Comparison Of Bone Mineral Density Research Articles

Body Composition Assessment in Adult Females with Anorexia Nervosa and Bulimia Nervosa—A Cross-Sectional Study Comparing Dual-Energy X-Ray Absorptiometry Scan and Isotopic Dilution of Deuterium

BackgroundEating disorders (EDs) compromise individuals’ nutritional status, affecting, among other organs and systems, bone health. ObjectivesThis study aimed to assess and compare bone mineral density (BMD) from DXA scan and deuterium (D2O) dilution of adult females with anorexia nervosa (AN) and bulimia nervosa (BN). MethodsThis was a cross-sectional study with 53 female participants (18–49 y) with a diagnosis of AN (n = 25) or BN (n = 28). DXA scan was performed to assess BMD, FM, and FFM, and D2O dilution was used to assess total body water (TBW), FM, and FFM. Interviews/questionnaires were used to assess symptoms, illness trajectory, and physical activity. t-test, chi-square test, Pearson’s linear correlation, linear regressions, and Bland-Altman analyses were performed, with a significance level of 5%. ResultsTBW below the recommended level for adult females (≥ 45%) was more frequent in BN (60%) compared with AN (21%; P = 0.013). FM index (FMI) (soft tissue only) (t-test P = 0.06), and FFM index (FFMI) (t-test P = 0.08) agreed between DXA scan and D2O dilution. Only FFMI did not show systematic bias of proportion (β: −0.2, P = 0.177). The diagnosis of BN, binge-eating episodes, and physical activity in AN were associated with the differences in the methods’ results. FMI was positively associated with BMD in AN, and both FMI and FFMI were positively associated with BMD in BN. ConclusionsIn adult females with EDs, DXA scan and D2O dilution achieved agreement for FMI and FFMI. Changes in FM and FFM are important in understanding the mechanisms behind bone loss in EDs. Protocols for body composition assessment in EDs can help to minimize the effect of the ED diagnosis, ED behaviors (that is, excessive exercise and purging behaviors), and weight on the accuracy of measurements.

Bone health in Norwegian female elite runners: a cross-sectional, controlled study

ObjectiveThe primary objective was to compare bone mineral density (BMD) in Norwegian female elite long-distance runners with a control group of inactive females. Secondary objectives were to identify cases of...

Bone loss after denosumab discontinuation is prevented by alendronate and zoledronic acid but not risedronate: a retrospective study

SummaryA retrospective study of 121 patients who stopped denosumab (Dmab) then received no treatment (NT), risedronate (RIS), alendronate (ALN), or zoledronic acid (ZOL). Bone density (spine and hip) during and after Dmab discontinuation was measured. Treatment with ALN or ZOL, not NT and RIS, mitigated BMD loss after Dmab discontinuation.IntroductionDenosumab (Dmab) discontinuation is associated with bone loss and multiple vertebral fractures. The purpose was to compare bone mineral density (BMD) change in patients following Dmab discontinuation with no subsequent treatment (NT) and three bisphosphonate (BP) treatments: risedronate (RIS), alendronate (ALN), and zoledronic acid (ZOL).MethodsIn a review of 121 patients aged 71.2 ± 8.1 years, discontinuing Dmab (mean 5.4 doses), 33 received NT and 88 received BP (22 RIS; 34 ALN; 32 ZOL). BMD change after 1 year was compared between groups at the lumbar spine (LS), femoral neck (FN), and total hip (TH). Risk factors for bone loss after Dmab discontinuation were compared between groups and incidence of vertebral fractures was determined.ResultsFollowing Dmab discontinuation, LS mean change (g/cm2; 95% CI) was for NT: − 0.041 (− 0.062 to − 0.021); RIS: − 0.035 (− 0.052 to − 0.017); ALN: − 0.005 (− 0.020 to 0.009); and ZOL: − 0.009 (− 0.025 to 0.008). Differences in LS were found between NT and ALN (p = 0.015), and NT and ZOL (p=0.037), but not between NT and RIS. The only significant difference in TH was found between NT and ZOL (p 0.034) with no group differences in FN. BMD gains during Dmab treatment were associated with BMD loss after Dmab discontinuation. In a subset, discontinuation after Dmab treatment (> 5 doses) followed by ALN (n = 22) and ZOL (n = 11) showed no difference in BMD. Five of 7 vertebral fractures occurred after Dmab discontinuation in NT.ConclusionSubsequent treatment with ALN or ZOL but not NT and RIS mitigates BMD loss after Dmab discontinuation.

