Ray Absorptiometry Research Articles

Effects of Pain, Depression and Quality of Life on Bone Mineral Density in Patients with Fibromyalgia

Objective: In this study, we aimed to assess the effects of bone mineral density with fibromyalgia on pain, depression and quality of life. Methods: In this case-control study, 100 women who were diagnosed as FMS and 100 women who were not diagnosed as FMS were included. Visual Analog Scala VAS , Fibromyalgia Impact Questionnaire FIQ and Hospital Anxiety and Depression Scala HADS were used for the patients. Bone mineral density BMD of the participants was measured with dual energy x ray absorptiometry DXA method. Results: The number of the tender points of the women with fibromyalgia and VAS, FIQ, HAD-A and HAD-D scores were found significantly higher than of the control group p0.05 . When BMD measurements and HAD-A and HAD-D scores of the fibromyalgia patients were compared; in the L1-L4 region of the patients with anxiety and depression; BMD mass, T score and Z score were found respectively lower than of those without anxiety and depression p=0.011 p=0.040 . Conclusions: The FIQ scores of the patients with low L1-L4 T scores were found higher than of the patients with normal T scores. The L1-L4 region of the patients with anxiety and depression; BMD mass, T score and Z score were found respectively lower than of those without anxiety and depression. This study confirmed the concept that FMS is a risk factor for osteoporosis.

Assessment of BMD and Statistical Analysis for Osteoporosis Detection

Biomedical engineering is one of the promising disciplines in engineering that deals with technology advancement in human health. Osteoporosis is a common metabolic disease categorized by decreased bone mass and increased liability to fractures. Bone densitometry is a broad term comprising the art and science of measuring the bone mineral content (BMC) and bone mineral density (BMD) of particular skeletal sites or the whole body. There are various methods to measure bone mineral density which differs based on the differential absorption of ionizing radiation or the sound waves. The methods are SPA (Single Photon Absorptiometry), DPA (Dual Photon Absorptiometry), SEXA (Single Energy X ray Absorptiometry), DEXA (Dual Energy X ray Absorptiometry), QCT (Quantitative Computed Tomography), QUS (Quantitative Ultra Sound) and RA (Radiographic absorptiometry). The DEXA test can measure the whole body but usually the lower spine and hips. A major disadvantage of DEXA is that currently there is a lack of standardization in bone and soft tissue measurements. Furthermore, for a given manufacturer, results may vary by the model of the instrument, the mode of operation or the version of the software used to analyze the data. In addition to that, DEXA scan images are only for the confirmation of correct positioning of the patient and correct placement of the regions of interest (ROI). Motivated by the above issues, this paper can pave a way for analysis in the measurement of BMD, measurement of T-score, and Z-score from the DEXA scan images. This proposed methodology includes segmentation algorithms such as k means clustering & mean –shift algorithm and comparison of the accuracy of algorithms. Also in addition, a novel mathematical analysis is also proposed to measure the T–score values in DEXA images with a new parameter ‘S’ from BMD values in order to detect the osteoporosis condition accurately.

Comparison of Bone Mineral Density of Dominant and Non-dominant Forearm of Badminton Players

ABSTRACT Research related to arm bone density of badminton players focused mainly on humerus, how much forearm exposed to physical load is affected by this stress has been studies less. Thus, the aim of this study was to investigate mineral density of dominant and non-dominant forearm bone mineral density of badminton players who have been regularly playing badminton for 10 years. 12 male badminton players whose dominant arms were the same voluntarily participated in this study. Bone Mineral Density (BMD) of the players was evaluated with Dual X Ray Absorptiometry (DEXA). Data was evaluated with SPSS 23. Controlled research method was used to estimate BMD of the players. Differences between dominant and non-dominant arms were assessed with a non-parametric test, Wilcoxon Signed Rank Test. P value was set at p<0.05. Significant difference was found between BMD of dominant right ultra-distal part and BMD of non-dominant left ultra-distal part (z:-2,94, sig:0,00) and between BMD of dominant right proximal part and BMD of non-dominant left proximal part (z:-2,09, sig:0,03). There was no significant difference between dominant proximal 1/3 part and non-dominant proximal 1/3 part (z:1,85, sig:0,06). As a result, long-term badminton training has positive effects on BMD.

