Higher Bone Mineral Density Values Research Articles

High prevalence of stress fractures and long-term amenorrhoea in high endurance female athletes: The misleading lack of correlation with bone mineral density

Aim & objectivesFemales who engage in high levels of sports have a high prevalence of menstrual cycle disorders and bone stress injuries (BSI). In this study, we determined the prevalence of menstrual disorders and fractures in female athletes and their association with bone mineral density (BMD) parameters. Material & methodsCross-Sectional Study. Forty-one female athletes from a public High-Performance Regional Centre; 24 high-endurance athletes (HEA) and 17 other athletes, were included. To form the control group, we invited medical students from a public University. Twenty-nine non-athletes (NA) were included. A health surveys and a dual-energy X-ray absorptiometry (DXA) were conducted for all participants. ResultsAmong the participants (median age, 24 years; body mass index, 21 kg/m2), the percentage of long-term amenorrhoea was 42 % in HEA vs. 0 % in NHEA (OR 25.35; 95 % CI 1.37–470.50, p = 0.008) or 10 % in NA (OR 6.20; 95 % CI 1.46–26.24, p = 0.022), and the percentage of BSI was 29 % in HEA vs. 0 % in NHEA or NA. Both groups of female athletes (HEA and NHEA) showed higher Z-scores than those of NA in the femur; however, only NHEA had a significant increase in the BMD on lumbar spine than that of NA. ConclusionThe prevalence of long-term amenorrhoea and/or BSI was significantly higher in the HEA than in the NHEA or NA females. In contrast, HEA, like NHEA, had higher BMD values in the femur than those of controls. It is unlikely that DXA parameters can be used to estimate cortical BSI risk in this population.

Hyperbaric oxygen therapy enhances graft healing and mechanical properties after anterior cruciate ligament reconstruction: An experimental study in rabbits.

Hyperbaric oxygen therapy (HBOT) has proven successful in wound healing. However, its potential effects on anterior cruciate ligament (ACL) injuries remain uncertain. This study aimed to investigate the impact of HBOT on graft healing following ACL reconstruction in rabbits. Male New Zealand rabbits underwent ACL reconstruction and were randomly divided into two groups: the HBOT group and the ambient air group. The HBOT group received 100% oxygen at 2.5 atmospheres absolute for 2 h daily for 5 consecutive days, starting from the first day after surgery. The ambient air group was maintained in normal room air throughout the entire period. After 12 weeks following the surgery, animals were euthanized, and their knees were harvested for analysis. The HBOT group demonstrated superior graft maturation and integration in comparison to the ambient air group, as evidenced by lower graft signal intensity on magnetic resonance imaging, decreased femoral and tibial tunnel size, and higher bone mineral density values on high-resolution peripheral quantitative computed tomography scans. Additionally, biomechanical testing indicated that the HBOT group had greater load to failure and stiffness values than the ambient air group. In conclusion, the adjuvant use of HBOT improved ACL graft maturation and integration, reduced tunnel widening, and enhanced the biomechanical properties of the graft. These results may provide important insights into the potential clinical application of HBOT as a therapeutic intervention to enhance graft healing after ACL reconstruction, paving the way for further research in this area.

The relationship of body mass index and T score in healthy and knee osteoarthritis women

Background: Osteoarthritis (OA) is a chronic, degenerative, slowly progressive disease common in women with multiple aetiology. Osteoarthritis occurs simultaneously with the reduction in bone mineral density (BMD)while a high bone mass index (BMI) value is one of the risk factors for OA. Objective: The purpose of this study was to determine the effect of BMI and BMD in healthy and knee OA women. Method: The study was conducted in an orthopaedic outpatient clinic in 2021. This is a quantitative descriptive study with accidental cross-sectional samplings. The Mann-Whitney test was used to analyse the data. Result: Subjects included in the inclusion criteria obtained 74 OA and 49 control groups. The largest subjects in the OA group were aged 56-65 years old (32, 43.24%), obese (51, 68.92%), and post-menopause (49, 66.22%). At the same time, the T score category was normal (14, 18.91%), osteopenia (22, 29.73%), and osteoporosis (38, 51.35%). Statistical analysis found a significant relationship between BMI and BMD (p = 0.002, p = 0.001) in controls and OA groups. Conclusion: Disorders of BMI and BMD are indicators of risk for OA. High BMI and low BMD values occur in women with knee OA. There is a relationship between BMI and BMD in healthy and knee OA women.

