Quantitative Ultrasound Densitometry Research Articles

Evaluation of the effectiveness of treatment and monitoring of patients with systemic bone tissue disorders during dental implantation

The article presents a study of bone mineral density by DEXA and evaluated the effectiveness of correcting therapy using vitamin D by quantitative ultrasound densitometry to increase the effectiveness of the treatment of patients with dental defects in the background of systemic osteoporosis by dental implantation. Materials and methods: 619 people were examined by quantitative ultrasonic densitometry. The dynamics of changes in bone mineralization was studied with an interval of six months and 1 year. A comparative analysis of the average values of quantitative ultrasonic densitometry was carried out at various times after the installation of dental implants in the control and main groups. Results. Sound velocity values in patients with normal bone mass were (4203,3 ± 7,9). In patients with osteopenia, the rate of ultrasound in bone tissue was 3992,2 ± 3,6 (p < 0.001); in patients with osteoporosis 3802,7 ± 14,9 (p < 0.001). All these parameters were obtained after the use of corrective therapy with vitamin D3. Conclusions. The analysis of the results of quantitative ultrasound densitometry revealed that in the group of patients with osteoporosis, the indicators were reduced by an average of 9.5 % compared with patients with normal bone indicators (p < 0.001).

PREVALENCE OF OSTEOPOROSIS IN WOMEN AGED 35 TO 65 YEARS IN TEA GARDEN COMMUNITY OF JORHAT DISTRICT

Background: Osteoporosis poses a huge challenge in India, as it is a developing country due to demographic transition and aging of the population along with limited resource availability in rural India.Osteoporosis predominantly affects postmenopausal women. The mal-nutrition, and smoking, consumption of liquor and tobacco may have an effect on bone mineral density (BMD) .Osteoporosis occurs in all populations, but not all populations are at equal risk. According to various studies, Asian women have higher predisposition for osteoporosis than their Caucasian people. Reasons attributed for lower bone mineral density (BMD) in Indians include possible genetic differences, nutritional deciency and smaller skeletal size. Smoking or tobacco intake, malnourishment, alcohol has a negative effect on bone mineral density [BMD]. Tea garden people are probably more affected than other communities in the surrounding area as evidence by high attendance of patients with osteoporosis & fragility fractures in Orthopaedic OPD of JMCH. Increase prevalence in the community might be wholly or partly due to poor socio-economic status , poor nutrition, lack of calcium and vitamin d in diet, dark skin and addiction to alcohol. Purpose of the study: to study the prevalence of osteoporosis in middle-aged to elderly tea garden women of Jorhat district. Materials and Methods: In this community based cross-sectional study, BMD (bone mineral density) of 360 female subjects, aged 35 to 65 years, were calculated using quantitative ultrasound bone densitometry.(QUS) In our study 24.7% were Results: osteoporotic, followed by 39.5% were osteopenic and 35.8% had normal BMD. Thus, the prevalence of osteoporosis in our study, in the female population of tea gardens of Jorhat district was 24.7%

Correlations of the Osteoporosis Self-Assessment Tool for Asians (OSTA) and Three Panoramic Indices Using Quantitative Ultrasound (QUS) Bone Densitometry.

This study aimed to evaluate the correlation between the Osteoporosis Self-Assessment Tool for Asians (OSTA) and three panoramic indices in relation to z-score and t-score values using quantitative ultrasound (QUS) bone densitometry. The sensitivity, specificity, and area under the curve (AUC) of the OSTA index were also measured using the QUS tool to evaluate the method's performance in identifying people at risk of osteoporosis. The study employed a cross-sectional design with 387 participants (190 men, 197 women). Patients' mandibular cortical indexes (MCI), mandibular cortical widths (MCW), and panoramic mandibular indexes (PMI) were measured from panoramic images. The sensitivity, specificity, and AUC were calculated using an OSTA index cutoff of ≤-1 and a t-score of ≤-1.0 for the QUS bone densitometry. The coefficient correlation of the OSTA index with the z-score (r = -0.563, p < 0.001) and t-score (r = -0.740, p < 0.001) shows a higher value than the MCI, MCW, and PMI, per the QUS. The sensitivity, specificity, and AUC values with a cutoff t-score of ≤-1.0 per the QUS in men was 90%, 50%, and 0.812, and in women, 96.8%, 30%, and 0.862. The OSTA index is a simple method that can be used in general dental practice.

