Dual-energy X-ray Absorptiometry Method Research Articles

Accurate Prediction of Three-Dimensional Humanoid Avatars for Anthropometric Modeling.

Objective To evaluate the hypothesis that anthropometric dimensions derived from a person's manifold-regression predicted three-dimensional (3D) humanoid avatar are accurate when compared to their actual circumference, volume, and surface area measurements acquired with a ground-truth 3D optical imaging method. Avatars predicted using this approach, if accurate with respect to anthropometric dimensions, can serve multiple purposes including patient metabolic disease risk stratification in clinical settings. Methods Manifold regression 3D avatar prediction equations were developed on a sample of 570 adults who completed 3D optical scans, dual-energy X-ray absorptiometry (DXA), and bioimpedance analysis (BIA) evaluations. A new prospective sample of 84 adults had ground-truth measurements of 6 body circumferences, 7 volumes, and 7 surface areas with a 20-camera 3D reference scanner. 3D humanoid avatars were generated on these participants with manifold regression including age, weight, height, DXA %fat, and BIA impedances as potential predictor variables. Ground-truth and predicted avatar anthropometric dimensions were quantified with the same software. Results Following exploratory studies, one manifold prediction model was moved forward for presentation that included age, weight, height, and %fat as covariates. Predicted and ground-truth avatars had similar visual appearances; correlations between predicted and ground-truth anthropometric estimates were all high (R 2 s, 0.75-0.99; all p < 0.001) with non-significant mean differences except for arm circumferences (%D ~ 5%; p < 0.05). Concordance correlation coefficients ranged from 0.80-0.99 and small but significant bias (p < 0.05 - 0.01) was present with Bland-Altman plots in 13 of 20 total anthropometric measurements. The mean waist to hip circumference ratio predicted by manifold regression was non-significantly different from ground-truth scanner measurements. Conclusions 3D avatars predicted from demographic, physical, and other accessible characteristics can produce body representations with accurate anthropometric dimensions without a 3D scanner. Combining manifold regression algorithms into established body composition methods such as DXA, BIA, and other accessible methods provides new research and clinical opportunities.

Comparison of QCT and DEXA findings for lumbar vertebra in young adults and the elderly.

The use of dual-energy X-ray absorptiometry (DEXA) and quantitative computed tomography (QCT) methods are important for the diagnosis and follow-up of osteoporosis, and are used especially in cases to determine the degree of osteoporosis and the risk of fracture, monitoring the effectiveness of the treatment applied. To compare the parameters measured using the DEXA method from the lumbar (L1-L4) vertebrae and the Hounsfield unit (HU) values measured with QCT at the same levels among young adults and the elderly. The study included 155 patients (age range = 26-93 years). A total of 57 (36.8%) patients (age range = 26-64 years) were defined as the first group, and 98 (63.2%) patients (aged ≥65 years) were defined as the second group. T-test and correlation analysis were performed to compare bone mineral density (BMD), T score, and HU values measured using DEXA and QCT. A statistically significant difference was found between T score, lumbar total BMD, and HU values according to age and sex (P < 0.05). When the values measured from lumbar vertebrae were compared using both DEXA and CT, a high correlation was found between them. In the study, it was observed that QCT attenuation measurements of the lumbar spine measured between different age groups provided reliable results in terms of BMD scanning, as in DEXA. It should be noted that QCT has a longer imaging time and higher radiation dose compared to DEXA, and unnecessary scans should be avoided.

The state of bone mineral density in men with ankylosing spondylitis and its relationship with the course of the disease.

The aim of the study was to study the structural and functional state of bone tissue in men with ankylosing spondylitis (AS) and to assess its relationship with the course of the disease. A study was conducted with the participation of 105 men with AS aged from 22 to 59 years (average age was 40.7 ±0.8 years) with a duration of the disease of 8.7 ±0.5 years and 29 persons of the control group. Disease activity and the degree of functional limitations were determined by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Activity Score correlated with C-reactive protein (ASDAS-CRP) and the Bath Ankylosing Spondylitis Functional Index (BASFI). Laboratory examination included determination of C-reactive protein (CRP). Bone mineral density (BMD) of the lumbar spine and femoral neck was determined by the method of dual-energy X-ray absorptiometry on the Hologic Discovery Wi device (S/N 87227). In men with AS, a decrease in BMD (according to the Z-score and T-score) was found in 41.9%, while the percentage of patients with osteoporosis at the level of the femoral neck and lower back was 16.7%. Development of osteoproliferative changes was observed in 42 (40%) patients. Bone mass loss was associated with high activity of the inflammatory process according to ASDAS, BASDAI (r = -0.39, -0.65), and CRP (r = -0.28, -0.38) and low functional capacity according to BASFI (r = -0.27, -0.59), while syndesmophytosis had a reliable association with the age of the patients, the duration of the disease and low functional capacity. Low-energy fractures occurred in 11.4% of men with AS. The presence of fractures was associated with high disease activity (ASDAS, BASDAI, CRP) and was not related to the age of the patients or duration of the disease. A decrease in BMD and the development of fractures were closely associated with high activity of the inflammatory process and low functional capacity, while syndesmophytosis was related to the age of patients and the duration of the disease.

Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference.

Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC). The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM). Baseline data were collected from 28 adults (mean=61.4±6.9years, 64.3% female) with obesity (BMI 38.6±5.0kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement. Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3cm). Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC. Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

Comparison of bone mineral density of osteoporotic and osteopenia menopausal women treated with oral bisphosphonates before stopping the treatment and 1year after drug holiday period.

Osteoporosis is a skeletal and bone disorder characterized by bone fractures and decreased bone mineral density (BMD). Bisphosphonates have a great tendency to bind to minerals, and their long-term use can increase the risk of bone fragility in patients. Stopping bisphosphonates after a period of time is called a drug holiday (DH). Recent evidence has shown that patients' BMD may decrease again during DH. However, few studies have been done in this regard. In the present study, we compared the BMD of postmenopausal women during bisphosphonates treatment and 1year after DH. A total of 202 patients were selected with osteopenia (n = 95) and osteoporosis (n = 107); they had been treated with alendronate for 5years (a rheumatologist confirmed the diagnosis of osteopenia and osteoporosis) and had undergone DH for 1year. At the arrival of all patients, BMD was checked with the DXA (dual-energy X-ray absorptiometry) method using the 2007 American Explorer model Hologic device based on the Caucasian race. One year later, patients were reassessed for BMD by the same device. The analysis of femoral neck (FN) and lumbar spine (LS) T-score indices in the osteopenia and the osteoporosis groups showed reduction after DH, and the difference was statistically significant in both groups (p = 0.001). After 1year of stopping bisphosphonate treatment, the average of FN and LS BMD decreased in both groups (p = 0.001). In general, it can be said that DH can reduce FN and LS T-scores. The results indicated a significant reduction in BMD after the DH period for both the osteoporosis and osteopenia groups in the early months. Also, the effect of DH in osteoporosis patients was more compared to the osteopenia individuals, which could have implications for their treatment approach, and also its effect on bone health. Key Points • The DH can reduce FN and LS T-scores • The BMD reduced after the DH period for both the osteoporosis and osteopenia groups • After 1 year of stopping bisphosphonate treatment, the average of FN and LS BMD decreased in both groups.

Comparative analysis of body fat measurement using two bioelectric impedance devices and three household scales (with the function of determining body composition) with dual-energy X-ray absorptiometry

Body composition assessment is often used in clinical practice to assess and monitor nutritional status. For example, body fat mass is a predictor of metabolic diseases, and for an athlete it is a criterion of performance. "Gold standard" - the method of dual-energy X-ray absorptiometry - in contrast to bioelectrical impedance analysis, is difficult to apply in everyday clinical practice. Therefore, it becomes relevant to compare the consistency of measured body fat mass using densitometry and bioimpedanceometry. The aim of the study was to perform a comparative analysis of body fat mass estimated by bioimpedanceometry (two bioelectric impedance devices and three household scales with a function of determining body composition) and dual-energy X-ray absorptiometry. Material and methods. Sixteen healthy, physically active adults aged 25 [23; 26] years, male (n=7) and female (n=9), participated in the cross-sectional study. Body composition was assessed under standard conditions in the morning, after a 12-hour fast, using densitometry (Stratos Dr X-ray densitometer) and bioimpedanceometry [bioelectric impedance devices: Medass ABC-01, Diamant AIST (with manufacturer's predictive equations); household scales with a function of determining body composition: Tanita BC-718, Picooc Mini, Scarlett SC-216]. Statistical analysis was performed using Statistica 10 package (StatSoft, USA), and included Friedman's chi-criterion, Lin's correlation concordance coefficient, Bland-Altman method, Spearman's correlation coefficient, and Wilcoxon's criterion with Bonferroni correction for multiple studies. Results. None of the bioimpedanceometry devices studied showed a relationship (Bland- Altman coefficient >0.2) or consistency (Lin's correlation concordance coefficient <0.9) when compared to densitometry, although Spearman correlation was moderate for Tanita BC-718 (r=0.603, p<0.05), Diamant AIST (r=0.641, p<0.01) and Scarlett SC-216 (r=0.609, p<0.05), and notable for Medass ABC-01 (r=0.841, p<0.01) and Picooc Mini (r=0.718, p<0.01). Conclusion. This study found that no bioelectrical impedance device has consistency with dual-energy X-ray absorptiometry in assessing body fat mass. Since the accuracy of body fat mass measurement is critical in body composition diagnosis, the assessment results obtained by bioimpedanceometry should be interpreted with caution.

