Lunar DPX Research Articles

Effect of Hypertension on Bone Mineral Density of Patients with Rheumatoid Arthritis.

Patients with rheumatoid arthritis (RA) are associated with low bone mineral density (BMD). Chronic comorbidities such as type II diabetes mellitus have shown to affect BMD parameters in patients with RA. Hypertension (HT) is a chronic disease and its coexistence with RA can alter bone health. The aim of this study was to investigate if HT affected BMD parameters in RA patients diagnosed for the first time. Patients with the diagnosis of RA who underwent BMD studies formed the study population. Patients with HT were sorted from this population and formed a separate group. Healthy controls were drawn from subjects who came for a check-up. BMD was done with the GE Lunar DPX machine. Mean T Scores at spine, femur neck and total femur were recorded. Data from the three groups were analysed and compared. Linear regression analyses were performed. Analysis suggested that the age had inverse and BMI had direct correlation with BMD T scores in all groups. The additional diagnosis of HT in RA patients was associated with higher BMD as compared to patients with RA, but lower than controls. R2 values were 0.341, 0.402 and 0.436 for mean T scores at spine, femur neck and femur total respectively. Figures from multiple regression analysis suggest that BMI alone did not explain the higher T score values in HT patients. Additional morbidity of HT in RA patients negates the porotic effect of RA as judged by bone densitometry. Hence, BMD reports should be read with caution in these patients.

Effect of hormone replacement therapy on intervertebral disc height

Objective Intervertebral discs act as shock absorbers, thereby helping to reduce the risk of vertebral body fractures. Previous studies have shown that estrogen loss following menopause is associated with disc height reduction whereas treatment with hormone replacement therapy (HRT) helps to maintain disc height. This study reports the effect of HRT on disc height from a post hoc analysis of a prospective randomized clinical trial of the effect of HRT on bone density. Methods A total of 355 healthy postmenopausal women aged (mean ± standard deviation) 55.4 ± 4.8 years were randomized to HRT with oral 1 mg or 2 mg estradiol plus dydrogesterone or placebo. Dual-energy X-ray absorptiometry measurements (Lunar DPX) were obtained at baseline and following 2 years of treatment. Intervertebral disc height was measured in discs between T12 and L3 using the bone densitometer ruler. Results Compared with baseline, treatment with HRT resulted in a significant increase in total disc height with 1 mg estradiol (0.16 ± 0.65 cm, p = 0.015) and with 2 mg estradiol (0.21 ± 0.86 cm, p = 0.006) whilst there was no significant increase with placebo (0.13 ± 0.65 cm, p = 0.096). Between-group differences were not statistically significant. Conclusions These results are consistent with previous findings of a beneficial effect of estrogen on discs. This may be in part responsible for the anti-fracture efficacy of HRT on vertebral fractures.

Fracture risk and fracture prevalence in women from outpatient osteoporosis clinic and subjects from population-based sample: A comparison between GO Study and RAC-OST-POL cohorts.

The method of recruiting the study subjects is an important element of the study design. It can have a strong influence on the results. Different recruitment schedules can give a different picture of the studied phenomenon. The aim of the study was to compare bone health in a group of female patients treated for osteoporosis with a population-based sample. A cohort of women from GO Study from 1 outpatient osteoporotic clinic (n = 1442, mean age 65.8 ±6.7 years) and population-based female sample of RAC-OST-POL Study (n = 963, mean age 65.8 ±7.5 years) were studied. Mean age did not differ between groups. Mean weight, height and body mass index (BMI) in subjects from GO Study and RAC-OST-POL Study were 69.5 ±13.1 kg, 157.8 ±6.1 cm and 27.9 ±5.1 kg/m2, and 74.2 ±13.7 kg, 156.0 ±6.0 cm and 30.5 ±5.4 kg/m2, respectively, and differed significantly (p < 0.0001 for each variable). Data on clinical risk factors for osteoporosis and fractures were collected. Bone densitometry at hip was performed using a Prodigy or Lunar DPX device (GE Healthcare, Waukesha, USA). Fracture risk was established using FRAX, Garvan and POL-RISK. Mean values of T-score for femoral neck in subjects from GO Study and RAC-OST-POL Study were -1.67 ±0.91 and -1.27 ±0.91 and differed significantly (p < 0.0001). In GO Study and RAC-OST-POL Study, there were 518 (35.9%) and 280 (29.1%) subjects with fractures, respectively. The fracture frequency was significantly higher in the GO Study group (p < 0.001). Among clinical risk factors, only rheumatoid arthritis (p < 0.0001) secondary osteoporosis (p < 0.0001) and falls (p < 0.0001) were more frequent in RAC-OST-POL Study. Fracture risk established using FRAX, Garvan and POL-RISK calculators was significantly greater in patients enrolled in the GO Study than in subjects from the RAC-OST-POL population-based sample (p < 0.0001 for each variable). Differences noted between female patients treated for osteoporosis and population-based sample, especially in regard to fracture risk, reveal a strong influence of recruitment criteria on study results in the field of bone health and osteoporosis.