Comparison of bone mineral density in forearm and hip regions and evaluation of area of these 2 sites.

Osteoporosis is a common disease among middle-aged and older people. Because bone mineral density (BMD) is obtained by dividing bone mineral content by area, accurate measurement of the surface of the studied area plays an important role. Therefore, the purpose of this study was to investigate the area of the hip and forearm regions based on gender and height. In a cross-sectional descriptive study of 758 individuals (702 female and 56 male, divided into 2 groups of ≥50 years old and <50 years old), experienced personnel performed densitometry of the forearm and femur using a Hologic device. The results were statistically analyzed using SPSS software version 21. In women ≥50 years old who were of white race, one-third of the forearm BMD showed moderate agreement with the femoral neck BMD, and in this group, total forearm BMD showed moderate agreement with the femoral neck BMD. In women <50 years old of Caucasian race, one-third of the forearm BMD showed good agreement with the femoral trochanter. In the same group of individuals, total forearm BMD also showed very good agreement with the femoral trochanter. In women <50 years old of white race, one-third of the forearm BMD showed good agreement with all 4 regions in the femur (trochanter, intertrochanteric, neck, total), and in the same group of individuals, total forearm BMD showed very good agreement with all 4 regions of the femur. According to the results obtained for comparison of forearm one-third with hip areas, it seems that simultaneous measurement of the forearm one-third area and different hip areas increases the accuracy of total BMD measurement.

Is Helicobacter pylori infection associated with osteoporosis? a systematic review and meta-analysis.

This study used systematic review and meta-analysis to evaluate the association between Helicobacter pylori infection and osteoporosis. PubMed, Ovid and Web of Science were searched to include observational studies published in English comparing bone mineral density changes between Helicobacter pylori-positive and -negative participants. The quality of the included literature was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). R software was used for meta-analysis, and odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the relationship between Helicobacter pylori infection and osteoporosis. Twenty-two studies involving 24,176 participants were included in the study. Our meta-analysis showed that Helicobacter pylori infection was significantly associated with the risk of osteoporosis (OR: 1.12, 95%CI: 1.03, 1.22). Participants infected with the CagA-positive Helicobacter pylori strain were more likely to develop osteoporosis (OR = 1.42, 95%CI: 1.09; 1.85). Infection with Helicobacter pylori, particularly the CagA-positive strain, has been associated with an increased risk of osteoporosis. The bone health of Helicobacter pylori-positive patients deserves more attention.

Comparison of bone mineral densityand biochemical factors in hemodialysis and peritoneal dialysis patients.

The aim of the study is to assess and compare the level of bone mineral density (BMD) in the patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) and to identify risk factors related to low BMD. Dual-energy X-ray absorptiometry (DEXA) scans were performed in 34 HD patients and 47 PD patients. Serum levels of albumin, calcium, phosphorus, alkaline phosphatase (ALP), intact parathyroid hormone (I-PTH), and 25-hydroxy (OH) vitamin D were recorded for the prediction of BMD loss. Among the biochemical parameters compared, only calcium levels differed between the group in such that HD patients had lower calcium compared with patients on PD (p=0.001). The overall prevalence of osteoporosis (OP) among all participants was 27%. There was a negative correlation between femur neck BMD and age (r=-554, p=0.007), and BMI (r=-555, p=0.007). Diabetic nephropathy was the only etiology associated with decreased BMD at the femoral site (p=0.027). There was a positive correlation between the serum albumin and BMD of lumbar spine (LS) (r=585, p=0.004). Bone mass of any site did not correlate with the dialysis type, duration of dialysis, and other biochemical markers like serum calcium, phosphorus, I-PTH, ALP, and 25 (OH) vitamin D. Prevalence of OP and osteopenia are high in dialysis patients, with no difference between patients on regular HD and PD. Bone mass loss is related to older age, higher BMI, and lower serum albumin level. DEXA measurement is necessary to monitor bone loss and timely treatment of OP in dialysis patients.

Assessment of Bone Mineral Density in Type 2 Diabetes: A Cone Beam Computed Tomography (CBCT) Study.

