Early Diagnosis Of Osteoporosis Research Articles

Entropy and uniformity as additional parameters to optimize the effectiveness of bone CT in the evaluation of acromegalic patients.

Acromegaly is considered an important cause of secondary osteoporosis. However, studies on bone mineral density (BMD) have yielded conflicting results and there are few studies that evaluate an accurate imaging method for early diagnosis of osteoporosis in these patients. The objective of this study was to assess whether entropy and uniformity on computed tomography (CT) scans are useful parameters for optimization of assessment of bone fragility in patients with acromegaly. We included 34 patients and 36 controls matched for age and sex in a cross-sectional study. Patients and controls underwent CT scan of the lumbosacral spine, dual-energy x-ray absorptiometry (DXA) and blood tests. A software was developed to calculate the entropy and uniformity by a region of interest (ROI) of the trabecular bone of the first lumbar vertebra (L1). The acromegalic group presented higher mean bone entropy (6.87 ± 0.98 vs. 6.03 ± 1.68, p = 0.013) and lower mean bone uniformity (0.035 ± 0.704 vs. 0.113 ± 0.205, p = 0.035) than control group. Analyzing only acromegalics, mean bone entropy was higher and bone uniformity was lower in patients with hypogonadism than patients without hypogonadism (7.28 ± 0.36 vs. 6.74 ± 1.08, p = 0.038 and 0.008 ± 0.002 vs. 0.043 ± 0.079, p = 0.031) respectively. Patients with acromegaly presented higher BMD and Z-score in the femoral neck than control group (1.156 ± 0.108 vs. 0.925 ± 0.326 g/cm2, p = 0.043 and 0.6 ± 0.6 vs. -0.05 ± 0.8, p = 0.041, respectively). Entropy was negatively correlated with T-score of the lumbar spine (rp = -0.357, p = 0.033) in control group and uniformity was positively correlated with T-score of the lumbar spine, neck, and total hip, respectively (rp = 0.371, p = 0.031; rp = 0.348, p = 0.043 and rp = 0.341, p = 0.049) in acromegalic group. The study identified that entropy and uniformity are a relevant parameters data in bone fragility assessment in acromegalic patients.

Synthesis and Characterization of an Amino‐oxy‐modified Sphingosine‐1‐Phosphate Derivative that Can Replace Thiolated‐S1P in Competitive ELSIA

Sphingosine‐1‐phosphate (S1P) is a signaling molecule that has various roles in vivo. Recently, S1P has emerged as a biomarker in the early diagnosis of osteoporosis and cancer. A competitive enzyme‐linked immunosorbent assay (ELISA) assay kit for detecting S1P in blood or in various samples is now commercially available. Competitive ELISA requires an anti‐S1P antibody and S1P‐coated microtiter plates. The antigenic derivative used here is the thiolated‐S1P in which a sulfur hydryl group is introduced at the terminal end of the S1P hydrophobic chain. However, the sulfur hydryl group is easily oxidized, and its solubility in water is considerably low, making it difficult to handle. In this study, amino‐oxy‐modified S1P derivatives that can replace thiolated‐S1P were synthesized. Amino‐oxy groups are easy to attach to proteins and other polymers without any linker, and are easy to handle because they are not easily oxidized, and soluble in water. The synthesized S1P derivative was directly immobilized on a microtiter plate, and an ELISA assay was performed which obtained comparable results with the conventional thiolated‐S1P reference. It is expected that the anti‐S1P antibody can be easily induced by attaching this amino‐oxy‐modified S1P to reduced carrier proteins.

Bone mineral density measurement in traumatic distal end radius fractures: A case–control study

INTRODUCTION: Osteoporosis is a global problem affecting over 200 million people worldwide. After a first osteoporotic fracture, there is an increased risk of a second fracture. Around 20% of patients experience a second fracture within 1 year of the first fracture. Early diagnosis of osteoporosis and its treatment after a fragility fracture are, therefore, very important interventions that can help in reducing the socioeconomic burden of osteoporosis. In this article, we present a case–control study of bone mineral density (BMD) in 100 cases of distal end radius fractures and matched controls. MATERIALS AND METHODS: One hundred patients with distal end radius fracture and 100 age- and sex-matched controls were selected based on predetermined selection criteria. All selected individuals were investigated for serum calcium, Vitamin D, and alkaline phosphatase. BMD was measured at calcaneum and distal radius. Data analysis was done to determine the strength of association between various parameters and BMD in cases and controls. RESULTS: The prevalence of osteoporosis was higher in age >45 years (35%) as compared to age CONCLUSION: There is a significant association between increasing age, female sex, Vitamin D deficiency, high alkaline phosphatase, presence of DER fracture, and osteoporosis.

