Normal Between Bone Mineral Density Research Articles

Is bone mineral density a prognostic factor in postmenopausal women with luminal A breast cancer?

Several studies are concerned about the association between bone mineral density (BMD) and the risk of breast cancer in postmenopausal women, but it is controversial. Therefore, we evaluated whether BMD might be a risk factor for recurrences, or metastases in menopausal luminal A breast cancer patients. In this retrospective study, data of 348 patients with luminal A breast cancer who received treatment at Pusan National University Yangsan Hospital between 2012 and 2016 were analyzed. Patients were divided into two groups: normal BMD and low BMD including osteopenia or osteoporosis in preoperative examination. Patients were also divided into three groups according to BMD changes: no change in BMD; improvement in BMD, and deterioration in BMD. Events were defined as recurrence, occurrence of contralateral breast cancer, and metastasis to any other organ. Preoperative examination revealed normal BMD in 129 of 348 patients and low BMD in 219 patients. During a median follow-up period of 78 months, only 14 patients (4.0%) experienced recurrences, distant metastases, or occurrences of contralateral breast cancer. Five-year disease-free survival rate was 98.2% for 219 patients with low BMD and 95.0% for 129 patients with normal BMD (P=0.33). Disease-free survival at 5 years was 97.0% for the no change in the BMD group, 94.6% for the BMD improvement group, and 98.4% for the BMD deterioration group (P=0.79). In this study, BMD had no statistically significant associations on recurrences, metastases, or incidences of contralateral breast cancer in postmenopausal patients with luminal A breast cancer.

Bone mineral density and body composition in normal weight, overweight and obese children.

BackgroundThere is a possibility that excess body fat affects bone mass gain and may compromise skeletal health in obese children. The purpose of the study was to identify the relationship between bone mineral density (BMD) and body composition in normal weight, overweight and obese children.MethodsThis was a cross-sectional study of 6- to 11-year-old children who attended the hospital's outpatient clinic. They were apparently healthy and had no history of prematurity, low birth weight, or chronic diseases. Body mass index (BMI) was used to identify subjects as normal weight, overweight or obese. BMD and body composition were assessed by dual energy X–ray absorptiometry. The BMD values (total and lumbar spine) were compared between normal weight, overweight and obese children. Correlation coefficients were calculated, and multivariate models were performed.ResultsForty-nine children were included: 16 with normal weight, 15 that were overweight and 18 with obesity; the mean age was 8.4 ± 1.7 years. All the participants had a normal BMD (> – 2 SD). BMD was higher in obese children and had a positive correlation with total and trunk lean mass in the three study groups (p < 0.001). In obese children, an inverse correlation of lumbar spine BMD (Z score) with total and trunk fat mass (p < 0.05) was identified. In the multivariate models (with the whole group), the total lean mass was the only significant variable that explained BMD variability.ConclusionsBMD in obese children was higher than that in normal weight children, which is explained by their greater lean mass and not by excess body fat. In obese children, a higher fat mass was related to a lower lumbar spine BMD. Lean mass had a direct correlation with BMD in the three study groups and was the most important predictor of BMD, reflecting the importance of strengthening the muscular system through performing physical activity and practicing a healthy lifestyle.

On the association between Chiari malformation type 1, bone mineral density and bone related genes

BackgroundChiari malformation type 1 (C1M) is a neurological disease characterized by herniation of the cerebellar tonsils below the foramen magnum. Cranial bone constriction is suspected to be its main cause. To date, genes related to bone development (e.g. DKK1 or COL1A2) have been associated with C1M, while some bone diseases (e.g. Paget) have been found to cosegregate with C1M. Nevertheless, the association between bone mineral density (BMD) and C1M has not been investigated, yet. Here, we systematically investigate the association between C1M and BMD, and between bone related genes and C1M. MethodsWe have recruited a small cohort of C1M patients (12 unrelated patients) in whom we have performed targeted sequencing of an in-house bone-related gene panel and BMD determination through non-invasive DXA. ResultsIn the search for association between the bone related genes and C1M we have found variants in more than one C1M patient in WNT16, CRTAP, MYO7A and NOTCH2. These genes have been either associated with craniofacial development in different ways, or previously associated with C1M (MYO7A). Regarding the potential link between BMD and C1M, we have found three osteoporotic patients and one patient who had high BMD, very close to the HBM phenotype values, although most patients had normal BMD. ConclusionsVariants in bone related genes have been repeatedly found in some C1M cases. The relationship of bone genes with C1M deserves further study, to get a clearer estimate of their contribution to its etiology. No direct correlation between BMD and C1M was observed.

Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis.

Background:The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC.Methods:We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed.Results:Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI: 1.11 - 4.02, P = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI: 23.77 - 43.77, p = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI: 0.92 - 1.10, p = 0.95, age-adjusted), and 0.95 (95% CI: 0.86 - 1.05, p = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity.Conclusions:Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.

Bone mineral density in patients with coronary artery disease and sarcopenia

Objective: to assess the relationship between bone mineral density (BMD) and the muscular apparatus in male patients with coronary heart disease (CHD).Patients and methods. The investigation enrolled 79 male patients (median age, 63 [57; 66] years) with an established diagnosis of CHD verified by coronary angiography.Muscle mass was assessed by multispiral computed tomography, by determining the axial muscle tissue area (cm2 ) at the level of LIII. Muscle strength was measured with a wrist dynamometer. Muscle function was examined using the tests of the Short Physical Performance Battery (SPPB). BMD at the neck and proximal femur as a whole and at the lumbar spine was measured by dual energy X-ray absorptiometry.For comparative analysis, the patients were divided into three groups (EWGSOP, 2010). Group 1 included 31 patients without sarcopenia; Group 2 consisted of 21 patients with presarcopenia; and Group 3 comprised 27 patients with sarcopenia.Results and discussion. Osteopenic syndrome was diagnosed in 34 (43%) patients: osteopenia and osteoporosis in 31 (39%) and 3 (4%) patients, respectively. Normal BMD values were observed in 45 (57%) men. The prevalence of osteopenic syndrome was significantly higher in the patients with sarcopenia than in those with presarcopenia (p=0.050) and was comparable to that in men without sarcopenia (p&gt;0.050). BMD at the neck and proximal femur as a whole was significantly lower in the patients with sarcopenia than in those without sarcopenia or with presarcopenia (p&lt;0.050). There was a direct correlation between BMD and the characteristics of muscle mass and muscle strength. Regression analysis showed that the total skeletal muscle area at the level of LIII had a significant direct impact on BMD at the neck and proximal femur as a whole, and the reverse – walking speed.Conclusion. The relationship between the characteristics of the muscular apparatus and BMD requires further investigation.

Association between Bone Mineral Density and Nutritional Status, Body Composition and Bone Metabolism in Older Adults.

To identify an association between bone mineral density (BMD) and nutritional status, body composition and bone metabolism in older patients. Cross-sectional study, involving older adults, with osteopenia/osteoporosis and with normal BMD. The mineral density of the lumbar spine from L1 to L4 and the proximal region of the femur was assessed using dual energy X-ray absorptiometry. Biochemical analyzes were performed of 25(OH)-D, calcium and parathormone. Weight, knee height, and abdominal (AC), mid-upper arm (MUAC) and calf (CC) circumferences were measured. The percentage of body fat (%BF) and Fat-Free Mass (FFM) were quantified by electrical bioimpedance analysis. The Body Mass Index (BMI) was calculated. The statistical analysis used bivariate and multivariate, parametric and/or non-parametric tests, and was considered significant when p <0.05. Of the total 51 older adults assessed, 30 of them (58.8%) were diagnosed with osteopenia/osteoporosis. Body weight (p = 0.001), BMI (p = 0.001), % BF (p = 0.030) and serum concentrations of 25(OH)-D (p = 0.003) were higher in the group without changes in BMD. BMI and serum levels of 25(OH)-D demonstrated a positive correlation with the BMD of all bone compartments and the AC displayed a positive correlation with the lumbar vertebrae. In the logistic regression models, adjusted for sex and age, the BMI and the serum concentration of 25(OH)-D were presented as a protective factor against osteopenia/osteoporosis. Higher body weight, BMI, AC and %BF, and sufficient serum levels of vitamin D, were shown to be promoters of BMD.