Low Bone Mineral Content: A New Risk Factor for Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Hematological Malignancies

CONCLUSIONS There is growing evidence about the influence of body composition (BC) on mortality in various patient groups, including patients with hematological malignancies. The aim of the study was to assess the impact of BC and bone mineral density (BMD) on the outcomes of allogeneic hematopoietic stem cell transplantation (alloHCT). We carried out an observational study involving patients with various hematological malignancies who underwent alloHCT between 2019 and 2022 in our institution. We assessed their total body BMD and BC employing densitometry with the dual-energy x-ray absorptiometry (DXA) method (Horizon A, Hologic, USA, 2017). Total body BMD includes variables such as BMD expressed in T and Z scores and bone mineral content (BMC). In addition, measured and calculated BC was obtained, which included body fat, and fat-free body mass values. The data on patients and disease characteristics, as well as the transplant details and outcomes were prospectively gathered. The study group consisted of 101 patients (49 males, 52 females), with a median age of 56 years (range, 19-69), presenting with various hematological malignancies classified according to Disease Risk Index (DRI) into low (12%), intermediate (56%), high (16%) and very high risk (16%) categories. The patients received transplants from matched related donors (13%) or matched unrelated donors (88%) after conditioning of either low (40%) or intermediate intensity (61%) according to transplant conditioning intensity (TCI) score. The median follow-up time was 24 months (range, 6-50), with an overall survival (OS) rate of 76% (95%CI 66-84) at 2 years. Significantly worse 2-year OS was found in patients with total body BMC (expressed in grams) below the median value vs ≥ median value calculated for each gender separately (65% vs 87%; p=0.015), high/very high DRI, compared to low/intermediate DRI (57% vs 85%; p=0.009), age over 60 years (64% vs 83%; p=0.045), and female patients, compared to male patients (64% vs 88%; p=0.011). In a multivariate Cox model, low total body BMC [HR 2.84 (95%CI 1.09-7.41); p=0.033], high/very high DRI [HR 3.46 (95%CI 1.42-8.41), p=0.006] and female gender [HR 3.29 (95%CI 1.19-9.07); p=0.021] remained the independent risk factors for OS. For the entire study group non-relapse mortality (NRM) and relapse incidence (RI) at 2 years was 10.4% (95%CI 5.4-19.7) and 24.7% (95%CI 16.4-35.3), respectively. The only identified risk factor for NRM was very high DRI [HR 4.55 (95%CI 1.08-19.18); p=0.039]. The factors that significantly impacted RI both in uni- and multivariate model were low total body BMC and high/very high DRI [HR 3.48 (95%CI 1.25-9.66); p=0.016, and HR 2.84 (95%CI 1.03-5.98); p=0.042, respectively]. Our results strongly suggest that low total body BMC determined by densitometry via the DXA method may serve as a new DRI-independent risk factor for worse alloHCT outcomes in patients with hematological malignancies.

Up-regulation of plasma miRNA-21 and miRNA-422a in postmenopausal osteoporosis.