Three panoramic indices for identification of healthy older people at a high risk of osteoporosis

BackgroundThis study aimed to identify whether healthy older adults are at a high risk of osteoporosis based on the association between the T-score values of bone mineral density (BMD) and three panoramic indices. Materials and methodsAll participants (50–64 years old) underwent calcaneal quantitative ultrasound (QUS) bone densitometry. In total, 371 panoramic images were included in the analysis. The mandibular cortical width (MCW), mandibular cortical index (MCI), and panoramic mandibular index (PMI) were the three parameters assessed. The data were examined using one-way analysis of variance or Kruskal–Wallis H and post hoc tests. Spearman’s rho was used to measure correlation coefficients. ResultsT-score distributions in the normal, osteopenia, and osteoporosis categories were 80 (21.6%), 236 (63.6%), and 55 (14.8%), respectively. T-scores were significantly related to age, MCW, PMI, and MCI (p < 0.001). Participants with osteopenia and a risk of progression to osteoporosis had an average MCW value of < 3.38 mm, a PMI of < 0.31, and an MCI class 2 and 3 distribution in 211 (56.9%) participants. The highest to lowest correlation coefficients with a significant relationship to the T-score were for age (r = -0.844), MCI (r = 0.456), MCW (r = 0.359), sex (r = 0.354), and PMI value (r = 0.292). ConclusionsThis study found that healthy older people with Class 3 MCI, an MCW < 3 mm, and a PMI ratio < 0.3 had a significant association with lower BMD T-scores on QUS and were at higher risk of osteoporosis.

Associations between Bone Material Strength Index, Calcaneal Quantitative Ultrasound, and Bone Mineral Density in Men.

ObjectivesImpact micro-indentation (IMI) measures bone material strength index (BMSi) in vivo. This study investigated how IMI is associated with calcaneal quantitative ultrasound and bone densitometry parameters in men.MethodsBMSi was measured on the tibial plateau using the OsteoProbe in 377 men (age 33-96 years) from the Geelong Osteoporosis Study. Broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) were assessed at the calcaneus using an ultrasonometer. Areal BMD was measured at several skeletal sites using dual-energy x-ray absorptiometry. Linear associations between parameters were tested using Pearson’s correlation. Multivariable regression techniques were used to determine associations between BMSi and other measures of bone, independent of confounders.ResultsBMSi was negatively correlated with age (r = –0.171, P = .001), weight (r = –0.100, P = .052), and body mass index (r = –0.187, P = .001), and positively with height (r = +0.109, P = .034). There was some evidence to support a positive association between BMSi and BUA (β = 0.052, P = .037), SOS (β = 0.013, P = .144), and SI (β = 0.036, P = .051). After age adjustment, this association was attenuated. No correlations were observed between BMSi and BMD at any skeletal site (r values ranged from –0.006 to +0.079, all P ≥ .13).ConclusionThere was a small positive association between BMSi and quantitative ultrasound (QUS) parameters, which were not independent of age. No associations were detected between BMSi and BMD. This suggests that BMSi and QUS are capturing common age-dependent properties of bone. Further research on the utility of IMI alone and complementary to conventional bone testing methods for predicting fracture risk is warranted.