SUN-395 Pelvic Bone Density Is Lower Than Bone Density of Hip and Femoral Neck in Postmenopausal Women

Pelvic fractures represent 7% of all fragility fractures; they account for 5% of the cost of osteoporotic fracture care, and are commonly (> 50%) associated with loss of independence in the elderly. The incidence of pelvic fractures has increased significantly over the past 3 decades. However, little is known about the relationship between bone mineral density (BMD) and pelvic fractures. We have conducted a pilot cross-sectional study to establish a method of measuring pelvic BMD and to correlate BMD of the pelvis with BMD at other skeletal sites. Postmenopausal women without a history of pelvis and hip fragility fractures were enrolled. Hip, spine, and pelvis DXA scans were obtained using a Hologic DXA machine. Pelvic BMD was calculated using Hologic Research Software from 3 areas of the pelvis (R1: public symphysis, R2: inferior pubic ramus, and R3: superior pubic ramus), corresponding to common fracture locations. Pelvis BMD was the average of the 3 pelvis sites. Pelvic BMD measurement precision error was calculated using the root mean square method (Recommended by International Society of Clinical Densitometry (ISCD)). Statistical analysis was used to compare BMD at different sites. Alpha error was set at 0.05. Of 73 postmenopausal women who were enrolled in the study (average age 64 years, average 15 years postmenopausal), 3% had chronic kidney disease, 7% had type 2 DM, 3% were on corticosteroids and none were smokers. BMD of femoral neck assessed on pelvic DXA was not significantly different from femoral neck BMD measured on standard DXA (P=0.09). To assess pelvis BMD measurement precision, 15 patients underwent 3 separate pelvic DXA images after repositioning. BMD precision error was 0.011g/cm2 which is slightly lower than the precision total hip BMD at our center (0.007 g/cm2). BMD of R1, R2, and R3 pelvic areas were measured as 0.44±0.15, 0.41± 0.15, and 0.62 ±0.19 g/cm2, respectively. Notably, BMD of R3 was significantly higher than the other 2 areas (P<0.001, ANOVA). Average BMD (0.49±0.14 g/cm2) of pelvis was significantly lower than BMD of femoral neck (0.72± 0.16 g/cm2), total hip (0.86±17 g/cm2) and spine (0.97± 19 g/cm2)(P <0.001). Average BMD of pelvis was significantly lower in participants with osteopenia and osteoporosis of the hip and femoral neck compared to participants with normal BMD in those locations. In summary, we report a precise method of measuring BMD of commonly fractured areas of the pelvis. Pelvis BMD is lower than hip, femoral neck, and spine. Bone density of the pelvis correlates with hip and femoral neck bone density. The results of this pilot study can be used for future studies looking at pelvic low bone density in patients with pelvic fragility fractures which could help identify patients at risk for pelvic fragility fractures and change how osteoporosis is defined based on DXA images.

Lower Serum Fibroblast Growth Factor 21 Levels are Associated with Normal Lumbar Spine Bone Mineral Density in Hemodialysis Patients.