Mid-arm muscle circumference as an indicator of osteoporosis in community-dwelling older men

BackgroundOsteoporosis is an underdiagnosed disease and is lack of convenient and cost-efficient screening tool. We undertook a study to determine whether mid-arm muscle circumference (MAMC) was associated with osteoporosis. DesignData were retrieved from the National Health and Nutrition Examination Survey (NHANES) III participants (aged 40–90 years). We divided the MAMC into tertile groups (T1, T2, and T3). Femoral neck bone density was analyzed because it was the reference skeletal site for defining osteoporosis in epidemiological studies. Participants with T- scores ≤ –2.5 were categorized as having osteoporosis. Multivariate logistic regression models were used to evaluate the associations between the MAMC tertiles and osteoporosis. ResultsAfter adjustment for multiple covariates, osteoporosis was significantly inversely associated with the MAMC tertiles in the male group (T2/T1: OR 0.47, 95 % CI 0.30–0.75 and T3/T1: OR 0.34, 95 % CI 0.18–0.64), whereas nonsignificant association was found in the female group (T2/T1: OR 0.92, 95 % CI 0.70–1.20 and T3/T1: OR 0.84, 95 % CI 0.47–1.53). Subgroup analyses (40–64 and ≥65 years old; BMI <25 and ≥25 kg/m2) revealed consistent results. ConclusionThe MAMC is an economical and practical tool that may assist in screening and early diagnosis of osteoporosis for the older men.

Issues related to the combination of chronic obstructive pulmonary disease and osteoporosis (review)

Although there is now much evidence that COPD is a more complex systemic disease than airway and lung disease, a comprehensive approach to early diagnosis and more accurate assessment of the disease is far from complete. The most common co-morbidities with COPD are cardiovascular disease, diabetes mellitus, osteoporosis, depression, anemia, etc. The problem of diagnosis and treatment of COPD patients with osteoporosis is currently topical and insufficiently studied. In this review the peculiarities of osteoporosis in COPD are considered: its prevalence, the influence of the severity of bronchial obstruction on the bone mineral density (BMD), clinical manifestations (frequency of vertebral body compression fractures (VBCF) and hip fractures), the influence of risk factors (glucocorticosteroids, low body weight, vitamin D deficiency, smoking, impaired lung ventilation, sedentary lifestyle, etc.) on the development of osteoporosis. Data of researches on studying bone formation markers and bone resorption in patients with COPD are given. Full understanding of the mechanisms of development, early diagnosis of osteoporosis in COPD patients will allow to choose the most effective therapeutic tactics, which will correspond to the modern concept of personalized medicine.

Ex Vivo Assessment of Cortical Bone Properties Using Low-Frequency Ultrasonic Guided Waves.

The early diagnosis of osteoporosis through bone quality assessment is a major public health challenge. Research in axial transmission using ultrasonic guided waves has shown the method to be sensitive to the geometrical and mechanical properties of the cortical layer in long bones. However, because of the asymmetric nature of cortical bone, the introduction of a more elaborate numerical model than the analytical plate and cylinder models, as well as its inversion, continues to be challenging. The aim of this article is, therefore, to implement a bone-like geometry using semianalytical finite-element (SAFE) modeling to perform the inverse characterization of ex vivo radii at low frequencies (< 60 kHz). Five cadaveric radiuses were taken from donors aged between 53 and 88 and tested using a typical axial transmission configuration at the middle of the diaphysis. The dispersion curves of the propagating modes were measured experimentally and then systematically compared with the solutions obtained with the SAFE method. For each sample, four parameters were estimated using a parameter identification procedure: 1) the bulk density; 2) the thickness; 3) the outer diameter; and 4) a shape factor (SF). The results showed a moderate agreement between the predicted bulk density and the average voxel value calculated from X-ray computed tomography images. Furthermore, a good agreement was observed between the geometrical parameters (thickness, outer diameter, and SF) and the reference images.

