Calcaneal Bone Mineral Density Research Articles

Study on the effect of elastic band resistance training combined with nano-protective gear on postoperative muscle strength and balance ability

This study explored the effect of elastic band resistance training combined with nano-protective gear on post-operative muscle strength and balance ability in elderly patients with hip fracture. A sample of 100 elderly patients with hip fractures who received treatment at the Department of Traumatology and Orthopedics in our hospital from July 2020 to December 2021 were selected for this study. These patients were randomly assigned to either the observation group or the control group, with 50 patients in each group. Rehabilitation exercises were conducted for both groups starting six weeks after surgery. The control group received traditional rehabilitation training, while the observation group engaged in elastic band resistance training combined with nano-protective gear. The study compared the fracture healing time, hospitalization time, and complication rate between the two groups. Additionally, the study assessed the calcaneal bone mineral density, grip strength of both upper limbs, Harris hip joint function, and daily living activity assessment scale (BADL) in both groups at 1 month, 3 months, 6 months, and 12 months after surgery. Furthermore, the balance ability (TUGT), fall efficacy (MSFE) and nursing satisfaction of the two groups of patients were evaluated 6 months after surgery. The hospitalization time and fracture healing time of patients in the observation group were significantly shorter than those in the control group. During follow-up at various time points (3, 6, and 12 months) after discharge, the observation group exhibited significantly higher Harris hip scores, BADL scores, quality of life scores, balance ability (TUGT) scores, and fall efficacy (MSFE) scores compared to the control group. Furthermore, the observation group had a lower incidence of complications and higher nursing satisfaction (92%) compared to the control group (74%). The findings of this study suggest that combining elastic band resistance training with nano-protective gear can improve postoperative muscle strength, balance ability, joint function, alleviate negative emotions, enhance daily living ability, improve quality of life, and increase nursing satisfaction in elderly patients with hip fracture.

Rate of tarsal and metatarsal bone mineral density change in adults with diabetes mellitus and peripheral neuropathy: a longitudinal study

BackgroundIn people with diabetes (DM) and peripheral neuropathy (PN), loss of bone mineral density (BMD) in the tarsals and metatarsals contribute to foot complications; however, changes in BMD of the calcaneal bone is most commonly reported. This study reports rate of change in BMD of all the individual bones in the foot, in participants with DM and PN. Our aim was to investigate whether the rate of BMD change is similar across all the bones of the foot.MethodsParticipants with DM and PN (n = 60) were included in this longitudinal cohort study. Rate of BMD change of individual bones was monitored using computed tomography at baseline and 6 months, 18 months, and 3–4 years from baseline. Personal factors (age, sex, medication use, step count, sedentary time, and PN severity) were assessed. A random coefficient model estimated rate of change of BMD in all bones and Pearson correlation tested relationships between personal factor variables and rate of BMD change.ResultsMean and calcaneal BMD decreased over the study period (p < 0.05). Individual tarsal and metatarsal bones present a range of rate of BMD change (-0.3 to -0.9%/year) but were not significantly different than calcaneal BMD change. Only age showed significant correlation with BMD and rate of BMD change.ConclusionThe rate of BMD change did not significantly differ across different foot bones at the group level in people with DM and PN without foot deformity. Asymmetric BMD loss between individual bones of the foot and aging may be indicators of pathologic changes and require further investigation.Trial registrationMetatarsal Phalangeal Joint Deformity Progression—R01. Registered 25 November 2015, https://clinicaltrials.gov/ct2/show/NCT02616263

THE EFFECT OF SPORTS IN PROMOTING THE ENHANCEMENT OF ADULT BONE DENSITY

ABSTRACT Introduction: Exercise is an important part of osteoporosis treatment. A moderate amount of exercise can improve bone metabolism, improve bone biomechanics and increase bone density. Objective: To study the effects of different sports on adult bone mineral density. Methods: We selected volunteers to perform different exercises and used quantitative ultrasound and bioelectrical impedance methods to test the volunteers. Results: Exercise can increase the content of lean body mass in body composition and reduce body fat percentage. The calcaneal bone mineral density of physical education students is positively correlated with low body weight. Conclusion: Exercise can promote the bone mineral density of young adults. Stronger weight-bearing exercises can better promote the increase of bone density. Level of evidence II; Therapeutic studies - investigation of treatment results.