P013 Serum osteoprotegerin and RANKL in patients with Juvenile Idiopathic Arthritis and their correlation with bone mineral density

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic arthropathy of childhood and is associated with low bone mass, and may hasten the onset of osteoporosis later in life1. Bone loss occurs because of an imbalance between osteoclasts-activating factors like receptor activator of nuclear factor-κB ligand (RANKL) and its inhibitor osteoprotegerin (OPG) 2. Dual energy X-ray absorptiometry (DXA) is the preferred method for measuring bone mineral density (BMD) in children and to identify and follow individuals at risk for fracture 3. The objective is the Evaluation of serum levels of osteoprotegerin and RANKL and their correlation with BMD in JIA patients. Methods Forty JIA patients (according to the revised classification criteria of ILAR) and 40 healthy children individually matched for age, sex and race were included in this study. Children excluded from the study were those with primary and secondary causes of osteoporosis (such as chronic illness). All patients were assessed clinically by: age, sex, body mass index, type of JIA, disease duration and disease activity (by Juvenile Arthritis Disease Activity Score; JADAS 10). The functional disability was assessed by the Childhood Health Assessment Questionnaire (CHAQ). Blood samples were collected from JIA patients and healthy controls to determine serum levels of OPG and RANKL by ELISA. DXA scans were done using GE Healthcare Lunar DPX, Madison, Wisconsin. Bone mineral density of the L1-L4 lumbar spine and total body less head (TBLH) was evaluated in g/cm2 and expressed as Z score for age, sex according to the reference data given for this equipment. Results The study included 40 patients (25 females) with a mean age of 11.14 years and median disease duration of 2.5 years. As regard JIA type, 45% of patients were oligoarticular, 32.5% were polyarticular, and 22.5% were systemic JIA. Median JADAS 10 was 13.95. Patients (especially polyarticular JIA) had significantly higher serum RANKL levels and lower serum OPG and OPG/RANKL ratio when compared with controls (with p-value &amp;lt;0.001, 0.032 and &amp;lt;0.001 respectively). A diagnosis of low BMD (BMD Z-score ≤ -2) was given in 25% of patients (15% polyarticular and 10% systemic) by DXA of lumbar spine, and 20% (10% polyarticular and 10% systemic) by DXA of TBLH. On the other hand, no patient was given a diagnosis of osteoporosis (BMD Z-score ≤ -2 and a significant fracture history). Low BMD at lumbar spine and TBLH was negatively correlated with serum RANKL while positively correlated with OPG/RANKL ratio. Moreover, low BMD at lumbar spine was positively correlated with serum OPG level Conclusion High RANKL and low OPG levels appear to be associated with low bone mass in JIA patients. Patients with JIA (especially polyarticular and systemic subtype) are at increased risk of low bone mineral mass. Disclosure of Interests None declared

Effect of type 2 diabetes mellitus on bone mineral density in patients with rheumatoid arthritis

Background: RA affection of bone manifests as low bone mineral density (BMD), generalised osteoporosis and increased risk of fragility fractures. Whereas, Type 2 Diabetes Mellitus (T2DM) produces many micro and macro vascular complications, its effects on bone and bone density is not very clear. The effect of coexistent RA and T2DM on BMD has not been well studied. Objective: The aim of this study was to investigate the effect of T2DM on BMD in patients with newly diagnosed RA. Methods: Patients diagnosed as RA were assigned to undergo BMD testing. Patients with T2DM were gathered from this population and formed a separate group. Healthy controls were drawn from subjects who came for a check-up. BMD was done with the GE Lunar DPX machine. Mean T Scores at spine, femur neck and total femur were recorded. Multivariate analysis was performed to compare T scores at various sites in the 3 groups. Age, gender, and steroid use were checked as confounding factors. Results: A total of 449 patients were diagnosed as RA during the period of 48 months. Of these, 337 (M-56, F-321) diagnosed as RA who had their BMD examined were enrolled in the study. Five hundred and one (M-248, F-253) healthy controls were enrolled. The mean T score values at femur neck, femur total and spine were -1.2+0.9, -0.8+1, -1.2+1.3 for controls, -2.4+0.8, -2.2+0.9, -2.9+0.9 for patients with RA and -1.7+1, -1.3+1, -1.7+1.2 for patients with RA+T2DM. The T scores at all sites in patients with additional T2DM were significantly better than those with only RA but significantly less than compared to controls. Similar results were obtained when separate analyses were done for males and females. Conclusion: Coexisting T2DM partly negates the low BMD measures and present with significantly higher values as compared to RA alone. In patients with this co morbidity, the BMD measures should be read with caution. With increasing evidence of diabetics having higher fragility fracture risk, measures other than the standard BMD need to be investigated which can quantify the exact fracture risk in patients with RA and T2DM.

