Dual Femur Research Articles

Effect of 24-Week, Late-Evening Ingestion of a Calcium-Fortified, Milk-Based Protein Matrix on Biomarkers of Bone Metabolism and Site-Specific Bone Mineral Density in Postmenopausal Women with Osteopenia.

Dietary calcium intake is a modifiable, lifestyle factor that can affect bone health and the risk of fracture. The diurnal rhythm of bone remodelling suggests nocturnal dietary intervention to be most effective. This study investigated the effect of daily, bed-time ingestion of a calcium-fortified, milk-derived protein matrix (MBPM) or control (CON), for 24 weeks, on serum biomarkers of bone resorption (C-terminal telopeptide of type I collagen, CTX) and formation (serum pro-collagen type 1 N-terminal propeptide, P1NP), and site-specific aerial bone mineral density (BMD), trabecular bone score (TBS), in postmenopausal women with osteopenia. The MBPM supplement increased mean daily energy, protein, and calcium intake, by 11, 30, and 107%, respectively. 24-week supplementation with MBPM decreased CTX by 23%, from 0.547 (0.107) to 0.416 (0.087) ng/mL (p < 0.001) and P1NP by 17%, from 60.6 (9.1) to 49.7 (7.2) μg/L (p < 0.001). Compared to CON, MBPM induced a significantly greater reduction in serum CTX (mean (CI95%); −9 (8.6) vs. −23 (8.5)%, p = 0.025 but not P1NP −19 (8.8) vs. −17 (5.2)%, p = 0.802). No significant change in TBS, AP spine or dual femur aerial BMD was observed for CON or MBPM. This study demonstrates the potential benefit of bed-time ingestion of a calcium-fortified, milk-based protein matrix on homeostatic bone remodelling but no resultant treatment effect on site-specific BMD in postmenopausal women with osteopenia.

Effects of 8-week increment aerobic exercise program on bone metabolism and body composition in young non-athletes.

The effects of aerobic exercise on bone metabolism are still unclear. Thus, the main goal of this study was to explore if there was an effect of the short-term aerobic exercise program on the bone remodeling process and if there were sex differences in the effect of the training program on bone metabolism. Twenty-one participants (men and women) aged 20-23 performed an 8-week aerobic exercise program three times per week in 1-h sessions with increases in the exercise load every 2 weeks. Bone density, bone mineral content and concentration of markers of bone metabolism: osteocalcin, C-terminal procollagen type I peptide, pyridinoline, parathyroid hormone, osteoprotegerin, and the receptor activator of nuclear kappa B ligand by ELISA were measured at the start and at the end of the study, while changes in body composition were assessed by a bioelectric impedance analysis method 6 times during the study. The aerobic exercise program increased the concentration of osteocalcin (11.34 vs 14.24ng/ml), pyridinoline (67.51 vs 73.99nmol/l), and the receptor activator of nuclear kappa B ligand (95.122 vs 158.15pg/ml). A statistically significant increase in bone density at neck mean (1.122 vs 1.176g/cm3) and in bone mineral content at dual femur (33.485 vs 33.700g) was found in women, while there was no statistically significant change at any site in men. 8 weeks of the aerobic exercise program with increment in intensity increased some of bone remodeling biomarkers and showed different effects for men and women.

Changes in Bone Mineral Density and Serum Lipids across the First Postpartum Year: Effect of Aerobic Fitness and Physical Activity.

This study evaluated the changes in bone mineral density (BMD) and serum lipids across the first postpartum year in lactating women compared to never-pregnant controls, and the influence of physical activity (PA). The study also explored whether N-telopeptides, pyridinoline, and deoxypyridinoline in urine serve as biomarkers of bone resorption. A cohort of 18 initially lactating postpartum women and 16 never pregnant controls were studied. BMD (dual energy X-ray absorptiometry), serum lipid profiles, and PA (Baecke PA Questionnaire) were assessed at baseline (4–6 weeks postpartum), 6 months, and 12 months. Postpartum women lost 5.2 ± 1.4 kg body weight and BMD decreased by 1.4% and 3.1% in the total body and dual-femur, respectively. Furthermore, BMDdid not show signs of rebound. Lipid profiles improved, with increases in high-density lipoprotein-cholesterol (HDL-C) and decreases in low-density lipoprotein cholesterol (LDL-C) and the cholesterol/HDL-C ratio at 12 months (vs. baseline). These changes were not influenced by lactation, but the fall the Cholesterol/HDL-C ratio was influenced by leisure-time (p = 0.051, time X group) and sport (p = 0.028, time effect) PA. The decrease in BMD from baseline to 12 months in total body and dual femur, however, was greater in those who continued to breastfeed for a full year compared to those who stopped at close to 6 months. Urinary markers of bone resorption, measured in a subset of participants, reflect BMD loss, particularly in the dual-femur, and may reflect changes bone resorption before observed changes in BMD. Results provide support that habitual postpartum PA may favorably influence changes in serum lipids but not necessarily BMD. The benefit of exercise and use of urinary biomarkers of bone deserves further exploration.

Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population

This study aimed to investigate the relationship between bone mineral density (BMD) and height-adjusted resistance (R/H), reactance (Xc/H) and phase angle (PhA). A total of 61 male and 64 female subjects aged over 60 years were recruited from middle Taiwan. The R and Xc were measured using Bodystat Quadscan 4000 at a frequency of 50 kHz. BMD at the whole body, L2–L4 spine, and dual femur neck (DFN), denoted as BMDTotal, BMDL2–L4, and BMDDFN, were calculated using a Hologic DXA scanner. The R-Xc graph was used to assess vector shift among different levels of BMD. BMD was positively correlated with Xc/H and negatively correlated with R/H (p < 0.001). The General Linear Model (GLM) regression results were as follows: BMDTotal = 1.473–0.002 R/H + 0.007 Xc/H, r = 0.684; BMDL2–L4 = 1.526–0.002 R/H + 0.012 Xc/H, r = 0.655; BMDDFN = 1.304–0.002 R/H + Xc/H, r = 0.680; p < 0.0001. Distribution of vector in the R-Xc graph was significantly different for different levels of BMDTotal, BMDL2–L4 and BMDDFN. R/H and Xc/H were correlated with BMD in the elderly. The linear combination of R/H and Xc/H can effectively predict the BMD of the whole body, spine and proximal femur, indicating that BIVA may be used in clinical and home-use monitoring tool for screening BMD in the elderly in the future.

Association between Bone Mineral Density and Metabolic Syndrome among Reproductive, Menopausal Transition, and Postmenopausal Women.

The menopausal transition stage brings physiological changes associated with the development of metabolic syndrome (MetS), which can affect bone mineral density (BMD), and may be more evident in the postmenopausal stage. The aim of this study was assessing the association between low BMD and MetS and its components among reproductive/menopausal transition and postmenopausal women in the northeast region of Mexico. A descriptive cross-sectional study was carried out (2015–2016) in 40–60-year-old women (n = 376) who were residents in the metropolitan area of Monterrey, in Nuevo Leon State, Mexico. Anthropometric measurements, blood pressure, a dual-energy X-ray absorptiometry (DXA) evaluation of BMD of two anatomical sites (lumbar spine and dual femur), and a biochemical analysis were obtained. The prevalence of MetS was 57.2%. In participants without MetS, the prevalence of osteopenia was 27.3% in the lumbar spine and 18.6% in the dual femur, while in participants with MetS, the prevalence of osteopenia was 35.8% in the lumbar spine and 14.4% in the dual femur. Osteoporosis in participants without MetS was present in 6.8% in the lumbar spine and in 1.8% in the dual femur, while in women with MetS, its prevalence was 4.7% in the lumbar spine and 0.5% in the dual femur. An association between low BMD at the lumbar spine and dual femur and components of MetS diseases was identified in Mexican women as follows: waist circumference ≥ 88 cm showed an increase risk for low BMD at femoral site in both reproductive/menopausal transition (OR 7.638; 95% CI: 1.607–36.298; p = 0.011) and postmenopausal women (OR 2.600; 95% CI: 1.023–6.609; p = 0.045); HDL < 50 mg/dL was associated with low BMD in both the femur (OR 3.639; 95% CI: 1.039–12.743; p = 0.043) and lumbar spine (OR 2.654; 95% CI: 1.092–6.447; p = 0.031); hypertension in postmenopausal women increased the risk for low BMD in the femur (OR 2.634; 95% CI: 1.150–6.035; p = 0.022). In conclusion, we found that components of the MetS were associated with low BMD, thus indicating that MetS increases the risk for developing osteopenia or osteoporosis. Furthermore, age was found to be an independent risk factor for low BMD.

