Dual-energy X-ray Absorptiometry Scans Research Articles

Comprehensive health assessment of retired martial arts athletes: bone density, dietary intake, physical activity, and wellbeing

Regular physical activity offers benefits like enhanced bone density, which often persists post-retirement. However, retirement can lead to weight gain and changes in quality of life due to reduced physical activity. Therefore, this study investigates the long-term effects of elite athletic experience by comparing retired Jordanian male elite athletes (ages 40–50) with non-athletes of the same age. The differences were explored in weight changes, bone density, quality of life, happiness, stress, insomnia, physical activity, and dietary intake to understand how martial arts impact these health dimensions.MethodsA descriptive case-control study was conducted among 30 retired male elite athletes and 20 age-matched non-athletes. Bone density and body composition were measured using dual-energy X-ray absorptiometry (DEXA) scans. Additional assessments included anthropometric measurements, a 3-day dietary recall, physical activity (International Physical Activity Questionnaire), quality of life (WHOQOL), happiness (Subjective Happiness Scale), stress (Perceived Stress Scale), and insomnia (Insomnia Severity Index).ResultsRetired athletes showed significantly higher Z-scores for the left femur (neck and total) and the AP spine, with p-values <0.05. Among non-athletes, 65% had normal bone density with a Z-score ≥ −1.9 and a T-score > −1.1, 20% had abnormal bone density with a Z-score < −1.9, and 15% had osteopenia with a T-score between −1.1 and −2.4. In contrast, 100% of retired athletes had normal bone density with a Z-score ≥ −1.9 and a T-score > −1.1. Retired athletes exhibited greater weight changes than non-athletes, with a p-value <0.05; the average weight gain among retired athletes was 18.548 kg, and the mean weight gain among non-athletes was 4.3 kg. There were statistically significant mean differences in perceived stress levels between retired athletes and non-athletes with a p-value <0.05. In contrast, there were no statistically significant mean differences between the groups in quality of life, subjective happiness, and the Insomnia Severity Index.ConclusionThe study reveals that retired elite athletes maintain better bone density but face greater weight gain and stress than their non-athlete counterparts. Both groups enjoy a high quality of life and low levels of insomnia. These findings underscore the importance of continued physical activity for health and suggest that both retired athletes and non-athletes should adopt a balanced lifestyle to manage weight and stress effectively.

Accelerometer-based sedentary time and physical activity with incident and progressive tobacco smoking in 2503 children: A 13-year mediation and temporal longitudinal study.

Long-term accelerometer-based studies examining whether engaging in physical activity (PA) reduces the risk of smoking in children are lacking, and whether directly measured adiposity increases smoking risk is uncertain. From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2503 children aged 11 years with complete smoking and at least one valid time-point movement behaviour data were followed up until age 24 years. ActiGraph assessed sedentary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) at ages 11, 15, and 24-year clinic visits and smoking-based questionnaires were administered, whilst fat mass was measured with dual-energy x-ray absorptiometry scanner. Data were analysed with generalized linear-mixed effect models with logit-links and structural equation models. Mean [SD] age at baseline was 11.71 [0.20] years and the prevalence of smoking at ages 13, 15, and 24 years were 1.5%, 13.5%, and 26.6%, respectively. Higher MVPA at age 11 years was significantly associated with lower odds of smoking at age 13 years (odds ratio, 0.991; [95% CI, 0.983-0.999], P=0.035). Cumulative MVPA during ages 11-24 years was significantly associated with lower odds of progressive smoking during growth from ages 13-24 years (0.992; [95% CI, 0.989-0.996], P<0.001). Cumulative ST and LPA had no significant associations with smoking. Higher fat mass suppressed (10% suppression) the inverse relationship between MVPA and smoking. In path analysis, higher MVPA at age 15 years temporally preceded reduced smoking at age 24 years. In the present study, engaging in MVPA from age 11 years may prevent 9 in 1000 children from starting smoking at the age of 13 years when smoking prevalence was 15 in 1000 children, i.e potentially preventing 60% of children from initiating smoking. However, the MVPA preventive approach diminished as children grew into young adults.

Development of bone mineral density and content in children with cerebral palsy: a retrospective, longitudinal study.