Studi korelasi antara sarkopenia dengan nilai bone mineral density (BMD) pada populasi geriatri di Desa Adat Kapal

Background: Sarcopenia is a common condition in geriatric population. Prior studies suggest its relationship with decreased bone mineral density (BMD) level.&#x0D; Objective: To determine the correlation between sarcopenia and bone mineral density among geriatric population.&#x0D; Methods: This cross-sectional study employed random sampling method to select for participants. Study were invited to attend for assessments including bioelectrical impedance analysis (BIA) and digital handgrip dynamometer from which muscle mass and power were determined respectively, whilst bone mineral density was assessed using quantitative ultrasound densitometry (QUS). Data analysis was performed using SPSS 16.&#x0D; Results: Sixty-six samples aged 60 to 77 years contributed data to the analysis in which 22.73% was sarcopenic. Abnormal BMD level (53%), low muscle mass (38%), low muscle power (28%), and low physical performance (29%) were assessed accordingly. Data analysis revealed correlation between BMD with muscle mass (r=0.282; p=0.023), age (r=-0.131; p=0.298), physical performance (r=-0.578; p=0.000), and handgrip (r=0.434; p=0.000). Comparative test yielded mean BMD level of -2,37 and -1,59 in sarcopenic and non-sarcopenic study respectively (p=0.003). There was positive correlation between sarcopenia and BMD level (r=0.373; p= 0.002).&#x0D; Conclusion: Sarcopenia prevalence is relatively high in geriatric population. Lower BMD level is observed in sarcopenic population. There is strong positive correlation between sarcopenia and BMD level, thus reflecting lower level of BMD in sarcopenic patient. Factors associated with BMD level according to the strength of correlation are physical performance, muscle power, muscle mass, and age.

MINERAL DENSITY OF BONE TISSUE AND INDICATORS OF BONE REMODELING IN HIGHLY SKILLED ATHLETES IN THE ANNUAL TRAINING CYCLE

Aim. The article aims at studying the relationship between the mineral density of heel bone and bone remodeling in cyclistduring the annual training cycle. Materials and methods. The study involved 14 highly skilled male cyclists (cycle track, MS, MSIC) aged 20–25 years with a sports experience of 5 to 16 years. The measurements were performed in the preparatory, pre-competitive and competitive periods of the annual training cycle. Bone mineral density (BMD) was measured by the method of quantitative ultrasound densitometry (QUS) using the Achilles Express ultrasonometer (Lunar, USA). BMD was estimated as a percentage of the peak norm for a given section of the skeleton (reference norms for 20–29 years). Results. The dynamics of BMD in the annual cycle correlates with a change in bone remodeling and phosphorus-calcium metabolism. A decrease in BMD during the competitive period is associated with an increase in β-Cross Laps and a decrease in osteocalcin, alkaline phosphatase, ionized calcium and serum phosphorus. Conclusion. A decrease in BMD is associated with an increase in the activity of osteoclasts and a decrease in osteoblastic activity. Indicators of bone remodeling and phosphorus-calcium metabolism reflect the status of bone tissue and the processes of general adaptation to training loads, and can be used as markers of risk of decreased BMD. The heel bone QUS method can be used to identify athletes at risk for hypotrophic conditions.

Effect of estrogen receptor-α gene polymorphism on serum osteoprotegerin and calcaneus bone density in postmenopausal women in Guangxi Zhuang nationality