Many researchers focused on diverse miRNAs in the progression of osteoporosis in postmenopausal women. This study aimed to evaluate the association between plasma miRNA-21-5p and miRNA-422a with osteoporosis in postmenopausal women. This cross-sectional comparative study was performed on 126 randomly selected postmenopausal women aged 50-65, including 65 osteoporotic and 61 normal-bone mineral density (BMD) women. miRNA-21 and miRNA-422a were identified using qRT-PCR in these women. BMD was evaluated by the dual-energy X-ray absorptiometry method. A binary logistic regression model adjusted for confounders was used to evaluate the associations between plasma miRNAs' expression levels and osteoporosis. The Area Under Curve (AUC) was calculated to differentiate low BMD in the postmenopausal period using Receiver-Operator Characteristic (ROC) curves. miRNA-21 and miRNA-422a were significantly up-regulated in osteoporotic compared to non-osteoporotic postmenopausal women. The expression levels of miRNA-21 and miRNA-422a indicated a significant reverse correlation with both lumbar spine and femoral neck density. After adjusting the confounders, the likelihood of osteoporosis in the postmenopausal women with under the median plasma levels of miRNA-21 (OR = 0.025; 95% CI: 0.003 to 0.198, p<0.001) and miRNA-422a (OR = 0.037; 95% CI: 0.007 to 0.211, p<0.001) was significantly less than the women with the levels above the median. There were significant inverse correlations between miRNA-21 (p<0.001, r = -0.511) and miRNA-422a (p<0.001, r = -0.682) with BMD-lumbar spine as well as an inverse correlation between miRNA-21(p<0.001, r = -0.374) and miRNA-422a (p<0.001, r = -0.602) with BMD-femoral neck. The AUC (95%CI) for miRNA-21 and miRNA-422a was 0.84 (0.77 to 0.91) and 0.98 (0.96 to 0.99), respectively. ROC analysis illustrated that sensitivity and specificity values were 83.1% and 74%, respectively, for miRNA-21 at the cut-off point of 3.38. Also, at the cut-off point of 2.86, a sensitivity of 94% as well as a specificity of 89% was determined for miRNA-422a. This study indicated that the odds of osteoporosis in postmenopausal women increased with the higher expression of plasma miRNA-21 and miRNA-422a.

SAT151 Assessments Of Body Composition In Women With Reactive Hypoglycemia

Abstract Disclosure: A. Adamska: None. A. Buczyńska: None. K. Łuka: None. A. Wiatr: None. K. Siewko: None. E. Duraj: None. A. Krętowski: None. A. Popławska-Kita: None. Introduction: Reactive hypoglycemia is characterized by low blood glucose level in non-diabetic patients. It manifests as a syndrome of adrenergic and neuroglycopenic symptoms in the postprandial period, and their resolution occurs after consuming carbohydrates. Reactive hypoglycaemia can also be seen in patients with insulin resistance and hyperinsulinism. In patients with reactive hypoglycemia can be observed disturbances in body composition. The aim of this study was to asses of body composition in women with reactive hypoglycaemia vs control group. Subjects and Methods: We examined 103 women: 49 subjects with RH and 54 control women matched for age and BMI. Four hours oral glucose tolerance test (OGTT) with 75 grams of glucose with estimation of serum glucose and insulin was performed. Body composition was analysed by dual-energy X-ray absorptiometry (DXA). Results: We did not observe differences in fat mass, fat free mass, android fat mass and fat free mass, gynoid fat mass and fat free mass and visceral adipose tissue estimated with DXA method between studied groups (all p&amp;gt;0.05). However, we have found positive relationship between fat mass and serum glucose concentration at 3rd hour of OGTT (r=0.29, p= 0.03) in the group of reactive hypoglycaemia. In the control group be observe relationships between android fat-free mass and serum glucose concentration at 3rd hour of OGTT (r=-0.3, p=0.02) and gynoid fat-free mass and serum glucose concentration at 3rd hour of OGTT (r=-0.27, p=0.04). Conclusions: Women with reactive hypoglycaemia is not differ in body composition estimated with DXA methods. However RH is connected in different manner with glucose homeostasis and fat and lean mass in comparison to control group. Presentation: Saturday, June 17, 2023

FRI030 The Clinical Significance Of The Oxidative Status Evaluation Among Insulin Resistant Overweight And Obese Patients