Impact of Skeletal Maturation on Bone Metabolism Biomarkers and Bone Mineral Density in Healthy Brazilian Adolescents

This study was conducted to evaluate the behavior of biomarkers in the bone formation and resorption in Brazilian adolescents according to their biological maturation. Eighty-seven volunteers were selected and divided into three groups according to their bone age (BIA); 10-12 years (n=25), 13-15 years (n=36) and 16-18 years (n=26). Few parameters and biomarkers such as, the weight (kg), height (m), body mass index (kg/m2), 3-day calcium intake (mg/day), assessment of pubertal events by Tanner criteria, levels of the biomarkers [osteocalcin (OC) (ng/mL), bone alkaline phosphatase (FAO) (U/L), and serum carboxy–terminal telopeptide (S–CTx) (ng/mL)] and their correlation with bone mineral density (BMD) (g/cm2) were measured by dual–energy X–ray attenuation of the lumbar spine, proximal femur and total body in each volunteer. The results showed that, all the biomarkers have similar behaviors, showing a higher median value for 13 to 15 years (FAO=154.71 U/L, OC=43.0 ng/mL, S–CTx=2.09 ng/mL; p<0.01) at the pubertal stage G4, and the median is decreased with the advancing IO and sexual maturation level. Additionally, the biomarker levels showed a parallelism with a peak velocity in the stature level, and interestingly, the training biomarkers indicated a negative correlation with BMD where high BMD values correlated with the low biomarker values. In conclusion, this is the first study were conducted in Brazilian adolescents with strict, and careful inclusion and exclusion criteria to assess the correlation between the bone markers and BMD against the indicators of biological maturation. The results of this study may help to understand and monitor the bone turnover and bone metabolism respectively.

SDH5 down-regulation mitigates the damage of osteoporosis via inhibiting the MyD88/NF-κB signaling pathway

Background Osteoporosis has become a serious public health problem especially in postmenopausal women. This work aims to assess both the function and mechanism of SDH5 in osteoporosis. Methods The animal model of osteoporosis in sprague-dawley rats was established by ultilizing Ovariectomy (OVX). The trabecular bone morphometry had been determined by micro-CT, and tibia injury of rats was detected through HE and alcian blue staining. Meanwhile, the levels of oxidative stress factors, including MDA, CAT, GSH-Px, and SOD, were detected by ELISA. The proliferation and apoptosis of osteoblasts isolated from OVX-induced rats were found out by CCK-8 and flow cytometry respectively. The expression of SDH5, Osterix (Osx), Type I collagen (CoL1A1), osteocalcin (OC), SOD1, SOD2, p-MyD88/MyD88, and p-NF-κB p65/NF-κB p65 was assessed by Western blot. The effect and mechanism of SDH5 knockdown on osteoporosis were verified by lipopolysaccharide (LPS) treatment. Results In the osteoporosis rat model, the expression of SDH5 had an up-regulated tend. A higher bone mineral density (BMD) value was found in the SDH5 knockdown group. SDH5 inhibition ameliorated bone loss, mitigated bone histopathological injury, alleviated oxidative stress, and elevated osteogenic marker protein expression in vivo and in vitro. SDH5 down-regulation also promoted the proliferation and restrained apoptosis of osteoblasts extracted from OVX-induced rats. Furthermore, we found that the underlying mechanism was associated with the inhibition of the MyD88/NF-κB pathway. Conclusion Down-regulation of SDH5 mitigates the damage of osteoporosis both in vivo and in vitro via inhibiting the MyD88/NF-κB signaling activation.