IntroductionThe main purpose of the study was to assess and compare bone mineral density (BMD) at prospective implant sites in the mandible in type 2 diabetes mellitus (T2DM) and non-diabetic patients using cone beam computed tomography (CBCT).Material and methodologyA total of 40 patients were included in this type of cross-sectional study. They were divided into two groups, A and B, according to their haemoglobin A1c values. Group A consisted of patients with HbA1c between the range of 6.1%-8% and group B had patients with no history of T2DM. CBCT scans were made of the mandibular arches of both the patients to evaluate the BMD at lingual and buccal cortical plates and the trabecular regions in two successive slices with the assistance of PlanMeca Romexis software (PlanMeca Romexis®, Helsinki, Finland). The Shapiro-Wilk test was used to determine the normality of continuous data. The Mann-Whitney U test was used to compare the groups.ResultsThere were no differences that were statistically significant between the two cohorts according to the Mann-Whitney U test at buccal cortical plate points 1 and 2. However, the diabetes group's mean bone density at implant sites-A, B, C, D, and E at trabeculae points 1 and 2 was considerably (7p>0.001) lower than the non-diabetic groups. The mean bone density of the diabetes group was marginally but significantly (p=0.009) lower than the non-diabetic group at lingual cortical plates.ConclusionIndividuals with type 2 diabetes mellitus show significantly lower bone mineral density in the lingual cortical plate and trabecular region, however, implant therapy can be performed with certain mentioned guidelines in such regions. In the buccal cortical region, the bone mineral density is seen to be unaffected.

Comparison of bone mineral density and Fracture Risk Assessment Tool in Saudi women with and without type 2 diabetes mellitus: A cross-sectional study.

To compare the bone mineral density and the fracture risks in Saudi women with and without type 2 diabetes mellitus (T2DM). This cross-sectional study was carried out at Taibah Early Diagnostic Center, Al Madinah Al Munawarah, Saudi Arabia. A total of 465 women with and without T2DM aged ≥40 years who visited the center for a dual-energy X-ray absorptiometry scan between December 2020 and July 2021 were randomly selected. The 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture (HF) were calculated using the Abu Dhabi Fracture Risk Assessment Tool (FRAX) with and without adjustment for T2DM. The adjustment was made by setting rheumatoid arthritis as the equivalent risk for T2DM in the FRAX. Bone mineral density values and the FRAX scores were compared between women with T2DM and non-diabetes. Of 465 women, 214 had T2DM, and 251 were non-diabetics. The mean age of women was 59.42±7.9 years. There were no significant differences in mean age, menopausal status, height, weight, and body mass index between T2DM and non-diabetic women. Bone mineral density values and the unadjusted FRAX scores were comparable between the 2 groups. However, after adjusting FRAX for T2DM, the FRAX for MOF and HF became significantly higher in T2DM women (p=0.000 and p=0.004). In Saudi women with T2DM, unadjusted FRAX underestimated the risk of MOF and HF. Type 2 diabetes mellitus should be included as one of the clinical risk factors for fracture in future versions of the FRAX score.

Matrix-bound Cyr61/CCN1 is required to retain the properties of the bone marrow mesenchymal stem cell niche but is depleted with aging

Previously, we showed that extracellular matrices (ECMs), produced ex vivo by various types of stromal cells, direct bone marrow mesenchymal stem cells (BM-MSCs) in a tissue-specific manner and recapitulate physiologic changes characteristic of the aging microenvironment. In particular, BM-MSCs obtained from elderly donors and cultured on ECM produced by young BM stromal cells showed improved quantity, quality and osteogenic differentiation. In the present study, we searched for matrix components that are required for a functional BM-MSC niche by comparing ECMs produced by BM stromal cells from “young” (≤25 y/o) versus “elderly” (≥60 y/o) donors. With increasing donor age, ECM fibrillar organization and mechanical integrity deteriorated, along with the ability to promote BM-MSC proliferation and responsiveness to growth factors. Proteomic analyses revealed that the matricellular protein, Cyr61/CCN1, was present in young, but undetectable in elderly, BM-ECM. To assess the role of Cyr61 in the BM-MSC niche, we used genetic methods to down-regulate the incorporation of Cyr61 during production of young ECM and up-regulate its incorporation in elderly ECM. The results showed that Cyr61-depleted young ECM lost the ability to promote BM-MSC proliferation and growth factor responsiveness. However, up-regulating the incorporation of Cyr61 during synthesis of elderly ECM restored its ability to support BM-MSC responsiveness to osteogenic factors such as BMP-2 and IGF-1. We next examined aging bone and compared bone mineral density and Cyr61 content of L4-L5 vertebral bodies in “young” (9–11 m/o) and “elderly” (21–33 m/o) mice. Our analyses showed that low bone mineral density was associated with decreased amounts of Cyr61 in osseous tissue of elderly versus young mice. Our results strongly demonstrate a novel role for ECM-bound Cyr61 in the BM-MSC niche, where it is responsible for retention of BM-MSC proliferation and growth factor responsiveness, while depletion of Cyr61 from the BM niche contributes to an aging-related dysregulation of BM-MSCs. Our results also suggest new potential therapeutic targets for treating age-related bone loss by restoring specific ECM components to the stem cell niche.

