMD at different site. Traditional risk factors such as old age, low BMI and female sex were associated with lower baseline TBS. Greater change in TBS over one year was associated with lower BMI and lower baseline CD4+ cell count, but unlike BMD measures, it was not correlated with treatment with TDF and LPV/r in our study population.ConclusionsWe present the first longitudinal analysis of change in TBS over 48 weeks compared with BMD among Asian PWH receiving ART. Before ART initiation, approximately 20% of PWH with impaired bone microarchitecture would not have been identified if DXA were used alone to assess for bone damage. Both BMD and TBS decreased after one-year ART. Change in TBS was not associated with different antiretroviral agents.The translational potential of this articleThe trabecular microarchitecture measured indirectly by TBS may provide clinicians additional information about bone damage in PWH.

Bone mineral density is increased in the cadmium-induced omphalocele chick model by using three-dimensional micro-computed tomography.

The cadmium (Cd) chick model has been described as a reliable model of omphalocele. Skeletal anomalies, including lumber lordosis, can be seen in the Cd chick model, as well as in the human omphalocele. Bone deformations, such as lordosis, are associated with high bone mineral density (BMD). Recently, three-dimensional microcomputed tomography (3DMCT) has been used to investigate skeletal development in small animal embryos. We used 3DMCT to test the hypothesis that the BMD is increased in the Cd-induced omphalocele chick model. After a 60-h incubation, chicks were exposed to either chick saline or Cd in ovo. Chick embryos were harvested at embryonic day 16.5 (E16.5) and were divided into control (n = 8) and Cd (n = 9). Chicks were then scanned by 3DMCT. The body volume, bone volume, bone/body volume ratio, bone mineral quantity and BMD were analysed statistically (significance was accepted at p < 0.05). Bone mineral density (mg/cm3) was significantly increased in the Cd group compared to control group (235.3 ± 11.7 vs 223.4 ± 4.6, p < 0.05), whereas there was no significant difference in the bone/body volume ratio between the Cd group and the control group (0.7 ± 0.1 vs 0.6 ± 0.0). The body volume (cm3) (0.3 ± 0.2 vs 0.3 ± 0.1), bone volume (cm3) (0.2 ± 0.2 vs 0.2 ± 0.1), and bone mineral quantity (mg) (51.3 ± 41.6 vs 41.5 ± 16.5) were not significantly different between the two groups. Increased BMD may be associated with lordosis of the vertebral column in the Cd-induced omphalocele chick model, stimulating osteogenesis by activating the canonical Wnt signalling pathway.

AMPKα1

With our increasingly aged and dysmetabolic population, the deleterious consequences of globally perturbed calcium metabolism become increasingly apparent.1 Net loss of bone mineral quantity and quality increases risk for osteoporotic fracture,2 whereas accumulating arterial calcium loads stiffen conduit arteries and impairs Windkessel physiology—the rubbery elasticity of conduit vessels that ensures smooth distal tissue perfusion throughout the cardiac cycle.3 Murine models were first used to identify that reciprocal change in skeletal versus vascular calcium accrual can occur in response to the dysmetabolic states of diabetes mellitus, uremia, and dyslipidemia4. However, the Multiethnic Study of Atherosclerosis (MESA) firmly established the general connection between accrual of metabolic syndrome parameters—impaired fasting glucose, hypertension, obesity, low high-density lipoprotein, hypertriglyceridemia, or frank type 2 diabetes mellitus (T2D)—and arterial calcium load in humans.5 Recent studies implementing high-resolution peripheral quantitative computed tomography have shown that older men and women with T2D exhibit greater cortical bone porosity—a feature that compromises bone strength and increases fracture risk.6,7 Patients with calcified peripheral arterial disease also exhibit deficiencies in trabecular bone structure on high-resolution peripheral quantitative computed tomography, further solidifying the relationship.8 Elegant human genetic studies by Mani et al9 highlighted that osteoporosis–atherosclerosis relationships are genetically determined in part by LRP6 signaling—with the cell-autonomous (osteoblast and vascular smooth muscle) contributions of …

Fat Infiltration in the Leg is Associated with Bone Geometry and Physical Function in Healthy Older Women.