Analysis of hydration and subchondral bone density on the viscoelastic properties of bovine articular cartilage

BackgroundArticular cartilage is known to be a viscoelastic material, however little research has explored the impact of cartilage water content and bone density on its viscoelasticity. This study aimed to isolate subchondral bone density and hydration of articular cartilage and analyse their effects on the viscoelastic properties of articular cartilage.MethodsDynamic mechanical analysis was used to test samples at frequencies of 1, 8, 12, 29, 49, 71, and 88 Hz. Synthetic bone material with densities of 663.7 kg/m3 and 156.8 kg/m3 were used to mimic the bone mineral density (BMD). Dehydration occurred in a stepwise manner at relative humidity (RH) levels of 100%, 30%, and 1%. These relative humidity levels led to water contents of approximately 76%, 8.5%, and ≈ 0% by mass, respectively.ResultsSamples from eight bovine femoral heads were tested under a sinusoidal load. Storage stiffness was lower on the lower substrate density. Storage stiffness, though, increased as cartilage samples were dehydrated from a water content of 76% to 8.5%; decreasing again as the water content was further reduced. Loss stiffness was lower on a lower density substrate and decreased as the water content decreased.ConclusionsIn conclusions, a decrease in hydration decreases the loss stiffness, but a non-linear relationship between hydration and storage stiffness may exist. Additionally, higher BMD values led to greater storage and loss stiffnesses.

The effect of body mass index on osteoporosis and fracture risk in patients with type 2 diabetes mellitus

Aim: Type 2 diabetes mellitus (DM), osteoporosis and obesity are increasingly common diseases due to the increase in the elderly population and the change in eating habits. However, the relationship between diabetes, obesity and osteoporosis has not been fully clarified in studies in the literature. In our study, it was investigated whether the combination of diabetes and obesity caused osteoporosis and increased fracture risk. 
 Material and Method: Our study was carried out with a total of 95 patients between the ages of 40 and 80, including 24 males and 71 females, who were tested due to the preliminary diagnosis of osteoporosis and diagnosed with type 2 DM in the physical medicine and rehabilitation outpatient clinic. The demographic characteristics, body mass index (BMI), bone mineral density (BMD) measurements, X-ray imaging, and fracture risk assessment scale (FRAX) calculations of patients were performed. Groups were compared in terms of BMD and FRAX according to the BMI classification. 
 Results: BMD and FRAX hip values were higher in the obese group according to the BMI classification compared to the pre-obese/normal group (p0.05).
 Conclusion: As a result of our study, it was observed that type 2 DM and obesity were associated with increased fracture risk despite high BMD values.

Bone formation effect of highly concentrated tricalcium phosphate biocomposite screws in a rabbit osteoporosis model.

The purpose of this study was to determine the efficacy of highly concentrated tricalcium phosphate (TCP) biocomposite screws on local bone formation in a rabbit model of osteoporosis induced by bilateral ovariohysterectomy (OHE). Fourteen 24-week-old female New Zealand rabbits (weight, 3-3.5 kg) were divided into two groups: (1) OHE and biodegradable poly(lactic-co-glycolic acid) (PLGA) without ß-TCP plate or screw insertion (OHE/Bio ScRew [BSR]) group and (2) OHE and biocomposite PLGA with highly concentrated ß-TCP plate and screw insertion (OHE/highly concentrated ß-triCalcium phosphate [HCCP]). Both groups underwent bilateral OHE and had two different types of screws and plates inserted at the proximal tibia. Bilateral tibiae were extracted at 25 weeks post-OHE. The extracted tibiae were scanned with ex vivo microcomputed tomography (micro-CT). Parameters including bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb. Th), and trabecular separation (Tb. Sp) were evaluated after staining the tibial samples with hematoxylin and eosin (H&E) and Masson's trichrome. We then performed pathological assessments. Micro-CT images revealed improved new bone formation near the implant in the OHE/HCCP group with higher values of BMD, BV/TV, and Tb.N but lower values of Tb. Th and Tb. Sp than the OHE/BSR group. Analyses of H&E and Masson's trichrome staining showed better new bone formation around the implant in the OHE/HCCP group than in the OHE/BSR group. The use of highly concentrated TCP biocomposite screw and plate might improve local bone formation and facilitate osteoconductivity in an osteoporotic rabbit model.