Objective To investigate the effect of estrogen receptor-α gene polymorphism on osteoprotegerin(OPG)and calcaneus bone density in early and late postmenopausal women in Guangxi Zhuang nationality, in order to provide the theoretical basis for the early prevention and treatment of postmenopausal osteoporosis caused by estrogen receptor gene-induced osteoprotegerin reduction. Methods The broadband ultrasound attenuation in the right heel bone was measured by quantitative ultrasound bone densitometry in 621 postmenopausal women of Guangxi Zhuang nationality.Peripheral blood mononuclear cells and their DNA were extracted.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to detect the estrogen receptor-α gene polymorphism.Serum osteoprotegerin level was determined by enzyme-linked immunosorbent assay.The differences of data distribution of OPG and calcaneus bone density were compared between five items of 3 genotypes and 2 alleles at the same age group of 40-, 45-, 50-, 55-, 60-, 65-, 70-, 75-80 years. Results Women aged 60 years and over versus those aged 40-59 years showed that serum osteoprotegerin(OPG)and bone mineral density(BMD)were decreased(P 0.05). Women aged 60 years and over showed that ER-α Puv Ⅱ polymorphism of allele big P versus p, Pp, pp, PP in the same age groups had significantly decreased serum osteoprotegerin and bone mineral density.Women aged 65 years and over showed that ER-α XbaⅠpolymorphism of heterozygote Xx versus xx, XX, X, x in the same age groups had a significantly increased serum osteoprotegerin and bone mineral density(P<0.05). Conclusions Women with big P allele of ER-α PvuⅡpolymorphism have low serum osteoprotegerin level and a decreased bone mineral density, who are prone to postmenopausal osteoporosis.Thus, P allele of ER-α PvuⅡpolymorphism is a causative agent.More attention should be paid to early prevention and treatment.But, women with the Xx heterozygote of ER-α XbaⅠpolymorphism have high serum osteoprotegerin level and an increased bone mineral density, who are not easy to suffer from postmenopausal osteoporosis.Therefore, Xx heterozygote of ER-α XbaⅠpolymorphism is a protective agent.The prevention and treatment of postmenopausal osteoporosis should be individualized based on estrogen receptor-α gene polymorphism. Key words: Zhuang nationality; Receptors, estrogen; Polymorphism, single nucleotide; Osteoprotegerin

Calcaneal Broadband Ultrasound Attenuation and Speed of Sound Measurements in a Population of Nigerian Children: Reference Data and the Influence of Sociodemographic Variables.

The aim of our study was to establish a reference database of calcaneal broadband ultrasound attenuation (BUA) and the speed of sound (SOS) in a healthy Nigerian population of children aged 6 to 14 years and also to investigate the influence of sociodemographic and anthropometric variables on them. The BUA and SOS of 1016 healthy children were measured by quantitative ultrasound densitometry. Height and weight were measured with a stadiometer and weighing balance, respectively, whereas the sociodemographic parameters of the participants were collected on a semistructured questionnaire. A multiple regression model using stepwise selection and Pearson correlation coefficients were used to examine the relationship between the ultrasound parameters and sociodemographic and anthropometric parameters. Comparisons between various age groups were made by analysis of variance. The mean BUA and SOS ± SD of the participants were 60.57 ± 16.21 dB/MHz and 1563.48 ± 21.74 m/s, respectively, for boys and 58.18 ± 15.16 dB/MHz and 1560.03 ± 22.32 m/s for girls. The BUA in both sexes was positively influenced by age and weight (P < .05), whereas only the father's educational status was its predictor (P < .05) in the boys. For the girls, the family size and mother's educational status were predictors of the BUA (P < .05). The SOS was marginally influenced by age and family size in the boys (P < .05), whereas the father's educational status was the predictor in the girls. The established BUA and SOS values in this study are baseline values, and further study, which would also involve data from a large number of Nigerian children, would be needed to support their effectiveness as reference values.

Skeletal status assessment by quantitative ultrasound and bone densitometry in children with different renal conditions

