Lumbar Spine In Postmenopausal Women Research Articles

Utility and validation of bone mineral density measurements atforearm in predicting trabecular microarchitecture and central-site osteoporosis in aging Indian postmenopausal women-a promising surrogate?

ObjectiveThe objective of this paper was to present the results of our study of the utility of bone mineral density (BMD) measurements at various segments of distal forearm in predicting central‐site osteoporosis and deteriorated trabecular microarchitecture.MethodsThis was a cross‐sectional study and BMD at the femoral neck, lumbar spine, and distal forearm were assessed using the dual‐energy X‐ray absorptiometry (DXA) scanner and bone microarchitecture at lumbar spine by trabecular bone score (TBS). The utility of forearm BMD in predicting osteoporosis as well as the deteriorated TBS was assessed by a receiver operating characteristic analysis.ResultsA total of 352 postmenopausal women with mean (SD) age of 60.7 (6.8) years were included. The odds of having osteoporosis at femoral neck [odds ratio (OR) = 14.1, 95% confidence interval (CI): 7.8–25.2] and lumbar spine (OR = 7.5, 95% CI: 4.6–12.1) was highest with the mid‐distal radius. A derived T‐score cut off ≤ −1.6, −1.9, and −1.7 at any segment of the forearm was elucidated to predict osteoporosis at the central‐site, femoral neck, and lumbar spine, respectively, with sensitivity of 80%–88% and specificity of 60%–70%. The T‐scores at all three forearm segments ≤ −1.2 showed fair performance in predicting degraded trabecular microarchitecture. The T‐scores thus derived were further validated in cohort of 360 Bengali postmenopausal women.ConclusionBMD assessment at the forearm may be utilized in prediction of trabecular microarchitecture and central site osteoporosis at the femoral neck and lumbar spine in postmenopausal women.

Association between severe lumbar disc degeneration and self-reported occupational physical loading.

ObjectivesOccupational physical loading has been reported to be associated with intervertebral disc degeneration. However, previous literature reports inconsistent results for different vertebral levels. The aim of our study was to investigate the association between lumbar disc degeneration (LDD) at different vertebral levels and the self‐reported physical loading of occupation.MethodsThe study population consisted of 1,022 postmenopausal women and was based on the prospective Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort. The severity of LDD was graded from T2‐weighted MRI images using the five‐grade Pfirrmann classification. Five intervertebral levels (L1–L2 to L5–S1) were studied (total 5110 discs). The self‐rated occupational physical loading contained four groups: sedentary, light, moderate, and heavy.ResultsThe heavy occupational physical loading group had higher odds for severe LDD at the L5–S1 vertebral level (OR 1.86, 95% CI: 1.19–2.92, p = .006) in comparison with the sedentary work group. A clear trend of increasing disc degeneration with heavier occupational loading was also observed at the L5–S1 level. Age, smoking, and higher body mass index (BMI) were associated with more severe LDD. Leisure‐time physical activity at the age of 11–17 years was associated with less severe LDD. Controlling for confounding factors did not alter the results.ConclusionsThere appears to be an association between occupational physical loading and severe disc degeneration at the lower lumbar spine in postmenopausal women. Individuals in occupations with heavy physical loading may have an increased risk for work‐related disability due to more severe disc degeneration.

Dietary Total Antioxidant Capacity Was Associated With Bone Mass and the Risk of Osteoporosis in Postmenopausal Women