Analysis of Calcaneal Bone Mineral Density (cBMD) in Healthy College Students.

BackgroundThere is limited evidence describing the relationship between calcaneal bone mineral density (cBMD) and activity level, menstrual history, or the development of bone stress injury (BSI).Hypothesis/PurposeThe purposes of this study were to: 1) examine the influence of physical activity on cBMD in healthy college students (HCS), 2) determine if there is an association between cBMD, body mass index (BMI), sex, menstrual history, and history of BSI in HCS, and 3) compare the cBMD of HCS to cBMD data collected on intercollegiate athletes (ICA) from a previous study.Study DesignCross-sectional designMethodsThis cross-sectional study recruited a convenience sample of HCS at one institution. Subjects provided self-reported injury and menstrual history, completed a physical activity questionnaire, and cBMD and BMI measures were obtained. Descriptive statistics, statistical analyses of relationships (Chi-square and relative risk), logistic regression, and differences (t-tests) were used in the statistical analyses.ResultsOne hundred three HCS (82 female, 21 male; age 21.9 ± 1.13) consented to participate. The composite score for work, leisure, and sport activity ranged from 5.6 to 11.1 (7.9 ± 1.1) for HCS subjects. There was no significant correlation between cBMD and physical activity in HCS, however, a significant correlation was found between reported age of onset of menstruation and left and right cBMD (r = -0.22 and r = -0.23; p < 0.05) and history of secondary amenorrhea and history of BSI (r = 0.32; p < 0.05). There was no difference in cBMD between the male ICA and male HCS, but highly significant differences in cBMD between the female ICA and female HCS groups (p < 0.000).ConclusionsAge of menarche and secondary amenorrhea are significantly associated with cBMD and history of BSI in HCS subjects, respectively. Differences in cBMD among the HCS subjects were not related to activity level. cBMD was significantly lower in female HCS as compared to female ICA. This difference in cBMD between ICA and HCS may be activity related.Level of EvidenceLevel 3

Calcaneal Bone Morphology in Association with Bone Mineral Density Status: A Cadaveric Study

Category:Basic Sciences/Biologics; Ankle; OtherIntroduction/Purpose:Displaced intra-articular calcaneal fractures are mostly treated by reduction and internal fixation. The calcaneal cortical thickness and regional bone density play an important role in the stability of the fixation construct. This study aims to assess the relationship between calcaneal bone morphology and bone mineral density (BMD) status.Methods:Seventeen fresh cadaveric specimens underwent a BMD scan at the femoral neck and were later classified according to WHO criteria into three groups, including normal five specimens, osteopenic six specimens, and osteoporotic groups six specimens. The calcaneus bone of each specimen was then dissected and evaluated for the bone morphology. The sustentaculum tali of the calcaneus was divided into anterior, middle, and posterior segment. The superior, inferior, and posterior cortices of the calcaneus were equally divided from medial to lateral into five segments and from anterior to posterior into three segments (Figure 1). The cortical thickness (mm) was measured at the center of each divided fragment. The calcaneal bone density (g/cm3) was quantified at three regions of interest (ROI), including superior, inferior, and posterior ROI (Figure 2).Results:The calcaneal cortical thickness and calcaneal bone density of each fragment or each ROI were demonstrated as the median and interquartile range (IQR) (Table 1-5, Figure 3). The overall cortical thickness and calcaneal bone density values were significantly lower in the osteopenic or osteoporotic group when compared with the normal BMD group. Notably, the cortical thickness of the normal group at the lateral one-fifth and/or lateral two-fifth fragment of the superior, posterior, and inferior cortices of the calcaneus were not significantly different when compared with the osteopenic or osteoporotic group. When focusing at the sustenaculum tali, the posterior cortical thickness was significantly different only when compared between the normal and osteoporotic groups. Inter and intra-rater reliability of the outcome measurements were all excellent (>0.80).Conclusion:The cortical thickness of the posterior aspect of the sustenaculum tali, as well as the cortical thickness of the lateral one-fifth and lateral two-fifth of the calcaneus, were less likely effected by the decrease in BMD status. However, the anterior part of sustenaculum tali, anteromedial area of superior and inferior cortex and inferomedial area of posterior cortex are thicker than others.