The aim of this study was to investigate long-term bone development in children with cerebral palsy (CP) using longitudinal measurements of total body less head bone mineral content (TBLH-BMC) and bone mineral density (TBLH-BMD). A retrospective longitudinal analysis was performed on 109 children with CP who participated in a rehabilitation programme from 2006 to 2018. Dual-energy X-ray absorptiometry (DXA) scans were performed at the beginning of the programme and repeated as clinically indicated. The study used SITAR growth curve analysis and the LMS method within the GAMLSS model to generate developmental trajectories for TBLH-BMC and TBLH-BMD. The findings suggest that the expected developmental trajectories of TBLH-BMC and TBLH-BMD in children with CP approximately follow the third percentile of healthy children. The median annual increase in bone mineral density was similar between GMFCS I-II and III-V groups at 5.12 and 5.79 %, respectively. Girls with CP reached age at peak velocity (APV) earlier than boys. The intensive exercise programme may have contributed to greater annual bone growth in children with more severe CP. Children with CP have bone growth trajectories close to the third percentile of their healthy peers, suggesting that age-adjusted z-scores for TBLH-BMC and BMD remain relatively stable throughout childhood and adolescence. Early and targeted interventions, including improving muscle strength and mobility and optimising nutritional and hormonal status, are essential to promote better bone health and quality of life in children with CP.

Higher bone mineral density at six years of age in very preterm-born infants fed human milk compared to formula feeding. A secondary analysis of an RCT

In very preterm-born infants, nutritional intake is important to reduce the risk of severe metabolic bone disease including the risk of a lower bone mineral density (BMD). The aim of this study was to evaluate bone mineral content (BMC) and BMD (measured as BMC per bone area (BA)) at six years of age in very preterm-born infants fed different diets post-discharge. Data on this topic so far is insufficient, and with this study we aim to supply more useful data. A prospective follow-up study of 281 children born very preterm (gestational age ≤ 32 + 0 weeks) and enrolled in a multicentre RCT on post-discharge nutrition. Infants fed human milk (HM) were randomised respectively to be fed unfortified HM (UHM) or fortified human milk (FHM) from hospital discharge to four months’ corrected age. Those not fed HM received a preterm formula (PF). At six years of age, BMD and BMC in all the children were established by means of a dual-energy X-ray absorptiometry (DXA) scan (Lunar Prodigy) and adjusted for sex, age, and anthropometrics. A total of 192 very preterm-born children (59 fed UHM, 67 FHM and 66 PF) had a DXA scan performed at median 6 (5.8—8.3) years of age. No significant difference was found comparing UHM and FHM according to height, weight, BA, BMC, and BMD at six years of age. However, a multiple regression analysis showed significantly improved BMD in breastfed children compared to PF-fed children. Conclusions: Fortified compared to non-fortified human milk post-discharge did not have an impact on BMD at 6 years of age in very preterm-born infants. Breastfed children demonstrated higher BMD than formula-fed children.What is Known:• Adequate nutritional intake is important to improve growth and to reduce the risk of severe bone disease in very preterm born infants.• Bone mineralization is attained later in preterm born infants compared to term born infants.What is New:• Feeding human milk with fortification compared to non-fortified human milk did not improve bone mineral density in children born very preterm in this follow-up study at six years of age.• Feeding human milk compared to formula was associated with increased BMD at six years of age among very preterm born infants.

P-451. Adherence to Bone Mineral Density Screening Recommendations in Older Adults with HIV

