Osteo-sono Assessment Index Research Articles

Dairy consumption, bone turnover biomarkers, and osteo sono assessment index in Japanese adults: A cross-sectional analysis of data from the Iwaki Health Promotion Project

PurposeDairy foods are nutritional sources of calcium, phosphorus, protein, and other nutrients that improve bone health. However, the effects of dairy consumption on bone biomarkers in the Japanese population remain unclear. This study explored the association between dairy consumption and bone biomarkers in Japanese adults. MethodsThis cross-sectional study was conducted as part of the Iwaki Health Promotion Project in Aomori, Japan. In total, 1063 adults were included in the analysis. Bone turnover marker levels were measured in local citizens during their annual medical checkups. The calcaneus osteo sono assessment index (OSI) was calculated using a quantitative ultrasound technique. The dietary intake of foods and nutrients was estimated using a food frequency questionnaire. Linear regression models were established using dairy consumption and bone biomarkers with adjustments. Statistic significance was considered by P < 0.05. ResultsIn multivariate models, the tartrate-resistant acid phosphatase 5b and parathyroid hormone concentrations were inversely associated with dietary dairy consumption after adjusting for age and sex. The undercarboxylated osteocalcin, a procollagen type I N-terminal peptide to bone alkaline phosphatase ratio, and OSI were the directly associated with dairy consumption in multivariate models with adjustment. ConclusionsDairy consumption is partially associated with bone turnover biomarkers and OSI in adult Japanese participants. Habitual consumption of dairy foods may contribute to the nutritional supplementation for maintaining bone health, including turnover and structure. Clinical trial registry number and website where it was obtainedThe Japanese Clinical Trials Registry (UMIN000040459), https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000046175.

Bone density estimation using tissue heat capacity.

Osteoporosis onset is relatively asymptomatic, the condition often being identified only once a significant fracture occurs, leading to a potentially serious prognosis. Currently, early identification of osteoporosis is complicated by the difficulty in measuring bone density without using x-ray absorptiometry or quantitative ultrasound, so a simpler method for estimating bone density is needed. Given that bone is reported to have a lower specific heat than other tissues, we investigated the possibility of estimating bone density using this difference in tissue thermal properties. The tibia medial surface (shin) and medial malleolus (ankle) of 68 healthy volunteers were cooled using an ice bag, and skin surface temperatures and heat flow were recorded. These measurements were then used to calculate the heat energy transferred per unit temperature. Bone density was estimated by quantitative ultrasound using the T score OSISD, which is the participant's osteo sono-assessment index (OSI) compared to the average OSI of young adults. The heat energy transfer per unit temperature at the shin, but not the ankle, showed a significant negative correlation with T score OSISD (r = -0.413, p = 0.001). Multiple regression analysis showed that heat energy transfer per unit temperature at the shin was a significant predictor of T score OSISD, along with age and height. These results show that tissue thermal property measurements are useful for estimating bone density.

Comparison between calcaneus quantitative ultrasound and the gold standard DXA in the ability to detect osteoporosis in chronic obstructive pulmonary disease patients

BackgroundOsteoporosis is a prevalent comorbidity in patients with COPD that is usually underrecognized and hence, undertreated. Compared to the gold standard dual-energy X-ray absorptiometry (DXA), calcaneus quantitative ultrasound (QUS) is less expensive, more portable, and more accessible, especially in less developed countries. The aim of this study was to investigate the ability of calcaneus QUS to screen and prescreen for osteoporosis in patients with COPD.MethodsThis cross-sectional study enrolled 67 males older than 50 years with clinically stable COPD. DXA scans of the lumbar spine (L2–4) and femoral neck were performed. QUS of the right calcaneus (AOS-100) was used to assess the broadband ultrasound attenuation (BUA), speed of sound (SOS), osteo sono-assessment index (OSI), and T-score. When the T-score was ≤ − 2.5, osteoporosis was diagnosed by both DXA and QUS.ResultsForty-eight patients (71.6%) had DXA T-scores ≤ − 2.5 at either the lumbar spine or femoral neck. All QUS parameters (BUA, SOS, OSI, and T-score) could discriminate DXA-determined osteoporosis (the area under the curve varied from 0.64 to 0.83). The QUS T-score was significantly moderately correlated with the DXA T-score at both the femoral neck (r = 0.55) and lumbar spine (r = 0.52). The sensitivity and specificity of QUS in identifying osteoporosis were 10.4% and 94.7%, respectively. The positive and negative predictive values were 83.3% and 29.5%, respectively. When a QUS T-score of 0.09 was used as the cutoff, the sensitivity exceeded 90%, and 15% of the DXA scans were not warranted.ConclusionsThe sensitivity and specificity of calcaneus QUS were not sufficient for QUS to be used as an alternative to DXA for osteoporosis screening. However, QUS may be useful for prescreening before DXA to identify COPD patients who have either a high or low likelihood of osteoporosis. Consequently, QUS reduces the need for DXA referral.