Diabetes mellitus and osteoporosis: pathogenetic relationship and current principles of treatment

Diabetes mellitus (DM) is a well known risk factor for osteoporosis and an increased risk of fractures. A lot of data has been published about the relationship between diabetes and bone health. DM type 1 and DM type 2 have different effects on bone mineral density (BMD). The central link in pathogenesis of bone fragility in patients with DM type 1 is a violation of the activity and gifferentiation of osteoblasts. On the contrary, hyperinsulinemia in DM type 2 activates the division and gifferentiation of osteoblasts and contributes to an increase in BMD. However, Higher BMD values in patients with DM type 2 are combined with slowdown in bone metabolism. As the result, high-quality bone remodeling does not occur. And bone strength decreases despite the high BMD. Despite the differences, DM type 1 and DM type 2 have common pathogenic pathways, that lead to increased bone fragility. For example, non-enzymatic glycation of bone matrix collagen and increase in concentration of sclerostin, which blocks the Wnt signaling pathway. In this review, we will analyze current data about epidemiology and pathogenesis of osteoporosis in DM and discuss the practical issues of the clinic, diagnosis, stratification of fracture risk and treatment. Special attention will be paid to the effects of glucose-lowering and anti-osteoporotic drugs on bone tissue.

Bone Material Strength Index as Measured by Impact Microindentation is Low in Patients with Primary Hyperparathyroidism.

ContextIn primary hyperparathyroidism (PHPT) bone mineral density (BMD) is typically decreased in cortical bone and relatively preserved in trabecular bone. An increased fracture rate is observed however not only at peripheral sites but also at the spine, and fractures occur at higher BMD values than expected. We hypothesized that components of bone quality other than BMD are affected in PHPT as well.ObjectiveTo evaluate bone material properties using impact microindentation (IMI) in PHPT patients.MethodsIn this cross-sectional study, the Bone Material Strength index (BMSi) was measured by IMI at the midshaft of the tibia in 37 patients with PHPT (28 women), 11 of whom had prevalent fragility fractures, and 37 euparathyroid controls (28 women) matched for age, gender, and fragility fracture status.ResultsMean age of PHPT patients and controls was 61.8 ± 13.3 and 61.0 ± 11.8 years, respectively, P = .77. Calcium and PTH levels were significantly higher in PHPT patients but BMD at the lumbar spine (0.92 ± 0.15 vs 0.89 ± 0.11, P = .37) and the femoral neck (0.70 ± 0.11 vs 0.67 ± 0.07, P = .15) were comparable between groups. BMSi however was significantly lower in PHPT patients than in controls (78.2 ± 5.7 vs 82.8 ± 4.5, P < .001). In addition, BMSi was significantly lower in 11 PHPT patients with fragility fractures than in the 26 PHPT patients without fragility fractures (74.7 ± 6.0 vs 79.6 ± 5.0, P = .015).ConclusionOur data indicate that bone material properties are altered in PHPT patients and most affected in those with prevalent fractures. IMI might be a valuable additional tool in the evaluation of bone fragility in patients with PHPT.

The Combined Effects of Milk Intake and Physical Activity on Bone Mineral Density in Korean Adolescents.