Bone Mineral Metabolism During Chemotherapy in Childhood Acute Lymphoblastic Leukemia.

The aim of this study was to evaluate levels of vitamin D, bone mineral density (BMD), and radiograph features at diagnosis and after 6 months of chemotherapy in patients with acute lymphoblastic leukemia (ALL). Vitamin D levels were also correlated with BMD and radiograph features. 25-Hydroxy vitamin D [25(OH)D] levels, BMD, and radiograph features were assessed in 50 newly diagnosed patients of ALL in the age group of 2 to 14 years. A total of 30 age-matched and sex-matched children were recruited as controls. Vitamin D deficiency was defined as 25(OH)D <10 ng/mL, Vitamin D insufficiency as 10 to 29 ng/mL, and Vitamin D sufficiency as ≥30 ng/mL. Enzyme immunoassay (EIA) was used for the quantitative measurement of 25(OH)D levels in plasma and a LUNAR DPX NT bone densitometer was used for the assessment of BMD. The mean age of the patients was 6.3 years, with a male:female ratio of 1.38:1. The mean 25(OH)D levels were 31.90±16.90 ng/mL in patients at diagnosis against 41.63±20.50 ng/mL in controls (P=0.02). Levels were 18.50±11.10 ng/mL postchemotherapy (P=0.00). Female sex was a risk factor for deficient 25(OH)D levels. There was a significant decrease in BMD postchemotherapy in the age groups of 5 to 10 and above 10 years at the femoral neck. Osteopenic changes were observed in more number of patients after 6 months of chemotherapy. There was a significant correlation between vitamin D levels, BMD, and osteopenic changes. Vitamin D deficiency was common among ALL patients, which worsened after chemotherapy. This had a significant correlation with BMD and osteopenic changes in radiograph.

AB0097 TISSUE CYTOKINES AS NEW DIAGNOSTIC BIOMARKER OF BONE METABOLISM DISORDERS IN RHEUMATOID ARTHRITIS

Background:Bone mineral density and proteins/peptides determination in blood and urine as markers of bone resorption and formation are currently used to diagnose osteoporosis (OP) and metabolic bone diseases. Recent evidence suggests that in RA changes in the secretion of hormones of white adipose tissue can be revealed [1,2,3,4].Objectives:To study the clinical and diagnostic value of serum fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin determination in RA patients complicated by OP.Methods:We examined 88 women with documented diagnosis of RA and mean disease duration of 6.56±0.88 years. We used EULAR/ARA 2010 criteria to diagnose the patients. Female patients with II degree of disease activity (DAS28), Steinbrocker stage II (erosive), rheumatoid factor- and anti-cyclic-citrullinated peptide antibody-positive were prevalent. We excluded patients who had surgery or developed an infection within the last 8 weeks, pregnant and breast-feeding women, those with severe heart, liver or kidney disease, immune deficiency, leukopenia or chronic infection.A control group of 45 healthy females aged of 25 and 59 years were included in the study. There were no reported findings of joint pain and RA symptoms in the group. The groups were adjusted for age (p&gt;0.05) and showed no statistically significant differences.We measured serum fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin levels (µg/ml) using ELISA commercial test systems. We used spectrophotometer with wavelength of 450 nm to detect the test results («Multiskan» immunoenzyme analyzer, Finland). We plotted a curve using computer software. We diagnosed OP using dual-energy X-ray absorptiometry with LUNAR DPX PRO (GE, USA).Results:At the first stage, the level of pro-inflammatory cytokines was studied in a group of healthy individuals. Then, the reference values of these indicators were measured as М ± 2δ. Patients with OP and RA had significantly higher levels of serum pro-inflammatory cytokines (р&lt;0.001). For example, mean serum Adiponectin levels in RA patients who had normal bone density and had no OP were 35.21±0.6 µg/ml. Mean serum Adiponectin levels in RA/OP patients with low bone mineral density were 52.42±0.69 µg/ml. Adiponectin levels of 44 µg/ml and higher were associated with osteoporosis. Adiponectin levels of 43.9 µg/ml and lower were associated with normal bone density. Other pro-inflammatory cytokines have demonstrated similar dynamics of level serum.Conclusion:Thus, we revealed that fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin levels depend on osteoporosis presence in RA patients. The test may be used to reduce the risk of low-energy fractures and to improve the quality of life in RA.