Association between Bone Mineral Density and Oral Frailty on Renal Function: Findings from the Shika Study.

The association between oral frailty (OFr) and body action has been investigated, but its association with systemic function remains unclear. Therefore, this cross-sectional study examined the association between OFr with decreased bone mineral density (BMD) and renal function in residents of Shika town, Ishikawa Prefecture, Japan aged ≥40 years. This study included 400 inhabitants. The OFr total score was assessed using three oral domains in the Kihon Checklist (a self-reported comprehensive health checklist), the number of teeth, and brushing frequency per day. Measurements were the estimated glomerular filtration rate (eGFR) and the osteo-sono assessment index (OSI). Using a two-way analysis of covariance (p = 0.002), significantly lower OSI was indicated in the eGFR < 60 and OFr group than in the eGFR of < 60 and non-OFr group after adjusting for age, body mass index, and drinking and smoking status as confounding factors. Multiple logistic regression analysis confirmed this relationship (p = 0.006). Therefore, lower BMD seems to be associated with lower renal function only when accompanied by OFr. Further longitudinal studies are needed to confirm these results.

Relationships of Exercise and Dietary Intake with Bone Density in Young Adult Women

The aim of this study was to investigate the relationships of dietary intake, exercise, and menstrual regularity with bone density. In 81 female university students, the osteo-sono-assessment index (OSI) was determined by quantitative ultrasonography. In addition, a questionnaire on the intake of calcium, vitamin D, and phosphorus, exercise experiences in junior high school and high school days, and menstrual regularity was administered. The OSI was higher in the group that had the habit of exercising in junior high school and high school. Furthermore, the higher OSI was associated with higher vitamin D intake and lower phosphorus intake. These findings suggest the importance of exercise and dietary intake for improving bone density.

Bone Strength of the Calcaneus Is Associated with Dietary Calcium Intake in Older Japanese Men, but Not Women.

The relationship between calcium intake and bone strength in older Asian individuals, including Japanese, is controversial; therefore, we herein investigated this relationship in older Japanese populations. We performed a cross-sectional analysis of 314 participants older than 65 years who voluntarily participated in a medical examination and responded to questionnaires. The osteo-sono assessment index (OSI) measured at the right calcaneus using a quantitative ultrasonic device was used as an indicator of bone strength. The daily dietary intake of calcium was assessed using a brief-type self-administered diet history questionnaire. A two-way analysis of covariance revealed a significant interaction between sex and calcium intake on the OSI (p &lt; 0.01). A multiple regression analysis showed a positive correlation between calcium intake and the OSI in males (p &lt; 0.01), but not females (p = 0.27). In females, grip strength divided by body weight positively correlated with the OSI (p = 0.04). The present results suggest that a higher calcium intake contributes to bone strength in older Japanese males. Although a higher grip strength may contribute to bone strength in females, the potential of estrogen as a confounding factor needs to be considered.

Chemical equilibrium model comprising calcaneus bone mineral density, low-density lipoprotein cholesterol, and physical work capacity in premenopausal women

Background: During menopause, bone density decreases, and low-density lipoprotein cholesterol (LDL-C) rapidly increases; a decrease in the estrogen level is a common factor in these phenomena. Methods: In this study, we focused on the fact that menopause is a spontaneous process, and aimed to derive the conditions that mitigate the decline in the osteo sono-assessment index (OSI), an index of bone mineral density (BMD), using a chemical equilibrium model. We attempted to establish the relationship between variables related to female hormone secretion (OSI, LDL-C) and a variable related to work capacity (physical work capacity [PWC] at 75% of maximal heart rate) by analogy, using the fact that Gibbs free energy, a thermodynamic variable related to spontaneous change, is related by three variables. Results: Consequently, if linearity is established between PWC and OSI when LDL-C is used as the standard, then the analogy of chemical equilibrium can be established between the deviation values of these three variables, with equilibrium constant K. Finally, the theoretically determined equilibrium model with constant K was applied to data obtained from the Sports Program Service (SPS) of the Yokohama Sports Medical Center. Conclusions: The present study suggests that the decrease in bone density could be alleviated by promoting an increase in LDL-C or by mitigating the decrease in PWC. In discussing personal health, mitigating bone density loss and maintaining a high work capacity are important components, which should also take into account the appropriate levels of LDL-C.