Recent evidence has indicated that fibroblast growth factor 21 (FGF21) regulates longitudinal bone growth, with increased FGF21 levels leading to bone loss. The present study evaluated the relationship between bone mineral density (BMD) and serum FGF21 levels in patients undergoing hemodialysis (HD). We analyzed blood samples from 95 patients undergoing HD and measured BMD using dual-energy X-ray absorptiometry of the lumbar vertebrae (L2–L4). Serum FGF21 concentrations were determined using a commercially available enzyme-linked immunosorbent assay kit. Thirteen (11.6%) patients were found to have osteoporosis, 27 (28.4%) osteopenia, and 57 patients had normal BMD. Advanced age and decreased body mass index, height, body weight, waist circumference, and triglyceride level were associated with lower lumbar T-scores, as were increased alkaline phosphatase, urea reduction rate, fractional clearance index for urea, and FGF21 levels. Low log-FGF21, increased body mass index, increased pre-HD body weight, and increased logarithmically transformed triglycerides (log-TG) were found to be significantly and independently associated with lumbar BMD by multivariate forward stepwise linear regression analysis with adjustment for significant confounders. We conclude that high serum FGF21 level is negatively associated with BMD in patients undergoing HD.

No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women

ContextThe association between bone mineral density (BMD) and breast arterial calcification (BAC) remains poorly understood and controversial.ObjectiveThe objective of this article is to examine the association between BMD and BAC in a large cohort of postmenopausal women undergoing routine mammography.DesignA cross-sectional analysis of baseline data from a multiethnic cohort was performed.SettingThe setting for this analysis is an integrated health care delivery system in Northern California in the United States.PatientsA total of 1273 women age 60 to 79 years (mean age, 67 years) were recruited within 12 months of screening mammography.Main outcome measureA BAC score (mg) was obtained from digital mammograms using a novel densitometry method. BAC presence was defined as a BAC score greater than 0 mg, and severe BAC as a BAC score greater than 20 mg.ResultsOverall, 53% of women had osteopenia and 21% had osteoporosis. The prevalence of BAC greater than 0 mg was 29%, 30%, and 29% among women with normal BMD, osteopenia, and osteoporosis, respectively (P = 0.98). The prevalence of BAC greater than 20 mg was 5%, 3%, and 5% among women with normal BMD, osteopenia and osteoporosis, respectively (P = .65). The odds ratios (ORs) of BAC greater than 0 mg vs BAC = 0 mg after multivariable adjustment were 1.09 (95% CI, 0.81-1.48; P = .54) for osteopenia and 0.99 (95% CI, 0.69-1.48; P = .98) for osteoporosis. The adjusted ORs for BAC greater than 20 mg vs BAC 20 mg or less were 1.03 (95% CI, 0.52-2.01; P = .93) for osteopenia and 1.89 (95 CI, 0.81-4.47; P = .14) for osteoporosis.ConclusionOur findings do not support an association of either osteopenia or osteoporosis with BAC presence or severity among postmenopausal women.

The Association of Bone Mineral Density with Mortality in a COPD Cohort. The HUNT Study, Norway

In individuals with chronic obstructive pulmonary disease (COPD), the presence of comorbidities is associated with increased mortality risk. We wanted to study the association between bone mineral density (BMD) and mortality among individuals with COPD in a population-based cohort study. Participants were recruited from the second (1995–1997) and third (2006–2008) surveys of the HUNT Study and followed until February 2019. Hip and forearm BMD were included as continuous T-scores or categorized according to WHO criteria (normal, osteopenia, and osteoporosis). Hazard ratios with 95% confidence intervals were estimated by multivariable Cox regression models. In total, 2076 and 3239 participants were identified as having COPD by FEV1/FVC below lower limit of normal (LLN) or <0.70, respectively, according to Global Lung Initiative (GLI) and Global Initiative for Chronic Obstructive Lung Disease (GOLD). The prevalence of osteoporosis was 15.7% vs. 16.6% in the GLI-COPD vs. GOLD-COPD cohorts. Mean follow-up was 12.7 and 11.9 years. Lower T-scores were associated with a 5% (95% confidence interval (CI) 1.01–1.09) increased mortality in the GLI-COPD and GOLD-COPD cohorts, respectively. However, the presence of osteoporosis (T < –2.5), compared to normal BMD, was not associated with mortality in neither GLI-COPD (HR 1.13, 95% CI 0.91–1.41) nor GOLD-COPD cohorts (HR 1.22, 95% CI 0.99–1.51). Thus, a small positive association was found between decreasing BMD T-score and mortality in both GLI-COPD and GOLD-COPD. However, osteoporosis as defined by WHO was not associated with mortality, probably due to loss of power upon categorization.