Early osteoporosis diagnosis improves post-hip fracture outcome

Abstract Background Hip fracture is associated with mortality and high rate of hospital re-admission after discharge. Osteoporosis screening and treatment have been shown to lower the risk of hip fractures. The aim of this study was to assess whether osteoporosis treatment also improves the post-hip fracture overall outcome. Methods All patients over the age of 65 that sustained a hip fracture at a tertiary University Hospital were approached to enroll in the study. The patients were informed of the context of the study, all queries were answered and an informed consent was signed by the patients in the presence of one of the investigators. The data were collected over an 8 month period from October 2017 to June 2018 and the cohort was followed up until February 2019. Recorded outcomes included mortality, re-admission and unscheduled hospital visit. Results The overall mortality rate of elderly patients after a hip fracture was 12.3% (n = 24) after a 6 month follow-up period. The overall event rate of elderly patients after a hip fracture was 29.7% (n = 58) after a 6 month follow-up period. Only 3% of patients were already on osteoporosis treatment. However, patients on treatment for osteoporosis had a favorable outcome with no deaths and significantly less overall events (p &amp;lt; 0.0001). Conclusions Early osteoporosis screening and treatment in the elderly can not only prevent falls and fractures, but also improve outcome in case a hip fracture does occur. Key messages Osteoporosis treatment improves outcome after a hip fracture. Despite relevant guidance, osteoporosis screening in the elderly remains suboptimal.

Texture Analysis and Genetic Algorithms for Osteoporosis Diagnosis

Early diagnosis of osteoporosis can efficiently predict fracture risk. There is a great demand to prevent this disease. The goal of this study was to distinguish osteoporotic cases from healthy controls on 2D bone radiograph images, using texture analysis and genetic algorithms (GAs). Gray Level Co-occurrence Matrix (GLCM), Run length Matrix (RLM) and Binarized Statistical Image Features (BSIF) were used for texture analysis. Features are numerous and parameter-dependent. The related experts can pick out the useful input features for the classifier. It however remains a difficult task and may be inefficient or even harmful as the data pattern is not clear. In this paper, GAs were used to optimize the two parameters of the co-occurrence matrix (distance parameter or pixel separation, orientation or direction) and the number of gray levels used in the preprocessing quantification step. GAs were also used to select the best combination of features extracted from GLCM and RLM matrices. Experiments were conducted on two populations composed of Osteoporotic Patients and Control Subjects. Results show that GAs combined with GLCM and BSIF features can improve the classification rates (ACC = 87.50%) obtained using GLCM (ACC = 77.8%) alone.

Low rate of densitometric diagnosis and treatment in patients with severe osteoporosis in Colombia.

Osteoporosis is a systemic skeletal disease associated with an increased risk of fragility fractures and is a public health problem worldwide due to population aging. Early osteoporosis diagnosis and treatment is very important for reducing the incidence of fragility fractures and the resulting complications. Our study describes the clinical characteristics of patients with fragility fractures and their risk factors, evaluates the level of knowledge that patients have about osteoporosis, and follows-up on each case to establish if, after the fracture, a densitometric diagnosis was made and the patient received specific treatment in his outpatient follow-up through his health insurance plan. A descriptive cross-sectional study was carried out in a university hospital in Bogotá, Colombia. The data was collected by means of a questionnaire, administered to all patients admitted by the orthopedic emergency department with a diagnosis of fragility fracture. After discharge, a telephone follow-up was done every 3months for 1year, and patients were asked if they had already had the dual X-ray absorptiometry (DXA) scan and if they had begun osteoporosis treatment. A total of 111 patients with an average age of 74.4years (± 11.3years), of which 84 (75.6%) were women, all consulted for osteoporotic fracture at the orthopedic emergency department of the hospital. Hip fracture was the most frequent (51.4%), followed by vertebral (23.4%), wrist (22.5%), and humerus (4.5%) fracture. A total of 49.5% (n = 55) of the patients did not know what osteoporosis is; 58.6% (n = 65) did not know that fracture is the main complication of this disease, and 62.2% (n = 69) did not associate fractures with osteoporosis. All patients were educated about osteoporosis and the importance of diagnosing and treating it. Patients were given a medical order to have a DXA scan upon discharge; however, only 24.3% (n = 27) had the DXA scan in the first year of the fracture. A total of 33.3% (n = 37) received calcium plus vitamin D, and only 9.9% (n = 11) received osteoporosis treatment (7 bisphosphonate patients and 4 denosumab). No patient received osteoformative therapy. Our study shows that Colombian patients have little knowledge about osteoporosis and its relationship with fragility fractures. It also shows that densitometries are not done and, what is worse, patients with a diagnosis of fracture have limited access to treatment after discharge.