Association of vitamin D nutritional status with calcaneal bone mineral density in school-age children: a prospective cohort study

Objective: To investigate the relationships between vitamin D nutritional status and the calcaneal bone mineral density (BMD) in children. Methods: Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing selected through stratified cluster sampling were included in the baseline survey. A follow-up investigation was conducted in 2019. The questionnaire survey, detection of serum 25-hydroxyvitamin D [25(OH)D] level and ultrasound measurement of calcaneal BMD were conducted. Multivariable linear and logistic regression models were used to analyze the relationships between baseline vitamin D nutritional status and the follow-up calcaneal BMD. Results: A total of 10 914 children aged (11.5±3.3) years (boys accounting for 49.6%) were included in the analysis. The average 25(OH)D level was (35.4±12.0) nmol/L, and the deficiency rate was 36.1%. After the adjustment for age, gender, body mass index, smoking status, alcohol use status, dairy products intake, vitamin D supplement, calcium supplement, physical activity, pubertal development, and baseline calcaneal BMD Z-score, for per 10 nmol/L increase in 25(OH)D, the follow-up calcaneal BMD Z-score increased by 0.01(P=0.041), and the OR(95%CI) of decreased calcaneal BMD Z-score after 2 years was 0.96 (0.93-1.00)(P=0.030). Compared with vitamin D adequacy, the follow-up calcaneal BMD Z-score of children with vitamin D insufficiency and deficiency decreased by 0.03(P=0.307) and 0.06 (P=0.046), and the risk of decreased calcaneal BMD Z-score after 2 years increased by 15%(P=0.037) and 21%(P=0.006), respectively (P for trend<0.05). Conclusions: Vitamin D nutritional status was closely related to calcaneal BMD, and children with adequate vitamin D nutritional status tended to obtain higher BMD. Children and adolescents are encouraged to maintain sufficient vitamin D levels, strengthen nutrition and exercise to promote bone health.

Study Profile of the Tohoku Medical Megabank Community-Based Cohort Study.

BackgroundWe established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.MethodsWe asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.ResultsAs a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.ConclusionThis cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis

Introduction Patients on maintenance hemodialysis (MHD) are highly predisposed to low bone mineral density (BMD). This study aims to assess the value of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and their combination in detecting high-risk patients for low BMD in MHD. Methods Patients’ BMD of the total hip, femoral neck, and lumbar spine were measured using dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) was assessed using BIA. Calcaneal BMD was measured using QUS. Patients with a T-score of ≤-2.5 were recorded as ‘low BMD.’ Results Overall, 93 subjects (62.37% female; mean age, 60.8 ± 16.2 years) were included in this cross-sectional study; approximately 36.56% met the ‘low BMD’ criteria. QUS-T score predicted low BMD with an area under the curve (AUC) value of 0.738, sensitivity of 70.59%, and specificity of 76.27%. The AUC for low BMD diagnosis using the BMC index (BMCI) measured through BIA was 0.679 (sensitivity, 91.18%; specificity, 38.98%). On the other hand, the combination of QUS-T score and BMCI yielded a higher AUC value of 0.762 with an improved specificity of 88.14%. Compared with the QUS and BIA alone, the net reclassification improvement (NRI) of the combination model increased by 47.16% (p = 0.022) and 78.36% (p < 0.0001), respectively. Integrated discrimination improvement (IDI) increased by 5.25% (p = 0.043) and 9.99% (p = 0.003), respectively. QUS-T score and BMCI were related to BMD independently assessed by DXA. Conclusion The combination of QUS and BIA is effective in screening for low BMD among MHD patients.