Abstract Objectives Antioxidant intake has been suggested to be associated with the risk of osteoporosis. However, the effect of dietary total antioxidant capacity (TAC) on bone health is not clear. The aim of the present study was to assess the hypothesis that dietary TAC was positively associated with bone mass and negatively with the risk of osteoporosis in Korean women. Methods This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, 2008–2011. Dietary TAC was estimated by using task automation technique and algorithm to calculate the theoretical TAC from one day of 24-hour recall data using a TAC database comprising antioxidant capacities of 42 dietary antioxidants, developed for common Korean foods. In total, 8230 women were divided into a postmenopausal and premenopausal group, and each group was subdivided into four groups according to quartiles of dietary TAC. Multiple regression analysis was performed to assess relationships between dietary TAC with bone mass and the risk of osteoporosis risk. Results Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio: 0.73, 95% confidence interval: 0.54–0.99; p-trend = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women, and BMC of total femur and lumbar spine in premenopausal women. Conclusions The present study suggested that dietary TAC was inversely associated with the risk of osteoporosis in postmenopausal women, and positively associated with bone mass in pre- and post-menopausal women. Further long-term cohort or intervention study will be necessary to confirm the effect of a high dietary TAC diet on bone health. Funding Sources This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Korean government.

Effects of thyroid-stimulating hormone suppression after thyroidectomy for thyroid cancer on bone mineral density in postmenopausal women: a systematic review and meta-analysis

ObjectivesWe assessed thyroid-stimulating hormone (TSH) suppression effects on bone mineral density (BMD) in postmenopausal women who underwent thyroidectomy.Data sourcesPubMed, EMBASE, Cochrane Library, Web of Science and SCOPUS were searched from...

Association of Dietary Total Antioxidant Capacity with Bone Mass and Osteoporosis Risk in Korean Women: Analysis of the Korea National Health and Nutrition Examination Survey 2008-2011.

Antioxidant intake has been suggested to be associated with a reduced osteoporosis risk, but the effect of dietary total antioxidant capacity (TAC) on bone health and the risk of osteoporosis remains unclear. We aimed to assess the hypothesis that dietary TAC is positively associated with bone mass and negatively related to the risk of osteoporosis in Korean women. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Dietary TAC was estimated using task automation and an algorithm with 24-h recall data. In total, 8230 pre- and postmenopausal women were divided into four groups according to quartiles of dietary TAC. Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio, 0.73; 95% confidence interval, 0.54–0.99; p-value = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women and BMC of the total femur and lumbar spine in premenopausal women. Our study suggests that dietary TAC is inversely associated with the risk of osteoporosis in postmenopausal women and positively associated with bone mass in both pre- and postmenopausal women.

Does Quantitative Ultrasound at the Calcaneus Predict an Osteoporosis Diagnosis in Postmenopausal Women from the Silesia Osteo Active Study?

The aims of the study were to assess the clinical conformity between quantitative ultrasound (QUS) and densitometry with use of the standard World Health Organization T-score thresholds to determine optimal diagnostic cutoff values for QUS T-scores in different age groups. Three hundred sixty-five postmenopausal Caucasian women were enrolled into the study and divided into two age groups (<65 y and ≥65 y). Skeletal status was assessed using QUS measurements at the calcaneus and bone densitometry at the spine and proximal femur (Hologic Explorer, Bedford, MA, USA). QUS measurement results expressed as the stiffness index (SI) correlated significantly with both femoral neck bone mineral density (r = 0.51, p < 0.0001) and lumbar spine bone mineral density (r = 0.52, p < 0.0001). On the basis of receiver operating characteristic curve analyses, the thresholds for correspondence between QUS T-score values and T-score –2.5SD in dual X-ray absorptiometry (DXA) were established. They ranged between –1.63SD and –1.70SD in relation to femoral neck DXA and between –1.22SD and –1.51SD in relation to lumbar spine DXA, depending on age category. In conclusion, the study described here confirmed that QUS measurements at the calcaneus may provide information comparable to DXA examinations at the femoral neck and lumbar spine in postmenopausal women.