Associations between physical physique/fitness in children and bone development during puberty: a 4-year longitudinal study

Bone growth is most remarkable during puberty. This study aimed to clarify the effects of physique and physical strength on bone mineral density and bone metabolism markers during puberty to help improve bone growth during puberty and prevent future osteoporosis. There were 277 pubertal participants (125 boys and 152 girls) in this survey from 2009 to 2015, all aged 10/11 and 14/15 years. The measures included physical fitness/physique indices (such as muscle ratio etc.), grip strength, bone density (osteo sono-assessment index, OSI), and bone metabolism markers (bone-type alkaline phosphatase and type I collagen cross-linked N-telopeptide). At 10/11-years-old for girls, a positive correlation was found between body size/grip strength and OSI. At 14/15-year-old for boys, all body size factors/grip strength were positively correlated with OSI. The change in body muscle ratio was positively correlated with change in OSI for both sexes. The height, body muscle ratio and grip strength at 10/11-year-old were significantly associated with OSI (positively) and bone metabolism markers (negatively) at 14/15-year-old for both sexes. Adequate physique building after 10/11 years for boys and before 10/11 years for girls may be effective in increasing peak bone mass.

Association of Knee Extensor Muscle Strength and Cardiorespiratory Fitness With Bone Stiffness in Japanese Adults: A Cross-sectional Study.

Knee extensor muscle strength and cardiorespiratory fitness (CRF) are major components of physical fitness. Because the interactive association of knee extensor muscle strength and CRF with bone health remains unclear, we aimed to investigate such association in Japanese adults. Altogether, 8,829 Japanese adults (3,731 men and 5,098 women) aged ≥45 years completed the maximum voluntary knee extension test, submaximal exercise test, medical examination, and a questionnaire on lifestyle habits. Using an osteo-sono assessment index, low bone stiffness tendency was defined as 80% under the young-adults mean. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated after confounder adjustment. Overall, 542 men (14.5%) and 978 women (19.2%) had low bone stiffness tendency. We observed an inverse association between muscle strength and low bone stiffness tendency after adjustment for CRF in both sexes (P for linear trend <0.001). Compared with the lowest CRF, the multivariable ORs for low bone stiffness tendency in the highest CRF were 0.47 (95% CI, 0.36-0.62) for men and 1.05 (95% CI, 0.82-1.35) for post-menopausal women (P < 0.001 and P = 0.704, respectively). No interactive association between muscle strength and CRF for low bone stiffness tendency existed in both sexes and irrespective of menopausal status. Knee extensor muscle strength and CRF were associated additively, not synergistically, with bone health. Maintaining high levels of both physical fitness components may improve musculoskeletal health in the cohort. The relationship between physical fitness and bone status should be longitudinally investigated in the future.

Relationship between Decreased Mineral Intake Due to Oral Frailty and Bone Mineral Density: Findings from Shika Study.

The relationship between oral frailty (OF) and bone mineral density is unclear. This cross-sectional study analyzed the relationship between mineral intake and bone mineral density in middle-aged and older people with pre-oral and OF. The participants, which included 240 people aged 40 years and older, completed the three oral questions on the Kihon Checklist (KCL), which is a self-reported comprehensive health checklist, the brief-type self-administered diet history questionnaire (BDHQ), and the osteo-sono assessment index (OSI). A two-way analysis of covariance on oral function and OSI indicated that the intake of potassium, magnesium, phosphorus, squid/octopus/shrimp/shellfish, carrots/pumpkins, and mushroom was significantly lower in the OF and low-OSI groups than in the non-OF and high-OSI groups. A multiple logistic regression analysis for OF showed that potassium, magnesium, phosphorous and carrots/pumpkins were significantly associated with OF in the low-OSI group but not in the high-OSI group. These results demonstrated that the decrease in mineral intake due to OF was associated with decreased bone mineral density, suggesting that the maintenance of oral function prevents a decrease in bone mineral density.