Antiresorptive treatments for corticosteroid-induced osteoporosis: a Bayesian network meta-analysis.

IntroductionCorticosteroid-induced osteoporosis (CIO) is the most common type of secondary osteoporosis, leading to fractures, and increased morbidity and mortality.Source of dataPubmed, EMBASE, Scopus and Google Scholar databases.Areas of agreementProlonged glucocorticoids administration leads to secondary osteoporosis.Areas of controversyThe optimal management for CIO is controversial.Growing pointsThe present study compared bone mineral density, fractures and adverse events in patients undergoing treatment with risedronate, alendronate, zoledronate, denosumab or etidronate for CIO.Areas timely for developing researchFor selected patients with CIO, alendronate performed better overall. These results must be interpreted within the limitations of the present study.Level of evidenceI, Bayesian network meta-analysis of randomized clinical trials.

The Impact of Component Design and Fixation on Stress Shielding After Modern Total Knee Arthroplasty.

Total knee arthroplasty (TKA) tibial baseplate thickness, metallurgy, and implant fixation with cement may influence stress shielding. The purpose of the present study is to compare bone mineral density of 2 cemented and press-fit TKA designs with differing tibial baseplate thicknesses and metallurgy over a 2-year period to assess for changes in stress shielding. One-hundred one TKAs were performed in this Institutional Review Board-approved, prospective study. There were 4 cohorts: DePuy Attune cemented and press-fit, and Stryker Triathlon cemented and press-fit. The Attune tibial baseplate was thicker; both cemented tibial and femoral components were cobalt-chromium. The DePuy Attune press-fit had a cobalt-chromium sintered bead porous coating while the Stryker Triathlon was 3-dimensional printed highly porous titanium alloy. All patients had quantitative dual-energy X-ray absorptiometry scans performed at baseline (4-6 weeks postoperatively) and at 1 and 2 years postoperatively. Stress shielding was evaluated by comparing percent change in bone mineral density in 11 radiographic zones over 2 years. Over a 2-year period, there were no differences in stress shielding on the tibial side in either cemented or press-fit between Stryker Triathlon and DePuy Attune; however, there were differences on the femoral side. The press-fit tibial components of the Stryker Triathlon and DePuy Attune had either similar or less stress shielding over a 2-year period compared to their cemented counterparts. This study comparing 2 TKA implants with differing tibial tray thickness did not find significant differences in tibial stress shielding between designs. There was a difference in stress shielding on the femoral side between designs, suggesting that longer term follow-up is warranted.

Comparison of Bone Mineral Density in US Adults With Diabetes, Prediabetes and Normoglycemia From 2005 to 2018.

BackgroundAccumulating evidence has shown that diabetes has an impact on bone metabolism with conflicting results. Furthermore, little is known about the relationship of prediabetes with bone mineral density (BMD). Therefore, we explored the association between BMD and glucometabolic status in adults in the US.MethodsIn this cross-sectional study, we extracted and analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. A total of 14610 subjects aged 40 ≥ years diagnosed with diabetes, prediabetes, or normal glucose regulation (NGR) and had available data on BMD were eligible.ResultsThe prevalence of prediabetes and diabetes in US adults aged 40 ≥ years were 39.2% and 26.4%, respectively. After multivariable adjustment, we found an increasing trend of BMD at the total hip, femoral neck, and lumbar spine with glucometabolic conditions from NGR and prediabetes to diabetes in adults aged ≥ 40 years in the US. This trend was more prominent in women than that in men. Fasting plasma glucose (FPG) and HbA1c levels were also positively correlated with BMD.ConclusionsGlucometabolic conditions were significantly associated with BMD values in US adults.