SummaryTwo methods of skeletal status assessment—quantitative ultrasound (QUS) and densitometry (DXA)—were applied and compared in a group of children with different renal disorders. Skeletal assessments in children with different renal conditions should rather not be based on a single diagnostic tool. Lumbar spine DXA is very effective to reveal disturbances secondary to glucocorticoids, whereas total body DXA and QUS are both better in identification of disturbances related to decreased GFR.IntroductionThe aim of the study was to evaluate the skeletal status in children in different stages of chronic kidney disease (CKD) or treated with glucocorticoids, using either densitometry (DXA) or quantitative ultrasound (QUS) methods.MethodsSeventy-six subjects (27 girls/49 boys) at the mean age of 11.8 ± 4.0 years were enrolled to the reported study. They were divided into three subgroups: with normal glomerular filtration rate (GFR) but treated with glucocorticoids (GCs, n = 38), with decreased GFR (CKD 2–5, n = 26) and with normal GFR and without any bone-toxic treatment (CKD 1, n = 12). DXA scans were carried out at lumbar spine (LS) and at total body (TB), and quantitative ultrasound (QUS) imaging was done at hand phalanges. QUS results were compared to those obtained from 310 healthy matched controls.ResultsThe average Z-score for LS-BMD and TB-BMD was below zero in all the study subgroups. Neither were there any significant differences in the mean Z-score for LS among the subgroups. The mean Z-score for TB was significantly the lowest in the CKD 2–5 subgroup. The percentage of subjects with TB Z-score ≤ − 2.0 was the highest in the CKD 2–5 subgroup (69.2%), whereas the percentage of subjects with LS Z-score ≤ − 2.0 was the highest in the GC subgroup (23.7%). QUS results in CKD 2–5 were significantly lower than those in the controls, whereas the results, obtained in GC and CKD 1 subgroups, were similar to those in healthy subjects.ConclusionsSkeletal status assessment in children and adolescents with different renal conditions should not be based on single diagnostic approach. DXA scanning, performed at lumbar spine, is potentially more appropriate to reveal disturbances secondary to long-term GC therapy, whereas TB-DXA is highly effective in the identification of skeletal disturbances related to decreased kidney function. QUS at hand phalanges seems to be a useful diagnostic means in CKD with diminished GFR but insufficient to detect GC-related disturbances.

State of bone tissue in patients with thyrotoxicosis syndrome

Оbjective. To determine the influence of thyroid functional state on bone mineral density indexes from data of ultrasound densitometry and laboratory methods of research.Materials and methods. 80 patients of reproductive age with thyrotoxicosis syndrome were recruited. The thyroid functional state was estimated by means of determination of thyroid-stimulating hormone (TSH) basal concentrations and free thyroxine in the blood serum. Subjects were invited to attend quantitative ultrasound densitometry (Sahara), and a fasting blood sample from which osteocalcin, serum N-terminal propeptide of type 1 procollagen and crosslinks were also measured.Results. Frequency of bone mineral density disorders in patients with thyrotoxicosis syndrome was 52,7%, including osteopenia in 40% and osteoporosis in 12.7%. A basic factor that results in the decline of bone mineral density in patients with thyrotoxicosis syndrome is excessive products of thyroid hormones, and also TSH-suppressive doses of levothyroxine. Ultrasound densitometry showed significant decrease of bone mineral density indexes and increase of frequency of osteopenia and osteoporosis as compared to healthy persons.Conclusions. Complex approach is the first brought to the estimation of bone metabolism state in patients with thyrotoxicosis syndrome. It contains an ultrasound densitometry and laboratory methods of research. Set factors (excessive products of thyroid hormones, reception of preparations of thyroid hormones in TSH-suppressive doses) and mechanisms of negative influence (stimulation of osteoclastic activity, decline of osteoblastic activity) on the state of bone metabolism in patients with thyrotoxicosis syndrome.

Decreased cortical thickness, as estimated by a newly developed ultrasound device, as a risk for vertebral fracture in type 2 diabetes mellitus patients with eGFR of less than 60 mL/min/1.73 m2.

SummaryCortical porosity is increasingly recognized as an important risk for fracture in DM patients. The present study demonstrated that decreased cortical thickness, assessed using a newly developed quantitative ultrasonic bone densitometry, is a significant risk factor for vertebral fractures in type 2 diabetes mellitus patients with stage 3 or higher chronic kidney disease, but not in those without.IntroductionCortical porosity is increasingly recognized as an important risk factor for fracture in type 2 diabetes mellitus (T2DM) patients as well as in stage 3 chronic kidney disease (CKD) patients in whom serum parathyroid hormone (PTH) starts to increase. The present study aimed to clarify whether the coexistence of CKD might affect the relationship of decreased cortical thickness (CoTh) in the development of vertebral fractures (VF) in T2DM patients.MethodsIn this cross-sectional study, trabecular bone mineral density (TrBMD), elastic modulus of trabecular bone (EMTb), and CoTh were estimated with a new quantitative ultrasound bone densitometry in 173 T2DM patients. VFs were identified radiographically.ResultsThirty-nine patients (22.5 %) had VF. Those with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (low eGFR) showed a significantly higher VF rate (32.4 %) than those with eGFR ≥60 mL/min/1.73 m2 (high eGFR, 16.2 %). Serum PTH was significantly higher with low eGFR than with high eGFR. In those with high eGFR, EMTb was significantly lower in VF(+) than VF(−). In those with low eGFR, TrBMD, EMTb, and CoTh were significantly lower in VF(+) than in VF(−). In a multivariate logistic regression analysis, EMTb was independently and significantly associated with VF in T2DM patients with a high eGFR, in contrast to those with only CoTh with VF in T2DM with low eGFR.ConclusionThis study demonstrated CoTh as a factor independently associated with VF in T2DM patients with low eGFR and increasing serum PTH levels.Electronic supplementary materialThe online version of this article (doi:10.1007/s00198-014-2843-x) contains supplementary material, which is available to authorized users.