Abstract Disclosure: A. Popławska-Kita: None. A. Buczyńska: None. E. Duraj: None. I. Sidorkiewicz: None. K. Łuka: None. K. Siewko: None. A. Adamska: None. A. Krętowski: None. Insulin resistance is a prevalent syndrome, developing and occurring simultaneously with weight gain, considering as predisposing factor for type 2 diabetes mellitus (T2DM), frequently resulting from metabolic syndrome development. Despite significant progress in the treatment of overweight and obesity, these patients are still at risk of developing chronic complications related to insulin resistance, such as T2DM and cardiovascular diseases, which are a significant clinical problem. In the pathogenesis of complications of insulin resistance among obese and overweight patients, an increasing role is attributed to oxidative stress. In physiological conditions reactive oxygen species (ROS) are formed from molecular oxygen in the cellular respiration process, but in concentrations exceeding the physiological are leading to the oxidative damage of macromolecules, such as: proteins, lipids, DNA. Furthermore, ROS may cause insulin resistance in the peripheral tissues by affecting various points in insulin receptor signal transduction increasing the risk of continued further weight gain. In this study, oxidative status among insulin resistant obese and overweight patients was determined. For the purpose of this study, 50 patients with obesity and insulin resistance (BMI&amp;gt;30), 50 overweight patients with insulin resistance (BMI&amp;gt;25) and 50 healthy volunteers (BMI&amp;lt;25) were enrolled. The oxidative status was determined using total oxidative capacity (TOC) and total antioxidant capacity (TAC). The body composition was assessed using the dual energy x-ray absorptiometry method (DXA). Insulin resistance was evaluated using the homeostatic model assessment for insulin resistance (HOMA) calculation. All patients underwent oral glucose tolerance test (OGTT) and glucose and insulin measurements at times: 0, 60, 120, 180 and 240 minutes. Overweight and obese patients presented increased TOC concentration and decreased TAC concentration comparing to control group (all, p&amp;lt;0.05). There were no differences in oxidative status between the obese and overweight groups (p&amp;gt;0.05). In the overweight study group, TOC moderately correlated with body weight, TAC moderately correlated with body fat mass and glucose concentration at 240 minutes in the OGTT. In the obese group, TOC moderately correlated with BMI, body fat mass and glucose levels in 240 minutes of the OGTT, and TAC correlated with body weight and fasting glucose.The results underline the importance of determining the oxidative status in obese and overweight patients, where oxidative status is related to glucose metabolism and body mass composition. Nevertheless, more research is needed to elucidate the effect of increased oxidative stress on the insulin resistance development. Presentation: Friday, June 16, 2023

A novel approach for assessing osteoporosis utilizing DXA, HU and VBQ

ObjectiveTo precisely assess preoperative osteoporosis in patients, a more precise method for evaluating osteoporosis is being developed to better guide the use of bone cement reinforced screws. MethodThe retrospective analysis was conducted on patients who underwent posterior lumbar decompression and fusion internal fixation at Shanghai Tongren Hospital.The general information, bone mineral density assessment data, Fracture risk prediction rate(WHO Fracture Risk Assessment Tool (FRAX)), and whether to use cement reinforced screws were collected. Definition of combination method: T value ​< ​−2.5 or HU value ​< ​110 or VBQ >3.5.The diagnostic rates of osteoporosis were compared between dual energy x-ray absorptiometry(DXA), Hounsfield Units(HU), Vertebral Bone Quality (VBQ), National Bone Health Alliance(NBHA), and combination methods, and the correlation between different methods was analyzed. Binary logistic regression was used to analyze the significant influencing factors of the use of cement-reinforced screws. ResultA total of 178 patients were enrolled in the study, aged 65.73 ​± ​14.43 years, 121 female, 57 male, Body Mass Index(BMI) was 22.88 ​± ​3.52, 57 (32.0%) used cement reinforced screws, and 14 (7.9%) had previous fracture history.The diagnostic rates of osteoporosis by DXA, HU, VBQ, NBHA and combination method were 22.5% (40/178), 47.2% (84/178), 56.2% (100/178), 64.0% (114/178) and 75.8% (135/178), respectively.HU, VBQ, NBHA, and combination methods were significantly different from DXA in the diagnosis rate of osteoporosis (P ​< ​0.001). Binary Logistics regression showed that age, T value, HU value, and VBQ value significantly influenced bone cement screw use, and the odds ratio of VBQ was 4.315. The prediction accuracy of the regression equation was 90.4%, the area under the receiver operator characteristic(ROC) curve was 0.974, and the Youden index was 0.830. ConclusionCurrently, the DXA method widely used for diagnosing osteoporosis yields false negative results and there are significant discrepancies among different diagnostic methods. The combined approach exhibits a higher detection rate (75.8%). Age, T value, HU value, and VBQ value significantly influence the use of cement screws with a regression equation accuracy of 90.4%. Cement-reinforced screws are recommended when osteoporosis is determined by a combination method.