Relationship between vitamin D receptor gene polymorphisms (BsmI, TaqI, ApaI, and FokI) and calcium intake on bone mass in young Japanese women

BackgroundThe high prevalence of low bone mass in young women in Japan has emerged as a serious health issue in recent years. Therefore, the aim of the present study was to reevaluate the relationship between genetic and dietary factors, as well as its influence on bone mass in young Japanese women, with particular emphasis on vitamin D receptor (VDR) gene polymorphisms and calcium intake.MethodsA total of 499 Japanese women aged 20–24 years were enrolled in the study. The bone mass of the calcaneus was assessed using the quantitative ultrasound method and expressed as the osteo sono-assessment index (OSI). VDR gene polymorphisms (BsmI, TaqI, ApaI, and FokI) were analyzed using DNA extracted from saliva. Calcium intake was assessed using the Food Frequency Questionnaire based on food groups (FFQg) and adjusted with the energy intake. Participants were divided into two groups based on the median calcium intake (250 mg/1000 kcal).ResultsConsequently, bone mass was significantly different among the BsmI and TaqI genotypes after adjusting for body mass index (BMI) (p = 0.030 and 0.019, respectively). In addition, the BsmI AA and ApaI GT genotypes showed significant differences in bone mass between the calcium-intake groups, with low OSI in the low-calcium intake group and high OSI in the high-calcium intake group, respectively, even after adjusting for BMI (p = 0.020 and 0.038, respectively).ConclusionsThese findings may prove instrumental in developing a logical approach towards preventing bone loss in young Japanese women.

Effect of Cdx2 Polymorphism on the Relationship between Dietary Calcium Intake and Peak Bone Mass in Young Japanese Women.

Studies investigating the effect of the caudal-type homeobox protein 2 (Cdx2) polymorphism in the vitamin D receptor gene and calcium intake on bone mass have shown inconsistent results. This study investigated whether the effect of calcium intake on peak bone mass is affected by Cdx2 polymorphism in young Japanese women. A cross-sectional study of 500 young women was conducted. Dietary intake was assessed by the Food Frequency Questionnaire. The osteo sono-assessment index (OSI), assessed by the qualitative ultrasound method, was used as a bone mass index. The subjects were divided into two groups by the median calcium intake. The OSI was not different among Cdx2 genotypes and between calcium groups (p = 0.960, p = 0.191, respectively). The interaction between calcium and Cdx2 genotypes on the OSI approached significance (GG versus GA and AA genotypes, p = 0.092). The difference in the OSI between calcium groups was significant in the GG genotype (p = 0.028), but not in the GA or AA genotypes (p = 0.501, p = 0.306, respectively). Adjustment for covariates (body mass index and physical activity) did not change the results. In conclusion, the relationship between dietary calcium intake and peak bone mass may vary according to Cdx2 polymorphism.

Muscle Strength and Bone Strength Assessed with Osteo-sono Assessment Index Among Recreationally Athletic Japanese Women

Low muscle strength is an independent risk factor for low bone strength, which is a well-established predictor of osteoporotic fracture. However, the association between muscle strength and bone strength remains unclear among recreationally athletic Asian women. PURPOSE: To investigate the association between muscle strength and bone strength among recreationally athletic Japanese women. METHODS: This cross-sectional study was conducted in 7091 recreationally athletic Japanese women [mean (standard deviation), age 50.3 (15.2) years] who had undergone medical checkup and various exercise tests voluntarily from 1998 to 2016 at a preventive medical center. Participants completed a maximal voluntary knee extension test, quantitative ultrasound (QUS), calcaneal measurements, a medical examination, and questionnaires on lifestyle. Muscle strength, expressed as Nm per body weight in kilogram (Nm/kg), was measured at 60 degrees/s in the knee with an isokinetic dynamometer. The osteo-sono assessment index (OSI) evaluated right calcaneus heel bone strength using a QUS measurement. Multiple linear regression analysis assessed independent association of muscle strength and OSI (×106) after adjustment for age, systolic blood pressure, smoking, drinking, prevalence of diabetes, and body mass index. RESULTS: Muscle strength had a positive association with OSI score after adjustment for potential confounding factors (β=0.17, 95% confidence interval; 0.15-0.19, p <0.001). Furthermore, age-stratified (≥50 years and under) analyses showed similar patterns of association. CONCLUSIONS: Our results suggest a dose-response association between muscle strength and bone strength after adjustment for potential confounding factors. We need to further investigate longitudinal relationship between muscle strength and bone strength in a cohort study.