Evaluation of the prevalence and correlated factors for decreased bone mass density among pre- and post-menopausal educated working women in Saudi Arabia.

Most of the previous studies on osteoporosis have focused on post-menopausal women, and more research is needed to evaluate its prevalence in pre-menopausal women. This study was carried out to evaluate the prevalence and correlated factors for decreased bone mass density among pre- and post-menopausal women. This was a cross-sectional study carried out in Applied Medical Sciences College under King Saud University. All pre- and post-menopausal women working there were invited to participate in the study. Measurement of bone mass density was done by quantitative ultrasound densitometry. One-fourth of the pre-menopausal females had osteopaenia. There was a significant correlation between having osteoporosis and increasing age, fertility period, parity, menopausal duration, gynaecological age, and presence of co-morbidity, especially hypertension and diabetes mellitus. Pre-menopausal females had high prevalence of osteopaenia (24.8%), and it is recommended to implement health education campaigns demonstrating the preventive measures of osteoporosis.

Early Life Risk Factors for Low Bone Mineral Density among Preschool Aged Children

Objective: To investigate the early life risk factors for low bone mineral density (BMD) in preschool aged children. Methods: Children aged 5 years from the Ewha Birth & Growth Cohort were followed from September 2010 to November 2011. The subjects included 146 who had their BMD measured using quantitative ultrasound densitometry. Those in the lowest quartile of BMD were classified as the low BMD group (n=35). The early life risk factors considered were birth outcomes, advanced maternal age (≥35 years), breast feeding, current anthropometric data, socioeconomic status, and physical activity. Results: The mean BMD was 68.1±13.4 (boys 67.7±12.1, girls 71.1±20.9, p<0.05). For early life risk factors, 17 subjects who were born to women of advanced maternal age belonged to the low BMD group (37.8% vs. 15.6%, p<0.01). In addition, the proportion of low BMD increased with the average time in sedentary activities, although not significantly (p-value for trend=0.06). No associations for other risk factors were found. In the multiple logistic analysis,

AB0800 Bone Mineral Density in Postmenopausal Women with Hip Osteoarthritis

BackgroundOsteoporosis and osteoarthritis are the common diseases in women in postmenopausal period. The reason why osteoarthritis and osteoporosis do not affect all women during their postmenopausal period has not been...

Quantitative Ultrasound Densitometry in University Level Cricket Fast Bowlers and Nonathletes