Association between handgrip strength and maximum expiratory flow with site-specific bone mineral density of healthy young adults.

To explore the association of handgrip strength and peak expiratory flow rate with site-specific bone mineral density T scores, and to study the correlation of body mass index and physical activity with the three parameters. The cross-sectional study was conducted in November 2018 at the Combined Military Hospital, Lahore Medical College and Institute of Dentistry, Lahore, Pakistan, and comprised healthy young adults. Data was collected using the international physical activity questionnaire. The subjects were grouped into low, moderate and high categories. Handgrip strength, peak expiratory flow rate, bone mineral density T scores and body mass index were measured for each subject. Data was analysed using SPSS 24. Of the 102 subjects, 52(50.9%) were males and 50(49%) were females. There was a significant difference between the median values for all parameters of males and females (p<0.05). Bone mineral density and physical activity were moderately associated with handgrip strength and peak expiratory flow rate (p<0.05). Body mass index showed a moderate association with bone mineral density (p<0.05). Healthy young adults with better respiratory function and handgrip strength were found to have higher values of site-specific calcaneal bone mineral density. Subjects with higher reported levels of physical activity and a higher body mass index within a healthy range presented with improved values of bone mineral density, handgrip strength and peak expiratory flow rate.

Trabecular bone mineral density correlations using QCT: Central and peripheral human skeleton

Musculoskeletal injuries to the lower leg and foot-ankle joint are associated with external mechanical loads resulting from motor vehicle crashes, under body blasts, falls from height, or sports. As an intrinsic material property, the bone mineral density (BMD) is related to bone strength. The clinically recognized biological sites for BMD evaluation are the hip and spine. The focus of this study was to define the correlation between BMD from standard clinical sites (hip and lumbar spine) compared to BMD from non-standard sites (foot-ankle-distal tibia bones). Twenty-one post-mortem human subjects (PMHS) with mean age, height, and mass of 63 ± 11 years, 179 ± 7 cm, and 86 ± 13 kg, respectively were used for analysis. Clinical BMD software (Mindways Software, Inc.) was used for trabecular BMD quantification using quantitative computed tomography (QCT). In quantification of BMD of the foot-ankle-distal tibia (hind foot), the trabecular BMD of the talus (316 ± 86mg/cc) was highest followed by the distal tibia (238 ± 72 mg/cc) and then calcaneus (147 ± 51 mg/cc). To correlate BMD values from foot bone regions with the central skeleton BMD values within the same PMHS, there were 18 lumbar spine and 12 hip BMDs available. The BMD of the distal tibia correlated best with the hip intertrochanter BMD (R2 of 0.72). Calcaneus BMD best correlated with the hip femoral neck BMD (R2 = 0.64). In summary, the hind foot bone BMD values correlated better with the hip as compared to the lumbar spine BMD from the same PMHS. These findings indicate that, in the absence of a direct measure of foot-bone BMD, hip BMD might be a better predictor of injury risk to hind foot rather than lumbar spine BMD, or alternatively, calcaneal trabecular BMD can be used to predict the risk of injury to hip. Further, these relationships between central and peripheral regions can also be implemented in finite element models for improved failure predictions.

Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children.