Different Amounts Of Protein Intake Influence Body Composition And Performance In Elite Cyclists

PURPOSE: The ideal amount of protein intake for endurance athletes has been poorly investigated. The aim of our study was to evaluated the physiological impact of different dietary protein intakes on body composition and performance outcomes in a group of elite cyclists. METHODS: Thirty-four elite cyclists (1600-1800 km/month) participated to the study. Subjects were divided in 4 groups with different levels of protein intake: normal (NP, 1.2 g/kg), moderate (MP, 1.6 g/kg), high (HP, 2.0 g/kg) or very high (VHP 2.4 g/kg)protein for 8 wk. In the diets fats were maintained constant whilst energy from carbohydrate and protein was modified to maintain an isocaloric diet. Body composition was assessed via Dual X Ray Absorptiometry (DXA) and via ultrasound to calculate cross sectional area (CSA) of the anterior thigh. VO2max, peak power output and 1 RM half squat test were also performed. RESULTS: After two months both HP and VHP showed a significant improvement of 1 RM (HP pre 133±14 Kg vs post 141±12 Kg, p<0.001; VHP pre 137±12 Kg vs post 144±11 Kg, p<0.001), PPO (HP pre 505±78 W vs post 534±67 W, p<0.001; VHP pre 512±55 W vs post 541±76 W, p<0.001), and VO2max (HP pre 62.1±5.8 mlO2/Kg vs post 64.5±5.9 mlO2/Kg, p<0.001; VHP pre 61.2±5,5 mlO2/Kg vs post 64.1±7,6 mlO2/Kg, p<0.001), without differences between groups. There were no significant changes of 1 RM and VO2max for both NP and MP whilst NP showed a significant decrease of PPO. Both HP and VHP showed a significant increase of lean body mass (LBM) (HP pre 64.72±1.9 Kg vs post 65.99±2.2 Kg, p<0.001; VHP pre 65.52±2.0 Kg vs post 67.61±1.7 Kg) whilst both NP and MP showed a significant decrease (NP pre 63.31±2.1 Kg vs post 62.4±2.3, p<0.05; MP pre 66.88±1.8 Kg vs post 65.80±2.9). HP and VHP showed a significant increase of anterior thigh CSA (HP pre 50.5±7.8 cm2 vs post 53.4±6.7 cm2, p<0.001; VHP pre 51.2±5.5 cm2 vs post 54.1±7.6 cm2). No chnages of blood values are detected. CONCLUSIONS: Our data suggest that an higher protein intake (2.0 and 2.4 g/Kg) may help elite cyclists to improve performance and to increase muscle mass without differences between the two levels of protein intake. Instead 1.2 and 1.6 g/Kg of protein seemed to be not sufficient and could impair performance and muscle mass.

PB1846 ANTHROPOMETRIC AND HORMONAL PARAMETERS IN COMPARISON WITH BONE MINERAL DENSITY IN MEN WITH HAEMOPHILIA FROM LOWER SILESIA ‐ PRELIMINARY REPORT

Background:In patients with haemophilia, recurrent episodes of bleeding lead to joint deterioration and bone resorption. To date, the effect of various risk factors on the bone mineral density (BMD) reduction have found conflicting results.Aims:The aim of the study was to analyze the impact of certain parameters, such as: viral status of patients, estradiol, testosteron, parathormone and vitamin D levels in relation to bone density.Methods:24 men with moderate and severe haemophilia, aged 18‐35 were enrolled. BMD at the lumbar spine, trabecular bone score (TBS) and total body densitometry were measured using dual X ray absorptiometry method (DXA) (densitometer Horizon, Hologic, 2017). Blood analyses were performed for morphology parameters, liver and kidney function parameters, HCV, HBV, HIV viral status, estradiol, testosteron, DHEA‐S, TSH, parathormone and Vitamin D levels.Results:The study population included 24 men with haemophilia A, who had been receiving prophylactic factor replacement therapy. HCV seropositivity was found in 6/24 patients (25%), whereas HBV seropositivity was detected in 4 patients (16,7%). There was no patient infected with HIV virus. No statistical correlation was found between BMD and viral serological status. It was found that in 15/24 patients BMD was normal with a Z‐score of &gt; ‐1 (62,5%), whereas in 9/24 patients (37,55%), BMD was decreased. In hemophilic patients with normal BMD Z‐score, the increased BMI, androidal fat deposit (AFD), gynoidal fat deposit (GFD), fat mass index (FMI), free fat mass index (FFMI), Estimated visceral adipose tissue (Est VAT) mass were detected. Among all analyzed hormones, only serum estradiol concentration was statistically higher in patients with normal BMD. In 17/24 examined patients Vitamin D deficiency (&lt;20 ng/ml) was detected (71%), although Vitamin D insufficiency (&lt;30 ng/ml) was found in 4/24 patients (16,7%). Three patients (12,5%) had a normal Vitamin D concentration.Summary/Conclusion:The higher BMD in haemophilic patients is related with certain anthropometric parameters, such as body‐fat‐, free‐fat‐mass indexes and visceral fat tissue. BMD negatively correlated with % body fat, androidal fat mass and PTH, whereas TBS negatively related with androidal/visceral fat mass. We found that Vitamin D deficiency is very common in haemophilic patients, however there was no correlation between Vitamin D levels and BMD.

