Dual X-ray Absorptiometry Method Research Articles

Molecularly Imprinted Polymers: Shaping the Future of Early-Stage Bone Loss Detection-A Review.

Osteoporosis is the deterioration of bone mineral density (BMD) because of an imbalance between bone resorption and formation, which might happen due to lots of factors like age, hormonal imbalance, and several others. While this occurrence is prevalent in both genders, it is more common in women, especially postmenopausal women. It is an asymptomatic disease that is underlying until the first incidence of a fracture. The bone is weakened, making it more susceptible to fracture. Even a low trauma can result in a fracture, making osteoporosis an even more alarming disease. These fractures can sometimes be fatal or can make the patient bedridden. Osteoporosis is an understudied disease, and there are certain limitations in diagnosing and early-stage detection of this condition. The standard method of dual X-ray absorptiometry can be used to some extent and can be detected in standard radiographs after the deterioration of a significant amount of bone mass. Clinically assessing osteoporosis using biomarkers can still be challenging, as clinical tests can be expensive and cannot be accessed by most of the general population. In addition, manufacturing antibodies specific to these biomarkers can be a challenging, time-consuming, and expensive method. As an alternative to these antibodies, molecularly imprinted polymers (MIPs) can be used in the detection of these biomarkers. This Review provides a comprehensive exploration of bone formation, resorption, and remodeling processes, linking them to the pathophysiology of osteoporosis. It details biomarker-based detection and diagnosis methods, with a focus on MIPs for sensing CTX-1, NTX-1, and other biomarkers. The discussion compares traditional clinical practices with MIP-based sensors, revealing comparable sensitivity with identified limitations. Additionally, the Review contrasts antibody-functionalized sensors with MIPs. Finally, our Review concludes by highlighting the potential of MIPs in future early-stage osteoporosis detection.

14–21 éves sportolók klasszikus antropometriai és modern műszeres technikákkal becsült testzsírszázalékának összehasonlító elemzése

Currently, one of the most accurate measurements of body composition components, including the fat content of the body is based on the method of dual X-ray absorptiometry (DEXA). The application of the DEXA method in clinical setting is usually limited to the assessment of bone health status due to the device’s cost and immobile nature, therefore in sport diagnostics the body composition estimation is usually carried out with other methods, such as bioimpedance analysis or anthropometrical methods based on the measurement of body dimensions, which ensure a rapid, accurate and frequently repeatable way of examination. For our research goal we choose the comparison of the most frequently used body fat percentage estimation methods. The accuracy of the other methods in the light of the DEXA estimations is presented. Sport Sciences and Diagnostic Research Centre of the Hungarian Handball Federation coordinated the assessment of 171 young elite handball players (14–21-year-olds), whose body composition estimations were performed in the spring and summer of 2023. The preliminary analysis of body fat percentage estimates in handball players carried out with different methods showed that the rapid and cost-efficient estimations based on anthropometric skinfold measurements can substitute the body fat percentage estimation method based on the clinically acclaimed golden standard dual X-ray absorptiometry technology. Body fat percentage estimation via InBody 770 device showed significantly lower values compared to the DEXA method, however this difference was consistent, therefore body composition assessment via InBody device can serve as an alternative of monitoring personal progress and status. We also carried out examinations with a novel ultrasound technology aided by BodyMetrix device, its subcutaneous fat thickness measurement estimated accurately the skinfold thicknesses on human body, its body fat percentage estimation based the skinfold thicknesses was adequately accurate compared to the DEXA method. With the aid of available DEXA measurement results and with the aim of creating an alternative method with low instrument requirement for body fat percentage estimation, which can be used with the highest accuracy particularly considering the body composition of young elite athletes, we created a modified sport-specific body fat percentage estimation equation. Our new estimation method was based on classical anthropometric skinfold measurements, and it accurately correlated with the DEXA body fat% estimates in case of young elite handball players.

Association of bone mineral density and potential risk factors for osteoporosis in patients with severe haemophilia A.