The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee

To find the relationship between bone mineral density (BMD) and risk of knee OA progression in a 5-year prospective study. 110 females with knee OA were examined twice with 5-year interval. Examination included filling questionnaires, VAS pain assessment, plain knee radiography and axial skeleton densitometry. I stage knee OA was established in 33 (30%) patients, II stage - in 46 (41.8%), III stage - in 26 (23.6%), and IV - in 5 (4.5%). Normal lumbar vertebrae densitometry BMD values were found in 45 patients (40.9%), osteopenia - corresponding BMD values - in 33 (30.0%), and osteoporosis - in 32 (29.1%). Normal femoral neck BMD values were identified in 60 (54.5%) patients, osteopenia - level BMD - in 48 (43.7%), osteoporosis - in 2 (1.8%). In all premenopausal patients (n=15) axial skeleton BMD values were normal. In 5-year interval radiographic progression was established in 40 patients (Group 2), while in 70 (Group 1) patients no progression occurred. Both groups were comparable in terms of age and disease duration, although, more patients from Group 2 tended to have normal baseline densitometry BMD values - both in lumbar vertebrae and femoral neck: 47.5% vs 37.1%, and 62.5% vs 44.3% as compared to Group 1 patients. Patients from Group 1 more often had BMD values corresponding to osteoporosis and osteopenia: 32.9% vs 22.5%, and 55.7% vs 37.5%, respectively, as compared to Group 2 patients, although not achieving statistical significance. These differences were still identifiable after 5-year interval. Absolute BMD values at the second examination in 5 years were indicative of statistically significant increase in femoral neck and total hip BMD in Group 2 patients with knee OA progression: 0.79±0.11 vs 0.73±0.16, р.

Densidad mineral ósea e indicadores bioquímicos y hormonales en niños con parálisis cerebral cuadripléjica.

Introduction: children with cerebral palsy (CP) have multiple risk factors for low bone mineral density or osteoporosis. Objective: to explore the association between bone mineral density (BMD) and biochemical and hormonal indicators of bone metabolism in children with quadriplegic cerebral palsy (CP). Methods: a cross-sectional analytical study included 59 participants from six to 18 years of age with quadriplegic CP. Serum concentrations of calcium, phosphorus, 25OHD metabolite, parathyroid hormone (PTH), alkaline phosphatase, and thyroid hormones were determined using standardized methods. The BMD measurement was obtained from the lumbar spine expressed in g/cm2 and Z-score. Unpaired Student's t-test, Chi-square test, odds ratio and Pearson's correlation were performed. Results: participants with CP and malnutrition had lower serum concentrations of calcium, phosphorus and alkaline phosphatase. Those who had low BMD showed lower serum concentrations of calcium, phosphorus and alkaline phosphatase. Most participants with low and normal BMD had vitamin D deficiency (27.1% and 10%) and insufficiency (35.4% and 30%), respectively. There was a significant correlation between BMD and serum concentrations of calcium, phosphorus, alkaline phosphatase, vitamin D and thyroid-stimulating hormone (TSH). There were no differences in the biochemical and hormonal indicators by level of gross motor function, use of anticonvulsants and oral versus enteral feeding method. Conclusion: malnutrition and alteration of vitamin D nutritional status were associated with low BMD and alterations of biochemical indicators of bone metabolism in pediatric patients with quadriplegic CP. The relationship between BMD and biochemical indicators of bone metabolism in children with quadriplegic CP was also demonstrated.

RELATIONSHIP BETWEEN BONE MINERAL DENSITY AND BODY COMPOSITION IN ELDERLY.