The purpose of this study was to examine the combined effects of milk intake and physical activity on bone mineral density in adolescents. This study was conducted using data from the 2009–2011 Korea National Health and Nutrition Examination Survey (KNHANES), which provided measurements of bone mineral density (BMD) in addition to basic health-related data. This study included 1061 adolescents aged 13 to 18 years (557 males and 504 females) whose data on milk intake and participation time in moderate to vigorous physical activity were available. BMD was measured by dual-energy X-ray absorptiometry (DXA). Milk intake was assessed using the 24-h recall method, and the levels of physical activity were examined using a questionnaire. The physical activity questions of 2009–2011 KNHANES were based on the Korean version of the International Physical Activity Questionnaire (IPAQ) short form. The subjects were classified into four groups according to milk intake and physical activity level: no milk intake + low-level physical activity group (MnoPlow), no milk intake + high-level physical activity group (MnoPhigh), milk intake + low-level physical activity group (MyesPlow), and milk intake + high-level physical activity group (MyesPhigh). The results of partial correlation controlling for age, body mass index (BMI), and energy intake showed that the BMD variables were associated significantly with physical activity in both males and females. Among males, the MnoPlow group had the lowest BMD in all BMD variables, showing a significant difference from the high-level physical activity groups (MnoPhigh, MyesPhigh) by multiple logistic regression analysis. Among females, the MyesPhigh group showed a significantly higher lumbar BMD value than the other groups. The MnoPlow group had approximately 0.3 to 0.5 times lower odds ratio for median or higher BMD values, compared to MyesPhigh group. These results show that milk intake and physical activity have a combined effect on BMD, and suggest that to achieve healthy bone growth, it is important to encourage both moderate to vigorous physical activity and milk intake during adolescence.

Evaluation of Relationships between Menopause Onset Age and Bone Mineral Density and Muscle Strength in Women from South-Western Poland.

Introduction The onset of the menopause entails numerous changes, both physical and mental, in the functioning of the bodies of women. Moreover, the early menopause increases the risk of occurrence of many civilization-related diseases. Major factors contributing to health deficits include lowered bone mineral density and sarcopenia, which can result in serious functional limitations and the acceleration of ageing processes in the body. The aim of this study was to determine how the menopause onset age is linked with bone mineral density and the strength of selected muscles of the limbs and the trunk. Material and Methods. 756 women aged 50-80 years were subjected to tests. The subjects were divided into three groups: (I) from 50 to 59 years, (II) from 60 to 69 years, and (III) from 70 to 79 years. Each of the women specified the age when her final menstrual period occurred. On this basis, groups of women with (1) the early menopause—before the 50th year of life—and (2) with the late menopause—after the 50th year of life—were distinguished. Bone mineral density (BMD), dominant hand grip strength, knee extensor and flexor strength, and functional upper and lower body muscle strength were determined in each of the women. Results The test results indicate differences in levels of muscle strength and BMD between the 50-year-old early- and late-menopausal women. The late-menopausal women score better motor ability test results and higher BMD values. The differences decrease in the groups of 60-year-old women, whereas the 70-year-old early- and late-menopausal women score similar results. Conclusions A higher percentage of women with a lowered bone mass and a lower strength level was found in the group of early-menopausal subjects. The rate of decline in hand grip strength, the functional efficiency of the upper and lower limbs, and BMD is faster in the late-menopausal women, whereby the two groups of 70-year-old women score similar test results.

Effect of quercetin on bone metabolism and serum osteocalcin in osteoporotic rats

Purpose: To determine the effect of quercetin on bone metabolism and serum osteocalcin in osteoporotic rats.&#x0D; Methods: Sixty specific pathogen-free rats were randomly divided into control group, model group; high, medium and low dose quercetin groups, and diethylstilbestrol group, with 10 rats in each group. The high, middle and low dose quercetin groups were given quercetin suspension at doses of 200, 100, 50 mg/kg/day, respectively; the ethylene estradiol group was given ethylene estradiol (1.0 mg/kg/week), while control rats received ethylene estradiol at doses of 200, 100, 50 mg/kg/day. Rats in the model group were given saline. Samples were taken after 6 weeks of administration. The levels of serum bone-derived alkaline phosphatase (BALP), estradiol (E2) and serum osteocalcin (BGP) in femur tissue were measured using ELISA kits. Bone mineral density (BMD) was determined using BMD tester.&#x0D; Results: Relative to normal rats, BALP and BGP levels in the model rats were markedly increased, while E2 was significantly lower (p &lt; 0.5). Quercetin treatment led to significant increases in BALP and E2 levels in the middle and high dose groups, relative to the model group, while BGP levels in all quercetin treatment groups decreased significantly, when compared to model rats (p &lt; 0.05). There were higher BMD values in quercetin and diethylstilbestrol groups than in model (p &lt; 0.05).&#x0D; Conclusion: Quercetin enhances bone formation and BMD, but decreases osteocalcin levels and maintains bone biomechanics in ovariectomized rats. Thus, it may find therapeutic application in maintaining bone health.&#x0D; Keywords: Quercetin, Osteoporosis, Bone metabolism, Osteocalcin