Bone mass density in patients with rheumatoid qrthritis: Influence of disease activity

Rheumatoid arthritis (RA) can affect bone density. Given the significant risk of low bone mass density (BMD) in RA patients, the present study aims to investigate the BMD in these patients. The present cross-sectional study included 415 RA patients from the Rafsanjan Rheumatology Clinic. The patients were included in the study by census based on the inclusion criteria, which included a physician's diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria, at least three months of disease history, and age between of 35 and 70 years. The BMD was measured using the dual-energy x-ray absorptiometry method in both the hip and the spine, and the RA severity was determined using the disease activity score-28 (DAS-28) index. The mean age of RA patients was 56.49 ± 11.73 years, with females accounting for 86.7% (300 people). The frequency of osteoporosis was 7.5% (26 people), and osteopenia was 43.6% (151 people) based on hip bone density, and 33% (137 people) and 38.1% (158 people) based on spine density, respectively. Age, fracture history, and DAS-28 score increased the probability of developing osteopenia or osteoporosis based on hip and spine bone density. According to the findings of a study in RA patients, increasing age, history of bone fracture, and DAS-28 score increase the probability of osteopenia or osteoporosis. Therefore, it is advised to pay close attention to the mentioned factors to prevent complications in these patients.

Body composition parameters in systemic sclerosis-a systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to summarize current evidence regarding body composition (BC) in SSc in order to gain new insights and improve clinical care in the context of the nutritional status of SSc patients. The databases Web of Science, PubMed, Scopus and Cochrane Library were searched on 4 January 2023. Studies were included if they provided data regarding BC obtained by dual-energy X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) in patients with SSc and healthy controls (HC). The study design criteria for inclusion were cohort and observational studies. The risk of bias assessment was performed using the Newcastle-Ottawa scale. For meta-analysis, mean difference with a 95% confidence interval was obtained and all results were depicted as forest plots. The number of retrieved publications was 593, of which nine were included in a random-effects meta-analysis totalling 489 SSc patients and 404 HC. Overall, significantly lower body mass index, lean mass (LM), fat mass (FM) and phase angle values were found in SSc patients when compared with HC. Furthermore, FM and LM were significantly lower in SSc patients when the DXA method was applied, whereas the same parameters were comparable between two groups of participants when BIA was applied. Altered BC is characteristic of SSc patients indicating the need for regular nutritional status assessment in order to improve the quality of life and clinical care of patients with SSc.

Body Composition Relationship to Performance, Cardiorespiratory Profile, and Tether Force in Youth Trained Swimmers.

This study sought to analyze the relationship between regional body composition, swimming performance, and aerobic and force profile determined through tethered swimming in well-trained swimmers. Eleven male and five female swimmers were involved in the study and underwent the following evaluations: (1) body composition, assessed by the dual-energy X-ray absorptiometry method (DXA); (2) swimming performance, determined for 200, 400, 800, and 1.500 m front-crawl swimming; (3) a tethered swimming force test to determine maximum and mean force (Fmax and Fmean); and (4) an incremental tethered swimming test for the aerobic profile determination of the swimmers. Oxygen uptake (VO2) was directly measured by an automatic and portable system (K4b2 Cosmed, Italy). The fat-free mass (lean mass + bone mineral content, LM+BMC) in lower and upper limbs (UL_LM+BMC: 6.74 ± 1.57 kg and LL_LM+BMC: 20.15 ± 3.84 kg) positively correlated with all indexes of aerobic conditioning level, showing higher coefficients to the indexes representing the ability to perform at high aerobic intensities (VO2max: 49.2 ± 5.9 mL·kg-1·min-1 and respiratory compensation point (RCP): 43.8 ± 6.0 mL·kg-1·min-1), which attained 0.82 and 0.81 (with VO2max), 0.81 and 0.80 (with RCP). The S200 (1.48 ± 0.13 m·s-1) was significantly correlated to Trunk_LM+BMC (r = 0.74), UL_LM+BMC (r = 0.72), Total_LM+BMC (r = 0.71), and LL_LM+BMC (r = 0.64). This study highlights that regional body composition plays an important role in swimming, and body segment analysis should be considered instead of the total body. Tethered swimming may represent a useful method for force and aerobic assessment, aiming at training control and performance enhancement.

Physical activity, quality of diet and bone mineral density in patients with inflammatory bowel disease.