Abstract Background HIV guidelines recommend bone mineral density (BMD) screening by dual-energy x-ray absorptiometry (DXA) for all postmenopausal women and all men ≥50 years. Uptake of these recommendations has been low. This study describes DXA screening practices among people with HIV (PWH) at highest risk for low BMD. Methods We conducted a retrospective chart review among PWH aged ≥65 or older who were seen for HIV care at the University of Colorado within the last year. First available and most recent DXA scans were collected; FRAX score was calculated to estimate 10-year risk of major osteoporotic and hip fractures. Demographics and clinical factors were also collected. Results We reviewed records of 300 PWH age 65 and older, including 243 (81%) men and 57 (19%) women. The mean age was 69.8 (SD 4.4) years, 62% were non-Hispanic white, 45% had a normal body mass index (18.5-24.9 kg/m2), and 60% reported current/prior tobacco use. 48% had a DXA scan ordered, including 53% of those with previous falls and 54% with prior fracture. Mean age at first DXA scan was 64.9 (SD 6.0) for males and 64.5 (SD 6.4) for women. Of those screened, 13% of women and 27% of men had normal BMD (T-score &amp;gt; -1.0); 45% of women and 53% of men had osteopenia (T-score &amp;lt; -1 to -2.5) and 42% of women and 20% of men had osteoporosis (T-score &amp;lt; -2.5). By FRAX, 10-year probability of major osteoporotic fracture was 9.8% [IQR: 5.7, 13.6] for women and 6.8% [4.7, 11.0] for men. The 10-year probability of hip fracture was 2.2% [0.8, 4.1] for women and 1.4% [0.6, 2.8] for men. Conclusion Older PWH are markedly under-screened for low BMD. There was low adherence to screening per current HIV guidelines, even among those with the highest risk. Osteopenia and osteoporosis were common, though FRAX scores suggested only moderate risk. Improved screening for reduced BMD and fracture risk in PWH is urgently needed. Disclosures Kristine M. Erlandson, MD MS, Gilead: Advisor/Consultant|Gilead: Grant/Research Support|ViiV: Advisor/Consultant

Addressing healthcare disparities and improving osteoporosis management in rural communities: a cluster randomized control trial.

Rural communities face limited healthcare access, financial constraints, and transportation barriers leading to health disparities. This study examined interventions that reduced health disparities in increasing the outpatient attendance and treatment rate of anti-osteoporosis medication (AOM), while identifying factors contributing to therapy refusal in rural communities. A total of 567 patients were randomized at the community level into three groups: multicomponent integrated care (MIC), osteoporosis care only (OC), and usual care (UC). Fracture Risk Assessment Tool and dual-energy X-ray absorptiometry scans were used to evaluate the osteoporosis and osteoporotic fracture risk. High- and moderate-risk patients were advised to pursue further hospital-based assessments and treatment. Both the MIC and OC groups received five interventions to address rural barriers, including specialist access, disease education, overcoming transportation barriers, peer support, and dedicated case managers. However, UC excluded transportation assistance, peer support, and case management. Outcomes measured included outpatient attendance, AOM treatment rates, and factors affecting hospital assessment refusal, analyzed via multivariable logistic modeling. In the MIC group, 73.3% of patients attended the outpatient clinic and 58.6% received AOM. In the OC group, 81% patients attended and 69.3% received AOM. Conversely, in the UC group, only 4.1% attended and received AOM. Significant differences in attendance and AOM rates were found between the MIC and UC groups and between the OC and UC groups (p < .001 for both). Common barriers included beliefs that treatment was unnecessary and lack of hospital access. Risk factors hindering outpatient attendance include male sex, low education, low budget, multiple disabilities, and osteopenia diagnosis. Addressing transportation barriers and implementing dedicated case management are crucial for improving healthcare access among rural patients. ClinicalTrials.gov NCT05104034.

Changes in Bone Mineral Density After Parathyroidectomy in Patients With Primary Hyperparathyroidism.

Patients with primary hyperparathyroidism (PHPT) are prone to low bone mineral density (BMD). This study aimed to explore factors associated with improved bone health after parathyroidectomy (PTx). We conducted a retrospective analysis of patients who underwent PTx for PHPT at our institution between 2016 and 2020. Patients who had a dual-energy X-ray absorptiometry (DEXA) scan before and after surgery were included. T score in the lumbar spine, femoral neck, hip, and radius were examined longitudinally. The cohort included 36 patients, predominantly White (80.6%) and female (97.2%), with an average age of 67±8ys. Before surgery, 25% were diagnosed with osteoporosis, 50% with osteopenia, and 25% had normal BMD. The mean preoperative calcium was 10.5±0.7mg/dL, and the median parathyroid hormone was 105 (75, 131) pg/mL. The median interval between the preoperative DEXA scan and surgery was 357 (134, 920) days. There was a significant improvement in the femoral neck T-score after surgery (-1.33±1.05 presurgery versus -1.16±1.19 postsurgery, P=0.016), but not in other regions. A longer time between the preoperative DEXA scan and surgery was associated with a lower likelihood of T-score improvement after surgery (odds ratio=0.92, 95% confidence interval 0.85 - 0.99). PTx improves BMD in the femoral neck of patient with PHPT. Early surgical intervention may be associated with better skeletal outcomes in PHPT.