Using dual X-ray absorptiometry (DXA) to assess body composition in children has limitations including expense, lack of portability, and exposure to radiation. The aims of this study were to examine: (1) validity of quantitative ultrasound (QUS) against DXA for measuring bone density and (2) the validity of in-built algorithm of bioelectrical impedance analysis (BIA) for measuring body composition in children (8-13 years) living in New Zealand. Total body less head (TBLH), bone mineral content (BMC), bone mineral density (BMD), and body composition were measured with DXA (QDR Discovery A, Hologic, USA); calcaneal BMD and stiffness index (SI) with QUS (Sahara QUS, Hologic, USA), and BIA on the InBody 230 (Biospace Ltd., Seoul, Korea). Relative validity was assessed using Pearson's and Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. In 124 healthy children, positive correlations between QUS SI and DXA (BMC and BMD) were observed (range = 0.30-0.45, P < 0.01). Results from Lin's CCC test showed almost perfect correlations between BIA and DXA fat free mass (0.96), fat mass (0.92), and substantial correlation for percentage of fat mass (0.75) (P < 0.05). Although BIA results were not as accurate as DXA and DXA remains the gold standard method for clinical assessment, BIA can be an alternative method for investigating body composition among children in large cohort field studies. Calcaneal QUS and DXA are not interchangeable methods for measuring bone density in children similar to our study population.

Genetic Predictions Of Bone Mineral Density In Ultramarathon Runners: For Men, But Not For Women

BACKGROUND: Various genetic markers have been identified as influencing bone mineral density (BMD). In a prior study in the UK Biobank, 22,866 SNPs were selected using LASSO based on ability to predict calcaneal bone mineral density. Kim in PLoS ONE 2018 tested this genetic risk score against other models and found it to have the best correlation with BMD. PURPOSE: Given the prevalence of low BMD and low energy availability in female and male endurance runners, this study investigated the correlation between this genetic risk score and BMD of runners at the Western States endurance race. METHODS: 51 runners at a 100-mile race underwent a genetic evaluation using an Affymetrix PMRA array including approximately 800,000 SNPs, which includes all those required for the Kim BMD genetic risk score. These runners also underwent dual-energy x-ray absorptiometry. We calculated Pearson’s correlation coefficients between the genetic risk score and spine, hip, femoral, and forearm BMD. RESULTS: 17 female and 34 male participants had a mean age, respectively, of 41.8 and 46.8 years (range 26.4-76.2). BMI ranged from 17.2-25.2 kg/m2 (female) and 19.3-39.4 kg/m2 (male). For the male runners, the genetic risk score significantly correlated with z-scores of the lumbar spine, total hip, femoral neck, forearm, and total body (r=0.52-0.58, p<0.005). For female athletes, all correlations were 0 or negative and non-significant (r=0.0 to -0.30, p=0.24-0.99). See Table 1. CONCLUSIONS: The BMD genetic risk score was significantly correlated with BMD in the male, but not female ultramarathon runners in this study. The sample size for women (n=17) is too small to draw robust conclusions, but we speculate that for female athletes, environmental and hormonal factors, such as low energy availability or menstrual irregularities, may decrease the influence of genetic factors.

Exercise-based correlates to calcaneal osteogenesis produced by a chronic training intervention.

Thirty workouts on a gravity-independent device (Impulse Training Systems, Newnan GA) evoked significant calcaneal bone mineral content (BMC, +29%) and density (BMD, +33%) gains. High speeds and impact loads were produced per repetition. We examined exercise performance variables from the 30-workout intervention to identify correlates to delta (∆) calcaneal BMC and BMD variance. Workouts included hip extension and seated calf press exercises done with subject's left legs. ∆ values were obtained from the first and 12th workouts for the hip extension movement, and for the first and 24th workouts for the seated calf press exercise. Per exercise the following variables were quantified: peak force (∆PF), peak acceleration (∆PA), impulse (∆I), and dwell times (∆DT). Dwell times are the elapsed time between the end of the eccentric phase, and the start of the next repetition's concentric phase. Pearson Coefficients assessed correlations between performance and criterion variables. With hip extension ∆DT calculated with data from the first and 12th workouts, there were significant correlations with calcaneal ∆BMC (r = -0.64) and ∆BMD (r = -0.63). With seated calf press ∆DT derived as the difference from the first and 24th workouts, there was a significant correlation with calcaneal ∆BMC (r = -0.48), but only a trend (r = -0.45) with ∆BMD as the criterion. No other variables correlated with significant amounts of calcaneal ∆BMC and ∆BMD variance. Negative correlations infer shorter dwell times evoked greater gains. The gravity-independent device warrants continued inquiry to treat and abate calcaneal losses.