ABSTRACT Background Fast bowling in cricket is an important skill that imparts mechanical loads on limbs. The differential loading patterns involved in bowling affect the peripheral limb bone status. Objective To evaluate bone properties using quantitative ultrasound densitometry (QUS), among fast cricket bowlers in comparison with nonathletes. A secondary objective was designed to find correlation between QUS parameters and bonespecific physical activity questionnaire (BPAQ). Methodology A total of 80 subject, 40 fast cricket bowlers of both gender (20 male and 20 female) and 40 nonathletes (20 male and 20 female) were included in our study and all are aged between 20 and 25 years. Bone speed of sound (SOS) was measured bilaterally at the distal radius and the mid tibia using Sunlight OmnisenseTM device. Results There was a significant difference between dominant side and nondominant side radial SOS (p &lt; 0.05) and tibial SOS (p &lt; 0.05) in cricket bowlers favoring dominant radial bone SOS and nondominant tibial bone SOS which was not found in nonathletes. Significant difference in dominant radial bone SOS values (p &lt; 0.05) and nondominant tibial bone SOS (p &lt; 0.05) values existed between cricket bowlers and controls. Positive correlation was found between tibial SOS and past BPAQ in all subjects. Conclusion QUS parameters were significantly higher in young cricket bowlers with greater values observed in the dominant arm and leading foot, thus reflecting the osteogenic effect that occurs due to the nature of the game. Further BPAQ is significantly correlated with lower limb bone properties as measured by QUS at mid shaft tibia. How to cite this article Shenoy S, Parthasarathy S, Sandhu JS. Quantitative Ultrasound Densitometry in University Level Cricket Fast Bowlers and Nonathletes. J Postgrad Med Edu Res 2013;47(2):83-89.

Assessment of Osteoporosis in Family Medicine Obtained by Ultrasound Densitometry

Introduction:Osteoporosis is a disease characterized by a decrease in bone mineral density, making bones become less rigid, and therefore susceptible to fractures, either spontaneously or with force, which is lower than otherwise needed for healthy bones fractured. Nearly 10% of the world population and 30% of women after menopause, suffer from osteoporosis. Clinical assessment of osteoporosis in family medicine is key to prevention, early detection and treatment of osteoporosis.Objective:To investigate the possibility of early detection and diagnosis of osteoporosis by analyzing the risk factors for osteoporosis and to compare the results with the parameters obtained by ultrasound densitometry of calcaneus, and determine the relationship of calcaneus densitometry with DXA findings, as the gold standard for the diagnosis of osteoporosis.Patients and methods:The study included all patients of Family Medicine Kalesija Team 1, aged 50 years and over, a total of 711 patients, of whom 425 were women and 286 men. In all patients we assessed the existence of the following risk factors for osteoporosis: Constitutional: gender, age, weight, constitution, menarche and menopause, loss of height and stooped posture; Living habits: smoking, alcohol consumption, coffee, physical activity, and medications: long-term use corticosteroids, anticonvulsants, antacids, thyroid hormones. Comorbidity: history of fractures, hyperthyroidism, COPD, Chussing’s disease, diabetes. In the group of high-risk patients determined by the clinical assessment, quantitative ultrasound densitometry screening was carried out. Monitoring parameters derived with densitometry: the value of T-score, BUA (Broadband Ultrasound Attenuation), SOS (Speed of Sound), QUI (Quantitative Ultrasound Index). To confirm the diagnosis of osteoporosis, in all patients with positive findings using ultrasound densitometry (T score lower than 2.5), another densitometry was performed by standard DXA method.Results:The incidence of osteoporosis was 96% in women and 4% in men. Differences in prevalence between men and women are statistically significant. People with and without osteoporosis significantly differ in gender, age, weight, constitution (BMI-Body Mass Index). The parameters that distinguish those with and without osteoporosis: age, weight, height, BMI, gender. Out of the total of 711 patients, in 11% of patients the clinical evaluation showed the existence of high risk of osteoporosis. In 9.8% patients, the values were determined by ultrasound densitometry, where T score was lower than 2.5 what induces a high risk of fractures, and for 8.8% patients the DXA confirmed the diagnosis of osteoporosis.Conclusion:Clinical assessment of osteoporosis in the family medicine clinic performed in timely and focused history of risk factors for osteoporosis, with additional findings from quantitative densitometry of calcaneus, was sufficient for the early detection and screening of patients with high risk for osteoporosis. With good clinical assessment of osteoporosis it will be necessary to send all patients who enter the high-risk group to undergo ultrasound densitometry of calcaneus, to make it possible to determine the risk of bone fractures and osteoporosis in time, and then refer patients for further processing and DXA measurements according to the guidelines by the WHO.