Romosozumab Improves Tissue Thickness-Adjusted Trabecular Bone Score in Women With Osteoporosis and Diabetes.

Trabecular bone score (TBS), a gray-level texture index derived from lumbar spine (LS) dual-energy x-ray absorptiometry (DXA) scans, is decreased in patients with diabetes and is associated with increased fracture risk, independent of areal bone mineral density (aBMD), but potentially influenced by abdominal fat tissue. Evaluate effect of romosozumab (210 mg monthly) for 12 months followed by alendronate (70 mg weekly) for 24 months vs alendronate alone (70 mg weekly) for 36 months on LS aBMD and TBS in women with type 2 diabetes (T2D) enrolled in the ARCH study. This post hoc analysis included women from ARCH who had T2D at baseline and LS DXA scans at baseline and ≥1 postbaseline visit (romosozumab-to-alendronate, n = 165; alendronate-to-alendronate, n = 195). aBMD and TBS (determined by an updated tissue thickness-adjusted TBS algorithm [TBSTT]) were assessed on LS DXA scans at baseline and ≥1 postbaseline visit (months 12, 24, and 36). Romosozumab led to significantly greater gains in LS aBMD and TBSTT at month 12 vs alendronate, and the greater gains with romosozumab were maintained after transition to alendronate and persisted significantly at months 24 and 36 vs alendronate alone. TBSTT percentage changes weakly correlated to LS aBMD percentage changes from baseline to month 36 (romosozumab-to-alendronate, R2 = 0.1493; alendronate-to-alendronate, R2 = 0.0429). In postmenopausal women with osteoporosis and T2D, 12 months of romosozumab followed by 24 months of alendronate vs alendronate alone significantly improved LS aBMD and TBSTT (independently of abdominal fat) and to a greater extent. Hence, romosozumab may improve bone strength in patients with T2D. ClinicalTrials.gov-NCT01631214.

Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence.

Obesity, classified by body mass index (BMI), is associated with higher postmenopausal breast cancer (BCa) risk. Yet, the associations between abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) with BCa are unclear. We assessed BCa associations with abdominal VAT and SAT in a prospective cohort of postmenopausal women without a history of cancer and with 27 years follow-up (N = 9950), during which all new cancers were adjudicated. Dual-energy X-ray absorptiometry scans assessed adiposity at baseline, year 3, and year 6. Competing risks multivariable sub-hazard ratios (SHR), with adjustments for sociodemographic, behavioral, reproductive, and anthropometric characteristics, were estimated for baseline and time-dependent associations between VAT, SAT, and incident BCa. Participants averaged 63.3 ± 7.4 years of age and a BMI of 28.20 ± 5.72 kg/m2 at baseline. The models included 738 incident BCa cases (N = 593 invasive; N = 145 in situ). Baseline VAT and SAT area were associated with significantly increased BCa risk, by 36% and 19% respectively. Increasing VAT/SAT ratio was associated with an 8% increase in incident BCa. Time-dependent models produced similar results. VAT and VAT/SAT associated BCa risk was highest for African American/Black women, though not significantly different from other groups. Quartiles (Q) of VAT/SAT were also explored; the SHR for Q4 compared to Q1 was 1.49 (95% CI: 1.18, 1.87). Higher abdominal VAT and SAT are associated with an increased risk of postmenopausal BCa, and VAT/SAT may provide a distinctive risk estimate. Potential racial and ethnic differences require replication in a larger sample.(NCT00000611).

Evaluating Bone Fracture Healing in a Rabbit Model Using Doppler Imaging Modes, Shear Wave Elastography, X-Ray, and Dual-Energy X-Ray Absorptiometry.

