Measured Bone Mineral Research Articles

A school-based physical activity program to improve health and fitness in children aged 6-13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785

BackgroundChildhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA). However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT) aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children.Methods/Design15 schools were randomized to the intervention (n = 9) or the control (n = 6) group, stratified by geographic region (urban vs. rural) and by age (1st and 5th grade). Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2–5 min each) during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health questionnaire in the intervention group compared to the control group. Secondary outcomes were overall fitness, differences in body composition including body fat distribution, cardiovascular risk factors, psychosocial health, bone mineral content and density of femur, lumbar spine and total body and food intake.DiscussionOur preliminary data suggest that the children were representative of Swiss children with respect to sex, socio-demographic status, and body mass index. Short-term results can be expected by the beginning of 2007. We hypothesized that our intervention will lead to an increase in PA, fitness and overall health. Based on our data, we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children.

Dual-Energy X-ray Absorptiometry Measurement and Accuracy of Bone Mineral After Unilateral Total Hip Arthroplasty

The standard technique for monitoring bone mineral in hip arthroplasty has been dual-energy x-ray absorptiometry (DEXA). The accuracy of DEXA in the cortical bone adjacent to femoral components has not been established. This study evaluated bone mineral in the cortical bone adjacent to the femoral component comparing DEXA and ashing. Seven pairs of human femora from postmortem donors with unilateral hip implants were examined. Twenty-eight ashed core specimens from both the medial and lateral sides were taken. Cortical bone loss was seen to be greater in the proximal and medial regions of the implanted femora. Dual-energy x-ray absorptiometry failed to show an acceptable level of accuracy compared with ash data ( r = 0.56; P = .002). It did show relative patterns of bone loss. Bone loss was consistent with implant-induced stress shielding.

Fruit and vegetable intakes and bone mineral status: a cross-sectional study in 5 age and sex cohorts

Evidence is increasing for positive effects of fruit and vegetable intakes on bone health. However, most of the studies to date were conducted in adults, and few reports included adolescents. We explored the association between bone mineral status and fruit and vegetable intakes in adolescent boys and girls (aged 16-18 y), young women (aged 23-37 y), and older men and women (aged 60-83 y). Bone mineral measurements of the whole body, hip, and spine were made in all subjects by using dual-energy X-ray absorptiometry. Information on health and lifestyle and physical activity was obtained by questionnaire. Fruit, vegetable, and nutrient intakes were ascertained from 7-d food diaries. In adolescent boys and girls and older women, significant positive associations were observed between spine size-adjusted bone mineral content (SA-BMC) and fruit intake. In boys only, femoral neck SA-BMC was also significantly and positively associated with the intakes of both fruit and dietary vitamin C. No significant associations were found in the young women or older men, or between bone measurements and intake of vegetables alone (after adjustments) in any of the groups. Higher fruit and vegetable intakes may have positive effects on bone mineral status in both younger and older age groups, especially at the spine and femoral neck. The specific mechanisms remain to be ascertained, but vitamin C, other fruit-specific antioxidants, and lifestyle may play a role.

THE CLASSIC: Quantitative Computed Tomography of Vertebral Spongiosa: A Sensitive Method for Detecting Early Bone Loss after Oophorectomy

THE CLASSIC: Quantitative Computed Tomography of Vertebral Spongiosa: A Sensitive Method for Detecting Early Bone Loss after Oophorectomy

Is there a positive association between mammographic density and bone mineral density?