Association of bone mineral density with nine urinary personal care and consumer product chemicals and metabolites: A national-representative, population-based study

Personal care and consumer products are extensively used and contain various chemicals that are recognized as endocrine disrupting chemicals. Few epidemiological studies measured the associations of these chemicals and metabolites, especially phenols, with bone health. We measured the associations between nine urinary phenol biomarkers and BMD and the subsequent prevalence of osteopenia/osteoporosis. National representative data from US adults aged over 20 years who participated in the National Health and Nutrition Examination Survey from 2005 to 2010 were used. 2,267 men, 1,145 premenopausal women and 1,033 postmenopausal women were included in the final analyses. Bisphenol A, benzophenone-3, triclosan, butylparaben, ethylparaben, methylparaben, propylparaben, 2,5-dichlorophenol and 2,4-dichlorophenol were measured by high-performance liquid chromatography-isotope dilution tandem mass spectrometry. Paraben concentrations, especially ethyl-, methyl- and propylparabens, were related to greater BMD in the femoral neck and intertrochanter and lumbar spine in men and premenopausal women. 2,4-dichlorophenol concentrations was associated with lower BMD and a higher prevalence of osteopenia + osteoporosis in men. Bisphenol A was associated with a higher prevalence of osteopenia + osteoporosis in the lumbar spine in postmenopausal women. Benzophenone-3 tended to be associated with a higher BMD of femur in men and premenopausal women. In conclusion, certain urinary personal care and consumer product chemicals and metabolites were significantly associated with BMD or osteopenia + osteoporosis. These results further indicate that, in future research, determination of the causal relationships and detection of undelying mechanism could be next important directions.

The association of potassium intake with bone mineral density and the prevalence of osteoporosis among older Korean adults.

BACKGROUND/OBJECTIVESOsteoporosis is characterized by low bone mass and results in vulnerability to fracture. Calcium and vitamin D are known to play an important role in bone health. Recently, potassium has been identified as another important factor in skeletal health. We examined the link between potassium intake and bone health among the Korean older adult population.SUBJECTS/METHODSThis retrospective, cross-sectional study included 8,732 men and postmenopausal women over 50 years old who completed the Korean National Health and Nutrition Survey (KNHANES) between 2008 and 2011. Potassium consumption was evaluated using a 24-hour recall method. Bone mineral density (BMD) was measured at three sites (total hip, femur neck, and lumbar spine) by dual-energy X-ray absorptiometry (DEXA). Multinomial logistic regression was used to examine the link between potassium intake and prevalence of osteoporosis and osteopenia, after controlling for potential confounding variables.RESULTSThe BMD of the total femur and Ward's triangle were significantly different according to the potassium intake among men (P = 0.031 and P = 0.010, respectively). Women in the top tertile for potassium intake showed higher BMD than those in the bottom tertile at all measurement sites (all P < 0.05). Daily potassium intake was significantly related to a decreased risk of osteoporosis at the lumbar spine in postmenopausal women (odds ratios: 0.68, 95% confidence interval: 0.48-0.96, P trend = 0.031). However, the dietary potassium level was not related to the risk of osteoporosis in men.CONCLUSIONCurrent findings indicate that higher dietary potassium levels have a favorable effect on bone health and preventing osteoporosis in older Korean women.

Role of T1 Weighted and Diffusion Weighted Magnetic Resonance imaging application in the diagnosis of osteoporosis in lumbar spine in postmenopausal women

Background: Postmenopausal Osteoporosis is one of the most common causes of primary osteoporosis. For two decades, diffusion-weighted imaging (DWI) has been applied to the evaluation of intracranial diseases, but technical advancement make it possible to apply DWI measurements to extra cranial sites, including vertebral column.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Objective: Using diffusion-weighted MR imaging technology to determine the &nbsp;DWI &nbsp;and &nbsp;ADC values of lumbar vertebral body &nbsp;in &nbsp;postmenopausal women &nbsp;in correlation &nbsp;with &nbsp;the &nbsp;&nbsp;DEXA &nbsp;t-scores. Patients and Methods: A cross sectional analytical studywas conducted at Al-Yarmouk Teaching hospital in Baghdad city. A total of 80 postmenopausal women, was recruited from subjects who underwent DEXA of the spine and categorized into three groups according to their t-score: Normal BMD, Osteopenia, and Osteoporosis. Then MRI study done for all of them including: T1, T2, DWI, and ADC value measurement.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Results: The values ​​of ADC at L3 vertebra were (0.46 ± 0.098) × 10-3 mm2/s, (0.42 ± 0.084) × 10-3 mm2/s, and (0.39 ± 0.052) × 10-3 mm2/s for the three groups: the normal, osteopenic, osteoporotic respectively. The values ​​of the diffusion signal intensity values ​​at L3 vertebra were 134.5 ± 5.7 mm2/s, 112.7 + 3.4 mm2/s, 101.3 + 4.4 mm2/s respectively. There was a significant difference among the three groups in both diffusion and ADC measurement.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; Conclusion: Both diffusion and ADC values are significantly lower in subjects with postmenopausal osteoporosis. There is a significant positive relationship between T score that was determined by DEXA, and the ADC value.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp

Lumbar muscle volume in postmenopausal women with osteoporotic compression fractures: quantitative measurement using MRI.

To investigate the relationship between paraspinal and psoas muscle volumes and acute osteoporotic or low-bone-mass compression fractures of the lumbar spine in postmenopausal women. Patient data were retrieved retrospectively for postmenopausal women with L-spine magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry showing osteoporosis/low bone mass. Group 1 comprised eight women aged 60-80years with MRI showing a single acute compression fracture. The age-matched group 2a (N = 12) and younger group 2b (N = 12) comprised of women whose MRIs showed no fractures. Cross-sectional MRIs of the paraspinal and psoas muscles and intramuscular fat volume for each muscle group were measured. Operator repeatability and reproducibility were obtained. Group 1 showed significantly smaller lean muscle volume for all muscle groups at L5/S1. Intramuscular fat volume was also smaller in most muscle groups in group 1, though only reaching statistical significance at variable muscle groups and levels. Measurements show both good intrarater repeatability and interrater reproducibility of lean muscle volume estimations (intraclass correlation coefficient (ICC), 0.999 for rater A and 0.997 for rater B; Cronbach's alpha 0.995) and intramuscular fat volume estimations (ICC, 0.995 for rater A and 0.982 for rater B; Cronbach's alpha was 0.981). This study provides the first quantitative evidence that compression fractures in postmenopausal women with underlying osteoporosis/low bone mass are associated with less paraspinal and psoas muscle volumes. Further longitudinal studies with larger cohorts are needed to verify this relationship. • The risk of osteoporotic compression fractures is higher in older women with smaller paraspinal muscle volume. • Older women show smaller paraspinal muscle volume and more intramuscular fat compared to younger controls.

Magnetic Susceptibility and Fat Content in the Lumbar Spine of Postmenopausal Women With Varying Bone Mineral Density.

Osteoporosis is a systemic disease characterized by low bone mass with increased fracture risk. Quantitative imaging biomarkers are important for accurately predicting fracture risk in patients with osteoporosis. To prospectively study the changes of magnetic susceptibility and fat content in the lumbar spine of postmenopausal females with varying bone mineral density (BMD), and investigate their application to osteoporosis assessment. Cohort. In all, 108 postmenopausal females (58.2 ± 6.7 [range 45-79] years old). Quantitative computed tomography (QCT) performed on a 64-detector CT scanner; quantitative susceptibility mapping (QSM) and mDixon quant MR imaging performed using a 3.0T imaging system with a 16-channel posterior coil. QCT, QSM, and mDixon were performed in 108 postmenopausal females to measure vertebral BMD, susceptibility, and proton-density fat fraction (PDFF). Mean vertebral QSM and PDFF were compared among three BMD cohorts (normal, osteopenic, and osteoporotic). Receiver operating characteristic analyses were performed to evaluate the performance of QSM, PDFF, and QSM+PDFF for assessing osteoporosis. Parameters were compared using Kruskal-Wallis test and Pearson test. Compared with that of the normal BMD group (-17.0 ± 43.6 ppb), vertebral QSM was significantly increased in osteopenia (30.8 ± 47.0 ppb, P < 0.001), and further increased in osteoporosis (82.0 ± 39.9 ppb, P < 0.001). QSM was negatively correlated with BMD (r = -0.70, P < 0.001) and positively correlated with PDFF (r = 0.64, P < 0.001). Compared with the area under the curve (AUC) of PDFF, the AUC of QSM was higher in differentiating between normal and osteoporosis (P = 0.44), and between osteopenia and osteoporosis (P = 0.13), but without statistical significance. The AUC of QSM+PDFF was significantly higher than that of PDFF for differentiating between osteopenia and osteoporosis (0.82 vs. 0.70, P = 0.039). The combination of vertebral susceptibility and fat content may be a promising marker for assessing postmenopausal osteoporosis. 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1020-1028.