ABSTRACTObjective:To evaluate the association between bone mineral density (BMD) and body composition in healthy older adults at different skeletal sites. Methods:We analyzed 87 medical records and BMD along with the body composition of men ranging from 60 to 87 years of age (mean: 68.5, standard deviation: 6.5). Inclusion criteria were normal BMD values (T-score greater than or equal to -1.0) and body mass index within normal or overweight range (18.5 to 29.5 kg/m2). Body composition was evaluated using bone densitometry with dual-energy X-ray absorptiometry (DEXA) in a LUNAR-DPX apparatus. Results:Greater lean mass, fat mass, and soft tissue was associated with better BMD values in older adults, and higher age was associated with poorer BMD. Conclusion:Body composition (lean and fat masses and soft tissue) in older men is positively associated with BMD at all body sites (arms, legs, and trunk). Level of Evidence II; Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.

Bone health in facioscapulohumeral muscular dystrophy: A cross-sectional study.

Herein we provide a comprehensive overview of bone health in facioscapulohumeral muscular dystrophy (FSHD). Ninety-four adult individuals with FSHD type 1 from 2 sites were included in this cross-sectional study. Clinical characteristics and determinants of bone health were examined. Relationships between bone mineral density (BMD), strength, and function were explored. Nearly a third of subjects were deficient in vitamin D3 . Mean whole-body BMD z-score was -0.7; 11% of subjects had greater than age-related reductions in whole-body BMD (z-score < -2.0). Whole-body and regional BMDs were associated with strength and function. Thirty-six percent had a history of fractures. Likelihood of fractures was reduced for those with normal whole-body BMD (odds ratio = 0.25, 95% confidence interval 0.04-0.78). A diagnosis of FSHD is not necessarily predictive of reduced BMD or increased fracture rate. Given the considerable variability of bone health in the FSHD population, strength and function can serve as predictors of BMD. Muscle Nerve 56: 1108-1113, 2017.

Association Between Bone Mineral Density and Pancreatic β-Cell Function in Elderly Men and Postmenopausal Women.

Purpose:To explore the association between bone mineral density (BMD) and β-cell function.Methods:A cross-sectional study was performed in Fujian, China, from 2011 to 2012. The study included 572 elderly men older than age 60 years and 1558 postmenopausal women aged 45 to 86 years, excluding those with diabetes and insulin resistance. Fasting glucose and insulin concentrations were measured. Pancreatic β-cell function was estimated by using the homeostasis model assessment (HOMA-β). Calcaneus BMD was measured by using quantitative ultrasonography. Multiple regression analyses were applied to explore the association.Results:Participants with decreased BMD had lower fasting glucose (P < 0.001 in postmenopausal women; P = 0.007 in elderly men) and greater HOMA-β (P = 0.001 in postmenopausal women; P = 0.008 in elderly men) than those with normal BMD, whereas no statistical differences in insulin were seen among categories of BMD. After adjustment for all confounders, HOMA-β was still significantly negatively related to BMD in both groups (all P < 0.001), and remarkable positive relationships were found between BMD and fasting glucose. Furthermore, binary logistic regression presented fully adjusted odds ratios for diabetes in those with osteoporosis vs those with normal BMD: 0.60 [95% confidence interval (CI), 0.38 to 0.94] and 0.66 (95% CI, 0.49 to 0.91) in the original selected population of elderly men (n = 1070) and postmenopausal women (n = 2825), respectively.Conclusions:BMD was independently inversely associated with HOMA-β and positively associated with fasting glucose in both elderly men and postmenopausal women, suggesting that bone mass may be a predictor of glucose metabolism. Further research is needed to verify the associations and determine the exact mechanism underlying them.

Novel association between bone mineral density scores and the prevalence of peripheral artery disease in both sexes.