Cervical and First Thoracic Spine Hounsfield Units Assessment and Relationship to Clinical Outcomes and Cervical Sagittal Parameters in Patients Undergoing Anterior Cervical Spine Surgery

This study had 3 objectives: to compare bone mineral density (BMD) from 3 axial slices, subchondral trabecular bone 2 mm inferior to the cranial endplate, middle of the vertebral body, and subchondral trabecular bone 2 mm superior to the caudal endplate; assess BMD variations and correlations of C1-T1 vertebrae; and correlate BMD with clinical outcomes and cervical sagittal parameters in patients undergoing anterior cervical discectomy and fusion. The study enrolled 71 patients who underwent anterior cervical discectomy and fusion between March 2017 and January 2020. Patient demographics, clinical outcomes, cervical sagittal parameters, and Hounsfield units (HUs) of C1-T1 vertebrae were recorded. Analysis of variance was performed to compare HUs from the axial slices. Pearson correlation coefficient was performed to calculate the relationship between mean HUs of C1-T1 and to assess correlations of mean HUs with clinical outcomes and cervical sagittal parameters. There were no significant differences between HUs of 3 axial levels. Mean HUs were highest in the mid-cervical spine (C4). Significant correlations in mean HUs among all measured spinal levels were observed. Age, sex, and body mass index were not related to mean HUs. Visual analog scale, Neck Disability Index, and Patient Health Questionnaire-9 scores were not related to HUs before and after surgery. There were significant correlations among mean HUs of C2-T1 vertebrae, C2-C7 sagittal vertical axis, and cranial tilt. Mean HUs of C4 had the strongest correlation with C2-C7 sagittal vertical axis. To our knowledge, this is the first study of cranial and caudal subchondral trabecular BMD using HUs and comparing them with the middle of the vertebral body and study of correlations between mean HUs of C1-T1 vertebrae and clinical outcomes and cervical sagittal parameters. Correcting C2-C7 sagittal vertical axis and cranial tilt would improve BMD of C1-T1 vertebrae.

Reference values for bone density and bone mineral content from 5 to 80 years old in a province of Chile.

BackgroundThe assessment of bone health throughout the life cycle is essential to determine fracture risk. The objectives of the work were (a) compare bone mineral density and content with international references from the United States, (b) determine maximum bone mass, (c) propose references for bone health measurements from ages 5 to 80 years old.MethodsResearch was carried out on 5,416 subjects. Weight and height were measured. Body Mass Index (BMI) was calculated. The total body was scanned using dual energy X-ray absorptiometry (DXA). Information was extracted from the bone health measures (bone mineral density (BMD) and bone mineral content (BMC)) for both sexes, according to pediatric and adult software.Results and DiscussionDifferences were identified between the mean values of Chilean and American men for BMD (~0.03 to 0.11 g/cm2) and BMC (~0.15 to 0.46 g). Chilean females showed average values for BMD similar to the US references (~−0.01 to 0.02 g/cm2). At the same time, they were relatively higher for BMC (~0.07 to 0.33 g). The cubic polynomial regression model reflected a relationship between BMD and BMC with chronological age in both sexes. For males, R2 was higher (R2 = 0.72 and 0.75) than for females (R2 = 0.59 and 0.66). The estimate of maximum bone mass (MBM) for males emerged at 30 years old (1.45 ± 0.18 g/cm2 of BMD and 3.57 ± 0.60 g of BMC) and for females at age 28 (1.22 ± 0.13 g/cm2 of BMD and 2.57 ± 0.44 g of BMC). The LMS technique was used to generate smoothed percentiles for BMD and BMC by age and sex. Results showed that maximum bone mass occurred in females at age 28 and in males at 30. Reference values obtained from this research may be used to evaluate bone health, diagnose bone fragility and osteoporosis in individuals and regional population groups.

Bone mineral density and vitamin D levels in parkinson’s disease: A retrospective controlled study

Aim: This study aimed to compare bone mineral density and vitamin D levels in patients with Parkinson’s Disease (PD) and healthy controls.Methods: Eighty-six patients aged 60-85, diagnosed with PD and receiving regular medical treatment for the disease were screened. Data for 34 participants (19 women and 15 men) meeting the inclusion criteria were entered into the retrospective analysis. The data for 31 healthy age- and sex-matched participants (18 women and 13 men) were also included. Bone mineral density (BMD) values and vitamin D levels of each participant were recorded.Results: BMD values for the femoral neck and total hip in the PD group were statistically significantly lower than healthy controls. In addition, T-scores for the femoral neck, total hip, and trochanteric area, and Z-scores for the total hip and trochanteric area were also lower in the patients with PD than in the healthy controls. The two groups did not have significant differences regarding lumbar spinal BMD measurements and T- and Z-score values or vitamin D levels.Conclusion: PD’s total hip and femoral neck BMD measurements are low. Further multicenter studies involving larger patient populations are now needed to understand the incidence and mechanisms of osteoporosis in PD.