The influence of habitual salt intake on bone remodelling in young healthy people

Introduction: Sodium alters calcium metabolism by increasing calcium excretion, thus possibly influencing bone metabolism. The hypothesis of the present study is that amount of dietary sodium intake affects the bone remodelling. This study aimed to assess whether a habitual intake of sodium has an effect on peak bone mass and biochemical indicators of bone metabolism.&#x0D; Subjects and Methods: In a cross-sectional study that involved 41 young men and women, six biochemical markers were assessed from blood samples using ELISA: osteocalcin, C-terminal procollagen type I peptide, receptor activator kappa B ligand, pyridinoline, parathyroid hormone, and osteoprotegerin, while bone mineral density (BMD) and bone mineral content (BMC) were measured by dual x-ray absorptiometry. Subjects were divided into two groups according to habitual sodium intake (low-Na and high-Na group) assessed by questionnaire.&#x0D; Results: No difference was found between groups of low and high Na intake in BMD and BMC, or in biochemical markers of bone metabolism. Since the groups differed in Ca intake, energy and vitamin D, adjustments were made for those cofounders. Regression analysis showed that only the dietary intake of vitamin D was associated with dual femur BMD and BMC, and no correlation was found between bone remodelling indicators and Na intake after adjustment for vitamin D intake.&#x0D; Conclusion: The present results could not confirm that habitual sodium intake above recommended levels affects bone remodelling processes or decreases bone mineral density in young healthy people if combined with adequate calcium intake.

Cross-calibration of GE Lunar iDXA and Prodigy Densitometer for measurement of bone mineral density in young adults

The assessment of bone mineral density (BMD) is essential to skeletal health, and dual-energy x-ray absorptiometry (DXA) is a type of bone densitometer that is extensively used in both clinical and research settings. When changing a DXA system during longitudinal monitoring or multicenter studies, it is important to conduct cross-calibration between the new and reference scanners to ensure that BMD values measured by the two systems are as close as possible. Purpose: To properly cross calibrate between the GE Lunar iDXA and Prodigy in healthy young adults. Methods: Thirty college students, ten males and twenty females, participated in the study. The BMD at the lumbar spine and dual femurs were measured using the GE iDXA and Prodigy by the same licensed technician on the same day. A paired sample t-test and linear regression analysis were utilized to compare the BMD values between the two systems. Limits of agreement were obtained by Bland-Altman analyses. Results: Although strong correlations were found between the two systems (r = 0.985 – 0.998), the iDXA had significantly higher lumbar spine (1.54%) and dual femur (1.28 - 1.56%) BMD values compared to the Prodigy. Conclusion: Our results suggest that calibration equations should be considered to examine data across densitometers to reduce system differences in the young adult population.

Observational Study to Evaluate the Effect of Epidural Steroid Injection on Bone Mineral Density and Bone Turnover Markers

Background: Epidural steroid injection (ESI) is widely used to manage low back pain. ESIs are commonly performed to treat pain accompanying intervertebral disc prolapse, spinal stenosis, facet joint pathologies, and other degenerative spinal pathologies. Corticosteroids for musculoskeletal conditions, regardless of the route of administration, can reduce bone mineral density (BMD) and increase the risk of fracture. With paraspinal administration of steroids, the severity of risk is enhanced as the steroid is being deposited in close proximity to bone. BMD and molecular markers of bone metabolism are the standard methods to assess the effect of any insult on bone strength and bone metabolism. Carboxy terminal crosslinked telopeptides of type 1 collagen (sCTX) and serum Procollagen Type I N-terminal propeptide (P1NP) are the reference markers of bone resorption and formation, respectively. Objective: We conducted this study to determine the effect of ESI on BMD and bone turnover markers. Study Design: This was a prospective observational cohort study, involving a cohort of 264 patients between the ages of 40 to 60 years who were advised to undergo ESI at L3-4 or L4-5 by their pain physician. Setting: Research was conducted at a tertiary care teaching hospital pain clinic in collaboration with the department of orthopaedics and radiodiagnosis. Methods: Serum CTX-1, P1NP, and pre-ESI BMD of the spine, femur neck, and dual femur were evaluated at baseline; these same parameters were serially evaluated post ESI on follow-ups at 1, 3, and 6 months. Additional follow-up at 10 days post ESI was called for evaluation of bone turnover markers (BTMs). A paired t test was used to analyze changes in BMD and BTMs vs baseline within the group. Cumulative incidence and relative risk of moderate to markedly low BMD were calculated using standard formulas. Any fractures sustained during follow-ups were also evaluated thoroughly and quantified separately. A P value less than .05 was considered statistically significant. Results: The proportion of pre-ESI moderately to markedly low BMD was 10.22% in the study population. There was a statistically significant increase in serum CTX 10 days post ESI which persisted at the one-month and 3-month follow-ups. There was no significant change in serum P1NP level post ESI after 7 days and at the one-month follow-up. The mean value of serum P1NP was, however, significantly higher at the 3-month follow-up. Statistical comparison of the mean BMD value at the spine and femur neck revealed statistically significant decline 3 months post ESI. There was no significant impact of ESI on the total femur BMD. The cumulative incidence of moderately low to markedly low BMD over a period of 6 months in the study population was 45 out of 223, i.e., 20.17%. Limitations: The study’s primary limitations included its high dropout rate, a larger reference range for BTMs, making them a less specific tool for comparison, and the absence of a control group. ESI has a negative impact on the BMD of the hip and spine. Reduced BMD should be considered as a potential side effect of ESI. Key words: Bone mineral density, bone turnover markers, epidural steroid injection, low back ache, osteoporosis Pain Physician 202