The aim of this study was to find an association between moderate, vigorous and total physical activity (PA); diet quality; and bone mineral density (BMD) among patients suffering from inflammatory bowel disease (IBD). We enrolled 54 IBD patients, including those with Crohn's disease (CD) and ulcerative colitis (UC), and 24 healthy adults. All subjects completed the Questionnaire of Eating Behaviour based on which prohealthy and nonhealthy diet indexes were calculated, and the questionnaire included questions from the International Physical Activity Questionnaire. Prohealthy and nonhealthy diet indexes were divided into low-, medium- and high scores. BMD and T- and Z-scores of the lumbar spine (L1-L4) and femoral neck (FN) were assessed using dual-energy X-ray absorptiometry method. BMD, T- and Z-scores of the FN and the Z-score of L1-L4 were significantly lower among patients with CD and UC than healthy controls. We did not find any differences in the time of PA among CD, UC and control groups (CG). The prohealthy diet index was higher among healthy subjects than the CD and UC groups. The nonhealthy diet index was lower among UC patients compared with the CG or CD patients. Prohealthy diet index positively correlated with BMD and T- and Z-scores of L1-L4 and FN in IBD. The prohealthy diet index correlated negatively with C-reactive protein and positively with body mass index. The prohealthy diet index correlated only with total PA in the CD group. A well-balanced diet and proper PA may decrease the risk of osteoporosis in IBD, so education of patients referring to nutrition and PA is needed.

Diagnostic Value of Clinical Parameters for the Prediction of Osteoporosis in Menopause Iranian Women

Background: Osteoporosis might result in an increased risk of bone fracture. Diagnosis of osteoporosis results in proper treatment and reduction of fracture rate. Objectives: This study aimed to construct a predictive model of osteoporosis case finding in Iranian women. Methods: A prospective diagnostic value study was designed, enrolling 317 asymptomatic women 50 years old or more referred for screening, at the Imam Hossein Medical Center, Tehran, Iran, for two years. The data was collected with the census method. A questionnaire including risk factors was completed, and bone mass densitometry (BMD) was done by the dual-energy X-ray absorptiometry (DXA) method in all cases. According to standard curves, bone density of the femur and lumbar spine clarified osteoporosis status for each person. In the first step, univariate analysis with osteoporosis as the main outcome did use the chi-squared test, independent sample t-test. In the next step, factors with a P-value of less than 0.2 were included in the multivariate logistic model, and a predictive model was constructed. The goodness of fit test was applied to assess the model building. The area under the curve (AUC) calculated for the model and the best cut-point for risk of menopause according to the Youden index were determined. The significance level was set at 0.05 for statistical analysis. Statistical analyses did use the program SSPS version 17.0 (SPSS, Inc., Chicago, IL, USA). Results: In 317 cases of the present study, the mean age of the population was 52.46 years old. Ninety-nine (%31.2) of these asymptomatic women revealed osteoporosis on the BMD test. Age and family history of osteoporosis were risk factors, and BMI, parity, and menopause age were protective factors for osteoporosis. Constructed model of osteoporosis prediction was as follows: (age × 0.149) + (family history × 0.963) - (BMI × 0.088) - (menopause age × 0.097) - (parity × 0.80). Optimal cutoff = 0.336 based on Youden method was chosen to predict the risk of osteoporosis. Conclusions: BMD test in Iran in more than 50 years old might find positive osteoporotic cases in at least 23.8%. BMD test in Iran in more than 50 years old might find positive osteoporotic cases in at least 23.8%. A model of osteoporosis probability constructed based on age, family history, menopause age, and parity in the present study can predict women at risk of osteoporosis.

Analysis of Age Distribution of Bone Mineral Density by Dual-Energy X-Ray Absorptiometry

Objective: to conduct the study of age distribution of bone mineral density (BMD) by the database of dualenergy X-ray absorptiometry (DXA) and to compare it with datа of population NHANES study. Material and methods. We used data from the densitometry of three-zone (total hip (TH), femoral neck (FN), and lumbar spine) measured by DXA from two outpatient clinics. The obtained data were compared with NHANES III for TH and FN and with NHANES 2005-08 for lumbar spine. The BMD value was corrected with the calibration coefficient for each DXA scanner. Adjustments were also made for the population distribution by sex and age. Results. Compared with NHANES for FN and TH, the obtained BMD values were significantly decreased for patients aged less than 50 years (men and women). The BMD values for FN and TH were unsignificantly decreased in men older 50 years. In women older 50 years unsignificantly decreased BMD values for FN and a significantly increased BMD values for TH were observed. The BMD values were decreased for lumbar spine in men and women throughout this age interval (more than 50 years old). Conclusion. The population BMD distribution in men and women was assessed by DXA method. The obtained dependence of the BMD for FN in women older 50 years was in good agreement with the results given by Russian and foreign authors.