In a issue of this journal, Crandall and colleagues [1] reported a positive association between percent mammo-graphic and bone mineral at the hip and lumbar spine in postmenopausal women. These associations were only observed after excluding women who were users of hormone replacement therapy and even then were of marginal, and not independent, significance (p = 0.04 and p = 0.08, respectively). The previously reported null findings from the larger studies by Kerlikowske and colleagues [2] and Buist and colleagues [3] were discounted by Crandall and colleagues [1] for not having stratified by hormone replacement therapy use. In a publication from our twin study we found no overlap between the genetic determinants of variation in percent mammographic and bone mineral [4]. We have now analysed our data on 268 pre- and postmenopausal female twins following the approach of Crandall and colleagues [1]. We fitted linear regression models with robust standard errors that took into account the clustering within twin pairs. Percent mammographic was the outcome variable and bone mineral measures (g/cm2) were the key exposure variables. As in Crandall and colleagues [1], we adjusted for age, body mass index (weight kg/height m2) and smoking (ever/never), even though there was no evidence in our data that smoking was associated with percent mammographic density. We found no evidence of a positive association with bone mineral at the hip or lumbar spine either overall or for women who were not current or users of hormone replacement therapy (Table ​(Table1)1) and no tests of interaction between hormone replacement therapy use and bone mineral were significant. After restricting analyses to postmenopausal women and stratification by use of hormone replacement therapy, to replicate the analyses of Crandall and colleagues [1], the lack of an association persisted both for women who were past or never users and for women who were current or users. Similar results were obtained for analyses of bone mineral at the forearm and femoral neck and total body bone mineral content (data not shown). There was also no evidence that recent hormone use has residual effects that may obscure the [putative positive] association between mammographic and bone mineral density [1]. Table 1 Regression coefficients for the effect of bone mineral measures on percent mammographic density, adjusting for age, body mass index and smoking Consequently, Crandall and colleagues' [1] claims of a positive association between mammographic and bone mineral and for a unifying biological mechanism behind bone mineral density, mammographic and breast cancer risk may be overstated. Their apparent finding may be an artefact of having conducted multiple analyses, having been misled by outliers or influential points, chance or by assuming effect modification without having tested for it. It may also reflect a true association but, given others' null findings [2,3], may be weaker than reported. As we have discussed [5], the absence of a strong association between mammographic and bone mineral may be an important observation; hormonal factors may explain little of the large variation across the population in mammographic density.

Automated Bone Mineral Measurement by X-ray CT

Automated Bone Mineral Measurement by X-ray CT

Clinical value of the biochemical markers of bone remodeling in the assessment of bone metabolic diseases

Bone markers have been useful research tools, with their clinical utility limited by their specific technical and analytical aspects and pre-analytical variability. Bone markers reflect different aspects of the quality of bone than BMD and, therefore, may add an independent, predictive value to the assessment of changes in bone mineral density and reductions in the risk of fracture. The decrease in bone marker levels is strongly related to the reduction in vertebral fracture risk through raloxifene, risedronate and alendronate. After anabolic therapy with teriparatide, early increases in bone formation markers are strong predictors of BMD responses. There are potential advantages of using markers for monitoring anti-osteoporosis treatment in the short term, in addition to the bone mineral measurements, to identify non-responders or non-compliance. The transition of biochemical bone markers into everyday clinical practice requires standardization of assays and quality control programs to reduce large inter-laboratory variations of data, defining criteria of a high bone turnover in terms of reference values, either young adult or age-matched, and better characterization of the markers across geographic areas and races and under various clinical conditions.

Effect of antiepileptic medication on bone mineral measures

Long-term antiepileptic drug (AED) use has been associated with bone disease, but many previous studies have been limited by inadequate control subjects. We used a cotwin affected sib-pair model to investigate this issue. The authors studied 31 female twin (15 monozygous and 16 dizygous) and four sibling pairs (< 3 years age difference) aged 21 to 75 years, in which one member had > 12 months of AED treatment. Areal bone mineral density (ABMD, g/cm2) was measured at the lumbar spine (LS), total hip (TH), femoral neck (FN), and total forearm (FA). Three primary a priori defined subgroups were analyzed: a) use for > 2 years, b) use of enzyme-inducing AEDs, or c) age older than 40 years. For all pairs (n = 35), there were no significant within-pair differences in any ABMD measure. However, in Subgroup a (n = 27), there was a within-pair difference at the FA (0.513 vs 0.534, -3.9%, p = 0.016). In Subgroup b (n = 29), there was also a within-pair difference at the FA for AED user vs nonuser (0.508 vs 0.529, -3.8%, p = 0.010). In Subgroup c (n = 15), there were within-pair differences at the FA (0.492 vs 0.524, -6.1%, p = 0.017) and the LS (0.884 vs 0.980, -9.8%, p = 0.036). Patients using AEDs for > 2 years, in particular those taking enzyme-inducing AEDs and those older than 40 years, have significantly lower bone mineral density at clinically relevant fracture risk sites.