The purpose of the current study was to investigate the association between bone mineral density (BMD) scores and the prevalence of peripheral artery disease (PAD) in a large cohort of subjects who underwent arterial Doppler assessments and calcaneal bone densitometry. The study was performed using data obtained from Life Line Screening Inc. Subjects were self-selected and paid for screening tests. The prevalence of PAD was significantly higher in men with osteopenia (4.5%) and osteoporosis (10.9%) compared to men with normal BMD (3.0%) ( p<0.001). Osteopenia (odds ratio (OR) 1.3) and osteoporosis (OR 2.3) were found to be independent risk factors for the presence of PAD in men. The prevalence of PAD was significantly higher in women with osteopenia (4.8%) and osteoporosis (11.8%) compared to women with normal BMD (3.3%) ( p<0.001). Osteopenia (OR 1.15) and osteoporosis (OR 1.8) were found to be independent risk factors for the presence of PAD in women. The current study reports a strong association of abnormal BMD analysis with the prevalence of PAD, which persists even when controlling for age and associated atherosclerotic risk factors. Although the mechanism by which these two disease processes is related is not completely elucidated, the presence of osteoporosis should make clinicians aware of the possibility of occult PAD or associated atherosclerotic disease in appropriate patients.

Bone mineral density and vitamin D status in children with epilepsy, cerebral palsy, and cerebral palsy with epilepsy.

We aimed to evaluate the relationship between bone mineral density (BMD) disorders and possible risk factors in patients with epilepsy only (EO), cerebral palsy only (CPO), and cerebral palsy-epilepsy (CP+E). A total of 122 patients [EO (n=54), CPO (n=30), CP+E (n=38)] and 30 healthy children were evaluated. BMD was only measured in patient groups, not in control subjects. BMD of lumbar vertebrae was determined by dual energy X-ray absorptiometry (DXA). An abnormal BMD was defined as low or low normal BMD. Low BMD rate in EO, CPO, and CP+E group was 3.7, 50, and 39.5%, respectively. Abnormal BMD values were significantly related to inadequate dietary Ca intake (p=0.017), severe intellectual disability (p<0.001), and immobility (p=0.018). In multivariate regression analysis, the risk of abnormal BMD was higher (3.9-fold) in patients not able to walk independently than the others (p=0.029). However, serum Ca-Vitamin D levels, insufficient exposure to sunlight, low BMI, and use of AED were not correlated with abnormal BMD. Abnormal BMD is a common problem in patients with CP and CP+ E. Abnormal BMD was related to the severity of CP, but not to vitamin D levels or AED treatment.

The relationship between bone mineral density and bone metabolic markers in patients with spine degeneration diseases needing surgery

Objective The aims of this study were to evaluate the morbidity of osteoporosis and the relationship between bone mineral density (BMD) and bone metabolic markers in the patients with spine degeneration disease needing surgery, at the same time to observe the influence of type 2 diabetes mellitus on bone metabolism and BMD. Methods This retrospective analysis included 139 patients suffered by spine degeneration disease needing surgery from the October 2013 to October 2014 in Beijing Jishuitan Hospital. Lumbar BMD was measured by quantitative computed tomography (QCT) before surgery. Serum N-terminal propeptide of type I procollagen (PINP) , β C-terminal cross-linked telopeptide of type I collagen (β-CTX), osteocalcin (OC) , 25-hydroxyvitamin D[25(OH)D], parathyroid hormone (PTH), calcium and phosphorus were quantified simultaneously. The relationship between the results of lumbar BMD measured by QCT and bone metabolic markers was analyzed by partial correlation. The differences of bone metabolic markers among three groups classified according to BMD were performed by one-way ANOVA and analysis of covariance. The influence factors of lumbar BMD measured by QCT were analyzed by multifactor linear regression. T-test was used to analyze the differences of BMD and bone metabolic markers between two groups with and without type 2 diabetes mellitus. Results The average age of 139 patients was(62.74±6.83) years old. Lumbar BMD revealed that the percentage of osteoporosis, osteopenia and normal BMD were 40.2% (56/139) , 43.8% (61/139) and 16% (22/139) separately. The percentage was 47% (66/139) in subjects with 25(OH)D below 30 nmol/L. The percentage of subjects with the concentrations of 25(OH)D between 30-50 nmol/L was 40% (55/139) , while the percentage of subjects with the concentrations of 25(OH)D between 50-125 nmol/L was only 13% (18/139). Partial correlation analysis revealed that lumbar BMD measured by QCT was negatively correlated with PINP (r=-0.352, P<0.01), β-CTX (r=-0.356, P<0.01) and OC (r=-0.276, P=0.001) with gender and type 2 diabetes mellitus as covariates. Along with the age of patients increasing and BMD reducing, the levels of PINP, β-CTX and OC increased gradually and the differences were statistically significant (F=11.575, P<0.01; F=11.550, P<0.01; F=9.738, P<0.01). Multiple linear regression analysis revealed that age and PINP were the main factors that influenced the change of BMD in the patients with spine degeneration disease needing surgery (β=-1.863, t=-5.425, P<0.01; β=-0.393, t=-2.061, P=0.041) . Subjects were divided into diabetes group and non-diabetes group according to the clinical diagnosis and whether having abnormal serum glucose. The levels of PINP (36.56±14.56 versus 49.51±16.68 μg/L) , β-CTX (0.39±0.20 versus 0.52±0.21 μg/L) and OC (14.21±5.13 versus 20.74±6.84 μg/L) in serum between two groups had significant differences (t=3.648, P<0.01; t=2.754, P<0.01; t=4.573, P<0.01) . Conclusions There was prevalence of osteoporosis, osteopenia and vitamin D deficiency in the patients with spine degeneration disease needing surgery. The patients with high level of PINP and age were more prone to appear lower BMD which increasing the risk of osteoporosis. The patients combined with type 2 diabetes mellitus had suppressed bone markers which maybe the risk factor, independent of BMD, increasing fracture risk.(Chin J Lab Med, 2016, 39: 267-271) Key words: Spinal diseases; Osteoporosis; Bone density; Diabetes mellitus, type 2; Retrospective studies