The objective of this study was to estimate the associations between muscular fat infiltration, tibia bone mineral quantity and distribution, and physical function in healthy older women. Thirty-five women (aged 60-75 years, mean 70 years) were recruited from the community. Percent intramuscular fat (%IntraMF) within the right leg tibialis anterior, soleus, and gastrocnemius muscles and total intermuscular fat (IMF) were segmented from magnetic resonance imaging scans at the mid-calf. Intramyocellular lipid (IMCL) content in the right tibialis anterior was measured with proton magnetic resonance spectroscopy. Right tibia bone content, area, and strength were measured at the 4, 14, and 66% sites using peripheral quantitative computed tomography. Physical function was assessed by gait speed on the 20 m walking test. After adjusting for age, body size, and activity level, %IntraMF had a negative association with bone content and area at all tibia sites (r = -0.31 to -0.03). Conversely, greater IMF was associated with increased bone content and area (r = 0.04-0.32). Correlation coefficients for the association between IMCL and bone were negative (r = -0.44 to -0.03). All measures of fat infiltration had a negative association with observed physical function (r = -0.42 to -0.04). Our findings suggest that muscular fat infiltration in the leg of healthy postmenopausal women has a compartment-specific relationship with bone status and physical function. Minimizing fat accumulation within and between muscle compartments may prevent bone fragility and functional decline in women.

Maternal high fat feeding results in higher fat mass and bone mineral content in weanling but not 3 month old female offspring

Using rodent models, maternal exposure to an obesogenic diet ‐ high in fat and sucrose ‐ can have adverse effects on offspring health and may set them on a trajectory for unfavorable body composition. The objective of this study was to determine whether maternal exposure to a high fat diet results in higher fat mass and lower lean and bone mineral content (BMC) and density (BMD) in female offspring at weaning (19 days) and young adulthood (3 months). Female rats (28 days old) were fed control (C, AIN93G with 7% soybean oil by weight) or high fat diet (HF, modified AIN93G with 20% lard by weight) for 10 weeks at which time they were bred and continued on the same diet throughout gestation and lactation. Body composition in female offspring at 19 days and at 3 months of age was measured using dual energy X‐ray absorptiometry. There was no significant effect of HF diet on body weight or absolute BMC, BMD, lean and fat mass at 19 days and 3 months of age. When corrected for body weight, fat mass and BMC was higher (P&lt;0.05) while lean mass was lower (P&lt;0.05) in 19 day old but not 3 month old offspring of mothers fed HF compared to C diet. These findings demonstrated that effects on offspring at time of weaning are not sustained when offspring consume a “healthy” diet post‐weaning. Moreover, understanding whether the higher quantity of bone mineral at PND 19 is accompanied by improved bone structure and strength requires further investigation.

Instrumentation for in vivo ultrasonic characterization of bone strength

Although it has been more than 20 years since the first recorded use of a quantitative ultrasound (QUS) technology to predict bone fragility, the field has not yet reached its maturity. QUS has the potential to predict fracture risk in several clinical circumstances and has the advantages of being nonionizing, inexpensive, portable, highly acceptable to patients, and repeatable. However, the wide dissemination of QUS in clinical practice is still limited and suffering from the absence of clinical consensus on how to integrate QUS technologies in bone densitometry armamentarium. Several critical issues need to be addressed to develop the role of QUS within rheumatology. These include issues of technologies adapted to measure the central skeleton, data acquisition, and signal processing procedures to reveal bone properties beyond bone mineral quantity and elucidation of the complex interaction between ultrasound and bone structure. This article reviews the state-of-the art in technological developments applied to assess bone strength in vivo. We describe generic measurement and signal processing methods implemented in clinical ultrasound devices, the devices and their practical use, and performance measures. The article also points out the present limitations, especially those related to the absence of standardization, and the lack of comprehensive theoretical models. We conclude with suggestions of future lines and trends in technology challenges and research areas such as new acquisition modes, advanced signal processing techniques, and modelization.

Present state and future trends in ultrasonic characterization of bone

Although it has been over 20 years since the first recorded use of a quantitative ultrasound (QUS) technology to predict bone fragility, the field has not yet reached its maturity. QUS have the potential to predict fracture risk in a number of clinical circumstances and has the advantages of being non‐ionizing, inexpensive, portable, highly acceptable to patients and repeatable. However, the wide dissemination of QUS in clinical practice is still limited and suffering form the absence of clinical consensus on how to integrate QUS technologies in bone densitometry armamentarium. There are a number of critical issues that need to be addressed in order to develop the role of QUS within rheumatology. These include issues of technologies adapted to measure the central skeleton, data acquisition and signal processing procedures to reveal bone properties beyond bone mineral quantity and elucidation of the complex interaction between ultrasound and bone structure. In this presentation, we review recent developments to assess bone mechanical properties. We conclude with suggestions of future lines and trends in technology challenges and research areas such as new acquisition modes, advanced signal processing techniques, and models.