A community-based study of the relationship between calcaneal bone mineral density and systemic parameters of blood glucose and lipids.

Osteoporosis (OP) is a disease characterized by decreased bone mineral density (BMD) and an increased risk of osteoporotic fractures. Nutritional factors (including glucose and fats lipids), have been implicated in OP.We hypothesized that the levels of blood glucose and lipids could be biomarkers for predicting the risk of OP. To test this hypothesis, we evaluated the potential relationship between BMD and levels of blood glucose and lipids via a community-based study in China.This was a community-based cross-section analysis, and a total of 8584 cases were investigated. The BMD of the left calcaneus was measured using an ultrasonic bone densitometer. The levels of blood glucose (fasting blood glucose [FBG], 2-h blood glucose [2hBG], and glycosylated hemoglobin [HbAlc]), and lipids (triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) were measured and analyzed.In our study population, the levels of FBG, 2hBG, HbAlc, TC, LDL-C and HDL-C were higher in the OP group than in the low bone density and the normal bone density groups, while the levels of HbAlc, TC, and LDL-C in the low bone density group were higher than those in the normal bone density group. In males, the level of blood LDL-C in the low bone density group was higher than that in the normal bone density group. In postmenopausal subjects, the levels of FBG, 2hBG and HbA1C were higher than those in the normal bone density groups, and the level of HbA1C in the low bone density group was higher than that in the normal bone density group. Pearson linear trend analysis demonstrated that BMD was positively associated with TC and LDL-C in males and negatively associated with FBG, 2hBG and HbA1C in postmenopausal females. Moreover, logistic analysis showed that BMD was correlated with TC in premenopausal females and HbA1C in postmenopausal females.OP is generally associated with abnormal levels of blood glucose and/or lipids; nevertheless, the relationship between OP and abnormal levels of blood glucose and/or lipids is complicate and different subpopulations may have different susceptibilities. Therefore, further detailed studies are warranted.

Is waist circumference a negative predictor of calcaneal bone mineral density in adult Chinese men with normal weight?

Our study aimed to evaluate the association between waist circumference (WC) and calcaneal bone mineral density (BMD) in adult Chinese men with normal weight. This was a cross-sectional study. A total of 4,663 male participants aged 40 years or older residing in Ningde and Wuyishan, two cities locating in Fujian province of China, were randomly recruited between 2011 and 2012. Each participant should complete a standard questionnaire, undergo anthropometric and calcaneus quantitative ultrasound (QUS) measurements and have blood sample taken. Anthropometric, biochemical and calcaneal QUS parameters of 1,583 male participants with BMI ranging from 18.5 to 22.9 were included in the analysis. WC was divided into quartiles (Q1-Q4: <71, 71-75, 75-78, >78 cm). The relationship between WC (quartiles) and BMD was analyzed by multiple linear regression models. Mean age of the whole population was 54.6±9.8 years. Anthropometric and biochemical parameters were almost normal. Multiple linear regression analysis showed that BMD was negatively associated with increasing WC quartiles except for Q2 after adjusting for age and BMI, and this relationship remained negative except for Q2 when further adjustment was made for other covariates. Multiple logistic regression model also showed that the risks of osteopenia and osteoporosis increased across WC quartiles. The present study indicated that WC was a negative predictor of calcaneal BMD in adult Chinese men with normal weight. It suggests that, even for the normal-weight Asian males, monitoring accrual of abdominal adipose is still helpful for the purpose of preventing bone loss.