Parameters Of The Athlete Triad In Male Ncaa Division I Athletes

Male athletes are at risk of developing a condition similar to the female athlete triad that is characterized by low bone mineral density (BMD), low energy availability (EA), and reduced reproductive hormones. However, the triad has not been well studied in males. PURPOSE: The purpose of this study was to assess BMD and EA in male NCAA division I athletes participating in leanness emphasized sports (cross country and wrestling) and non-leanness sports (soccer and basketball). We hypothesized that EA and BMD would be lower in XC and wrestling compared to soccer and basketball and EA would be positively correlated with BMD. METHODS: Participants included 27 NCAA division I male athletes (20.3 ± 0.3 yr) participating in soccer (n = 5) or cross country (XC, n = 7), wrestling (n = 10), or basketball (n = 5). Following a 12 hr fast and abstinence from physical activity, a resting metabolic rate test, dual energy X-ray absorptiometry scan, and 24-hour food intake recall was performed during an early morning testing session. Two unannounced follow-up food intake recalls were performed over the phone and used to determine mean daily energy intake. Activity energy expenditure was assessed using an Actigraph accelerometer for 7d. Low EA was defined: [(energy intake – activity energy expenditure) /fat free mass (kg)] ≤ 20 kcal/kg. RESULTS: XC had lower BMI, fat free mass, total, lumbar spine, and dual femur BMD (g/cm2) compared to soccer, wrestling, and basketball. XC athletes also had lower total BMD, lumbar spine, and dual femur Z-scores compared to wrestling and basketball, but not soccer. XC had significantly greater EA than basketball. CONCLUSIONS: In support of our hypothesis, BMD was lower in athletes participating in XC, a leanness sport, compared to all other sports. Surprisingly, EA was highest in XC and negatively correlated with BMD. These data suggest the interrelationship between components of the athlete triad is complex and low EA may not be the primary cause of low BMD in male athletes.

Relationships Of Bone Mineral Density And Muscular Performance In College Students

The skeletal system is adapted to mechanical loading such as gravity and muscle contraction. The current gold standard to assess the skeletal health is to use the Dual Energy X-ray Absorptiometry (DXA) to measure bone mineral density (BMD), however, the DXA is costly and not portable. Muscular performance assessment, such as grip strength and jump power, are fairly simple and affordable measurements. PURPOSE: To investigate the relationships between BMD and muscular performance in healthy young adults. METHODS: Thirty healthy college-age individuals, ten males (23.7 ± 1.9 years; 171.9 ± 6.7 cm; 81.8 ± 11.4 kg) and twenty females (23.1 ± 1.9 years; 161.8 ± 6.1 cm; 64.9 ± 15.3 kg), volunteered for the study. Scans of total body, lumbar spine, dual femur and dual forearm were obtained by the iDXA by a licensed technician. Muscular performance was assessed by grip strength, single-leg vertical jump, knee extension and flexion. Pearson’s correlations were used to examine the relationships between BMD, muscular performance, and body composition. RESULTS: Radius BMDs were significantly correlated with grip strength at their corresponding side (r = 0.684 on the right and r = 0.744 on the left, p < 0.001 for both). Total hip BMDs and femoral neck BMDs had strong correlations with hamstring peak torque (PT) and jump peak power (PP) at their corresponding side (p < 0.001 for all) but not quadricep PT (Table 1.). We also found strong correlations between all sites BMD and body composition variables: total mass, total bone free lean mass (BFLM), legs BFLM, and arms BFLM (p < 0.05). CONCLUSION: Our results suggest that muscular performance assessments of grip strength, vertical jump and knee extension are potential alternative tools to estimate bone mineral density in young adults. Further study in a large population and all ages are needed for future investigation.Table 1.: Selected Pearson’s Correlation Coefficients (n=30)

Skeletal Health and Associated Injury Risk in Collegiate Female Rowers.