In people with haemophilia (PWH), recurrent episodes of bleeding lead to joint deterioration and bone resorption. To date, the effects of various other factors on bone mineral density (BMD) reduction have found conflicting results. The aim of this study was to analyse the relationships between BMD, bone mineral content (BMC), and trabecular bone score (TBS) parameters based on the dual X-ray absorptiometry method (DXA) and potential risk factors for osteoporosis in patients with severe haemophilia A. Fifty-five men with severe haemophilia A, aged 18-68 years, and 59 healthy volunteer men were enrolled in this study. Densitometric-derived lumbar spine and femoral neck BMD, BMC, and TBS were measured. Blood analyses were performed for morphology parameters, liver and kidney function parameters, and viral status. Serum levels of oestradiol (E2 ), testosterone (T), dehydroepiandrosterone sulphate (DHEA-S), parathormone, and vitamin D were measured. Patients showed significantly lower BMD compared to controls (p<.003). The result below the expected range for age was nearly double (6.82%vs. 3.92%) in PWH under 50 years old compared to controls. Haemophilic patients also exhibited significantly higher vitamin D3 deficiency (p<.0001), which was strongly associated with low TBS. Additionally, low body mass index and high neutrophil/lymphocyte ratio were correlated with low BMC and BMD. This study confirms the prevalence of low BMD and BMC in patients with haemophilia in Poland. Factors that contribute to low BMD are primarily vitamin D deficiency, low BMI, high neutrophil/lymphocyte ratio, and low testosterone/oestradiol ratio.

Male and female athletes matched for maximum oxygen uptake per skeletal muscle mass: equal but still different.

We matched highly trained competitive male and female athletes using maximal oxygen uptake (V̇O<inf>2max</inf>) per kg skeletal muscle mass (SMM) to show sex differences in factors limiting V̇O<inf>2max</inf>. Thirteen highly trained male (28±3.0 yr) vs. 13 female (21.3±3.0 yr) endurance athletes and 10 male (23.9±3.8 yr) vs. 10 female sprinters (21.9±3.3 yr) performed an incremental running treadmill test until exhaustion. Main cardiorespiratory variables were measured using ergospirometry. SMM was determined using the dual X-ray absorptiometry method and a regression equation based on measured appendicular lean soft tissue. Basic hematological parameters were obtained from capillary blood samples taken before exercise. In both endurance and sprint groups, male athletes had significantly higher muscle mass (by 8-12%) and substantially lower total fat (by 55-58%). For almost all body composition indicators, the effect size of sex differences was very large (Cohens d>1.4). Male athletes obtained significantly higher values in cardiorespiratory variables (by 12-34%) and factors related to oxygen transport (9-13%). Cohens d of the revealed differences was large or very large in both groups (0.8-2.1 in sprinters and 0.8-2.3 in endurance athletes). Male and female competitive athletes having the same V̇̇O<inf>2max</inf> per kg SMM strongly differ in main factors limiting maximum oxygen uptake. These differences are more pronounced in endurance- than in sprint-trained athletes. The strongest differences are seen for body composition (fat, lean, and muscle mass) and central cardiac factors.

Beyond bone mineral density: new developments in dual X-ray absorptiometry assessment of bone quality

Bone mineral density, bone texture, bone geometry and bone strength are all elements necessary for a proper osteoporotic fragility fracture prediction assessment. Data regarding bone quantity (density) and, in part, bone quality (structure and geometry) are obtained by the gold standard method of dual X-ray absorptiometry (DXA), while data about bone strength are obtained by means of a new DXA index called the bone strain index (BSI). The BSI evaluates bone resistance by means of average strain calculation, and it is based on finite element analysis applied to DXA spine and femoral scans. The BSI includes local information on bone density distribution, bone geometry and, unlike variables of bone mineral density and bone quality such as the trabecular bone score, it represents the status of the bone in a particular loading condition. This review illustrates the methodology for calculating the BSI and discusses findings on its reproducibility and data about its capability to predict fragility fractures and monitor pharmacological treatment for osteoporosis.

Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index.

For a proper assessment of osteoporotic fragility fracture prediction, all aspects regarding bone mineral density, bone texture, geometry and information about strength are necessary, particularly in endocrinological and rheumatological diseases, where bone quality impairment is relevant. Data regarding bone quantity (density) and, partially, bone quality (structure and geometry) are obtained by the gold standard method of dual X-ray absorptiometry (DXA). Data about bone strength are not yet readily available. To evaluate bone resistance to strain, a new DXA-derived index based on the Finite Element Analysis (FEA) of a greyscale of density distribution measured on spine and femoral scan, namely Bone Strain Index (BSI), has recently been developed. Bone Strain Index includes local information on density distribution, bone geometry and loadings and it differs from bone mineral density (BMD) and other variables of bone quality like trabecular bone score (TBS), which are all based on the quantification of bone mass and distribution averaged over the scanned region. This state of the art review illustrates the methodology of BSI calculation, the findings of its in reproducibility and the preliminary data about its capability to predict fragility fracture and to monitor the follow up of the pharmacological treatment for osteoporosis.

Maximal Oxygen Uptake Adjusted for Skeletal Muscle Mass in Competitive Speed-Power and Endurance Male Athletes: Changes in a One-Year Training Cycle.

We compared the changes in maximum oxygen uptake (max) calculated per skeletal muscle mass (SMM) with conventional max measures in a 1-year training cycle. We hypothesized that the pattern of changes would differ between SMM-adjusted and absolute or weight-adjusted values, and the differences between groups of distinct training specialization and status will depend on the measure used. Twelve sprinters (24.7 ± 3.3 years), 10 endurance runners (25.3 ± 5.3 years), and 10 recreationally trained controls (29 ± 4.5 years) performed a treadmill test until exhaustion to determine max. Their SMM was estimated based on the dual X-ray absorptiometry method and a regression equation. The significance of differences was assessed using analysis of variance (p ≤ 0.05). The pattern of the longitudinal change was not different between max/SMM and standard measures. Also, the significance of differences between sprinters and endurance athletes remained similar regardless of the max measure. Sprinters and controls had similar absolute (~4.3 L·min−1) and total weight-adjusted (~52 vs. ~56 mL·min−1·kg) max, but they significantly differed in SMM-adjusted max (~110 vs. ~130 mL·min−1·kg SMM−1). In summary, SMM-adjusted max is not more useful than standard measures to track longitudinal changes in competitive athletes. However, it allows to better distinguish between groups or individuals differing in training status. The results of our study are limited to male athletes.

Changes in Blood Concentration of Adenosine Triphosphate Metabolism Biomarkers During Incremental Exercise in Highly Trained Athletes of Different Sport Specializations.

Włodarczyk, M, Kusy, K, Słomińska, E, Krasiński, Z, and Zieliński, J. Changes in blood concentration of adenosine triphosphate metabolism biomarkers during incremental exercise in highly trained athletes of different sport specializations. J Strength Cond Res 33(5): 1192-1200, 2019-We hypothesized that (a) high-level specialized sport training causes different adaptations that induce specific biomarker release dynamics during exercise and recovery and (b) skeletal muscle mass affects biomarker release. Eleven sprinters (21-30 years), 16 endurance runners (18-31 years), 12 futsal players (18-29 years), and 12 amateur runners as controls (22-33 years) were examined. Hypoxanthine (Hx), xanthine (X), uric acid (UA), ammonia (NH3), and lactate (LA) concentrations were determined at rest, during an incremental treadmill exercise test (every 3 minutes), and during recovery (5, 10, 15, 20, and 30 minutes after exercise). Hx, X, and UA concentration was determined from plasma, while LA and NH3 from whole blood, and muscle mass was assessed using dual X-ray absorptiometry method. At rest, during incremental exercise, and up to 30 minutes into the postexercise recovery period, sprinters had lowest Hx, X, and UA concentrations, and endurance athletes had lowest NH3 concentrations. For LA during exercise, the lowest concentrations were noted in endurance athletes, except when reaching maximum intensity, where the differences between groups were not significant. There were no significant correlations observed between skeletal muscle mass and biomarker concentration at maximal intensity and recovery in any group. In conclusion, the magnitude of exercise-induced biomarker concentration is only related to training adaptations through specific training profile but not to muscle mass. In addition, the results suggest that combined measuring of LA, NH3, and Hx concentration in blood is useful in indirectly reflecting key changes in exercise- and training-induced energy status. Further research should focus on studying how specific training sessions affect individual biomarker response in highly trained athletes.