Willingness to pay for osteoporosis risk assessment in primary dental care

BackgroundFragility fracture related to osteoporosis among postmenopausal women is a significant cause of morbidity. The care and aftercare of these fractures are associated with substantial costs to society. A main problem is that many individuals suffer from osteoporosis without knowing it before a fracture happens. Dentists may have an important role in early identification of individuals with osteoporosis by assessment of dental radiographs already included in the dental examination. The aim of this study was therefore to investigate postmenopausal women’s preferences for an osteoporosis risk assessment in primary dental care.ResultsMost respondents (129 of 144 (90%)) were willing to pay for an osteoporosis risk assessment in primary dental care. The overall mean willingness to pay (WTP) including respondents that denoted none or zero WTP was 44.60 € (CI 95% 38.46–50.74 €) (median 34.75 €). A majority (80.6%) of the respondents that denoted WTP also gave a motivation for their answer. The two most common reasons denoted for being willing to pay for osteoporosis risk assessment were the importance of early diagnosis and preventive care to avoid fractures (41.0%) and the importance of knowledge of a risk of osteoporosis (26.4%). A majority of respondents (67.8%) considered it valuable if dental clinics would offer osteoporosis risk assessment.ConclusionsPostmenopausal women seem to find it valuable to be offered osteoporosis risk assessment in primary dental care and are willing to pay for such a risk assessment. From a societal perspective early diagnosis of osteoporosis by risk assessment in primary dental care could prevent osteoporotic related fractures and benefit women’s health and quality of life, as well as have a major impact on the health-care budget in terms of cost-savings.

Relationship between quantitative parameters of lumbar vertebral perfusion and bone mineral density (BMD) in postmenopausal women.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a noninvasive method to evaluate the microcirculation of bone marrow in local tissue, which will be a new tool for the diagnosis of osteoporosis. To investigate the relationship between quantitative perfusion parameters (Ktrans, Kep and Ve) and bone mineral density (BMD) in postmenopausal women. The subjects were divided into 3 groups according to T value: normal bone mass group (T value ≥-1.0); bone loss group (-2.5 < T <-1.0); and osteoporosis group (T ≤-2.5). Ktrans, Kep and Ve of the lumbar spine were measured using quantitative DCE-MRI. The relationship between these parameters and age was analyzed. Bone mineral density of the lumbar spine and femoral neck gradually decreased with age. The values of Ktrans, Kep and Ve significantly decreased with age. The values of Ktrans, Kep and Ve of the lumbar vertebrae in the osteoporosis group were lower than those in the bone loss and normal bone mass group. Bone mineral density was positively correlated with the Ktrans and Ve of the lumbar vertebrae. The incidences of bone loss and osteoporosis increased with age. The measurement of BMD was conducive to early diagnosis of osteoporosis. Ktrans, Kep and Ve values of the lumbar vertebra decreased with age, and have a positive correlation with lumbar BMD. The value of DCE-MRI may play a role in the diagnostic algorithm of osteoporosis.

A new biosensor for osteoporosis detection

Osteoporosis is a disease that is characterized by deterioration of bone tissue and increased risk of fracture as it leads to a decrease in bone mineral density, which is an important public health problem. Today, bone mineral density is measured by radiological techniques. Alternative techniques are needed because of the disadvantages such as excessive radiation intake, the cost of radiological techniques, and the necessity for specialist personnel for the devices. The quantitative determination of biochemical markers that play a role in bone mineralization may be a good alternative for the osteoporosis diagnosis and especially in the follow-up of treatment.In this study, a specific and sensitive immunological biosensor, which quantitatively determines the osteocalcin molecule, has been developed to be used in the early osteoporosis diagnosis and to evaluate the response to the drug treatment. Anti-osteocalcin antibody was immobilized onto gold electrode surface via covalent immobilization method by using 6-mercaptohexanol, 1,4-butanedioldiglycidyl ether, ethanolamine, and glutaraldehyde. Immobilization steps and biosensor characterization were specified by cyclic voltammetry and electrochemical impedance spectroscopy. The detection time and range of Ocn biosensor were determined as 45 min and 10–60 pg µL−1 Ocn concentration, respectively. The Ocn biosensor was successfully applied in artificial serum samples spiked with Ocn.