Baker, BS, Buchanan, SR, and Bemben, DA. Skeletal health and associated injury risk in collegiate female rowers. J Strength Cond Res 36(4): 1125-1133, 2022-Rowing has been associated with low bone mass and stress fractures. The aim of this study was to compare bone density, geometry, and skeletal asymmetries between competitive female rowers and matched controls and within rowers based on reported injury status, allowing for the calculation of practical injury risk prediction equations. Rowers (n = 24) and controls (n = 24) completed total body, lumbar spine, and and dual femur and radii dual energy x-ray absorptiometry and peripheral quantitative computed tomography scans. One-way analyses of covariance were performed between rowers and controls, and one-way analyses of variance were performed between rowers based on reported rib injury status (injured [n = 11]; injury-free [n = 13]). Logistic regression was used to create prediction models of rowers' injury status. Significance was set at p ≤ 0.05. Rowers were taller, had greater lean mass, less fat mass, and mostly equivalent skeletal measures compared to controls, which were within normal ranges (p < 0.048). Injury-free rowers consumed over 500 mg·d-1 more calcium and were less symmetrical at the 4% tibiae and hips (p < 0.015). The strongest predictive regression model of reported rib injury in rowers comprised calcium intake and the symmetry index of hip strength index (R2 = 0.833; p < 0.001). A more practical model including daily calcium intake and total bone specific physical activity (PA) scores can be used to correctly predict injury status 75% of the time (R2 = 0.750; p = 0.022). This is the first study to provide practitioners an injury prediction model for competitive rowers, reiterating the importance of proper nutrition and auxiliary PA focusing on balanced movement patterns.

Assessment of Aromatase Inhibitor-Induced Bone Loss and Appropriateness of Supportive Therapy in Postmenopausal Breast Cancer Patients at a Tertiary Care Center

Objective: To assess aromatase inhibitor-induced bone loss (AIBL) and its management in postmenopausal women (PMW) with breast cancer (BC). Materials and Methods: A cohort of 350 PMW with BC receiving aromatase inhibitors (AIs) during a span of 4 years was evaluated retrospectively. Bone mineral density (BMD) of the patients at lumbar spine (LS) and dual femur was monitored at baseline and annually for 2 years. Baseline fracture risk was evaluated using WHO fracture risk assessment tool. Results: At baseline, only 35.4% of the patients received supportive therapy such as calcium and Vitamin D supplements ± bisphosphonates. Significant decrease of mean BMD occurred at LS, left femur, and right femur (LF and RF) at 1 year (P

Sex Differences in Muscle-Bone Interactions in Chinese Men and Women

Muscle-bone interactions are important for bone health as mechanical forces from muscular contraction place large stresses on bone. Little is known about sex differences in bone and muscle characteristics in Asians. PURPOSE: To examine sex differences in bone characteristics, grip strength, and lower body strength and power in Chinese adults (n=53). METHODS: Chinese males (n=28) and females (n=25) had body composition and aBMD (total body, lumbar spine, dual femur) assessed by DXA, and bone geometry (4%, 38%, 66%) of the non-dominant tibia measured by pQCT. Leg strength (two-leg press) and power (jump mat) and maximal grip strength (handgrip dynamometer) were measured. RESULTS: There were no sex differences in physical activity or calcium intake. After adjusting for height and weight, males had significantly greater leg press 1RM, grip strength, jump height, jump time, lumbar spine aBMD, 4% total BMC, 4% total area, and 4% bone strength index (BSI) (p<0.05) than females. In males, leg 1RM was positively correlated with total body aBMD (r= 0.427), and left femoral neck aBMD (r=0.445), and jump power was positively correlated with total body aBMD (r=0.580) and all hip aBMD variables (r=.487 to 0.646) (all p< 0.05). Females generally had stronger correlations between muscle and bone variables: leg 1RM (all p<0.05) and jump power (all p<0.003) were positively related to all aBMD variables (r=0.432 to 0.819). Jump power and BSI were positively correlated (r=0.378, p=0.048) in males, whereas jump power and leg 1RM showed moderate to strong correlations with 4% total BMC, total area, and total BSI (r=0.460 to 0.836, p<0.05) in females. CONCLUSION: Based on our findings, Chinese males had greater bone size, bone strength, and muscle strength than females; however, females exhibited more and stronger relationships between muscle and bone variables than males.Table 1: Sex Differences in Muscle and Bone variables (unadjusted Means ± SD)