COPD as an independent risk factor for osteoporosis and fractures.

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of osteoporosis and fractures, but screening and prophylactic measures to prevent both disorders are often neglected in this population. This case-control study assessed the prevalence of osteopenia, osteoporosis, and fractures in patients with COPD, and identified potential risk factors for fractures in this population. Overall, 91 patients with COPD (COPD group; COPDG) and 81 age- and sex-matched controls (control group; CG) were assessed with bone mineral density (BMD), thoracic/lumbar spine radiographs, and serum PTH and 25-hydroxyvitamin D (25[OH]D) levels. The occurrence of prior fractures was retrieved from clinical history. The prevalence of total fractures in the COPDG was 57.1% (odds of fracture 4.7 times greater compared with the CG), and the femoral neck T-score emerged as the best predictor of fractures. Compared with the CG, the COPDG had lower spine and femoral BMD (p ≤ 0.01) and 25(OH)D levels (p = 0.01) and 2.6 times greater odds of osteoporosis. Among men, vertebral fractures were more prevalent in the COPDG versus CG (25.9% vs. 6.5%, respectively, p = 0.01). The odds of fracture increased with femoral neck T-scores ≤ - 2.7 in the CG and ≤ - 0.6 in the COPDG. These results add robust evidence to an increased odds of osteoporosis and fractures in COPD. Fractures in the COPDG occurred at higher BMD values than expected, suggesting that COPD may be an independent marker of fracture risk, reinforcing a need for regular osteoporosis screening with BMD measurement and prophylaxis of fractures in patients with this disorder.

DXA Measured Distal Femur Bone Mineral Density in Patients After Total Knee Arthroplasty: Method Development and Reproducibility

Introduction: Total knee arthroplasty (TKA) is increasingly being performed. Distal femur periprosthetic fracture is a potentially catastrophic complication following TKA and existing data document substantial distal femur bone mineral density (BMD) loss following TKA. However, distal femur BMD is virtually never measured clinically as no consensus approach exists. This pilot study's purpose was to define regional BMD variation throughout the femur, suggest standard dual-energy X-ray absorptiometry (DXA) regions of interest (ROIs) and evaluate BMD reproducibility at these ROIs. Methods: Thirty volunteers 2–5 yr post TKA had both entire femurs imaged twice using a Lunar iDXA with subject repositioning between scans; the atypical femur fracture feature of enCORE software was utilized. To define femoral BMD distribution, custom 1 cm ROIs were stacked one atop the other starting at the intercondylar notch and continuing to the base of the lesser trochanter. Femur length was measured with the ruler tool to calculate distance at 5% increments. ROIs encompassing each 5% increment were utilized to measure BMD at each location. Descriptive statistics were used to determine mean BMD at each ROI and reproducibility at the 15%, 25%, 45%, 60%, and 80% ROIs. Results: The 5 and 10% ROIs included prosthetic and/or patella, causing high BMD values. Distal femur BMD was lowest at the 15% ROI and was higher (p < 0.05) at each more proximal ROI to 45%, then plateaued from 45% to 75%. BMD reproducibility at these regions was excellent; coefficient of variation (CV) from ∼1% to 3.5%. As periprosthetic fractures generally occur in the distal femur, we propose measuring femur BMD using ROIs placed at 15% and 25%. A 60% region could also be used as a highly cortical site. Conclusion: Existing DXA capabilities allow distal femur BMD measurement with good reproducibility. Further research using standardized ROIs to assess distal femur BMD loss after TKA, and interventions to mitigate this loss, is indicated.