High dietary sodium intake is associated with low bone mass in postmenopausal women: Korea National Health and Nutrition Examination Survey, 2008-2011.

Several studies have reported that large amount of dietary sodium intake is highly associated with elevated urinary calcium. However, the direct effect of excessive dietary sodium intake on bone mass, as a risk factor for osteoporosis, is still a controversial issue. The aim of the present study was to assess the relationship between high intake of sodium and lower bone mass and risk of osteoporosis in adult women. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. Participants (n=9526 women older than 18years) were divided into a premenopausal (n=4793) and postmenopausal (n=4733) group. Both groups were subdivided into five groups according to quintiles of energy-adjusted sodium intake. Multiple regression analysis was performed to assess relationships between sodium intake and lower bone mass. Multivariate linear regression analysis showed that high sodium intake was negatively associated with bone mineral content (BMC) and bone mineral density (BMD) in postmenopausal women. After adjusting confounding factors, high sodium intake was negatively associated with BMC and BMD of the lumbar spine in postmenopausal women. Postmenopausal women, whose sodium intake was ≥2000mg/day (odds ratio 1.284, 95% CI 1.029-1.603, P=0.027), were at risk of developing osteoporosis after adjustment of confounding variables. The present study suggested that high sodium intake could be a potential risk factor for low bone mass after adjusting for confounding factors in postmenopausal women.

Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review.

BackgroundTo examine whole-body vibration (WBV) effect on bone mineral density (BMD) and fall prevention in postmenopausal women, we performed a meta-analysis and systematic review of prospective randomized controlled trials (RCTs) comparing change in BMD of the femoral neck and lumbar spine and related factors of falls between WBV group and control group.MethodsEMBASE, PubMed, Cochrane Central Register of Controlled Trials, ISI Web of Science, and China National Knowledge Infrastructure (CNKI) were searched up to April 2015; search strategy was used as follows: (vibration) AND (osteoporo* OR muscle* OR bone mineral density OR BMD). All prospective randomized controlled trials comparing related factors of falls and BMD change in the femoral neck and lumbar spine between WBV group and control group were retrieved.ResultsEight of 3599 studies with 1014 patients were included, 477 in the WBV group, and 537 in the control group. We found that there was no significant difference in all magnitude groups of the femoral neck (N = 936, WMD: 0.00 (–0.00, 0.01); p = 0.18). A statistical significance showed in the all magnitude groups (N = 1014, WMD: 0.01 (0.00, 0.01); p = 0.01) and low-magnitude group (N = 838, WMD: 0.01 (0.00, 0.01); p = 0.007) of the lumbar spine. No significant difference was found in high-magnitude group of the lumbar spine (N = 176, WMD: 0.00 (−0.01, 0.02); p = 0.47), low-magnitude group (N = 838, WMD: 0.00 (−0.00, 0.00); p = 0.92) and high-magnitude group (N = 98, WMD: 0.02 (−0.00, 0.05); p = 0.06) of the femoral neck. All the studies provided data of related factors of falls such as strength of the lower limb, balance, and fall rate reported effectiveness of WBV therapy. In addition, no complication was reported.ConclusionsLow-magnitude whole-body vibration therapy can provide a significant improvement in reducing bone loss in the lumbar spine in postmenopausal women. Moreover, whole-body vibration can be used as an intervention for fall prevention.