Bone mass in axial spondyloarthritis: A literature review

To review the published literature reporting bone loss in patients with axial spondyloarthritis (SpA) particularly those studies using dual X-ray absorptiometry (DXA) methods. This literature review examines the reported bone mass in patients with ax-SpA, particularly those using the DXA methods. The MEDLINE, Web of Science and Scopus databases were searched for relevant articles published between September 1992 and November 2013. Some of used search terms were ankylosing spondylitis (AS), SpA, spondyloarthropathy, bone loss, bone mass, osteopenia, bone mineral density, osteoporosis (OP), densitometry. Studies in which bone loss was investigated by using DXA in patients with SpA were eligible. Each article was reviewed and the key elements were noted. There were 286 hits on MEDLINE, 200 on Web of Science and 476 on Scopus. After applying inclusion and exclusion criteria, we identified 55 articles in our systematic search. The sample size of the studies varied from 14 to 332 patients with SpA. The reported age range varied from 25 to 56 years in the reviewed studies. The symptom duration of patients with axSpA varied from 1.6 to 49 years. There were more males than females in these studies. Most of the recruited females were premenopausal women. Reported HLA-B27 positivity changed between 19% to 95%. The prevalence of OP and osteopenia in patients with SpA varied from 3%-47% to 5%-88%, respectively, in the included studies. In particular, the prevalence of OP and osteopenia ranged from 2.0%-47.0% and 5.0%-78.3%, respectively, in patients with AS. There are conflicting results regarding the relationship among disease activity, acute phase response and bone mass. Some studies suggest good correlation of bone mass with disease activity and acute phase reactants. Bone loss may be determined in patients with axSpA at the lumbar spine or proximal femur even in the early phase of the disease and may be associated with inflammation (bone marrow edema) at the vertebral colon.

AB0806 Polymorphisms Analysis of Bone Metabolism Genes in Relation to Bone Mineral Density in Patients with Chronic Periodontitis

BackgroundPolymorphisms in Vitamin D receptor (FokI (VDR-F) and BsmI (VDR-B)), Estrogen receptor (Pvu II (ESR1P) and Xba I (ESR1X)), Collagen type1 (SpI (COL1A1) and Calcitonin Receptor (Alu I (CTR)) are...

Genetic and environmental factors in human osteoporosis

Osteoporosis is a common disorder, with prolongation of the average life span it has become a major public health problem. On the formation of osteoporosis genetic factors and environmental influences could play a role then it is considered as multi-factorial. Because a variety of functions to affect susceptibility to the formation of osteoporosis VDR-F, VDR-B, COL1A1, ESR1X, ESR1P and CTR are thought to be candidate genes. In this study, the aim is to investigate the relationship between these genes polymorphism and bone mineral density (BMD) values of lumbar vertebra and femoral neck in 188 Turkish people. Lumbar spine and femoral neck BMD of the individuals included in the study were measured by the dual X-ray absorptiometry method. The genotyped polymorphisms by simultaneous amplification of five regions of the genome, containing six SNPs of interest and detecting the amplified product, using the kit MetaBone Clinical Arrays(®). Statistical analyses indicated that; VDR-B gene polymorphisms major (P = 0.013), VDR-F polymorphisms have minor (P = 0.082) effect on femur BMD. None of the other genes has any significant effect on spinal BMD. Patient age, body mass index and diet has significant effect on femoral and spinal BMD. Osteoporosis is a multi-factorial disease and many genetic and non-genetic risk factors contribute to the development of osteoporosis. Early detection of a genetic predisposition to osteoporosis should allow delay and/or limit unfavorable changes in the bone tissue.