Bone Quality and Bone Mineral Quantity Using Intraoral Dental Radiograph of the Mandible:An Analysis of Males and Females in Their 60&apos;s

Bone Quality and Bone Mineral Quantity Using Intraoral Dental Radiograph of the Mandible:An Analysis of Males and Females in Their 60&apos;s

Evidence for common controls over inheritance of bone quantity and body size from segregation analysis in a pedigreed colony of nonhuman primates ( Macaca nemestrina)

The genetic determinants of bone mineral quantity and body size and their postulated interaction are just beginning to be elucidated. The heritability of bone quantity and its relationship to components of body size were therefore investigated using segregation analysis applied to a large pedigreed nonhuman primate ( Macaca nemestrina) breeding colony. The colony consisted of 216 females and 16 males with uniform dietary histories, environmental conditions, and rearing of offspring apart from the mother to minimize familial aggregation. Bone quantity (bone mineral content and spinal areal density) was measured by dual-energy X-ray absorptiometry (DXA). Size included measures of body mass, length, breadth, and a composite index. Body mass was determined from both body weight and lean body mass by DXA. Length was assessed by measuring trunk and thigh lengths, and breadth by measuring chest circumference and bitrochanteric width. A composite index of size was also calculated from a linear function of trunk and thigh lengths, chest circumference and bitrochanteric width, and lean body mass. Traits of bone quantity and size were highly correlated ( r = 0.56–0.96, p < 0.001). Significant ( p ≤ 0.03) univariate heritabilities were found for spine bone mineral density (SPBMD; h 2 = 0.66) and whole body bone mineral content (WBBMC; h 2 = 0.40) and size measures of length (trunk h 2 = 0.71, thigh h 2 = 0.65), breadth (bitrochanteric width h 2 = 0.31), lean body mass (LEAN; h 2 = 0.37), and the composite index of size (SIZE-PC, h 2 = 0.49) adjusted for demographic variables. The data were also subjected to an analysis of bivariate genetic correlations and factor analysis, both of which suggested a robust interaction between body size and bone quantity. Bivariate genetic correlations between body size and the bone quantities WBBMC, SBMD, and spine bone mineral content (SPBMC) were high (e.g., using LEAN as a measure of size, r = 0.57, 0.41, and 0.57, respectively). Factor analysis showed that 80% of the phenotypic and 72% of the genetic variances of all traits were accounted for by a single factor, suggesting common genetic controls operative over bone quantity and size.

Ultrasound characterization of bone demineralization.

Quantitative ultrasound (QUS) assessment of bone may permit an assessment of bone properties currently not available by bone densitometry techniques. To explore the effects of the quantity of bone mineral on acoustic parameters, we carried out an in vitro study of the impact of demineralization on attenuation of ultrasound in trabecular bone. Ten fresh cubes of trabecular bone obtained from bovine distal femurs were progressively demineralized using formic acid solution. The progression of demineralization was controlled by monitoring the specimen bone mineral density (BMD) using dual x-ray absorptiometry (DXA). At five stages of demineralization-0% (baseline), 25%, 50%, 75%, and 100% (all mineral removed)-the US properties of the specimens were assessed (Walker Sonix UBA 575+). The US parameters investigated were broadband ultrasound attenuation (BUA) and ultrasound attenuation in bone (UAB). Both DXA and QUS measurements were made along the three orthogonal axes of each cube. Our results demonstrated significant variability in both BUA and UAB along the three principle axes of the cubes whereas BMD did not differ in the different directions. A strong but nonlinear correlation was found between BMD and US attenuation. A reduction in BMD to 50% of the baseline values resulted in BUA (UAB) reduction to 25% and 19%, respectively. A random effect model analysis supported a multiplicative relationship between BMD and the US parameters. US attenuation is a sensitive indicator of bone mineral changes with nonlinear dependence on bone mineral loss. Bone collagen structure reinforced by hydroxyapatite crystal accounts for fundamental US characteristics. Ultrasound attenuation associated with trabecular orientation is basically dominated by the mineral spread in a collagen framework.

Intramedullary Nailing and Cortical Bone Mineral Content

A transverse diaphyseal osteotomy of the tibia was stabilized using rigid intramedullary nailing in rabbits. In a 2nd group, nailing was performed without osteotomy. The rabbits were sacrificed 3 to 24 weeks postoperatively, and the nails were removed. The mineral content (BMC) was measured by dual photon absorptiometry and the mineral density (BMD) was calculated. At 24 weeks the osteotomized bones had significantly lower BMC values than did the respective nonosteotomized bones or the intact bones. The BMC of the nonosteotomized bones remained above the control level throughout the experiment. The minimum BMD values of the osteotomized bones were detected at 3 weeks, whereafter they gradually approached the control level over time. The results suggest that rigid intramedullary nailing in connection with osteotomy causes a significant decrease in cortical bone mineral mass, seen at 24 weeks postoperatively. The photon absorption method used seemed sensitive enough to detect changes in cortical bone mineral quantity in these experimental conditions.

A Clinical Study on Bone Mineral Quantity in the Mandibular Base in Childhood

A Clinical Study on Bone Mineral Quantity in the Mandibular Base in Childhood