Bone Mineral Density and Sports Participation

The objective of our study was to identify differences in bone mineral density (BMD) according to different sports among adolescents, as well as to identify assessments of relevant mediators. The sample consisted of 429 adolescents with a mean age of 13.3 ± 1.7 yr. The sports modalities that we evaluated were judo, karate, kung fu, swimming, basketball, and soccer. Nonsports group was composed of 111 adolescents. Bone density was assessed using dual-energy X-ray absorptiometry. Regarding BMD values, female engaged in karate had higher BMD values than girls from the no sports group (p = 0.01). Boys engaged in soccer and karate presented the highest BMD values than all the other groups (p = 0.01). The most relevant mediators were the body mass index and lean soft tissue for boys and girls. Different sports presented different results regarding BMD gains, which were influenced by body mass index and whole-body lean soft tissue.

Effects of vitamin B12, folate, uric acid, and serum biomarkers of inflammation on bone mineral density in postmenopausal women.

IntroductionDespite the accumulating evidence suggesting a possible relationship between femur and lumbar bone mineral density (BMD) and serum uric acid (UA), it is unclear whether alterations in UA levels reflect any underlying subclinical inflammatory conditions in postmenopausal osteoporosis. In addition, the mechanistic link between osteoporosis and dietary factors including vitamin B12 and folate in postmenopausal women is still obscure. The aim of the present study is to investigate the association between serum vitamin B12, folate, UA, and subclinical inflammatory markers and BMD measurements in postmenopausal women.Material and methodsOne hundred and eighty-four postmenopausal women were recruited for the present study. Clinical data, as well as serum vitamin B12, folate, UA, conventional inflammatory markers, and other related biochemical markers, were assessed for each subject. Bone mineral density measurements of proximal femur and lumbar spine were taken using dual-energy X-ray absorptiometry. Correlation analysis was performed between serum vitamin B12, folate, UA and other biochemical and metabolic parameters.ResultsAlthough no association was found between serum inflammatory markers, vitamin B12 and folate levels with femur neck and lumbar spine BMD measurements, elevated UA levels were observed in subjects with normal BMD values. Higher BMD values were obtained in higher UA tertiles. UA (p < 0.001) and BMI (p = 0.003) were found to be correlated with femur neck BMD measurements.ConclusionsThe femoral and lumbar BMD measurements were associated with serum UA levels. Higher serum UA levels were found to have a protective effect on postmenopausal osteoporosis irrespective of inflammation and dietary factors.

Role of Fat and Bone Biomarkers in the Relationship Between Ethnicity and Bone Mineral Density in Older Men

Osteoporosis is an important health issue for older adults, and has been relatively understudied in older men. This study aimed to examine ethnic differences in bone mineral density (BMD), and elucidate the role of bone turnover markers (BTMs), fat and fat biomarkers on these ethnic differences. BMD at the lumbar spine and femoral neck, marrow fat at femoral neck, visceral adipose tissue (VAT) and subcutaneous adipose tissue, bone and fat biomarkers were evaluated in 120 healthy men aged ≥ 60 years. Indians had higher BMD values compared to Chinese at the lumbar spine (β = 20.336, SE = 4.749, p < 0.001) and the femoral neck (eβ = 1.105, SE = 0.032, p < 0.001), after adjusting for BTMs, fat composition and lifestyle choices. Marrow fat, VAT and adiponectin were independent predictors of BMD. However, these factors did not explain the lower BMD observed in older Chinese men. Our findings suggest that older Chinese men are at significant risk of osteoporotic fractures due to lower BMD. Fat appears to be a key factor associated with lower BMD, and warrants further longitudinal studies to elucidate the complex interactions between adipose tissue and bone strength.