Comparison of bone mineral density according to domains of sedentary behavior in children and adolescents

BackgroundSomatic maturation and the age at onset of puberty are closely related to bone mineral density (BMD), and are potential confounders of the associations between physical activity, sedentary behavior (SB) and BMD in adolescents. Thus the aim was compare BMD at different anatomical sites according to different domains of SB.MethodsThe sample consisted of 88 young people (54 boys and 34 girls; 9.5 ± 1.5 years). The self-reported SB was measured by the time spent on TV, computer, video game and smartphone. BMD at each location and throughout the body was assessed by DEXA. Physical activity was assessed by a questionnaire. The comparison of the different types of BMD sites according to the SB levels for each screen device and the total SB were analyzed by Covariance Analysis (ANCOVA).ResultsWhole-body BMD was higher in young people with low total SB (Total BMD = 0.957 ± 0.042) than in those with moderate (Total BMD = 0.921 ± 0.053) and high SB (Total BMD = 0.929 ± 0.051) (p-value = 0.011). Children and adolescents with low total SB had higher BMD legs (0.965 ± 0.056) than young people with high total SB (BMD legs = 0.877 ± 0.209), but this relationship was attenuated when the analyzes were adjusted for physical activity (p-value = 0.068).ConclusionAdolescents with high sedentary behavior tend to have lower whole body bone mineral density than those with low sedentary behavior.

BONE HEALTH AND GROWTH IN SPINAL MUSCULAR ATROPHY TYPE 2 AND 3

Objective: Spinal muscular atrophy is a lower motor neuron disease, but other parts of the body could be affected. This study compared bone mineral density with bone metabolism and physical growth rates in patients diagnosed with spinal muscular atrophy type 2 and type 3. Material and Methods: Twenty-six patients with spinal muscular atrophy were included in the study (15 patients for type 2 and 11 for type 3). Weights and heights of patients were measured, standard deviation scores were determined, and the body-mass index was calculated. Motor function and pubertal assessment were performed. Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-hydroxyvitamin vitamin D levels were compared. Spine radiography for scoliosis and bone densitometry for bone mineral density were performed, and volumetric bone mineral density was calculated for age and sex. Results: Medians of height standard deviation scores were significantly lower in type 2 patients. There was no difference between the two groups in terms of serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-hydroxyvitamin D levels. The ratio of scoliosis was higher in type 2 patients as was its severity, but Z-scores of volumetric bone mineral density was lower in the same group. Conclusion: This study showed that bone mineralization and growth rates were significantly lower in spinal muscular atrophy, mainly in type 2. Further studies are needed to evaluate bone health in spinal muscular atrophy patients.

BONE HEALTH AND GROWTH IN SPINAL MUSCULAR ATROPHY TYPE 2 AND 3

Objective: Spinal muscular atrophy is a lower motor neuron disease, but other parts of the body could be affected. This study compared bone mineral density with bone metabolism and physical growth rates in patients diagnosed with spinal muscular atrophy type 2 and type 3. Material and Methods: Twenty-six patients with spinal muscular atrophy were included in the study (15 patients for type 2 and 11 for type 3). Weights and heights of patients were measured, standard deviation scores were determined, and the body-mass index was calculated. Motor function and pubertal assessment were performed. Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-hydroxyvitamin vitamin D levels were compared. Spine radiography for scoliosis and bone densitometry for bone mineral density were performed, and volumetric bone mineral density was calculated for age and sex. Results: Medians of height standard deviation scores were significantly lower in type 2 patients. There was no difference between the two groups in terms of serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-hydroxyvitamin D levels. The ratio of scoliosis was higher in type 2 patients as was its severity, but Z-scores of volumetric bone mineral density was lower in the same group. Conclusion: This study showed that bone mineralization and growth rates were significantly lower in spinal muscular atrophy, mainly in type 2. Further studies are needed to evaluate bone health in spinal muscular atrophy patients.