Quantitative diagnosis of osteoporosis using lumbar spine signal intensity in magnetic resonance imaging.

Osteoporosis is the most common metabolic bone disease that is not recognized in many elderly people. To determine the cause of low back pain, lumbosacral MRI is done for a large population who may not have gone under dual energy X-ray absorptiometry (DXA). The aim of this study was to predict bone density using lumbar spine signals in lumbosacral MRI in high risk patients for osteoporosis including post-menopausal females and calculate a threshold for a new quantitative MRI-based score to be used in estimation of lumbar spine bone mass density. 82 menopaused females, who had undergone DXA before, were selected and MRI was done within 6 months after DXA. 69 healthy females aged 20-29 years who had undergone lumbar MRI were selected as reference group. Results were analyzed and threshold and diagnostic performance of MRI-based score (M-score) on the method of T-score was calculated. Negative correlation between M-score and T-score was detected. Cut off point of 2.05 was found for M-score with near sensitivity of 90% and specificity of 87% for detecting osteoporotic patients from non-osteoporotic individuals. M-score is a MRI-based method which can identify patients at risk of osteoporosis. Early diagnosis of osteoporosis can reduce morbidity and mortality caused by it. The research introduced cut of points for M-score as a new MRI quantitative method to be used as an opportunistic technique for detecting osteoporotic patients.

Utility of the Serum Cystatin C Level for Diagnosis of Osteoporosis among Middle-Aged and Elderly People

Purpose Osteoporosis is a common age-related disorder leading to increased bone fragility and risk of fracture. Early diagnosis of osteoporosis is a vital step in providing early therapeutic intervention. Serum cystatin C is a marker of early renal dysfunction, a predictor of cardiovascular and inflammatory diseases, and an inhibitor of the differentiation of osteoclast precursor cells. The purpose of this study was to evaluate the relationship between serum cystatin C and osteoporosis. Methods We enrolled 46 subjects who attended a health checkup and underwent measurement of bone status by quantitative ultrasound and determination of the level of serum cystatin C. A comparative study was conducted between those with and without osteoporosis for all subjects collectively and in two subgroups aged <65 and ≥65 years. Results Serum cystatin C levels were strongly correlated with age, creatinine, and bone status data, with significant negative correlations with stiffness, T-score, and percentage of young adult mean. Among patients with osteoporosis, serum cystatin C was significantly higher even after adjustment for age and sex, whereas no significant difference was noted in creatinine. For patients aged ≥ 65 years, serum cystatin C was significantly higher in subjects with osteoporosis, although there was no significant difference in age between normal subjects and those with osteoporosis. Conclusions To the best of our knowledge, this is the first study to demonstrate an association between serum cystatin C and osteoporosis. Serum cystatin C is significantly higher in osteoporosis and in particular may be a useful marker for osteoporosis among middle and elderly people aged ≥ 65 years. Measurement of serum cystatin C can be carried out easily and may contribute to early diagnosis and treatment of osteoporosis.

Detection of Osteoporosis from Percussion Responses Using an Electronic Stethoscope and Machine Learning.

Osteoporosis is an asymptomatic bone condition that affects a large proportion of the elderly population around the world, resulting in increased bone fragility and increased risk of fracture. Previous studies had shown that the vibroacoustic response of bone can indicate the quality of the bone condition. Therefore, the aim of the authors’ project is to develop a new method to exploit this phenomenon to improve detection of osteoporosis in individuals. In this paper a method is described that uses a reflex hammer to exert testing stimuli on a patient’s tibia and an electronic stethoscope to acquire the impulse responses. The signals are processed as mel frequency cepstrum coefficients and passed through an artificial neural network to determine the likelihood of osteoporosis from the tibia’s impulse responses. Following some discussions of the mechanism and procedure, this paper details the signal acquisition using the stethoscope and the subsequent signal processing and the statistical machine learning algorithm. Pilot testing with 12 patients achieved over 80% sensitivity with a false positive rate below 30% and accuracies in the region of 70%. An extended dataset of 110 patients achieved an error rate of 30% with some room for improvement in the algorithm. By using common clinical apparatus and strategic machine learning, this method might be suitable as a large population screening test for the early diagnosis of osteoporosis, thus avoiding secondary complications.