This study investigated methods of evaluating the bone fracture healing process using superb microvascular imaging (SMI; two modes color SMI [cSMI] and monochromeSMI [mSMI]), and shear wave elastography (SWE), relative to X-ray, dual-energy X-ray absorptiometry (DXA), and platelet endothelial cell adhesion molecule 1 (PECAM-1) also know as cluster of differentiation 31 (CD-31) staining in a rabbit model. This IACUC-approved study involved eight rabbits that underwent a bilateral fibula osteotomy and were followed for 7 or 21 days (Groups 1 and 2 with 4 rabbits in each). Ultrasound examinations using cSMI, mSMI, and SWE were performed on Days 0, 4, 7, 14, and 21 post-surgery. At the final time point, rabbits had X-ray imaging followed by euthanasia and DXA scan. Finally, the fracture areas underwent decalcification, and specimens were stained with CD-31 for pathological analysis. Ultrasound and X-ray findings were compared using ANOVAs or paired t-tests with CD-31 stains and DXA was used as a reference. Comparing SMI ultrasound images between the last time points for Group 1 (Day 7) and Group 2 (Day 21) showed no statistical significance difference for cSMI (P = .14) and mSMI (P = .06), similarly when compared with CD-31 stains there was no statistical significance difference for cSMI in Group 2 (P = .13). The SWE ultrasound images from the last time points in Groups 1 and showed no statistical significance difference (P = .33), the same results were then compared with DXA and also showed no statistical significance difference (P = .14). When comparing results of the X-ray images from the last time points for Groups 1 and 2 a statistical significance difference was found (P = .01), and when X-ray images were compared with DXA there was a statistical significance difference (P < .001). Compared with CD-31 stains cSMI on Day 21 was not statistically significant (P = .13). Results comparing SWE with DXA were also not statistically significant (P = .14). These results indicate the potential of using certain ultrasound imaging techniques to monitor the bone fracture healing process.

Associations between accurate measures of adiposity and fitness, blood proteins, and insulin sensitivity among South Asians and Europeans.

South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between 'gold standard' measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs). A total of 46 SAs and 41 EURs completed 'conventional' (lifestyle questionnaires, standard physical exam) as well as 'gold standard' (dual energy X-ray absorptiometry scan, cardiopulmonary exercise test, and insulin suppression test) assessments of adiposity, fitness, and insulin sensitivity. In a subset of 28 SAs and 36 EURs, we also measured the blood-levels of eleven IR-related proteins. We conducted Spearman correlation to identify correlates of steady-state plasma glucose (SSPG) derived from the insulin suppression test, followed by multivariable linear regression analyses of SSPG, adjusting for age, sex and ancestral group. Sixteen of 30 measures significantly associated with SSPG, including one conventional and eight gold standard measures of adiposity, one conventional and one gold standard measure of fitness, and five proteins. Multivariable regressions revealed that gold standard measures and plasma proteins attenuated ancestral group differences in IR, suggesting their potential utility in assessing IR, especially among SAs. Ancestral group differences in IR may be explained by accurate measures of adiposity and fitness, with specific proteins possibly serving as useful surrogates for these measures, particularly for SAs.

Correlation Between Handgrip Strength and Bone Density and Fragility Fracture Risk Among Older Adults: A Cross-Sectional Study.

Population aging has led to a surge in elderly care needs worldwide. Bone aging, skeletal muscle degeneration, and osteoporosis pose critical health challenges for the elderly. The process of bone and skeletal muscle aging not only impacts the functional abilities but also increases fragility fracture risk. Although a negative correlation between handgrip strength and fragility fracture risk has been identified in elderly populations, there is a lack of related research in Taiwan. This cross-sectional study was designed to investigate the association between handgrip strength and two outcome variables, bone density and risk of fragility fracture, in Taiwanese individuals aged 65 years and older with low bone mass. A total of 548 older adults, including 84 men and 464 women, were recruited between August 2019 and July 2021. Bone mineral density T-scores acquired using dual-energy X-ray absorptiometry scan, the total score for the Taiwan-specific Fracture Risk Assessment (FRAX) tool, and bilateral handgrip strength acquired using a digital hand dynamometer were recorded along with other factors such as comorbidities, dietary habits, and daily activities. In this study, the mean age was 70.9 (SD = 5.6) years, mean bone mass index was 24.1 (SD = 3.5) kg/m2, mean FRAX main fracture risk score was 19.5% (SD = 8.3), and mean FRAX hip fracture risk score was 7.7% (SD = 5.7). Lumbar and hip T-scores were both significantly correlated with both dominant and nondominant handgrip strength in older woman. Older age; both lower hip and spine T-scores; both lower dominant and nondominant handgrip strengths; having Type 2 diabetes, coronary artery disease, or chronic hepatic disease; and lacking a steady job were significantly associated with a higher risk of fragility fracture. The results of this study provide important information regarding the correlation between handgrip strength and several variables, including bone mineral density T-score, FRAX score, comorbidities, and job status, among older adults. Notably, these correlations were found to be particularly strong in the female participants. This information may be used to facilitate the early identification of elderly individuals at a high risk of fragility fractures, enabling the timely development of preventive nursing strategies and the provision of targeted interventions.