FEMALE ATHLETE TRIAD PADA ATLET PUTRI DI PUSAT PENDIDIKAN LATIHAN (PUSDIKLAT) RAGUNAN JAKARTA

Background: Female athletes tend to consume improper for supporting their performance, so that can impact eating disorder. Eating disorder can lead menstrual irregularity and osteoporosis for them, so they have risk of female athlete triad. The aimed of this study to determine prevalence of female athlete triad in education and training centre (PUSDIKLAT) Ragunan Jakarta. Methods: Descriptive research with cross sectional design, and calculation of total subject used stratified proportional random sampling. The sample was composed of 65 female athletes in Education and Training Center (PUSDIKLAT) Ragunan Jakarta. Data include nutritional status, eating disorder, menstrual disorder, and bone density. Assessment of nutritional status used BMI/A percentile and percent body fat; measurement of percent body fat used body fat analyzer HBF 200; assessment of eating disorder used eating disorder diagnostic scale; measurement of menstrual irregularity used questionnaire including frequency, menstrual cycle, menarche, and menstruation on last 3 months; and measurement of bone density used quantitative ultrasound bone densitometry. Result: Female athlete triad not found on subjects, but 15 subjects (23.1%) had bulimia and 1 subject (1.5%) had menstrual irregularity, i.e oligoamenorrhea, whereas bone density of all subjects (100%) normal, so that only 1 subject (1.5%) had two symptom of female athlete triad (bulimia and oligoamenorrhea).fifty six subjects (86,2%) had normal nutritional status. Based on fat body percent, that was found 1 subject (1.5%) having underfat, 10 subjects (15.4%) overfat, and 2 subjects (3.1%) obese. Conclusion:Female athlete triad not found in Education and Training Center (PUSDIKLAT) Ragunan Jakarta

In Vivo Calcium and Phosphate Iontophoresis for the Topical Treatment of Osteoporosis

In addition to systemic treatment, osteoporosis may be treated topically by incorporating calcium and phosphate into the bone. This article describes the use of a recently developed, novel iontophoretic apparatus suitable for local ion delivery into bones. In this study, in vivo experiments were performed to compare the effects of local electrotherapy and those of systemic hormone replacement on bone. In this study, local iontophoresis was carried out in ovariectomized and control rats. Bone density, biomechanical, and elemental studies were performed. Forty 12-week-old Sprague-Dawley rats received an ovariectomy (OVX) or were sham-operated (sham). Twenty-one weeks later, tibias of subgroups of sham-operated and OVX animals were subjected to serial local iontophoresis (IOP) treatments, received systemic subcutaneous 17β-estradiol (E2), or were treated with the combination of IOP and E2. Changes in bone density were detected by quantitative ultrasound densitometry and expressed as amplitude-dependent speed of sound (AD-SoS). Biomechanical studies and elemental analysis were performed at the end of the experiments. Osteopenia developed 21 weeks after OVX in the proximal tibial regions; the mean difference estimate (95% confidence intervals) of AD-SoS values between the sham-operated and OVX animals was 188.7 (140.4-237.1). Serial iontophoretic treatment resulted in an increase in bone density in both sham-operated and OVX animals (sham+IOP versus sham: 121.4 [73.01-169.7]; OVX+IOP versus OVX: 241.6 [193.2-289.9]). Similar changes in AD-SoS were detected after 17β-estradiol (E2) treatment; however, even greater changes occurred after OVX+E2+IOP versus OVX+E2 (123.4 [75.1-171.8]). Similar improvements also were evident regarding the biomechanical features of the tibias. A limitation of this study was the relatively small number of rats. The efficacy of local IOP using calcium- and phosphate-donating microparticles is comparable to that of estrogen therapy as evidenced by steadily increasing bone density, restoration of the calcium and phosphate balance, and improvement in the biomechanical properties of the bone.

Effect of age and disease on bone mass in Japanese patients with schizophrenia

BackgroundThere have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan.MethodsWe recruited patients (n = 362), aged 48.8 ± 15.4 (mean ± SD) years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI) was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community.ResultsMean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males.ConclusionsOlder schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.