ASYMPTOMATIC VERTEBRAL COMPRESSION FRACTURES IN POSTMENOPAUSAL WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that most commonly occurs in women. Improved treatments for SLE have led to a substantial increase in the life expectancy of patients, so the problems of complications of both the disease itself and its therapy have come to be top priority. The most common complications of SLE among the musculoskeletal system lesions are osteoporosis and related vertebral compression fractures (VCFs). However, only one third of these fractures has clinical manifestations and causes the patient to seek medical advice. More VCFs remain undetected because they have no or scarce symptoms. The question of the influence of various factors (gender, age, menopause, etc.) on the incidence of VCFs in patients with SLE remains open. It should be expected that in postmenopausal women with SLE, the incidence of VCFs may be considerably higher than that in the population. Objective : to determine the frequency of and to evaluate the role of various factors in the development of asymptomatic vertebral fractures in postmenopausal women with SLE (a retrospective study). Subjects and methods . A total of 86 postmenopausal women (mean age, 59±7.9 years) with a diagnosis of SLE, which met the 2012 Systemic Lupus Collaborating Clinics (SLICC) criteria, were examined. The mean duration of the disease and menopause was 15±8.3 and 12.8±7 years, respectively. All the patients with SLE were treated with glucocorticoids (GC) at a dose of 15±5 mg/day calculated with reference to prednisolone for more than 12 months (mean, 159.7±90.9 months) and had a low disease activity (the mean SLEDAI-2K score was 5.1±3.9). The ACR damage index for SLE averaged 5.5±2.6. All the patients underwent vertebral fracture assessment (VFA) using a Hologic Explorer bone densitometer to identify VCFs in the thoracic and lumbar spine. The anterior, middle, and posterior heights of ТhIV–LV, and the height of each vertebra as well as the underlying vertebra were calculated and compared. If the differences in the anterior, middle, or posterior vertebral heights were >20–25%, this deformation was regarded as VCFs. Bone mineral density (BMD) in the hip and spine was measured with an X-ray bone densitometer. Results. VFA revealed VCFs in 40 (46.5%) patients with SLE; these were detected for the first time in 22 (55%) patients since they had no significant clinical manifestations. VCFs happened most commonly in the mid-thoracic spine (ThVI–IX). All the patients with asymptomatic VCFs had a fracture of only one vertebra. The patients with VCFs had a longer duration of SLE and menopause, more frequently received cytostatic therapy, and had a higher cumulative dose and a longer duration of GC therapy. They also had a higher damage index and lower BMD values in LI–IV than patients without VCFs (p 0.05). Conclusion. The detection rate for VCFs is nearly 50% in postmenopausal women with SLE, and about every two VCFs remain undetected. The long duration of SLE, menopause, and GC treatment, a high cumulative dose, a high damage index and low BMD values in LI–IV were associated with VCFs. VFA is an effective screening method to detect asymptomatic VCFs.

Bone Mineral Density in the Noninstitutionalized Elderly: Influence of Sociodemographic and Anthropometric Factors.

Objective. Analysis of bone mineral density (BMD) in the elderly and its associated factors according to sex. Methods. A cross-sectional study is presented herein, with a random sample of 132 noninstitutionalized elderly people. Individuals who did not use diuretics were excluded. BMD was obtained from examination of total body densitometry and its association with sociodemographic variables, lifestyle, anthropometric, and body composition was verified. Results. Mean BMD for men was 1.17 ± 0.12 g/cm2 and for women was 1.04 ± 0.11 g/cm2. Higher education was associated with higher BMD values in men (p < 0.05). There was a reduction in BMD in the age group 75–79 years of age in women and over 80 years of age in men (p < 0.05). Underweight was associated with significantly low BMD for both sexes (p < 0.01), while normal weight was associated with low BMD in women (p < 0.001). Discussion. The elderly with low schooling and in older age groups are more probable to also present low BMD. Lower levels of body mass index also indicated towards low BMD.