AB0079 ANGIOPOETIN-LIKE PROTEIN TYPE 3 AS AN INDICATOR OF RHEUMATOID INFLAMMATION AND RESORPTION OF BONE TISSUE IN RHEUMATOID ARTHRITIS

:Objectives:to study the role of type 3 angiopoietin-like protein (ANGPTL3) in the development of osteoporotic processes associated with inflammation in rheumatoid arthritis (RA).Methods:88 patients with RA were examined (women - 100%, average age - 54.2 ± 12 years old, disease duration - 11.2 ± 8.7 years, positive for rheumatoid factor (RF-IgM) - 72.7%, positive for anti-citrullinated protein antibody (ACPA) - 67%), DAS28 activity: remission - 21.6%, minimal - 11.4%, medium - 59.1%, high - 7.9%.), functional class: 0 - 1.1%, I - 25%, II - 65.9%, III - 8%). The study was conducted on a bone X-ray densitometer LUNAR DPX (GE, USA). Most of the patients (96.6%) were residents of cities, and 67 (76.1%) people lived in the metropolis (number of inhabitants more than 1 million people).The concentration of ANGPTL3 in serum was determined by enzyme immunoassay using a commercial test system “Human Angiopoietin-like Protein 3 ELISA” (“Bio Vendor”).Results:Osteoporosis is found in 52 (59%) people. Increased ANGPTL3 values (&gt; 445 ng / ml) were determined in 80.7% of cases. A significant positive correlation was found between the level of ANGPTL3 and the age of patients (r = 0.23, p = 0.032), the functional class (r = 0.214, p = 0.046), the presence of osteoporosis (r = 0.36, p = 0.039), living in the metropolis (r = 0.214, p = 0.046) and smoking (r = 0.31, p = 0.036), as well as a negative relationship with the duration of walking per day (r = -0.314, p = 0.003) and weekly (r = - 0.319, p = 0.002) was determined. The level of ANGPTL3 correlated with the activity of RA calculated by the DAS28-CRP index (p = 0.037), but not by the DAS28-ESR index (p = 0.135).It is noteworthy that ANGPTL3 is closely related to changes in bone mineral density (BMD) in the femoral neck (BMD Total: r = -0.33, p = 0.042; BMD Troch: r = -0.36, p = 0.038; BMD Wards: r = -0.44, p = 0.009), but not in the spine (L1-L4) (p&gt; 0.05). The lack of connection of ANGPTL3 with ACPA (p = 0.128) may indicate different mechanisms of influence on systemic BMD in patients with established RA.Conclusion:ANGPTL3 can be used as an indicator of pathological processes associated with rheumatoid inflammation and the development of osteoporosis. Living in a metropolis, smoking and low physical exertion has an additional negative effect on resorptive processes in bone tissue in women with active RA.Disclosure of Interests:None declared

Skeletal system evaluation using RTG absorptiometry in women with bone mineral density disorders.

IntroductionOsteoporosis is a metabolic disease of the skeleton, characterized by decreased bone mass and abnormal microarchitecture, which contribute to an increased risk of fractures. Currently, over 200 million people are struggling with it worldwide, and therefore it is considered a social disease. Many of the affected require constant help from others, which is often associated with an increase in the cost of health care.Aim of the studyTo analyze the role of prophylaxis in the improvement of bone mass density and the evaluation of various methods of treating bone mineral density (BMD) disorders in women.Material and methodsThe cohort study includes retrospective analysis of 105 patients documentation which were examined using the DXA densitometric method (Dual Energy X-Ray Absorptiometry) using LUNAR DPX equipment. The test results were given in g/cm2 and presented using a T-score (SD average result for peak bone mass in young healthy women) and Z-score (SD mean score for the same group of women). The study included only women with BMD disorders. The analysis, the evaluation and statistical analysis are presented in Microsoft Excel, 2010. The bioethical commission agreement was not needed in this case.ResultsThe largest group (55 surveyed patients) – 52.4%, were women suffering from osteoporosis. Decreased BMD was less common in patients living in urban areas. Among patients who suffered from osteoporosis, severe bone pain in the whole body occurred most often.ConclusionsIn Polish society, the incidence of osteoporosis is increasing. The main reason is the aging of the population. The number of fractures associated with this ailment increases after the age of 60. Analyzing the methods of treatment and assessing their effects on the reduced density of bone mass shows that the process of bone tissue disorders has deepened in non-treated patients.