Bone density and bone metabolism regulated by vitamin D receptor allele polymorphism in a German study sample

It has been reported that the spinal bone density is associated with vitamin-D-receptor (VDR) gene polymorphisms. The results of recent studies have been contradictory concerning the predictive power for low bone mineral density (BMD). Regional population-specific influences have been found to affect the vitamin-D-endocrinologic-system, diminishing the influence of VDR polymorphism on BMD and on bone turnover. We have examined the association of bone density, fracture predictivity and biochemical markers of bone turnover with VDR polymorphism in a German population. Blood and urine were collected from a heterogeneous subset of 164 caucasian subjects with ethnic German background. Polymerase chain reaction and subsequent digestion with Bsm I were used to examine variations of VDR genotypes. The morning following initial specimen collections, both urinary excretion rate of pyridinoline crosslinks (Pyr) and serum levels of bone alkaline phosphatase (BAP) were determined. For determination of the bone mineral density, the well-established method of dual X-ray absorptiometry was used. The VDR BB-genotype was associated with low bone mineral density for age-matched subjects (90.1 +/- 15.5%) versus the bb-genotype (100.8 +/- 10.8%) at the lumbar spine and at the Ward's triangle (91.8 +/- 17.9% versus 101.9 +/- 12.1%). 34.2% of BB-genotype subjects, 14.2% of bB-genotype subjects and 12.6% of bb-genotype subjects had Z-score related bone mineral density < 85%. The fracture rate at typical osteoporotic fracture sites was 23.6% for the BB-, 10.8% for the bB- and 0.0% for the bb-genotype. The urinary excretion rate of free pyridinoline crosslinks was higher for the BB-genotype than for the bB- or the bb-, however the difference was not significant. No genotype specific variations were seen for bone alkaline phosphatase. The authors conclude from this study that bone mineral density at the axial skeleton is associated with the vitamin-D-receptor allele polymorphism and that there is an influence on bone turnover and fracture rate in a German subset. The analysis of the VDR-genotype can be considered as a new piece in the puzzle of the diagnostic of osteoporosis for we get prognostic hints concerning the rate of fracture.

Ankylosing spondylitis and bone mineral density—what is the ideal tool for measurement?

Ankylosing spondylitis (AS) is characterised by chronic inflammation and partial ossification, yet vertebral fractures due to osteoporosis, although common, are frequently unrecognised. The aim of this study was to (1) show the frequency of changes in the progress of osteopenia/osteoporosis in AS depending on duration and stage of the disease and (2) assess the ranking of two different methods of bone density measurement in this clinical pattern. We measured bone density in 84 male and female patients with both dual X-ray absorptiometry (DXA) and single energy quantitative computed tomography (SE-QCT). In the initial and advanced stages of the disease, a high decrease in axial bone density could be verified (DXA: osteopenia in 5% and osteoporosis in 9.2%; SE-QCT: osteopenia in 11.8% and osteoporosis in 30.3%). Peripheral bone density decrease as in osteopenia could be proven in 17.6% by DXA measurement. With SE-QCT, a decrease in vertebral trabecular bone density could already be observed in the initial stage and continued steadily during the course of the disease; cortical bone displayed the same trend up to stages of ankylosis. With DXA, valid conclusions are more likely to be expected in less marked ankylosing stages of AS. In stages of advanced ankyloses in the vertebral region (substantial syndesmophytes), priority should be given to SE-QCT, due to the selective measurement of trabecular and cortical bone. The DXA method often yields values that are too high, and the replacement of vertebral trabecular bone by fatty bone marrow is not usually recorded as standard. There may already be an increased risk of bone fracture in AS in osteopenia on DXA along with an osteoporosis already established on SE-QCT.