Bone mineral measurements of subchondral and trabecular bone in healthy and osteoporotic rabbits

Experimental models of osteoporosis in rabbits are useful to investigate anabolic agents because this animal has a fast bone turnover with predominant remodelling over the modelling processes. For that purpose, it is necessary to characterize the densitometric values of each type of bony tissue. To determine areal bone mass measurement in the spine and in trabecular, cortical and subchondral bone of the knee in healthy and osteoporotic rabbits. Bone mineral content and bone mineral density were measured in lumbar spine, global knee, and subchondral and cortical bone of the knee with dual energy X-ray absorptiometry using a Hologic QDR-1000/W densitometer in 29 skeletally mature female healthy New Zealand rabbits. Ten rabbits underwent triplicate scans for evaluation of the effect of repositioning. Osteoporosis was experimentally induced in 15 rabbits by bilateral ovariectomy and postoperative corticosteroid treatment for 4 weeks. Identical dual energy X-ray absorptiometry (DXA) studies were performed thereafter. Mean values of bone mineral content at the lumbar spine, global knee, subchondral bone and cortical tibial metaphysis were: 1934+/-217 mg, 878+/-83 mg, 149+/-14 mg and 29+/-7.0 mg, respectively. The mean values of bone mineral density at the same regions were: 298+/-24 mg/cm(2), 455+/-32 mg/cm(2), 617+/-60 mg/cm(2) and 678+/-163 mg/cm(2), respectively. Bone mineral content and bone density of healthy rabbits followed a normal distribution at the four skeletal regions studied. Precision after triplicate repositioning yielded a coefficient of variation ranging from 2.6% to 3.8%. The least significant change ranged between 7.3% and 10.7%. Bone mineral density measured at the four different skeletal regions correlated significantly. Bone mineral density in osteoporotic rabbits was significantly lower in the four regions studied than that in controls, rendering a T-score of, respectively, -2.0+/-1.1 in the lumbar spine, -2.2+/-2.1 in the global knee, -1.9+/-0.6 in the subchondral bone, and -5.7+/-3.1 in the cortical tibia (P<0.05). DXA is a reliable and precise method to evaluate the bone mass in rabbits. Our results also suggest that subchondral bone is a bone of mixed densitometric characteristics with marked cortical bone predominance.

Cross-Calibration of Lunar DPX-IQ and DPX Dual-Energy X-Ray Densitometers for Bone Mineral Measurements in Women

When dual-energy X-ray absorptiometry (DXA) instruments are replaced, it is essential to determine if systematic differences in measurements occur. As a part of the Kuopio Osteoporosis Risk Factor and Prevention study (N=14,220), a group of women, aged 36 to 69 yr underwent anteroposterior lumbar spine L2 to L4 (n=89) and proximal femur scans (n=88) by the Lunar DPX and DPX-IQ, respectively, during the same visit. A high linear association (r from 0.944 to 0.989, p<0.001) between the two scanners was established for lumbar spine and proximal femur bone mineral density (BMD). The average DPX values for BMD were 1.1% and 2.0% higher than those of DPX-IQ for the lumbar spine (p<0.001) and Ward's triangle (p=0.001), respectively. Femoral neck BMD values by the DPX were 1.4% lower (p<0.001) compared to DPX-IQ. The difference between trochanter BMD results (0.1%) was not significant (p=0.809). In the femoral neck and trochanter, but not in the lumbar spine or Ward's triangle, the differences in BMD values of the two machines were found to depend on body mass index. After linear formulas based on simple and multivariate linear regression analyses were calculated, the differences were negligible, enabling objective comparison of longitudinal measurements.

How Many Women Have Osteoporosis?

Abstract Osteoporosis is widely viewed as a major public health concern, but the exact magnitude of the problem is uncertain and likely to depend on how the condition is defined. Noninvasive bone mineral measurements can be used to define a state of heightened fracture risk (osteopenia), or the ultimate clinical manifestation of fracture can be assessed (established osteoporosis). If bone mineral measurements more than 2 standard deviations below the mean of young normal women represent osteopenia, then 45% of white women aged 50 years and over have the condition at one or more sites in the hip, spine, or forearm on the basis of population-based data from Rochester, Minnesota. A smaller proportion is affected at each specific skeletal site: 32% have bone mineral values this low in the lumbar spine, 29% in either of two regions in the proximal femur, and 26% in the midradius. Although this overall estimate is substantial, some other serious chronic diseases are almost as common. More importantly, low bone mass is associated with adverse health outcomes, especially fractures. The lifetime risk of any fracture of the hip, spine, or distal forearm is almost 40% in white women and 13% in white men from age 50 years onward. If the enormous costs associated with these fractures are to be reduced, increased attention must be given to the design and implementation of control programs directed at this major health problem.