Current and Emerging Diagnostic Imaging-Based Techniques for Assessment of Osteoporosis and Fracture Risk.

Osteoporosis is a metabolic bone disorder characterized by low bone mass, degradation of bone microarchitecture, and susceptibility to fracture. It is a growing major health concern across the world, especially in the elderly population. Osteoporosis can cause hip or spinal fractures that may lead to high morbidity and socio-economic burden. Therefore, there is a need for early diagnosis of osteoporosis and prediction of fragility fracture risk. In this review, state of the art and recent advances in imaging techniques for diagnosis of osteoporosis and fracture risk assessment have been explored. Segmentation methods used to segment the regions of interest and texture analysis methods used for classification of healthy and osteoporotic subjects are also presented. Furthermore, challenges posed by the current diagnostic tools have been studied and feasible solutions to circumvent the limitations are discussed. Early diagnosis of osteoporosis and prediction of fracture risk require the development of highly precise and accurate low-cost diagnostic techniques that would help the elderly population in low economies.

Dynamic expression of matrix metalloproteinases 2, 9 and 13 in ovariectomy-induced osteoporosis rats.

The aim of the present study was to examine the dynamic expression of matrix metalloproteinase (MMP)-2, MMP-9 and MMP-13 in an ovariectomy (OVX)-induced osteoporosis rat model. A total of 80 Sprague-Dawley female rats (age, 3 months) were randomly divided into the OVX and sham groups, with 40 rats in each group. Rats in the sham group received sham surgery, while the remaining rats were ovariectomized. After 12, 16, 20 and 24 weeks, 10 rats from each group were randomly sacrificed, respectively. It was observed that the bone mineral density (BMD) and the trabecular bone area in the OVX group were significantly lower as compared with those in the sham group (P<0.01). The expression levels of MMP-2 and MMP-9 were negatively correlated with the BMD, while MMP-13 was positively correlated with the BMD. The expression levels of MMP-2 and MMP-9 increased more abruptly and were significant higher in the OVX group in comparison with those in the sham group between 12 and 24 weeks after surgery (P<0.01). More specifically, the MMP-9 mRNA expression level in the OVX group increased abruptly between 12 and 24 weeks after surgery. By contrast, in the sham group, the MMP-9 mRNA level was undetectable between 12 and 16 weeks, and increased steadily between 16 and 24 weeks. Furthermore, the mRNA and protein expression levels of MMP-13 initially increased and then decreased in the OVX group (P<0.01 vs. the sham group), whereas they continuously increased in the sham group between 12 and 24 weeks after surgery. In conclusion, MMP-2, MMP-9 and MMP-13 regulated the development of osteoporosis, and MMP-9 may be used as an important marker in the early diagnosis of osteoporosis.

Combined radiogrammetry and texture analysis for early diagnosis of osteoporosis using Indian and Swiss data