Does coffee drinking have beneficial effects on bone health of Taiwanese adults? A longitudinal study

BackgroundResults from studies investigating the association between coffee consumption and osteoporosis or bone mineral density (BMD) have been inconsistent. This longitudinal study was performed to assess the effect of coffee drinking on bone health of Taiwanese adults.MethodsData were retrieved from the Li-Shin (Landseed) Hospital in Taoyuan City. In 2006, 6152 participants completed a questionnaire on coffee drinking and other lifestyle factors. In 2014, 5077 of them were followed up. Nonetheless, a total of 2395 participants with incomplete data were excluded. The final analyses included 2682 participants comprising 1195 men and 1487 women (706 premenopausal and 781 postmenopausal). T-scores were derived from the osteo-sono assessment index (OSI) which is a surrogate of BMD. Coffee drinking was categorized as “no, medium, and high” based on the number of cups that were consumed per week in both 2006 and 2014.ResultsIn general, medium and high coffee drinking were associated with higher T-scores. However, significant results were observed only among high drinkers (β = 0.158; P = 0.0038). Nonetheless, the test for linear trend was significant (P = 0.0046). After stratification by sex, medium and high coffee drinking were associated with higher T-scores. However, significant results were prominent only among high male drinkers (β = 0.237; P = 0.0067) and the test for trend was significant (P = 0.0161). Based on menopausal status, coffee drinking was associated with higher T-scores. Nevertheless, significant results were found only among premenopausal women (β = 0.233; P = 0.0355 and β = 0.234; P = 0.0152 for medium and high coffee drinking, respectively. The test for linear trend was significant (P = 0.0108).ConclusionCoffee drinking was significantly associated with higher T-scores hence, a lower risk of osteoporosis in men and premenopausal women.

Cancer survivors exhibit a different relationship between muscle strength and health-related quality of life/fatigue compared to healthy subjects.

We investigated the difference in relationship between muscle strength and quality of life (QOL)/fatigue in long-term cancer survivors and healthy subjects. Thirty-six cancer survivors and 29 healthy subjects were assessed for body composition and bone status at the calcaneus using the Osteo Sono Assessment Index. Muscle strength was evaluated via handgrip and knee extensor strength. Health-related QOL was assessed using the Medical Outcome Study 36-item Short-Form Health Survey. Fatigue was measured using the brief fatigue inventory. Cancer survivors exhibited lower QOL scores in the physical functioning, physical role function, bodily pain and general health domains (p<.05). Grip and knee extension muscle strength in cancer survivors was positively correlated with the physical function and bodily pain of QOL (p<.05). The usual fatigue subscale score was only significantly higher in cancer survivors than in healthy subjects (p<.05). However, there were no correlations between muscle strength and fatigue in cancer survivors. Our results showed that muscle strength was an important factor for improving QOL in cancer survivors. We believe that the findings of this study will be relevant in the context of planning rehabilitation for cancer survivors.

短期大学女子学生の踵骨骨強度と筋厚、皮下脂肪厚、および体力的指標との関連

短期大学女子学生の踵骨骨強度と筋厚、皮下脂肪厚、および体力的指標との関連

Factors Associated With Bone Density Among Japanese Teenagers

Bone health is a significant issue for children to encourage healthy physical development. The objective of this research was to analyze the relationship between bone density and daily habits to explore effective strategies for promoting bone health in children. Participants were 157 junior high school students living in Yamagata, Japan. Each student's bone density was measured, and they answered a questionnaire in Home Economics class at school. The calcaneus density was measured using an ultrasound technology system (AOS-100SA, Hitachi, Japan). The Osteo Sono-assessment Index (OSI) was used as an index of bone density. Frequency of eating calcium rich foods such as milk products and small soft-boned fish was assessed by a questionnaire, and the results of which were summarized with a total diet score. The students were divided into three (high/middle/low) groups according to their total diet scores. The students were also divided into two groups (high/low) according to the frequency of their physical activity. Two-way ANOVA tested for differences in mean OSI across gender and groups. The high diet score group showed significantly (p=0.04) higher OSI than the other two groups in both genders. The high physical activity group had marginally (p=0.09) higher OSI than the low physical activity group in both genders. Nutrition educators need to help students achieve a calcium rich diet, and daily physical activity should be also recommended to encourage bone health in teenagers.