Tooth loss and bone mineral density in postmenopausal South Korean women: The 2008–2010 Korea National Health and Nutrition Examination Survey

PurposeThe current study aimed to investigate the association between the number of remaining teeth and bone mineral density (BMD) using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2010. MethodsThis study enrolled 7315 Korean subjects (3364 men over 50 years of age and 3951 postmenopausal women). BMD was measured using dual-energy X-ray absorptiometry at three sites: the total femur (TF), femur neck (FN), and lumbar spine (LS). The number of teeth present was categorized into four groups (≤10, 11–20, 21–25, and ≥26 teeth). ResultsMore remaining teeth were significantly associated with a higher BMD at the TF, FN, and LS in postmenopausal women after adjusting for all the covariates, but not in elderly men. In both sexes, subjects with a normal BMD tended to have more remaining teeth than those who were diagnosed with osteopenia and osteoporosis. A lower prevalence of osteoporosis was also significantly associated with more remaining teeth (number of teeth ≥26) in postmenopausal women. This trend was statistically significant in osteoporosis at the FN (p for trend=0.019). ConclusionThe number of remaining teeth was associated with osteoporosis, especially at the FN, in postmenopausal women.

Association between fat mass, lean mass, and bone loss: the Dubbo osteoporosis epidemiology study

Lower body fat mass is a risk factor for bone loss at lumbar spine in postmenopausal women, but not in men. Body lean mass and fat mass were not associated with femoral neck bone loss in either gender. Bone density and body mass are closely associated. Whole body lean mass (LM) and fat mass (FM) together account for approximately 95 % of body mass. Bone loss is associated with loss of body mass but which of the components of body mass (FM or LM) is related to bone loss is not well understood. Therefore, in this study, we sought to assess whether baseline FM or LM has predictive value for future relative rate of bone mineral density (BMD) changes (%/year). The present population-based cohort study was part of the ongoing Dubbo Osteoporosis Epidemiology Study (DOES). BMD, FM, and LM were measured with dual energy X-ray absorptiometry (GE-LUNAR Corp, Madison, WI). BMD measurements were taken in approximately every 2 years between 2000 and 2010. We only included the participants with at least two BMD measurements at the femoral neck and lumbar spine. In total, 717 individuals (204 men and 513 women) aged 50 years or older were studied. Rate of bone loss at femoral neck and lumbar spine was faster in women than in men (all P < 0.01). In bivariable regression analysis, each 5 kg greater FM in women was associated with 0.4 %/year (P = 0.003) lower bone loss at lumbar spine. This magnitude of association remained virtually unchanged after adjusting for LM and/or other covariates (P = 0.03). After adjusting for covariates, variation of FM accounted for ∼1.5 % total variation in lumbar spine bone loss. However, there was no significant association between FM and change in femoral neck BMD in either men or women. Lower FM was an independent but modest risk factor for greater bone loss at the lumbar spine in women but not in men. If further studies confirm our findings, FM can help predict lumbar spine bone loss in women.

Relation of serum 25 hydroxyvitamin D levels to bone mineral density in southern Chinese postmenopausal women: A preliminary study.