FRI0514 NEW DIAGNOSTIC BIOMARKER OF BONE TISSUE METABOLISM DISORDERS IN RHEUMATOID ARTHRITIS

Background Bone mineral density and proteins/peptides determination in blood and urine as markers of bone resorption and formation are currently used to diagnose osteoporosis (OP) and metabolic bone diseases. However, these methods have some disadvantages for bone turnover evaluation. Recent evidence suggests that in RA changes in the secretion of hormones of white adipose tissue can be revealed [1,2,3,4]. One of them is Adiponectin possessing anti-inflammatory, anti-diabetic and anti-atherogenic properties. Changes in Adiponectin levels may reflect influence of immune inflammation on bone turnover. Objectives To study the clinical and diagnostic value of serum Adiponectin determination in RA patients complicated by OP. Methods We examined 88 women with documented diagnosis of RA and mean disease duration of 6.56±0.88 years. We used EULAR/ARA 2010 criteria to diagnose the patients. Female patients with II degree of disease activity (DAS28), Steinbrocker stage II (erosive), rheumatoid factor- and anti-cyclic-citrullinated peptide antibody-positive were prevalent. We excluded patients who had surgery or developed an infection within the last 8 weeks, pregnant and breast-feeding women, those with severe heart, liver or kidney disease, immune deficiency, leukopenia or chronic infection. A control group of 45 healthy females aged of 25 and 59 years were included in the study. There were no reported findings of joint pain and RA symptoms in the group. The groups were adjusted for age (p>0.05) and showed no statistically significant differences. We measured serum Adiponectin levels (μg/ml) using Human Adiponectin ELISA commercial test systems (BioVendor, Czech Republic, cat № RD195023100). We used spectrophotometer with wavelength of 450 nm to detect the test results («Multiskan» immunoenzyme analyzer, Finland). We plotted a curve using computer software. We diagnosed OP using dual-energy X-ray absorptiometry with LUNAR DPX PRO (GE, USA). Results Serum adiponectin levels in the control group were 12.5±0.9 μg/ml (M±m). Adiponectin levels in healthy subjects measured as M ± 2δ, ranged between 0.44 and 24.56 μg/ml. Patients with OP and RA had significantly higher levels of serum Adiponectin (p Conclusion Thus, we revealed that Adiponectin levels depend on osteoporosis presence in RA patients. We suppose that Adiponectin determination may be useful laboratory marker for OP diagnosis. The test may be used to reduce the risk of low-energy fractures and to improve the quality of life in RA.

A Cross-Calibration Study of GE Lunar iDXA and GE Lunar DPX Pro for Body Composition Measurements in Children and Adults

To cross-calibrate dual energy X-ray absorptiometry machines when replacing GE Lunar DPX-Pro with GE Lunar iDXA. A cross-sectional study was conducted in 126 children (3-19 years) and 135 adults (20-66 years). Phantom cross calibration was carried out using aluminum phantom provided with each of the machines on both machines. Total body less head (TBLH), lumbar spine (L2-L4) and left femoral neck bone mineral density (BMD), bone mineral content (BMC), and bone area were assessed for each patient on both machines. TBLH lean and fat mass were also measured. Bland-Altman analysis, linear regressions, and independent sample t test were performed to evaluate consistency of measurements and to establish cross-calibration equations. iDXA measured 0.33% lower BMD and 0.64% lower BMC with iDXA phantom as compared to DPX-Pro phantom (p < 0.001). In children, TBLH-BMC, femoral BMC and area were measured 10%-14% lesser, TBLH area was higher by 1%-2% and L2-L4 area by 10%-14% by iDXA as compared to DPX-Pro. iDXA measured higher TBLH fat [15% (girls), 31% (boys)] than DPX-Pro. In adults, TBLH-BMD (1.7%-3.4%), BMC (6.0%-10.9%) and area (4.2%-7.6%) were measured lesser by iDXA than DPX-Pro. L2-L4 BMD was higher [2.7% (men), 1.8% (women)] by iDXA than DPX-Pro. Femoral BMC was 2.11% higher in men and 4.1% lower in women by iDXA as compared to DPX-Pro. In children, R2 of cross-calibration equations, ranged from 0.91 to 0.96; in adults, it ranged from 0.93 to 0.99 (p < 0.01). After the regression equations were applied, differences in BMD values between both machines were negligible. A strong agreement for bone mass and body composition was established between both machines. Cross-calibration equations need to be applied to transform DPX-Pro measurements into iDXA measurements to avoid errors in assessment. This study documents a need for use of cross-calibration equations to transform DPX-Pro body composition data into iDXA values for clinical diagnosis.