Effect of Diet and Lifestyle on Obesity and Bone Mineral Density Among Women

The study objective was to analyze the dietary intake and lifestyle pattern among obese and non‐obese women and to examine the effects of dietary intakes and lifestyle pattern on bone mineral density (BMD) and obesity. The study was based on the sample of 29 women (15 non‐obese and 14 obese/overweight), 20 to 60 years of age. The dietary intakes were measured by 24‐hour dietary recalls, and lifestyle pattern was assessed through the Simple Lifestyle Indicator Questionnaire (SLIQ). Body weight and height of study participants were measured to calculate body mass index (BMI). Dual‐energy X‐ray absorptiometry (DXA) was used to total body bone mineral density (BMID), lumbar spine BMD (L1 to L4), and dual femur BMD, as well as percent body fat. The non‐obese group had a BMI between 18.5 to 24.9 kg/m2, while the obese/overweight group had a BMI ≥ 25 kg/m2 (P 0.05). Average energy intake was 1864 ± 717 kilocalories (kcal) for the non‐obese women, and was 2080 ± 775 kcal for the obese/overweight women (P = 0.44) . Similarly daily intake of protein, fat, carbohydrate, vitamins (A, B12, D, E, K), and minerals (calcium, magnesium, phosphorus, potassium) were similar between the non‐obese and obese/overweight groups (P > 0.05). Dietary intake could not explain the difference in BMI between groups. Both groups had dietary intakes as per the Recommended Dietary Allowances (RDA), except for vitamin D and potassium; both groups consumed about 30% to 50% less than the RDA. The obese/overweight group had a higher mean BMD of 1.26 ± 0.12 g/cm2 compared to the non‐obese group (BMD = 1.15 ± 0.08 g/cm2) (P < 0.05). Similarly, the obese/overweight group had a higher dual femur BMD (1.12 ± 0.12 g/cm2) and percent body fat (42.16 ± 6.17%) compared to the non‐obese group (0.94 ± 0.27 g/cm2 and 29.18 ± 6.29%, respectively). There was no significant difference in lifestyle pattern between the non‐obese and the obese/overweight groups. The lifestyle components did correlate with BMD or BMI. There was no significant correlation found between total energy intake and BMD in the non‐obese group. In addition, there was no correlation between age and BMD in the non‐obese and obese/overweight groups. This study found that the obese group had a higher BMD than the non‐obese group. In addition, BMD was significantly correlated (P < 0.05) with BMI and vitamin K intake in the obese/overweight group, but not in the nonobese group. Therefore, BMI and vitamin K intake might be protective factors for bone health among obese/overweight women.

Bone mineral density in retired rugby players: initial findings from the UK Rugby Health project

Introduction Regular exercise that delivers impact forces to the skeleton are positively associated with bone strength. Athletes from high impact sports such as rugby have higher bone density than non-athletes ( Hind et al., 2015 ). Engaging in regular impact exercise is widely suggested as a means for reducing the risk of osteoporosis in later life ( Heinonen et al., 1996 ). However, to date there have been few studies of the bone density of retired athletes and none in retired rugby players. Objective To investigate bone mineral density (BMD) at the hip and spine, and the prevalence of low BMD, in a cohort of retired rugby players. Methods Retired rugby players (77 males; 25.8 years competitive rugby; 10.6 years since retirement; 36 former professional; 41 former amateur level) were separated into two groups: over 50 years of age (n = 27; 57.2 ± 7 years; 175.8 ± 7.6 cm; 94.9 ± 16.9 kg) and under 50 years (n = 50; 40.1 ± 6.2 years; 182.1 ± 6.4 cm; 101.9 ± 13.8 kg). Each participant received dual energy X-ray absorptiometry scans (Lunar iDXATM; GE Healthcare, WI; Encore software version 15.0) of the dual femur and the lumbar spine. BMD for the lumbar spine, femoral neck and total hip were derived. T-scores were evaluated for participants aged over 50 years, and Z-scores for those aged under 50 years ( ISCD, 2015 ). Results Eight (30%) retired players aged over 50 years had osteopenia (T-score Conclusion Our findings suggest that participation in high impact sports during young adulthood might not be sufficient to reduce the risk of osteoporosis in later life. Further research is needed to identify why some former rugby players have low BMD and others don't. This research would have the potential to inform assumptions on the role of exercise for bone health throughout the lifespan. Bone mineral density, T-scores or Z-scores for male retired rugby players, mean, SD (range) Retired rugby players aged Femoral Neck BMD (g.cm−2) n=50 Total Hip BMD (g.cm−2) n=50 Lumbar Spine BMD (g.cm−2) n=48† Hip Z-score n=49* Lumbar Spine Z-score n=47†* Lowest Z-score n=49* 1.135 ± 0.146 1.192 ± 0.151 1.319 ± 0.139 0.3 ± 1.1 0.3 ± 1.2 -0.1 ± 1.0 (0.814 – 1.502) (0.924 – 1.611) (1.040 – 1.677) (-1.7 – 3.5) (-2.1 – 3.3) (-2.1 – 3.5) *no reference score for n=1 participant (non-white) †n=2 lumbar spine scans unreportable due to Retired rugby players aged >50 years Femoral Neck BMD (g.cm−2) n=27 Total Hip BMD (g.cm−2) n=27 Lumbar Spine BMD (g.cm−2) n=20‡ Hip T-score n=27 Lumbar Spine T-score n=20‡ Lowest T-score n=27 1.018 ± 0.180 1.099 ± 0.179 1.226 ± 0.164 -0.4 ± 1.4 0.1 ± 1.4 -0.6 ± 1.2 (0.650 – 1.421) (0.699 – 1.459) (0.822 – 1.512) (-3.2 – 2.7) (-3.2 – 2.4) (-3.2 – 1.5) ‡n=7 lumbar spine scans unreportable due to