The association between body fat distribution and calcaneal bone mineral density in children and adolescents aged 6-16 years in Beijing

Objective: To understand the association between body fat distribution and calcaneal bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing. Methods: Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 15 030 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, body composition and calcaneus bone mineral density were conducted. The relation of fat mass percentage (FMP), trunk to total fat ratio (TrTFR), trunk to limb fat ratio (TrLFR), limb to total fat ratio (LTFR) and viscera to total fat ratio (VTFR) with calcaneus BMD were assessed using the multivariate linear regression models after adjusting for possible confounding effects. The central fat distribution types were divided into 4 groups including type 1: both trunk fat and visceral fat greater than the sex-and age-specific internal P(75); type 2: barely trunk fat greater than P(75); type 3: barely visceral fat greater than P(75); type 4: both trunk fat and visceral fat greater than P(75). The central fat distribution types were included into the model in the form of dummy variables to analyze its relationship with calcaneal BMD. The sex-and age-specific z-scores of fat distribution indicators and BMD were calculated. Results: A total of 15 030 participants aged (11.4±3.3) years (50.2% boys) were involved in the analysis. In both genders, after adjusting for age, height, lean mass index, smoking, drinking, physical activity, milk intake, vitamin D and calcium supplementation, FMP, TrTFR, TrLFR and VTFR were negatively correlated with calcaneal BMD (all P value<0.05), while LTFR was positively associated with calcaneal BMD (all P values<0.05). Compared to the central fat distribution type 1, the regression coefficients (95% CI) of type 2, 3 and 4 were -0.253 (-0.418, -0.087), -0.385 (-0.567, -0.204) and -0.428 (-0.487, -0.369) in boys, respectively; the regression coefficients (95% CI) of type 3 and 4 were -0.158 (-0.301, -0.015) and -0.226 (-0.290, -0.163), respectively. Conclusion: Body fat distribution and central fat distribution in children and adolescents were correlated with calcaneus bone mineral density.

The association between blood lipids and calcaneus bone mineral density in children and adolescents aged 6-16 years in Beijing

Objective: To investigate the association between blood lipid and calcaneus bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing. Methods: Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 14 303 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, blood lipid and calcaneus BMD were conducted. Multivariate linear regression was applied to quantify the association between calcaneal BMD as a dependent variable and blood lipid level as an independent variable after adjusting for the potential confounding factors. Furthermore, quantile regression was used to analyze the association between blood lipid level and different percentiles (P(25), P(50) and P(75)) of ultrasonic velocity values of bone mineral density, and parallel test was conducted for regression coefficients of different percentiles. Results: A total of 14 303 participants aged (11.4±3.3) years (49.9% boys) were involved in the analysis. The mean age of 14 303 participants was (11.0±3.3) years. 7 142 boys accounted for 49.9%. The mean±SD of calcaneal BMD, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) were (1 540.9±33.8) m/s, (3.90±0.76), (2.18±0.62), and (1.40±0.32) mmol/L, respectively. The P(5)0 (P(25), P(75)) of triglyceride (TG) was 0.69 (0.49-0.94) mmol/L. After the adjustment of age, height, smoking, drinking, vitamin D and calcium supplementation, dairy intake, physical activity, FMI, and MMI, a significantly inverse association (P<0.05) between TG level and calcaneus BMD was observed in both genders, which the regression coefficients (95%CI) in boys and girls were -0.064 (-0.085, -0.044) and -0.073 (-0.094, -0.053), respectively. Conclusion: The level of BMD was associated with TG in boys and girls. Therefore, it is important to prevent children from hypertriglyceridemia for the bone health promotion.