What happens to bone mineral density, strength and body composition of ex-elite female volleyball players: A cross sectional study

Summary Background and aim Bone Mineral Density (BMD) and effects of exercise have been extensively studied for prevention and treatment. However, little is known as what happens to body composition, bone, and strength in a long period of time after quitting. The aim of this study was to compare BMD of ex-elite volleyball players (Ex-eVP) and sedentary women (SW) at the age of 40 and over regarding to their body composition, muscle strength. Materials and methods Thirty-three Ex-eVP and 33 sedentary women SW volunteers at the ages of 40 and over participated in the present study. BMD was measured by Dual Energy X-Ray Absorptiometry (DXA, Lunar Model DPX). Body composition compartments were obtained from total body scans. Takei Physical Fitness Test Dynamometers were used to measure subjects’ leg, back and hand grip static strength. Results Findings revealed that all sites of BMD values of ex-eVP (except for distal forearm values) were higher than that of SW. Body composition were examined in part, body weight of ex-eVP (67.9 ± 8.3 kg) were not significantly higher than SW (65.2 ± 9.2 kg), and lean body mass were significantly higher (41.59 ± 4.96 P Conclusion Playing volleyball at young ages helps to prevent osteoporosis and/or reverse bone loss, due to the possibilities of having less age-related bone loss and/or/both achieved higher peak bone mass than that of the sedentaries, notwithstanding age-related bone loss.

Bone mineral density, vitamin D status, and calcium intake in healthy female university students from different socioeconomic groups in Turkey.

Our aims were to (1) examine the effects of different SES on BMD, vitamin D status, and daily calcium intake and (2) investigate any association between vitamin D status and BMD in female university students. A questionnaire was used to obtain information about SES, daily calcium intake, and physical activity in 138 healthy, female university students (age range 18-22years). Subjects were stratified into lower, middle, and higher SES according to the educational and occupational levels of their parents. All serum samples were collected in spring for 25-hydroxyvitamin D concentration (25OHD). Lumbar spine and total body BMD was obtained by dual-energy X-ray absorptiometry (DXA) scan (Lunar DPX series). Osteopenia was defined as a BMD between - 1.0 and - 2.5 standard deviations (SDs) below the mean for healthy young adults on lumbar spine DXA. No significant difference was found between the three socioeconomic groups in terms of serum 25OHD concentration, BMD levels, or BMD Z scores (p > 0.05). Both the daily intake of calcium was significantly lower (p = 0.02), and the frequency of osteopenia was significantly higher in girls with low SES (p = 0.02). There was no correlation between serum 25OHD concentration and calcium intake and BMD values and BMD Z scores (p > 0.05). The most important factor affecting BMD was weight (β = 0.38, p < 0.001). Low SES may be associated with sub-optimal bone health and predispose to osteopenia in later life, even in female university students.

Quality Control of Dual Energy X-Ray Absorptiometry

Dual energy X-ray absorptiometry (DXA) is a dominant technique for the measurement of bone mineral density (BMD). Quality control (QC) of DXA is very important for the accuracy of results and correct interpretation made by the physician. We have performed the quality control procedures of Lunar DPX Pro bone densitometer according to the manufacturer’s recommendations and current clinical guidelines at the Institute of Nuclear Medicine & Allied Sciences (INMAS), Khulna. The objective of this study is to maximize the performance of the technologist as well as the reliability of the equipment (Linearity, X-ray tube output, Half value layer, Kerma-area product, Radiation field size, Fan angle, Spatial resolution, Room safety). The study result shows that the mean BMD reading is 1.004 g/cm2 with a standard deviation of 0.0035 and co-efficient of variation 0.34%. It also shows that the precision of the technologist is good and there is no malfunctioning in the DXA bone densitometer.

Evaluation of Bone Mineral Density by Dual Energy X-ray Absorptiometry in Patients with Chronic Obstructive Pulmonary Disease

Introduction: Osteoporosis or low bone mass is one of the systemic effects of the chronic obstructive pulmonary disease (COPD). Fracture may occur as a complication of low bone mass in these patients that increases the morbidity. There is lack of awareness about the decreased bone mass in these patients. There is significant need to screen those patients who are at risk, so that early diagnosis can be made and preventive and or therapeutic measures can be taken to avoid the consequences of osteoporosis. Dual energy X-ray absorptiometry (DEXA) is the current gold standard for the diagnosis of osteoporosis or low bone mass. Objective: To evaluate the bone mineral density of the chronic obstructive pulmonary disease patients with dual energy X-ray absorptiometry and compare with the controls (non-COPD patients). Method: In the period of January 2010 to December 2010 a total number of 100 subjects were included in the study. Among them fifty patients were with chronic obstructive pulmonary disease and fifty apparently healthy persons without chronic lung diseases taken as comparison group controls. Bone mineral density (BMD) of lower lumber spine (L1-L4) and left femoral neck were measured by Lunar DPX pro (GE) scanner. Low BMD was defined according to World Health Organization (WHO) criteria based on T score of patients and were compared with the controls. Results: BMD was significantly low in COPD patients than in control group. At femoral neck, low BMD was found among 84% of patients with COPD and 36% of controls without COPD. At lumber spine low BMD was found among 86% of patients with COPD and 60% of patients without COPD. Conclusion: This study suggests that bone mineral density is low in chronic obstructive pulmonary disease.Bangladesh J. Nuclear Med. 18(1): 27-31, January 2015