Submitted, Not Presented: Stomach.

Introduction: Osteoporosis is often regarded as the disease specific to female, whereas male patients with osteoporosis are increasing as well. Although the main factor of osteoporosis in female is the decrease of estrogen production, the etiology is not clear for men. In Western countries, infection of H. pylori, particularly CagA-positive strain, has been shown as a possible risk for osteoporosis in male. The absorption of calcium is affected by acidity of gastrointestinal tract. In Japan, most H. pylori strains are CagA-positive and severe gastric mucosal atrophy is often observed in infected patients causing the reduction of gastric acid secretion. Thus, there could be more clear relationship between H. pylori infection and loss of bone density in Japan comparing with Western populations. The aim of this study was to examine whether H. pylori infection associates with loss of bone density in Japanese healthy males. Methods: 295 healthy male adults who attended the mass survey in 2014 were enrolled into the study (mean age: 50.2 ± 15.4 years old). We measured H. pylori stool antigen and the titer of serum antibodies to H. pylori. H. pylori status was defined as positive or negative when both tests showed concordant results. The bone density was examined calcaneal osteo sono-assessment index (OSI) using quantitative ultrasound. Osteopenia was defined when measured OSI was less than 1.0 SD from the mean OSI of the young age (20-44 years old) according to WHO diagnostic criteria. We performed logistic regression models and calculated the adjusted odds ratio (OR) for having osteopenia as a dependent variable. The independent variables were age, BMI, serum level of estradiol, the intake of calcium per day, smoking, drinking, periodical exercise, last educational background and H. pylori infection. Results: Bivariate and multivariate analyses revealed that only age was significantly different between subjects with or without osteopenia. In multivariate analysis, the adjusted OR of age for osteopenia was 2.88 (95%CI: 1.46-5.68, p < 0.001). On the other hand, the adjusted OR of H. pylori infection for osteopenia was 0.92 (0.47-1.81; p=0.81). Conclusion: Age was a significant risk for developing osteopenia in Japanese males. Unlike Western populations, no significant association was found between H. pylori infection and osteopenia in this series of adult males.

Effects of Fok-I polymorphism in vitamin D receptor gene on serum 25-hydroxyvitamin D, bone-specific alkaline phosphatase and calcaneal quantitative ultrasound parameters in young adults.

Several genes have been implicated as genetic determinants of osteoporosis. Vitamin D receptor (VDR) is an intracellular hormone receptor that specifically binds to the biologically active form of vitamin D, 1-alpha, 25- dihydroxyvitamin D3 [1, 25(OH)2D], and mediates its effects. One of the most frequently studied single nucleotide polymorphisms is the restriction fragment length polymorphism (RFLP) Fok-I (rs2228570). The presence of a Fok-I site, designated f, allows protein translation to initiate from the first ATG. An allele lacking the site (ATG>ACG: designated F), initiates from a second ATG site. In the present study, we explored the effect of the VDR Fok-I genotype on associations among serum bone-specific alkaline phosphatase (ALP), 25- hydroxyvitamin D3 [25(OH)D], 1, 25(OH)2D, and the dietary nutrient intake in healthy young Japanese subjects (n=193). Dietary nutrient intakes were calculated based on 3-day food records before the day of blood examinations. Quantitative ultrasound (QUS) parameters at the right calcaneus (heel bone) were measured. The allele frequencies were 0.622 for the F allele and 0.378 for the f allele in all subjects. Grouped by the VDR genotype, a significant positive correlation between the levels of serum bone-specific ALP and 25(OH)D was observed in the FF-type (p=0.005), but not in the ff-type. In addition, there was a significant positive correlation between the level of serum 25(OH)D and osteo-sono assessment index (OSI) in the FF-type (p=0.008), but not in the ff-type. These results suggest that the level of circulating 25(OH)D is an important factor when assessing the VDR Fok-I polymorphism to prevent osteoporosis.

Osteo-sono assessment index in calcaneus of married volleyball players

Osteo-sono assessment index in calcaneus of married volleyball players