Vertebral body anomalies on bone density scans in younger and older retired rugby players: the UK Rugby Health project

Introduction Lumbar spine (LS) bone mineral density measured by dual energy X-ray absorptiometry (DXA) may be abnormally elevated by conditions in or around the spine. The International Society for Clinical Densitometry recommends excluding vertebrae if there is a focal structural abnormality (FSA) affecting some but not all of the scanned vertebrae, or if there is a T-score discrepancy (>1.0 SD difference in bone density between adjacent vertebrae). Anomalies can include osteoarthritis and degenerative changes, and fracture which have previously been reported in retired rugby players ( Hind et al., 2014 ; Davies et al., 2017 ). Objective To quantify vertebral body exclusions in a UK cohort of younger and older retired rugby players. Methods Retired rugby players (77 males; 10.6 yrs post retirement) aged 50 years or over (n = 27, 57.2 ± 7 years; 175.8 ± 7.6 cm; 94.9 ± 16.9 kg) and under 50 years (n = 50;40.1 ± 6.2 years; 182.1 ± 6.4 cm; 101.9 ± 13.8 kg) received one DXA scan of the anteroposterior lumbar spine (L1-L4; Lunar iDXA TM ; GE Healthcare, WI; Encore software v 15.0). A DXA scan of the dual femur was also performed. T-scores were evaluated for those aged over 50 years, and Z-scores for those aged under 50 years ( ISCD, 2015 ). Each LS scan was evaluated in consensus by two experienced densitometrists and vertebrae were excluded where there was evidence of a FSA or a T/Z-score discrepancy. If more than two vertebrae were excluded, the scan was defined un-reportable. Results In retired rugby players aged >50y, 18 (67%) scans required vertebral body exclusion. There were 41 exclusions and seven scans were un-reportable. In younger retired players ( 50 y was 0.1 ± 1.4. The mean LS Z-score for Conclusion In this cohort of UK retired rugby players, a high number of vertebral body anomalies were identified. Therefore, our findings demonstrate the need for care when interpreting lumbar spine bone density DXA scans. We also suggest that vertebral body exclusions apply to Z-scores as well as T-scores where there is evidence of FSA or BMD discrepancy. It is recommended that hip scans are conducted alongside lumbar spine BMD scans in former athletes where the prevalence of degenerative changes can be high.

Bone Mineral Density in Collegiate Dance Majors Compared to Healthy Controls.

The bone mineral density (BMD) status of dancers is currently unknown. Some research indicates that female dancers have no difference or higher BMD than non-dancers. Other evidence indicates they have lower BMD, predisposing them to osteoporosis and fractures later in life. These differences among studies may be due to differences in dancer type, age, level, and lack of control of confounding variables. Few studies have been completed on college-level dancers. To evaluate BMD in female college-level dance majors. 20 female multi-genre collegiate dance majors and 12 female non-dancer control subjects participated in the study. Each participant underwent three consecutive dual energy x-ray absorptiometry scans to determine BMD of the total body, dual femurs, and lumbar spine. Statistical analysis was completed by an independent samples t-test. The lumbar spine demonstrated a significant difference between groups (p=0.011), with dancers showing greater BMD (1.32±0.10 vs 1.21±0.12 g/cm2). There was no significant difference between groups for total body or dual femur BMD (p=0.104 and 0.175, respectively). College-level dancers may have higher BMD of their lumbar spine than non-dancers, but not in other areas. This area may have increased BMD due to loading from dance activity and warrants further investigation.