Osteoporosis is a bone disorder characterized by bone loss and decreased bone strength. The most widely used technique for detection of osteoporosis is the measurement of bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA). But DXA scans are expensive and not widely available in low-income economies. In this paper, we propose a low cost pre-screening tool for the detection of low bone mass, using cortical radiogrammetry of third metacarpal bone and trabecular texture analysis of distal radius from hand and wrist radiographs. An automatic segmentation algorithm to automatically locate and segment the third metacarpal bone and distal radius region of interest (ROI) is proposed. Cortical measurements such as combined cortical thickness (CCT), cortical area (CA), percent cortical area (PCA) and Barnett Nordin index (BNI) were taken from the shaft of third metacarpal bone. Texture analysis of trabecular network at the distal radius was performed using features obtained from histogram, gray level Co-occurrence matrix (GLCM) and morphological gradient method (MGM). The significant cortical and texture features were selected using independent sample t-test and used to train classifiers to classify healthy subjects and people with low bone mass. The proposed pre-screening tool was validated on two ethnic groups, Indian sample population and Swiss sample population. Data of 134 subjects from Indian sample population and 65 subjects from Swiss sample population were analysed. The proposed automatic segmentation approach shows a detection accuracy of 86% in detecting the third metacarpal bone shaft and 90% in accurately locating the distal radius ROI. Comparison of the automatic radiogrammetry to the ground truth provided by experts show a mean absolute error of 0.04 mm for cortical width of healthy group, 0.12 mm for cortical width of low bone mass group, 0.22 mm for medullary width of healthy group, and 0.26 mm for medullary width of low bone mass group. Independent sample t-test was used to select the most discriminant features, to be used as input for training the classifiers. Pearson correlation analysis of the extracted features with DXA-BMD of lumbar spine (DXA-LS) shows significantly high correlation values. Classifiers were trained with the most significant features in the Indian and Swiss sample data. Weighted KNN classifier shows the best test accuracy of 78% for Indian sample data and 100% for Swiss sample data. Hence, combined automatic radiogrammetry and texture analysis is shown to be an effective low cost pre-screening tool for early diagnosis of osteoporosis.

BONE REMODELING IN NORM AND IN PRIMARY OSTEOPOROSIS: THE SIGNIFICANCE OF BONE REMODELING MARKERS

Osteoporosis is a systemic skeletal disease is characterized by low bone mass and microarchitectural deterioration of bone tissues, leading to bone fragility and low-energy The incidence of osteoporosis has risen because the life expectancy of the population has been increasing . Osteoporosis is an extremely common disease: osteoporosis affects more than 200million people worldwide and causes more than 8.9 million fractures. In Russia, among people aged 50 years and older, osteoporosis is diagnosed in 34% of women and 27% of men. The social significance of osteoporosis is determined by its consequences — fractures of the bones of the peripheral skeleton and vertebral fractures, leading to high material costs and causing a high level of disability and mortality. The normal physiological process of bone remodeling involves a balance between bone resorption and bone formation. In osteoporosis, this process becomes unbalanced, resulting in gradual losses of bone mass and density due to enhanced bone resorption and/or inadequate bone formation. Several signaling pathways underlying primary osteoporosis have been identified, such as the osteoprotegerin/ receptor activator of nuclear factor kappa-B (RANK)/RANK ligand(RANKL), bone morphogenetic proteins, canonical wnt-signaling pathway. In addition, genetic disorders are involved in the development of the pathogenesis of osteoporosis. To identify osteoporosis, WHO recommends the use of dualenergy X-ray absorptive densitometry, which allows you to study the quantitative characteristics of bone tissue. Currently, there are various methods for evaluation of the quality of bone (microarchitectonics, the ability of bone tissue to be resistant to fracture), but these methods have limitations such as high cost and limited availability for their widespread using. The study of markers of bone remodeling in norm and in pathology helps to assess the quality of bone tissue indirectly, gives prospects in the selection of targeted therapy and improvement of early diagnosis of osteoporosis.

Association of bone mineral density (BMD), body mass index (BMI) and serum osteocalcin in South Indian post menopausal women

Abstract Aim The main objective of this study is to analyse the correlation of body mass index (BMI), bone mineral density (BMD) and age with that of serum osteocalcin in postmenopausal women of south India and thereafter investigate the possibility of using osteocalcin as a tool for early diagnosis of osteoporosis. Method Forty five women with age ranging from 45-75 years old underwent BMD [using quantitative ultrasonography (QUS) examinations at t- score at calcaneus], BMI, and osteocalcin estimation. The correlation of results obtained between the above parameters was evaluated using Pearson’s correlation test. Result The findings indicated a significant negative correlation between serum osteocalcin levels and BMD (r = −0.628, p ≤ 0.0001) and linear regression equation (y = −2.538x + 15.88, R2 = 0.395). The correlation between osteocalcin with BMI and that of age with osteocalcin was found to be non-significant (r = 0.0048, p = 0.97 & r = 0.0701, p = 0.64 respectively). Conclusion Since the findings highlight a significant correlation between serum osteocalcin and BMD, this study infers that serum osteocalcin along with BMD could be used as a specific bone marker to detect the onset of osteoporosis at a considerably early age among postmenopausal women.