Sexual dimorphism in exercise-induced response on steroid hormones to a 24-week supervised concurrent training intervention.

Steroid hormones are key mediators of adaptative responses to exercise, a stimulus that may concurrently affect their blood concentrations. However, the chronic endocrine adaptations and whether these potential changes are dependent on exercise intensity remain undetermined. Moreover, it is also unknown if the exercise-induced effects on steroid hormonal status are related to the participant' sex. This study aimed to investigate the intensity effects of a 24-week supervised concurrent training intervention on steroid hormones in sedentary young men and women. A total of 106 untrained young adults (68% women) aged 18-25 years were randomly assigned to one of the three groups: (I) Control group (no exercise; n = 35); (II) Ex-Moderate group (concurrent training at moderate intensity; n = 36); (III) Ex-Vigorous group (concurrent training at vigorous intensity; n = 35). Steroid hormones (i.e. cortisol, testosterone and dehydroepiandrosterone sulfate (DHEAS)) were measured in plasma through a chemiluminescent method. Body composition parameters were determined using a dual-energy X-ray absorptiometry scanner. No significant changes in steroid hormones levels were observed after the intervention (all p ≥ .129). However, a time x group interaction was noted in the testosterone/cortisol ratio (T/C ratio) only in women (p = .044). Concretely, our data showed a significant decrement of T/C ratio in both the Ex-Moderate group and in the Ex-Vigorous compared with the control group (Δ = -24.2 ± 2.0% and Δ = -38.9 ± 45.4%, respectively). Our 24-week supervised concurrent training intervention showed no significant changes in steroid hormone levels. However, a significant decrement of T/C ratio was observed only in women, indicating a sexual dimorphism in the effect on T/C ratio.

Clinical Relevancies of Sarcopenic Obesity in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MASLD).

Sarcopenic obesity (SO) is associated with adverse outcomes in diseased patients. This study aimed to examine the prevalence and risks associated with SO, with a focus on the impact of SO on cardiovascular risk in patients with MASLD. In this cross-sectional study, patients with MASLD were prospectively enrolled. Through dual-energy X-ray absorptiometry (DXA) scans, their body compositions were analyzed to identify who had SO and osteopenia/osteoporosis. The primary aim is to investigate risks associated with SO, followed by analyzing the association between SO and cardiovascular disease (CVD). Two hundred and twenty-three patients with MASLD were enrolled. The prevalence of SO was 47.1%, respectively. Patients coexisted with MASLD and SO had increased visceral adipose tissue (VAT), higher fatty liver index (FLI) and fibrosis 4 (FIB-4) score. Regression analysis revealed higher FLI and FIB-4 score, as well as history of hypertension, were risks associated with SO. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score was higher in patients coexisted with MASLD and SO compared to those without (10.1% vs. 7.3%, p = 0.006). Regression analysis showed that increased VAT and FIB-4 score were associated with raised risk of ASCVD. Prevalence of SO in MASLD patients is considerable. The presence of SO also linked to higher risk of ASCVD. Therefore, the recognition of SO in patients with MASLD is important in clinical care.

Impact of age and body mass index on dual-energy X-ray absorptiometry scan results in postmenopausal women

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; To analyse the impact of age and body mass index (BMI) on dual-energy X-ray absorptiometry (DXA) scan results in postmenopausal women.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; The study included 100 postmenopausal women who underwent the DXA procedure, out of which 50 had a normal BMI and 50 were overweight/obese. Data that were examined included age, BMI, T-score of the lumbar region and the femoral neck, as well as bone mineral density (BMD). Correlation results were presented as Pearson&amp;amp;rsquo;s correlation coefficient (r).&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; The T2-score and BMD2 were significantly lower in older patients compared to younger ones (p=0.008 and p=0.007, respectively). Post hoc test results showed that the T2-score and BMD2 were significantly lower in patients &amp;amp;ge;71 years of age compared to patients &amp;amp;le;59 years of age (p=0.006 and p=0.005, respectively). Also, T1- and T2-scores, as well as BMD1 and BMD2, were significantly higher in overweight/obese patients (p&amp;amp;lt;0.001 and p=0.003; p&amp;amp;lt;0.001 and p=0.002, respectively). The correlation between BMI and the T1-score was moderate (r=0.429), between BMI and the T2-score weak (r=0.348), between BMI and BMD1 moderate (r=0.431), and between BMI and BMD2 weak (r=0.344).&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; Our study showed that both age and BMI are important factors affecting DXA procedures and should be taken into account with each postmenopausal woman individually in everyday practice.&amp;lt;/p&amp;gt;

Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.

Periprosthetic fractures (PPF) typically occur from low-energy mechanisms and are pathognomonic for osteoporosis. However, osteoporosis is often underrecognized and undertreated. The aim of this study was to examine trends in dual energy X-ray absorptiometry (DXA) scans and treatment of osteoporosis after PPF between 2010 and 2020. Patients older than 40 who experienced a lower extremity PPF between 2010 and 2020 and had no prior history of osteoporosis screening or treatment were identified utilizing a large national administrative database. Rates of bone mineral density (BMD) measurement using DXA and anti-osteoporotic treatment with pharmacotherapy, or either intervention within 1year following experiencing a PPF were determined. The rate of change for these interventions was calculated using the compounded annual growth rate (CAGR), with linear regression used to determine whether trends were statistically significant. In total, 5.7% and 3.6% of patients were screened and treated for osteoporosis, respectively. Between 2010 and 2020, there was no significant change in rates of osteoporosis screening (CAGR + 0.1%; p = 0.13), treatment (CAGR - 2.4%; p = 0.29), or either intervention (CAGR - 1.1%; p = 0.77) within 1year following PPF. Factors associated with intervention included older age, female sex, and increased comorbidities. Our study found that there has been no significant change in the rates of osteoporosis screening or treatment within 1year following PPF. Orthopedic surgeons and allied healthcare workers can play an integral role in helping to curtail the osteoporosis epidemic.

Hounsfield Unit Utilization in Cervical Spine for Bone Quality Assessment: A Scoping Review.

Bone mineral density (BMD) is an essential indicator of bone strength and plays a crucial role in the clinical management of various spinal pathologies. Hounsfield units (HUs) calculated from computed tomography (CT) scans are a well-established, effective, and non-invasive method to determine bone density in the lumbar spine when juxtaposed to dual-energy X-ray absorptiometry (DEXA) scans, the gold standard for assessing trabecular bone density. Only recently have studies begun to investigate and establish HUs as a reliable and valid alternative for bone quality assessment in the cervical spine as well. In addition, multiple recent studies have identified cervical HUs as an accurate predictor of cage subsidence, an undesired complication of anterior cervical discectomy and fusion (ACDF) of anterior cervical corpectomy and fusion (ACCF) procedures. Subsidence involves migration of the spinal fusion cage into vertebral bodies, causing a loss of disk space, negatively altering spine alignment, and possibly necessitating further unwanted surgical intervention. Using the PRISMA-ScR checklist and the registered scoping review protocol (INPLASY2024100126), this review explores the current research on the use of cervical spine HU measurements as both a determinant of BMD and as a prognosticator of postoperative subsidence following cervical spine procedures (i.e., ACDFs and ACCFs) with the aim of improving clinical and surgical outcomes.

Obese Hypertensive Men Have Fasting Serum Concentrations of Leptin Similar to Those of Obese Normotensive Men.