Dual-Energy X-Ray Absorptiometry Measurements of Total-Body Bone Mineral During Weight Change

Bone mineral measurements were made using dual-energy X-ray absorptiometry during a multicenter diet trial. There were five centers, two using Hologic QDR4500 fan-beam scanners, two using Lunar Prodigy fan-beam scanners,and one using a pencil-beam Lunar DPX. Measurements were made at 0, 2.5, and 6 mo. The mean weight loss was 7.9 kg, but there was a wide range. With the Lunar instruments, the total-body bone mineral density reduced with weight loss, but with the Hologic scanners, it appeared to increase. This anomaly is similar to that observed previously with a Hologic QDR1000 pencil-beam scanner. It was shown that changes of fat distribution can lead to alterations in bone measurement without any real change in the skeleton. With all of the scanners, there was a strong correlation between the change in the bone mineral content and bone area, with some values of the latter being quite implausible. There was an associated worsening of long-term precision compared with that derived from short-term duplicated scans, more marked with the Lunar scanners. It is concluded that measurement artifacts preclude the valid assessment of total-body bone mineral during weight change.

Letters to the Editor

>The Authors' Reply: The correspondence by Drs. Ahmed and Weaver (1) addresses an important issue regarding the correct interpretation of bone mineral measurements and gives us the opportunity to discuss the matter in greater detail. A variety of non-invasive techniques are available to assess the peripheral, central, and the entire skeleton (2). Among them, dual-energy X-ray absorptiometry (DXA) and quantitative ultrasonography (QUS) are greatly influenced by the size of the bone studied and the amount of soft tissue surrounding the bone (2). In particular, bone mineral content (BMC) and bone mineral density (BMD) measurements obtained by DXA are underestimated in individuals of smaller skeletal size and overestimated in larger individuals (2). Therefore, medical conditions associated with impaired skeletal growth or with soft tissue distribution complicate the interpretation of DXA or QUS measurements. Moreover, bone dimensions are changing rapidly in children, complicating even further the already complex picture. BMC and BMD change throughout childhood and adolescence. The tempo of mineral accrual is more closely related to pubertal and skeletal maturation than to chronological age (3). Pubertal staging and bone-age assessment should thus be considered for a correct interpretation of bone mass measurements. Finally, DXA measurements are often reported as standard deviation scores (Z-scores) form age- and sex-matched control population. The use of Z-scores, mutuated from adult studies, is questionable in children, because it does not consider differences in size and skeletal maturation (2). In our review (4), we dedicated a section to the problems of bone mass measurement in pediatric subjects, and we highlighted briefly the problems related to every available technique. We agree with Drs. Ahmed and Weaver on the high prevalence of growth failure in patients with chronic inflammatory diseases. In this respect, patients with inflammatory bowel diseases, celiac disease and cystic fibrosis share common characteristics that may greatly affect the interpretation of bone mass measurements. Common errors in DXA measurements interpretations are the use of Z-scores to diagnose low bone mass, inattention to short stature, inappropriate reference database and failure to account for pubertal development or skeletal age differences (2,5). These errors lead to an over-estimation of the prevalence of low bone mass in children, as correctly asserted in the correspondence by Drs. Ahmed and Weaver (1). A recent position statement by the International Society of Clinical Densitometry suggests to avoid the use of osteopenia and osteoporosis when referring to bone mass measurements in children (6). The use of "low bone mass" when BMD is 2 SD below age- and sex-matched norms is suggested. However, it is also suggested to consider bone size and skeletal ages as important factors affecting the interpretation of DXA measurements. Careful interpretations of bone-mass measurements is certainly mandatory, especially in young patients, to avoid unnecessary psychologic stresses and avoidable treatment. In our opinion, in clinical practice results of bone mineral measurements should be evaluated after a thorough medical examination, including anthropometric assessment, pubertal staging and skeletal age determination. The help of clinicians who have a strong knowledge of the limitations of bone mass measurements is also recommended. Stefano Mora Graziano Barera Laboratory of Pediatric Endocrinology and Department of Pediatrics; Scientific Institute H S. Raffaele; Milano, Italy