Background & objectives:Vitamin D insufficiency is prevalent in postmenopausal women and has been related to low bone mineral density (BMD). However, controversial results have been reported for the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and BMD. This study was done to investigate whether serum 25(OH)D levels were associated with BMD in postmenopausal women living in Guangzhou in southern China.Methods:This cross-sectional study involved 119 asymptomatic postmenopausal women, aged 48-85 yr, who were consecutively selected from Guangzhou city. BMD was measured at the lumbar spine and femoral neck. The correlation between serum 25(OH)D levels and BMD wes investigated.Results:With increasing serum 25(OH)D levels categorized as <20, 20-30, and ≥30ng/ml, the PTH levels decreased gradually (P=0.031). Bivariate correlation analyses showed an inverse relationship between serum 25(OH)D and PTH levels after controlling for age and BMI (r=-0.209, P=0.023). Although subjects with vitamin D<30 ng/ml had significantly lower BMD, age- and BMI-adjusted serum 25(OH)D was weakly correlated with BMD at femoral neck (r=0.185, P=0.045), and not at lumbar spine (r=0.172, P=0 0.063). In multiple regression analyses, serum 25(OH)D was a predictor for BMD at femoral neck (R2=0.424). However, serum β-CTX was a determinant for BMD at lumbar spine (R2=0.361).Interpretation & conclusions: Serum 25(OH)D levels showed a positive correlation with BMD at femoral neck and serum β-CTX levels were inversely correlated with BMD at lumbar spine in postmenopausal women. Further studies are needed to elucidate the clinical impact of these findings.

Relationship of adiposity to bone volumetric density and microstructure in men and women across the adult lifespan

Recent evidence suggests that adipose tissue may negatively impact bone health, challenging the traditional paradigm that increased fat mass, through mechanical loading or endogenous estrogen production, is beneficial to the skeleton. We hypothesized that it is primarily the visceral compartment of body fat that is detrimental to bone metabolism, resulting in impaired bone density and architecture. In an age-stratified population sample of 218 women and 291 men (age 20–97years), we assessed visceral (VAT) and subcutaneous (SAT) adipose tissue areas at the L2–L3 interspace level by single slice quantitative computed tomography (QCT) and measured total body fat mass (TBF) by dual-energy X-ray absorptiometry. We then correlated these findings with volumetric bone mineral density (vBMD) at the femoral neck (FN) and lumbar spine (LS) assessed by central QCT, and with vBMD and microstructural parameters at the ultradistal radius (UDR) by high resolution peripheral QCT (HRpQCT). In unadjusted analyses in postmenopausal women, TBF and SAT were positively correlated with total, trabecular, and cortical vBMD at the FN, LS, and UDR and with trabecular microstructure at the UDR. By contrast, VAT was not correlated with vBMD at the FN or LS but was positively correlated with UDR total and trabecular vBMD but not cortical vBMD. Adjustment for age or for bioavailable estradiol and testosterone levels reduced these correlations, while adjustment for body weight eliminated most positive associations. Assessment of the VAT/SAT ratio, however, demonstrated a negative relationship with vBMD at the FN and LS in postmenopausal women, a relationship eliminated when adjusted for age. Correlations between skeletal parameters and adipose measurements in pre-menopausal women and older men were weaker and mostly non-significant. In younger men, VAT was negatively associated with vBMD, cortical thickness, and trabecular microstructure at the UDR, and with LS vBMD and FN cortical vBMD. These associations generally remained after adjustment, with some negative associations (e.g. UDR cortical area) being accentuated. Similar results were found when the VAT/SAT ratio was correlated with FN vBMD in younger men; in contrast, VAT/SAT was positively correlated with FN vBMD in older men and this relationship was strengthened by age-adjustment. Together, our data suggest that adiposity has associations with bone that are age-, gender-, menopausal status-, adipose depot-, and bone compartment-specific. These novel observations warrant further investigations to establish any causal relationships.

Effect of 6 months of whole body vibration on lumbar spine bone density in postmenopausal women: a randomized controlled trial

BackgroundThe issue of osteoporosis-induced fractures has attracted the world’s attention. Postmenopausal women are particularly at risk for this type of fracture. The nonmedicinal intervention for postmenopausal women is mainly exercise. Whole body vibration (WBV) is a simple and convenient exercise. There have been some studies investigating the effect of WBV on osteoporosis; however, the intervention models and results are different. This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density (BMD) of the lumbar spine in postmenopausal women.MethodsThis study randomized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial. The WBV group received an intervention of high-frequency (30 Hz) and high-magnitude (3.2 g) WBV in a natural full-standing posture for 5 minutes, three times per week, at a sports center. Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention.ResultsSix months later, the BMD of the WBV group had significantly increased by 2.032% (P=0.047), while that of the control group had decreased by 0.046% (P=0.188). The comparison between the two groups showed that the BMD of the WBV group had increased significantly (P=0.016).ConclusionThis study found that 6 months of high-frequency and high-magnitude WBV yielded significant benefits to the BMD of the lumbar spine in postmenopausal women, and could therefore be provided as an alternative exercise.