Prevalence of metabolic syndrome markers among women at 1-year postpartum as per prepregnancy body mass index status: A longitudinal study

Introduction:Maternal body composition (BC) changes during lactation. Increased prepregnancy obesity is associated with poor obstetric outcomes. The aim was to study changes in maternal BC postpartum (PP) to 1-year PP with reference to their prepregnancy body mass index (BMI) status.Methods:The study design was a 1-year follow-up study. Sixty-five apparently healthy primiparous women (28.6 ± 3.4 years delivered full-term infants) were randomly selected from December 2010 to June 2013 and postclassified on the basis of their prepregnancy BMI status. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, and BC at total body (dual energy X-ray absorptiometry, GE, Lunar DPX) were collected using standardized protocols.Results:Forty-one women were classified in Group A with normal prepregnancy BMI (20.4 ± 2.0 kg/m2) and 24 women in Group B with overweight/obese (OW/OB) prepregnancy BMI (26.1 ± 1.9 kg/m2). At 1 year, 75% of women returned to normal BMI in Group A, whereas all 100% of women from Group B remained in OW category at 1-year PP. Nearly 43% of Group B women showed the presence of at least two metabolic syndrome risk factors as compared to 36% in Group A at 1 year.Conclusion:Women with OW/OB prepregnancy BMI accumulated higher visceral fat with a higher prevalence of metabolic risk factors at 1-year PP. Our study underlines the importance of maintaining BMI status in reference range in reproductive years.

Concurrent agreement between an anthropometric model to predict thigh volume and dual-energy X-Ray absorptiometry assessment in female volleyball players aged 14-18 years.

BackgroundA variety of performance outputs are strongly determined by lower limbs volume and composition in children and adolescents. The current study aimed to examine the validity of thigh volume (TV) estimated by anthropometry in late adolescent female volleyball players. Dual-energy X-ray absorptiometry (DXA) measures were used as the reference method.MethodsTotal and regional body composition was assessed with a Lunar DPX NT/Pro/MD+/Duo/Bravo scanner in a cross-sectional sample of 42 Portuguese female volleyball players aged 14–18 years (165.2 ± 0.9 cm; 61.1 ± 1.4 kg). TV was estimated with the reference method (TV-DXA) and with the anthropometric method (TV-ANTH). Agreement between procedures was assessed with Deming regression. The analysis also considered a calibration of the anthropometric approach.ResultsThe equation that best predicted TV-DXA was: -0.899 + 0.876 × log10 (body mass) + 0.113 × log10 (TV-ANTH). This new model (NM) was validated using the predicted residual sum of squares (PRESS) method (R2 PRESS = 0.838). Correlation between the reference method and the NM was 0.934 (95%CI: 0.880–0.964, Sy∙x = 0.325 L).ConclusionsA new and accurate anthropometric method to estimate TV in adolescent female volleyball players was obtained from the equation of Jones and Pearson alongside with adjustments for body mass.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0730-7) contains supplementary material, which is available to authorized users.