Ten-year probabilities of clinical vertebral fractures according to phalangeal quantitative ultrasonography

The objectives of the present study were to estimate 10-year probabilities of clinical vertebral fractures in women, according to age and bone mineral assessment using phalangeal quantitative ultrasound (QUS). Risks were computed from UK derived data on the incidence of a first symptomatic vertebral fracture and mortality rates for each year of age using Poisson models. The 10-year probability of vertebral fracture was determined as the proportion of individuals fracture-free at that site from the age of 45 years. We assumed that the risk of fracture increased with decreasing QUS as assessed by an independent re-analysis of a previously published, multicenter cross-sectional study. For amplitude-dependent speed of sound (AD-SoS) information was available from 8,502 women, and vertebral fracture risk increased 1.7-fold for each SD decrease in measurement. For fast wave amplitude (FWA), available in 6,573 women, the risk gradient was 2.4/SD. In a subset of the population ( n =1,572) in whom bone mineral density was measured at the lumbar spine, the gradient of risk was 2.3/SD, with similar gradients of risk noted for AD-SoS (1.8/SD) and FWA (2.6/SD). Ten-year probabilities increased with age and decreasing Z -score. The use of absolute risk permits information from different types of bone mineral measurements to be applied for the assessment of patients, either alone or in combination with other independent risk factors.

Bone mass measurement in pediatrics

The methodology of the bone mineral measurement from childhood through adolescence contains a few problems. Continuously growing child shows continuous enlargement of the bone and the difference in bone size exerts ineligible effects on the DXA value. Therefore, we should be careful to evaluate the value from the point of this view. This manuscript overviewed normal bone growth and problems in bone mineral assessment during childhood and adolescence.

Bone mass and bone metabolism in pediatric gastrointestinal disorders.

Bone mass and bone metabolism in pediatric gastrointestinal disorders.

Dual-energy X-ray absorptiometry of the pig: Protocol development and evaluation

As part of a prospective study in bone mineralisation in adult pigs it was necessary to establish guidelines and to define sites for bone mineral measurements. Particular requirements were that, the protocol should be suitable for a mass screening programme in both postmortem specimens and in live animals, and should deliver results of known reliability. Estimates of bone mineral content (BMC) and bone mineral density (BMD) in areas within the 4th metacarpal bone yielded coefficients of variation (CV) in the order of 7% for both regions and estimates in regions which included the entire metacarpal–phalangeal area yielded CV values in the order of 0.7% and 0.6% for BMC and BMD, respectively. A region of interest taken from the coccygeal vertebrae yielded coefficient of variation values of 3% and 2% for BMC and BMD, respectively. Accuracy of dual-energy X-ray absorptiometry (DXA) was estimated using a standard curve derived from BMC determined by ashing. There was a high correlation between mineral content determined by DXA and by ashing ( R 2=0.99, p<0.0001). The results suggest that the regions used in this study are suitable for use in large, mass screening, prospective studies.

OLDER WOMEN WITH FRACTURES

Many older patients with fractures are not managed in accordance with evidence-based clinical guidelines for osteoporosis. Guidelines recommend that these patients receive treatment for clinically apparent osteoporosis or have bone mineral density measurements followed by treatment when appropriate. This cohort study was conducted to further characterize the gap between guidelines and actual practice with regard to bone mineral density measurement and treatment of older women after a fracture. Our purpose was to aid in the design of more effective future interventions. We identified female members of a not-for-profit group-model health maintenance organization who were fifty years of age or older and who had a diagnosis of a new fracture as defined in the study. We used administrative databases and the clinical electronic medical records to obtain data on demographics, diagnoses, drugs dispensed by the pharmacy, and the measurement of bone mineral density. The study population included 3812 women with an average age of 71.3 years. Fewer than 12% of the women had a diagnosis of osteoporosis prior to the index fracture; 10.7% had an increased risk for secondary osteoporosis and 38.8%, for falls because of a diagnosis or medication. It was found that 46.4% of the study population had been managed as specified by clinical guidelines. The patients who had been managed as specified by the guidelines were younger and less likely to have the risk factor of a weight of <127 lb (58 kg), a hip fracture, or a wrist fracture. They were also more likely to be taking steroids on a chronic basis and to have had a vertebral fracture. The percentage of women who had measurement of bone mineral density increased during the study period, from 1.3% in 1998 to 10.2% in 2001. Of the patients receiving treatment for osteoporosis, 73.6% adhered to the treatment regimen. Adherence to guidelines for evaluation and treatment for osteoporosis after a patient sustained a fracture did not improve between 1998 and 2001 despite the promulgation of evidence-based guidelines. Methods to enhance education and facilitate processes of care will be necessary to reduce this gap. It may be fruitful to target high-risk subgroups for tailored interventions for prevention of refracture.