Thyroid function and bone mineral density among Indian subjects

Background:Thyroid hormones affect bone remodeling in patients with thyroid disease by acting directly or indirectly on bone cells. In view of limited information on correlation of thyroid function with bone mineral density (BMD) in euthyroid subjects, we undertook this study to evaluate the correlation between thyroid function with BMD in subjects with normal thyroid function and subclinical hypothyroidism.Material and Methods:A total of 1290 subjects included in this cross sectional study, were divided in Group-1 with normal thyroid function and Group-2 with subclinical hypothyroidism. Fasting blood samples were drawn for the estimation of serum 25(OH)D, intact parathyroid hormone, total and ionized calcium, inorganic phosphorus, and alkaline phosphatase. BMD at lumbar spine, femur, and forearm was measured.Results:BMD at all sites (radius, femur, and spine) were comparable in both groups. There was no difference in BMD when subjects were divided in tertiles of TSH in either group. In group-1, FT4 and TSH were positively associated with BMD at 33% radius whereas FT3 was negatively associated with BMD at femoral neck in multiple regression analysis after adjustment for age, sex, BMI, 25(OH)D and PTH levels. In group-2, there was no association observed between TSH and BMD at any site. Amongst all study subjects FT4 and FT3 were positively correlated with BMD at lumbar spine and radius respectively among all subjects.Conclusion:TSH does not affect BMD in euthyroid subjects and subjects with subclinical hypothyroidism. Thyroid hormones appear to have more pronounced positive effect on cortical than trabecular bone in euthyroid subjects.

Which Method is More Efficient in Determining Osteoporosis, QUS or DEXA?

Dear Editor, We read with much interest the recently published article, “Effects of Raloxifene on Bone Metabolism in Hemodialysis Patients With Type 2 Diabetes,” by Saito et al (1). First, we would like to congratulate the authors. We wish to share a few scientific facts related to this interesting article. It was a pleasure to inform from this article that no difference was observed in BMD (bone mineral density) changes between patients with diabetes and nondiabetics after using raloxifene one year long. We have previously shown that the effects of low dose HRT and raloxifene on BMD at the lumbar spine and hip sites and biochemical markers of bone turnover in a randomized trial (2). In our study, the bone mineral density measurements with dual energy Xray absorptiometry (DEXA) method is accepted by the WHO as the gold standard for the diagnosis of osteoporosis. Satoi et al. proposed the SOS value has been shown to be significantly and positively correlated with lumbar BMD in the general population using methods such as DEXA in Patients and Methods section (1, 3). Quantitative calcaneal ultrasound has several potential advantages, including relatively low cost, no need for ionizing radiation, compact size, and ease of use. These advantages would make Quantitative calcaneal ultrasound an ideal screening tool if it can be shown to be an accurate indicator of skeletal density and fracture risk (4). The BMD measurement is accepted by the WHO as the gold standard for the diagnosis of osteoporosis. In another study, we have found a poor to moderate correlation between Quantitative ultrasound parameters (BUA, SOS, SI) and femoral and spinal BMD in pre and postmenopausal women (5). Tuna et al also reported, that the diagnostic value of tibial SOS did not seem to be high for discriminating between normal and low BMD at the femur and lumbar spine in postmenopausal women (6). I think that their results would be more precise if the authors’ preferred DEXA in spite of the measurement of calcaneal quantitative ultrasound parameters (SOS). We appreciate the authors and editor for publishing an important clinical article that may be beneficial to clinicians.