High Incidence Of Osteopenia Research Articles

Bone mineral density in patients with primary chronic adrenal insufficiency

Forty-four patients (11 men and 33 women) with primary chronic adrenal insufficiency (CAI) treated by substitute synthetic glucocorticoids (GC) prednisolone and dexamethasone and 9a-fluorohydrocortisone (cortineff) were examined in order to investigate the effects of various factors on changes in mineral compactness of bone tissue (MCB). In men the disease duration was 10.33±1.4 years, in women 11.64±3.49 years. Twenty (60%) women were postmenopausal, ten of these (50%) for more than ten years. None of these women was treated by estrogens. Bi-energy x-ray absorptiometry (BRA) of forearm bones was carried out in all 44 patients and quantitative computer-aided tomography (CAT) of L2, L3, and L4 vertebrae was carried out in 25 patients. Plasma levels of dihydroepiandrosterone sulfates (DEA-S) were measured; in men plasma testosterone was measured. A decrease of MCB to less than —1 SD by the T index was detected by BRA in 72.7±13.4 men and in only 42.4±8.6%o women, and by the Z index in 45.5±15.01 men and 33.3±8.2% women. CAT of the spine showed MCB decrease by the T index in 83.3±15.23% men and 63.15±11.07%o women and by the Z index in 16.7±15.23%o men and 26.3±10.1 women. Despite an appreciably high incidence of osteopenia and osteoporosis in men, the difference between men and women by these parameters is insignificant. Among women at least 80% osteopenias and osteoporosis occurred in postmenopausal women. In women with decreased MCB (Z<—1) the duration of the postmenopause was significantly (p<0.05) higher than in women with normal MCB. No significant differences in the disease duration, patients’ age, and plasma levels of DEA-S and testosterone between groups with normal and decreased MCB were observed in both men and women. Analysis of correlations of the results of both osteodensitometry methods showed a strong inverse correlation between MCB and duration of postmenopause. In four men CAT of the spine revealed a strong positive correlation between MCB and testosterone level. Hence, a characteristic feature of the osteopenic syndrome in patients with CAI treated by substitute synthetic GC is its increased incidence in men, compatible to that in women; the duration of postmenopause is a significant factor of risk of osteopenia in women with CAI.

Osteopenic syndrome in liquidators of the Chernobyl power plant accident consequences

Bone system was examined in 112 liquidators; in 71 of these osseous tissue density was studied by osseous densitometer using bienergetic x-ray absorptiometry and in 45 x-ray examinations, analyses of biochemical and hormonal parameters were carried out. Spinal painful syndrome was detected in 61 to 82 % of the examinees. For analysis of densitometric and x-ray parameters the liquidators were divided into 2 groups: group I included those who worked at the power plant in 1986 (55 %) and group 2 were those who worked there in 1987-1989. Radiation doses in group 1 reliably surpassed those in group 2 (p0.001). Bone mineral density in the lumbar vertebrae was significantly lower in group 1 as against group 2 and lower in both groups us. controls. More than 5 % osseous mineral loss was revealed in 73 % of group 1 liquidators and in 43 % of group 2 ones. Analysis of spinal roentgenograms in 45 liquidators showed a high incidence of negligible and moderately expressed osteoporosis without compression fractures of vertebral bodies: osteopenia signs were found in 87 % of group 1 examinees complaining of pain in the spine and in 73 % of group 2 examinees; signs of osteochondrosis and spondylosis were detected in 40 % of group 1 and in 47 % of group 2 subjects. Hence, a higher incidence of osteopenia in liquidators, more manifest condition and its higher detection rate in subjects exposed to higher radiation doses indicate a certain contribution of radiation factor to the development of the osteopenia syndrome in liquidators.

Loss of regional bone mineral density in the first 12 months following renal transplantation.

A high incidence of osteopenia is likely in renal transplant recipients in whom pre-existing uraemic osteodystrophy, persisting hyperparathyroidism and glucocorticoids constitute a formidable array of risk factors. The correction of some biochemical and hormonal abnormalities, an increase in body weight and an increase in physical activity following transplantation could favour improvements in skeletal integrity. Using dual energy X-ray absorptiometry (DEXA), we studied prospectively the regional bone mineral density (BMD) of 34 consecutive cadaveric renal allograft recipients who were already established on dialysis. BMD of these patients was measured at the time of transplantation and was repeated at 3, 6 and 12 months following the transplantation. Immunosuppression was achieved using triple therapy: azathioprine, cyclosporin-A and prednisolone. At baseline, total BMD and BMD at the lumbar spine and femoral neck did not differ from age- and sex-matched controls. Females experienced marked and progressive bone loss at the lumbar spine, with less marked changes at the femoral neck. Males, in contrast, experienced substantial reduction of BMD at the femoral neck at 6 months and a recovery at 12 months without significant change at the lumbar spine. Whole body bone mineral content fell transiently in males, with partial recovery by 6 months. No significant correlation was found with the cumulative doses of either corticosteroids or cyclosporin-A, the duration of hospitalisation, the function of the transplant, patient age or menopausal status.(ABSTRACT TRUNCATED AT 250 WORDS)