Calcitonin load test to assess the efficacy of salmon calcitonin

Background: Monitoring treatments of osteoporosis is required to identify patients not responding to the treatment in a way that reflects mechanism of action of the antiresorption drug on bone. Neither bone mineral measurement nor the available biochemical markers of bone remodeling can be used to monitor efficacy of treatment with nasal spray salmon calcitonin (sCT) since the changes in individual patients are modest and do not exceed the least significant change. Method: The novel calcitonin load test (CLT) was developed to assess the biological response to sCT in postmenopausal osteoporotic women. The CLT is based on the time course and an extent of suppression of serum C-terminal telopeptide of types I collagen (CTX) after the intranasal and subcutaneous administration of sCT. The CLT was conducted in 30 untreated postmenopausal osteoporotic women (control group, mean age, 67.7±8.4 years), and in 120 postmenopausal osteoporotic women (mean age, 68.5±8.1 years) treated with 200 IU of sCT (Miacalcic Nasal, Novartis, Switzerland), for up to 8.4 years (mean, 3.5±2.1 years). Results: After 90 min from the intranasal administration of 400 IU of sCT, a decrease ( p<0.01) in serum CTX by 58±11% was found in the control group, and by 60±11% in 74% of the treated patients. In the remaining treated patients, the decrease in CTX did not exceed the least significant change. The number of patients not responding to the CLT increased with duration of the treatment up to 34% in patients treated for over 4 years. Of the non-responders to the nasal spray sCT, 63% failed to respond to the subcutaneous administration of 10 IU of sCT. In the treated group, a significant negative correlation has been found between the percentual changes in CTX from its baseline levels detected during the CLT, and a rate of changes in the femoral neck BMD ( p<0.01). Conclusion: The CLT can be used as a tool to identify patients that respond to administration of CT, and will profit from a continued treatment with sCT.

INFLUENCE OF ASYMMETRICAL LOADING ON SKELETAL AND SOFT TISSUE STRUCTURES

Asymmetrical loading produces a temporary functional scoliosis, but the long term effect of such weight bearing is unclear. It is also unknown whether chronic, static submaximal loading is sufficient to incite adaptive bone mineral density (BMD) or lean tissue responses. This is of concern due to the adaptive nature of bone, muscle, and connective tissue. Also of interest is the potential development of muscular strength imbalances due to external stress. PURPOSE To determine to what extent (if any), muscular and/or skeletal adaptations occur due to asymmetrical static loading. METHODS Eight healthy male commercial cameramen (44±7 yrs) underwent infrared thermographic imaging of the upper body, isometric scapular elevation strength testing, scapular and shoulder manual muscle testing, and dual energy X-ray absorptiometry (DEXA) bone mineral and lean tissue measurements. Researchers conducted two-way repeated measures ANOVA testing to determine within subject differences between loaded (right) and unloaded (left) sides of the body for upper body mean surface temperature, trunk/arm bone mineral and lean tissue content, scapular regional BMD, femoral neck BMD, and scapular elevation isometric force generation. RESULTS Participants' left sided trunk/arm lean tissue masses were significantly greater than right. (19,304±3245 vs. 18,519±3068 g, p < 0.05) No significant differences existed bilaterally for any other dependent variable. CONCLUSION Repetitive asymmetrical static loading with a hand held commercial camera was insufficient to induce adaptive bone or lean tissue changes within the loaded side of the body. However, participants did demonstrate increased lean tissue mass in the left trunk/arm region. Further research is recommended to determine whether repetitive, asymmetrical loading induces adaptive changes within the unloaded side of the body during camera carriage. Supported in part by Gatorade Sports Science Institute U.S. Student Grant Program.