THE RISK FACTORS AND SPECIFIC FEATURES OF OSTEOPENIC SYNDROME IN PATIENTS WITH CHRONIC NON-INFECTIOUS DISEASES

Objective: to analyze the risk factors (RFs) of osteoporosis (OP), the risk of OP-related fractures, the specific features of osteopenic syndrome in patients with chronic non-infectious diseases (CNID) (coronary heart disease (CHD), hypertension, chronic obstructive pulmonary disease (COPD), and asthma). Materials and methods. The investigation enrolled 377 patients (mean age 55.3 ± 1.6 years) with CNID and 221 persons (mean age, 53.2 ± 1.3 years) who formed a control group. According to the nosological entity, the patients were divided as follows: Group 1 included 84 patients with CHD and hypertension; Group 2 comprised 99 hypertensive patients; Group 3 consisted of 70 patients with COPD; and Group 4 included 124 asthmatic patients. The examinees of all the groups were matched for age, gender, and body mass index. The investigation excluded patients with functional class IV chronic heart failure, continuous atrial fibrillation, heart valve disease, or myocardial noncoronarogenic diseases and those with other diseases and conditions that could have an independent impact on bone metabolism. Prior to the examination, the patients had received no specific therapy for the prevention and treatment of OP. RFs for OP were assessed using the one-minute test recommended by the International OP Foundation (2008); 10-year risk for OP-related fractures were calculated applying the FRAX computer program in accordance with the guidelines of the International OP Association and the World Health Organization (WHO, 2008). To investigate bone mineral density (BMD), bioenergy X-ray densitometry of the lumbar spine and proximal femur was carried out by means of a Lunar DPX apparatus (USA). The results were assessed using the t-test in standard deviations (SD) from the peak bone mass according to the WHO guidelines. Results. The RFs of OP were more frequently recorded in the patients with CNID than in the healthy individuals. RFs, such as smoking, low physical activity, and low-energy fractures, were most common in the patients with cardiovascular disease or COPD. The frequent use of glucocorticoid therapy was also an important RF in the patients with COPD. CHID considerably increased the risk of fractures in the succeeding 10 years after disease onset. The high risk of fractures, those of the proximal femur in particular, provides a rationale for the need for timely antiosteoporotic therapy in the majority of patients with CNID. The performed investigation demonstrated that the BMD values in the patients with CNID corresponded, on the average, to the osteopenia criteria; the lowest BMD values were recorded in the patients with COPD and associated cardiovascular disease. The severe course of osteopenic syndrome (a BMD decrease that was diagnostically significant for OP concurrent with fractures was observed in one-third of patients with CNID. The patients with cardiovascular disease or COPD showed a high incidence and degree of OP, which allows these diseases to be considered as a RF for decreased BMD. The long-term uncontrolled course of disease, the degree of organ and functional disorders in the patients with CNID, and concomitant use of glucocorticoid therapy contribute to a reduction in BMD. Conclusion. RFs for OP were identified in the majority of patients with CNID. The high risk of fractures due to an obvious BMD decrease in patients with CNID requires timely diagnosis, treatment, and prevention of osteopenia.

Serbian

The aim of this work was to study the effect of two modalities of antiosteoporotic therapy in postmenopausal women at the level of biochemical markers of bone turnover such as bone specific alkaline phosphatase (BALP) and deoxypiridinoline (Dpd) as well as bone mineral density (BMD). The study included 87 patients with postmenopausal osteoporosis (OP). Group A consisted of 48 patients treated with alendronate (AL), whereas group B included 39 patients treated with hormone replacement therapy (HRT). BMD was measured by Lunar DPX 2000 device, on the lumbar spine and the femur, and bone markers (BM) were measured by commercial ELISA assays. There was a statistically significant decrease in the levels of BALP and Dpd after 6 weeks and 8 months of both types of therapy compared to the level of these markers before therapy. There was a statistically significant increase of BMD on both locations after 8 months of both therapies. In addition, there was a statistically significantly higher degree of changes of Dpd values in the group treated with AL than in the group treated with HRT. On the other hand, the changes in the level of BALP were significantly higher in the group treated with HRT. We concluded that the early effect of the two studied antiosteoporotic medications can be monitored by changes in the levels of BM. Dpd as bone resorption marker proved to be a better indicator of the efficiency of applied medications compared to bone formation markers such as BALP. Acta Medica Medianae 2015;54(3):5-11.

Comparison Of Health Anthropometric Indicators According To High Density Lipoproteins Concentration

It is known that the high density lipoproteins (HDL) serum rates are little influenced by the accumulation of body fat, but the following question arises: do those with low concentrations of HDL also have worse anthropometric indicators of health risk? PURPOSE: To compare the percentage of whole body fat and trunk, waist circumference and changes in blood lipids among male subjects with HDL below or above 40 mg/dL. METHODS: The study took place with 117 young adult men. The body composition was assessed using DEXA (Dual Energy X-ray Absorptiometry) Manufacturer: Lunar Model DPX - IQ, version 4.6 software. With a tape measure the waist circumference was measured, and espectrophotometry was done to estimate blood lipids concentrations (Total Cholesterol (TC), triglycerides (TG), HDL cholesterol and low density lipoprotein (LDL) cholesterol). RESULTS: It was identified 61 males with HDL = 31.5 ± 5,3 mg/dL (G1) and 56 males with HDL = 47.9 ± 8,9 mg/dL (G2). The G1 had significantly greater waist circumference (88.27 ± 8,01 cm) vs. (84.31 ± 10,91 cm), higher percentage of trunk’s body fat (25.16 ± 8.55) vs. (20.43 ± 10.36) and whole body fat (22.16 ± 7.18) vs. (18.61 ± 9.21) and higher TG concentrations (166.21 ± 88,68 mg/dL) vs. (112 04 ± 67,64 mg/dL) and LDL concentrations (104.64 ± 35,47 mg/dL) vs. (90.37 ± 34,03 mg/dL). CONCLUSION: The G1 individuals presented a worse situation for both parameters, percentage of body fat and blood variables. This is probably due to the fact they are factors, such as physical inactivity and poor diet, that lead to the accumulation of body fat and to the disarrangement of the metabolic variables, factors that may have led to decreased HDL concentrations.