Validation of Quantitative Ultrasonography for Osteoporosis Diagnosis in Postmenopausal Women Compared to Dual-Energy X-Ray Absorptiometry (DEXA).

Introduction Bone mineral density (BMD) is an essential indicator for diagnosing osteoporosis and evaluating the success of osteoporotic treatment. Dual-energy X-ray absorptiometry (DEXA), quantitative ultrasonography (QUS), and quantitative computed tomography (QCT) are frequently used for measuring BMD. The objective of the study was to evaluate the ability of QUS to screen for osteoporosis and bone density in postmenopausal women by calibrating it against DEXA. Methods This cross-sectional study was conducted at the Department of Orthopedics and Trauma Center of the tertiary care center, Lucknow. A total of 90 patients visited this department from August 2017 to July 2018 for the present study. BMD in the same patient was evaluated by using DEXA and ultrasonography methods. Data were entered in Microsoft Excel and analyzed by using SPSS Software. Results According to linear regression analysis, T neck was found statistically significant with T QUS (p<0.001) and z QUS (p<0.001). T lumbar and T wrist were found statistically significant with T QUS (p<0.001) but not with z QUS (p>0.001). Z neck was found statistically significant with T QUS (p<0.001) and z QUS (p<0.001). Z lumbar was found statistically significant with T QUS (p<0.001) but not with z QUS (p>0.005). Z wrist was not found statistically significant with T QUS (p>0.005) or with z QUS (p>0.005). Conclusion In the present study, we found that QUS can be used as a screening tool for detecting osteoporosis by measuring BMD in contrast to DEXA. QUS also can be used to predict the DEXA values for osteoporosis and to detect osteoporosis.

The correlation of triglyceride/high-density lipoprotein cholesterol ratio with muscle mass in type 2 diabetes patients

ObjectiveTriglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is correlated with metabolic diseases. The prevalence of sarcopenia is significantly higher in type 2 diabetes mellitus (T2DM) patients compared with healthy controls. The purpose of our study is to evaluate the correlation of TG/HDL-C ratio with muscle mass in T2DM patients.MethodOur study consists of 1048 T2DM inpatients recruited from the department of endocrinology. Skeletal muscle index (SMI) was detected with a dual energy X-ray absorptiometry method. Low muscle mass was diagnosed using the criteria of SMI less than 7.0 kg/m2 (in male subjects) or 5.4 kg/m2 (in female subjects).ResultThe prevalence of low muscle mass was 20.9% and 14.5% in male and female groups respectively. SMI was correlated with TG/HDL ratio after adjustment for age, duration of diabetes, diastolic blood pressure (DBP), and HbA1c in male subgroup. In female subgroup, SMI was associated with TG/HDL ratio after adjustment for age and DBP.ConclusionHigher TG/HDL-C ratio is correlated with muscle mass in T2DM patients.

Bone fragility, sarcopenia and cardiac calcifications in an elderly population: a preliminary study

Cardiovascular disease, osteoporosis and sarcopenia are very common age-related conditions. This study aimed at investigating the relationships of cardiac calcifications, as assessed by using GCCS with BMD, fragility fractures and sarcopenia in elderly subjects. In a cohort of 106 subjects (age 70.4 ± 5.8 yrs) we measured lumbar (BMD-LS), femoral BMD (femoral neck: BMD-FN, total femur: BMD-TH) and body composition (BMD-WB) with Dual-energy X-ray Absorptiometry (DXA) method. We also evaluated the presence of sarcopenia on the basis of the EWGSOP Consensus. All subjects, simultaneously, underwent to a transthoracic color doppler echocardiography exam to assess the presence of cardiac calcifications. The degree of non coronaric cardiac calcifications was evaluated using the Global Cardiac Calcium Score (GCCS). The degree of cardiac calcification assessed by GCCS was significantly higher in osteoporotic patients (p < 0.001). Furthermore, an inverse correlation emerged between BMD and GCCS, statistical significance was found at lumbar spine and femoral sub-regions in female population (p < 0.01). Moreover by dividing population according to the presence of fragility fractures, we observed that GCCS values were significantly higher in subjects with fractures in respect of non-fractured ones (p < 0.05). Multiple regression models showed that BMD-LS and BMD-FT were independently associated with cardiac calcification. GCCS values were significantly associated with BMI and ASMM in women (p < 0.01 and p < 0.05, respectively) and with handgrip strength in men (p < 0.05). Our data confirm the presence of a relationship between cardiac calcifications and decreased BMD values. It's also the first study that relates sarcopenia and valvular calcifications.