Comparison of bone mineral density and vertebral fracture assessment in postmenopausal women with and without distal radius fractures

ObjectivesTo compare bone mineral density (BMD) in Thai postmenopausal women with and without distal radius fracture, and to investigate the role of vertebral fracture assessment (VFA) in diagnosing osteoporosis after distal radius fracture. MethodsA cross-sectional study was conducted in Thai postmenopausal women with and without distal radius fracture. BMDs of the femoral neck (FN), total hip (TH), lumbar spine (LS), and VFA were obtained within 2 weeks of injury. BMD were compared between groups. Participants were classified into osteoporosis, osteopenia or normal using BMD alone, and BMD plus VFA, where a mere presence of vertebral compression fracture indicated osteoporosis. ResultsFifty postmenopausal women with distal radius fractures and 111 non-fracture postmenopausal women participated. The mean BMD was significantly lower at all sites in the fracture group (FN BMD 0.590 ± 0.075 vs 0.671 ± 0.090, p = 0.007; TH BMD 0.742 ± 0.103 vs 0.828 ± 0.116, P = 0.009; LS BMD 0.799 ± 0.107 vs 0.890 ± 0.111, P = 0.009 in the fracture vs non-fracture group respectively). VFA increased the prevalence of osteoporosis from 16 (32%) to 23 (46%) in the fracture group, and 7 (6.31%) to 17 (16.22%) in the non-fracture group, with a number needed to treat 9. ConclusionsPostmenopausal women with distal radius fractures had lower BMD. Incorporating VFA into diagnosis of osteoporosis increased the prevalence of osteoporosis in both fracture and non-fracture groups. Postmenopausal women aged 50 years or older with distal radius fracture are a good target for the investigation of osteoporosis.

Impact of Adolescent Pregnancy on Bone Density in Underprivileged Pre-Menopausal Indian Women

High prevalence (31.5%) of adolescent pregnancies (AP) have been reported in India. Reports suggest that pregnancy during adolescence may have deleterious effects on peak bone mass. Very few studies have described the long-term effects of a history of AP on bone mass. The objective of this study was to compare bone mineral density (BMD) and bone geometry of premenopausal women with first childbirth during adolescence (i.e., before age of 19 years) or after 20 years. A cross-sectional study was conducted in 242 women (age 28.0-54.5 years) from Pune, India (November, 2015 to November, 2017). Women were divided into 2-groups: Group-1: women-who had 1st-pregnancy and childbirth before 19 years of age (AP n = 131) and Group-2: women-who had 1st pregnancy after 20 years of age (non-AP n = 111). Demographic data, anthropometric measurements, and biochemical tests were performed using standard protocols. Physical activity and nutrient intakes were recorded using validated questionnaires. Areal BMD and bone geometry were measured using Dual-Energy-Absorptiometry-DXA (Lunar-iDXA, GE Healthcare) and peripheral-quantitative-computed-tomography-pQCT (XCT2000, Stratec Inc.). Mean age of the study group was 37 ± 4.6 years; in women from group-1 mean age at first delivery was 16.9 ± 1.6 years as against 22.6 ± 3.1 years in group-2. Both groups were similar in body mass index and socioeconomic status. pQCT measured radial diaphyseal cortical thickness (1.97 ± 0.3 mm vs 1.88 ± 0.3 mm resp., p = 0.016, periosteal circumference (38.0 ± 3.6 mm vs 36.7 ± 2.5 mm, resp. p = 0.016), total bone area (114.3 ± 24.8 mm2 vs 108.7 ± 14.7 mm2 resp. p = 0.026) and stress-strain index (SSI = 217 ± 75 vs 201 ± 40 mm3 resp. p = 0.042) were significantly higher in group-1 than group-2. After adjusting for anthropometric and lifestyle parameters, pQCT measured cortical thickness (1.98 ± 0.03 mm in group-1, 1.87 ± 0.03 mm group-2, p = 0.01, mean ± SE) and iDXA derived aBMD at forearm were still significantly higher (0.599 ± 0.006 g/cm3 vs 0.580 ± 0.006 g/cm3, p = 0.023) in Group-1. Our data suggest that women with a history of adolescent pregnancy had better bone geometry and higher aBMD at radius in later years. We speculate that early exposure to pregnancy resulted in higher aBMD at the radius and induced changes at radial diaphysis with bones becoming thicker and wider among these women.