Evaluation of the Prevalence and Severity of Periodontal Diseases between Osteoporotic and Nonosteoporotic Subjects: A Cross-sectional Comparative Study

To evaluate the prevalence and severity of periodontal diseases between osteoporotic and nonosteoporotic subjects. The study population included 140 subjects (70 osteoporotic and 70 nonosteoporotic) age group of 35-70 years. Skeletal (calcaneal) bone mineral density (BMD) was measured by quantitative ultrasound technique (QUS) for T score values. Periodontal status was examined by plaque index (PI), bleeding index, probing depth (PD) and clinical attachment level. Digital panoramic and intraoral periapical radiographs (IOPA) were taken with fixed reference point for evaluation of bone interdental alveolar bone loss (ABL). The recorded data for T score, interdental ABL and periodontal status were subjected to statistical analysis for correlation and regression procedure. The prevalence of the periodontal diseases, in osteoporotic group 120 (54.5%) were with periodontitis and in nonosteoporotic group 100 (50%) were with periodontitis. Correlation of T score with age, PI, gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and ABL in nonosteoporotic group was found statistically not significant. The age was (r = -0.052) indicating positive association with weak correlation, The PI is (r 0.060) indicating positive association, the GI was (r = -0.053) indicating negative association with weak correlation, the PPD was (r = 0.070) indicating positive association with weak correlation, the CAL was (r = 0.133) indicating positive association with weak correlation, ABL was (r 0.027) indicating positive association with weak correlation. Calcaneal BMD was related to ABL and, to a less extent, to CAL, implicating osteoporotic subjects are at high risk indicator for periodontal diseases. Even though the pathogenesis of periodontitis and osteoporosis differs; these diseases have several common risk factors. Both may have a additive impact on patients, which requires concomitant medical and dental management which mandates simultaneous diagnosis of both. How to cite this article: Manjunath SH, Rakhewar P, Nahar P, et al. Evaluation of the Prevalence and Severity of Periodontal Diseases between Osteoporotic and Nonosteoporotic Subjects: A Cross-sectional Comparative Study. J Contemp Dent Pract 2019;20(10):1223-1228.

Randomised study of children with obesity showed that whole body vibration reduced sclerostin.

New strategies are required to increase physical activity and improve metabolic profiles in children with obesity. We studied the effect of whole body vibration (WBV) on children with obesity on biochemical markers of energy and bone metabolism, anthropometric measurements, muscle parameters and calcaneal bone mineral density (BMD). This was a randomised, prospective, controlled study of 30 children with a median age of 13 years (range 7-17) at Queen Silvia Children's Hospital, Gothenburg, Sweden, from 2013 to 2015. The target for the intervention group was to perform WBV three times a week for 12 weeks, and the study parameters were assessed at baseline and 12 weeks. The 16 in the WBV group achieved 51% of the planned activity, mainly at home, and were compared with 14 controls. Sclerostin, bone-specific alkaline phosphatase and carboxy-terminal collagen cross-links decreased in the WBV group (p < 0.05) and balance improved (p < 0.006), but osteocalcin and insulin remained unchanged. Anthropometric data, muscle strength and calcaneal BMD did not differ between the groups. WBV did not affect most of the clinical parameters in children with obesity, but the reduction in sclerostin implies that it had direct effects on osteocytes, which are key players in bone mechanotransduction.

Reproductive factors influencing bone mineral density in postmenopausal women

ABSTRACTThis study examined the relationship between reproductive characteristics and bone mineral density (BMD) in postmenopausal women who had been referred to the menopause clinics of the National Population and Family Development Board and of the Hospital Kuala Lumpur from July 2011 to January 2012. The participants of this study were 201 postmenopausal Malaysian women aged 45–71 years. Some socio-demographic, lifestyle, and reproductive factors were recorded. Calcaneal BMD was measured by quantitative ultra-sonography. Correlations of reproductive factors with BMD were assessed by Pearson’s correlation test and multiple regression analysis. Age at menopause was not significantly correlated with BMD, while the years after menopause, age at the first menstrual period, number of pregnancies, and total lactation periods were inversely correlated with it. Among reproductive factors, only the association between lactation duration and BMD remained significant after adjusting for age, body mass index, activity, and calcium intake. The results indicated that except for prolonged total time of lactation, other reproductive factors were not significantly associated with BMD in postmenopausal women.