Inverse Association Between Serum Osteoprotegerin and Bone Mineral Density in Renal Transplant Recipients

BackgroundOsteoprotegerin (OPG) has pleiotropic effects on bone metabolism as well as endocrine function. Our aim was to evaluate the relationship between bone mineral density (BMD) and serum OPG concentration in renal transplant recipients. MethodsFasting blood samples were obtained from 69 renal transplant recipients. BMD was measured in lumbar vertebrae (L2–L4) by dual-energy X-ray absorptiometry. Eight patients (11.6%) had BMD values indicative of osteoporosis, 28 patients (40.6%) had BMD values indicative of osteopenia, and 33 patients had normal BMD values. Increased serum OPG levels (P < .001), decreased body mass index (BMI) (P = .033), and decreased body weight (P = .010) were significantly correlated with low lumbar T-score cut-off points between groups (normal, osteopenia, and osteoporosis). ResultsWomen had significantly lower lumbar BMD values than men (P = .013). Menopause (P = .005), use of tacrolimus (P = .020), and use of cyclosporine (P = .046) were associated with lower lumbar BMD in renal transplant recipients. Univariate linear regression analysis revealed that lumbar BMD was positively correlated with height (P = .016), body weight (P = .001), and BMI (P = .015) and negatively correlated with age (P = .039) and log-OPG (P = .001). Multivariate linear regression analysis revealed that log-OPG (β: −0.275, R2 change = 0.154, P = .014), body weight (β: 0.334, R2 change = 0.073, P = .004), and age (β: −0.285, R2 change = 0.079, P = .008) were independent predictors of lumbar BMD values in renal transplant recipients. ConclusionsSerum OPG concentration correlated negatively with lumbar BMD values in renal transplant recipients.

The relationship of total body composition with bone mineral density in postmenopausal women with type 2 diabetes

Aim. To determine the relationship between bone mineral density (BMD) and total body composition in postmenopausal women with type 2 diabetes. Materials and Methods. The study included 78 women, from 50 to 70 years of age (median 63 years). Twenty women had normal body mass index (BMI), 29 ones were overweight and 29 had obesity. The body composition and BMD was studied by dual-energy X-ray absorptiometry. Results. Women with normal BMD had higher BMI, total and truncal fat mass, as well lean mass as compared to women with osteoporosis and osteopenia (all p