Effect of Dietary Intake on Bone Mineral Density among Non‐Obese and Obese Women

ObjectiveAnalysis of dietary intake among non‐obese and obese women was conducted to examine the effects of dietary intakes on bone mineral density (BMD) and obesity.MethodologyThis study was based on a sample of 29 women (15 non‐obese and 14 obese/overweight), 20 to 60 years of age. Dietary intakes were measured by Automated Self‐Administered (ASA) 24‐hour dietary recalls. Body weight and height were measured to calculate body mass index (BMI). Dual‐energy X‐ray absorptiometry (DXA) was used to measure total body BMD (TBBMD), lumbar spine BMD (L1 to L4), and dual femur BMD, as well as percent body fat.ResultsThe non‐obese group had a body mass index (BMI) between 18.5 to 24.9 kg/m2, while the obese/overweight group had a BMI ≥ 25 kg/m2 (P &lt; 0.001). There was no significant difference between the non‐obese group and obese/overweight group with respect to age and ethnicity (P &gt; 0.05). Average energy intake was 1864 ± 717 kilocalories (kcal) per day for the non‐obese women, and 2080 ± 775 kcal/day for the obese/overweight women (P = 0.44). Similarly, daily intake of protein, fat, carbohydrate, vitamins (A, B12, D, E, K), and minerals (calcium, magnesium, phosphorus, potassium) were similar between the non‐obese and obese/overweight groups (P &gt; 0.05). Dietary intake could not explain the difference in BMI between groups. Both groups met the Recommended Dietary Allowances (RDA), except for vitamin D and potassium; both groups consumed about 30% to 50% less than the RDA. However, there was a significant correlation (R = 0.68, P = 0.0076) between vitamin K intake and BMD in the obese/overweight group, but not in the non‐obese group (R = 0.18, P = 0.52). The non‐obese group had a significantly lower TBBMD compared to the obese/overweight group (BMD = 1.15 ± 0.08 g/cm2 and 1.26 ± 0.12 g/cm2, respectively) (P &lt; 0.05). Similarly, the non‐obese group had a significantly lower dual femur BMD and percent body fat (0.94 ± 0.27 g/cm2 and 29.18 ± 6.29%, respectively) compared to the obese/overweight (1.12 ± 0.12 g/cm2 and 42.16 ± 6.17%, respectively) (P &lt; 0.05). In addition, BMI was significantly correlated with BMD (R = 0.79, P = 0.007) in the obese/overweight group, but not in the non‐obese group (R = 0.32, P = 0.23).ConclusionsWe found that the non‐obese group had a lower BMD than the obese/overweight group. In addition, BMD was significantly correlated (P &lt; 0.05) with BMI and vitamin K intake in the obese/overweight group, but not in the non‐obese group. More research needs to be conducted to assess the effect of dietary intake and obesity on BMD in women.Support or Funding InformationThis work was supported by the American Association of University Women (www.aauw.org)'s International Post‐Doc Award to Dr. Prekshi Aggarwal.

Comparison of bone mineral density among pre- and post-menopausal women with and without chronic generalized periodontitis.

Background:There have been a very limited number of studies regarding the assessment of bone mineral density (BMD) using dual energy X-ray absorptiometry scan. Hence, the purpose of the study was to assess the relationship between BMD and periodontal health in three different study groups.Materials and Methods:The study comprised of thirty female individuals who were categorized into three groups: ten premenopausal women with healthy periodontium (Group A), ten premenopausal women with generalized chronic periodontitis (Group B), and ten postmenopausal women with generalized chronic periodontitis (Group C). Number of teeth, plaque index, probing depth, clinical attachment level, interproximal alveolar bone loss, T-score for dual femur and posteroanterior (PA) spine, and BMD for dual femur and PA spine of each individual were recorded in all the three groups.Results:The BMD and T-score of dual femur and PA spine were found to be low in Group C when compared to Group A and B which was statistically significant.Conclusion:Postmenopausal women with generalized chronic periodontitis (Group C) exhibited severe periodontal destruction with less BMD. Hence, it is suggested that periodontitis may be a risk indicator for osteoporosis in postmenopausal women and vice versa.

Changes in body composition of Indian lactating women: a longitudinal study.

Lactation places enormous demands on maternal bone mineral homeostasis. Indian middle class women (MSC) consume energy dense food supplements to meet these demands post-partum (PP) along with restricted physical activity (PA). Effects of these changes on body composition (BC) of PP women have not been studied. To examine longitudinal changes in: a) bone mineral density (BMD) at total body (TB), AP-spine (APS) and dual femur neck regions (DF) b) BC by body weight, lean mass, fat mass using dual energy X-ray absorptiometry (DXA) at baseline, 6-months and 1-year in urban MSC women. 76-primi-parous (28±3.2 yrs) randomly selected PP women (<7-days) were studied; 70 reassessed at 6- months and 42 1-yr PP. Data on anthropometry, BC, BMD at TB, APS and DF by DXA collected (baseline, 6- months, 1-yr PP). Weight, waist and body mass index (BMI) decreased both at 6-month and 1-yr PP with respect to baseline (p<0.05). BC changes showed increase in android fat % at 1-yr by 10% over baseline (p<0.05). BMD with initial decline at 6-months (-2.8%, -2.3% and -2.3% respectively) recovered partially by 1-yr (+2.5% +1.2% and +4.8% respectively) at DF and TB with complete recovery at APS (p<0.05). These urban relatively sedentary MSC women consumed fat rich food PP with higher android fat retention and partial recovery of BMD at DF and TB at 1-year. Modifications in activity and dietary nutrient intakes may be necessary to prevent cardiovascular and bone health related risks.