Leptin is a hormone which is secreted by the adipocytes. In the circulation, leptin levels are directly proportional to the body fat percentage. Studies have shown that higher leptin levels are associated with an increased risk of hypertension after adjusting for body mass index (BMI). Therefore, leptin has been proposed as a mediator of obesity-related hypertension. Whether leptin is associated with hypertension when controlling for body fat percentage remains unclear. We studied 103 obese men (BMI ≥30.0kg/m2). All men were healthy and were medication-free. We measured blood pressure using 24-hour ambulatory blood pressure (ABP) recordings. Hypertension was defined as 24-hour systolic ABP ≥130mm Hg and/or 24-hour diastolic ABP ≥80mm Hg, and normotension was defined as 24-hour ABP <130/80mm Hg. We measured fasting serum leptin concentrations and used dual-energy X-ray absorptiometry scanning to determine body fat percentage. Of the 103 obese men, 64 were hypertensive (24-hour systolic ABP (mean ± standard deviation) 137±11mg Hg and 24-hour diastolic ABP 83±6mm Hg) and 40 were normotensive (24-hour systolic ABP 117±6mg Hg and 24-hour diastolic ABP 73±4mm Hg). The 2 groups had similar fasting serum leptin concentrations (median (interquartile range)) 13.4 (5.7-36.1) µg/L versus 13.4 (5.4-27.1) µg/L, P=0.88) and total fat mass percentage (34.8±4.5% versus 34.0±4.7%, P=0.90). Obese hypertensive men have serum leptin concentrations similar to those of obese normotensive men with comparable body fat percentage measurements. This finding does not support leptin's candidacy as a mediator of obesity-related hypertension.

Trends in osteoporosis assessment, diagnosis after fragility fractures, and treatment for hospitalized patients with osteoporosis or fragility fractures between 2012 and 2021.

The goal of the current study is to explore trends in assessment, diagnosis after fragility fractures, and osteoporosis treatment among hospitalized patients in Xiamen, China, between 2012 and 2021. We conducted a retrospective cross-sectional study, using the Cochran-Armitage trend test to describe trends. Logistic regression was performed to identify the influencing factors of anti-osteoporosis medication (AOM) treatment. We performed a sensitivity analysis to verify the robustness of our findings. From 2012 to 2021, the rates of dual-energy X-ray absorptiometry (DXA) scans and bone turnover marker (BTM) examinations increased from 0 to 37% and 36.5%, respectively. 29.3% of patients with fragility fractures were diagnosed with osteoporosis. The use rate of AOM was only 22.7%. There was an upward trend in the prescription of bisphosphonates, increasing from 1% in 2012 to 16.8% in 2021. The use of calcitonin ranged from 4.1% (2014) to 32.7% (2021). Calcium and vitamin D supplementation prescribing increased significantly from 5.6% in 2012 to 78.7% in 2021. Logistic regression analysis showed that old age, female sex, history of fractures, DXA scans, and osteoporosis diagnosis were significantly associated with increased AOM use. Tobacco use, hypertension, diabetes, congestive heart failure, cerebral vascular accidents, and severe liver diseases were associated with a reduced likelihood of AOM treatment. Although assessment, diagnosis after fragility fractures, and osteoporosis treatment have increased over the past decade, there are still deficiencies in the management of osteoporosis. In the future, it will be necessary to further strengthen management of osteoporosis.

Assessing and Managing Primary Hyperparathyroidism and Fracture Risk in England: A Survey of Medical Professionals.

To describe diagnostic approaches and management strategies for patients with primary hyperparathyroidism (PHPT) and recent fracture in England. We developed a survey based on a patient at high fracture risk and a new diagnosis of probable PHPT. The survey was circulated among 50 secondary care professionals identified by the Society for Endocrinology Calcium and Bone special interest group. Descriptive statistics, combinatorial, and thematic analyses were employed. In the patient with hyperparathyroidism and a recent fracture, 54% of respondents favoured a 24-hour urinary calcium: creatinine clearance ratio, with 85% opting to do so after correcting vitamin D levels. Thirty-two percent (16/50) preferred the spot urinary calcium:creatinine clearance ratio, as a random test (56%, n = 9/16). Ninety-six percent of the respondents agreed they would include a fracture risk assessment in their management plan. Eighty-five percent of the respondents selected dual-energy X-ray absorptiometry scans of the lumbar spine, total hip, and femoral neck as the most popular choice. Before initiating antiosteoporotic medications (AOMs), 94% of the respondents preferred correcting vitamin D levels with diverse regimens. IV zoledronate acid was the preferred AOM, and 58% (n = 29/50) supported cinacalcet usage if the patient was ineligible for parathyroid surgery, while 26% (n = 13/50) opposed cinacalcet use entirely. No significant correlation was found between status as an endocrinology consultant or working in a tertiary care hospital and these management preferences. This study of National Health Service medical staff identified highly-varied clinical practices in managing PHPT in the setting of high fracture risk, highlighting the need for pragmatic guidelines and wider education.