Design and simulation of a multienergy gamma ray absorptiometry system for multiphase flow metering with accurate void fraction and water-liquid ratio approximation

Abstract Multiphase flow meters are used to measure the water-liquid ratio (WLR) and void fraction in a multiphase fluid stream pipeline. In the present study, a system of multiphase flow measurement has been designed by application of three thallium-doped sodium iodide scintillators and a radioactive source of 133Ba simulated by Monte Carlo N-particle (MCNP) transport code. In order to capture radiations passing across the pipe, two direct detectors have been installed on opposite sides of the radioactive source. Another detector has been placed perpendicular to the transmission beam emitted from the 133Ba source to receive radiations scattered from the fluid flow. Simulation was done by the MCNP code for different volumetric fractions of water, oil, and gas phases for two types of flow regimes, namely, homogeneous and annular; training and validation data have been provided for the artificial neural network (ANN) to develop a computation model for pattern recognition. Depending on applications of the neural system, several structures of ANNs are used in the current paper to model the flow measurement relations, while the detector outputs are considered as the input parameters of the neural networks. The first, second, and third structures benefit from two, three, and five multilayer perceptron neural networks, respectively. Increasing the number of ANNs makes the system more complicated and decreases the available data; however, it increases the accuracy of estimation of WLR and gas void fraction. According to the results, the maximum relative difference was observed in the scattering detector. It was clear that transmission detectors would demonstrate the difference between the flow regimes as well. It is necessary to note that the error calculated by the MCNP simulator is &lt;0.5% for the direct detectors (TR1 and TR2). Due to the difference between the data of the two flow regimes and the errors of data in the simulation codes of the MCNP, it was possible to separate these flow regimes. The effect of changing WLR on the efficiency for a constant void fraction confirms a considerable variance in the results of annular and homogeneous flows occurring in the scattering detector. There is a similar trend for the void fraction; hence, one can easily distinguish changes in efficiency due to the WLR. Analysis of the simulation results revealed that in the proposed structure of the multiphase flow meter and the computation model used for simulation, the two flow regimes are simply distinguishable.

Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis: A case-control study.

Rheumatoid arthritis (RA) has been related to an impairment of the nutritional status. Body mass index (BMI) has been used but questions arise about how to properly evaluate nutritional status in RA patients. Few studies have evaluated it by dual-energy X-ray absorptiometry.In women with RA, to analyze: (1)their nutritional status compared to that of a control population,(2)differences between the prevalence of impairment of nutritional status measured by dual energy X ray absorptiometry (DXA) and by classical methods used in clinical care,(3)determinants of nutritional status,(4)prevalence of sarcopenia.Case–control study including 89 women with RA. The control group was composed by 100 patients affected by non-inflammatory rheumatic disorders. Study variables included age, RA duration, history, activity and disability, and in relation to nutritional status: BMI, serum albumin (ALB), whole body DXA assessment, and skeletal muscle index (SMI).Mean age of patients was 62 ± 8 years, mean duration of RA was 14 ± 9 years, mean disease activity score (DAS28) was 3.7 ± 1.4 and mean Health Assessment Questionnaire was 0.88 ± 0.77. BMI was 27.43 ± 5.16 Kg/m2 in patients and 27.78 ± 3.98 Kg/m2 in controls (P: ns). ALB was within normal range in all patients.By whole body DXA, RA patients presented a statistically significant lower lean mass in all locations and lower fat mass in limbs than controls. Patients had a redistribution of fat mass to trunk. Lean mass directly correlated with fat mass.Neither BMI nor ALB correlated with DXA parameters.BMI, appendicular lean mass and SMI correlated inversely with disease duration. Trunk lean mass correlated inversely, and fat mass directly, with RA disability parameters.RA patients fulfilled criteria of sarcopenia in 44% of cases versus 19% of controls (P <.001). In RA patients, regarding SMI, BMI showed a high specificity to detect sarcopenia (94% of the patients with low BMI had sarcopenia) but low sensitivity (47% of the patients with normal BMI or overweight had sarcopenia).RA patients have an impairment of nutritional status associated to disease duration that looks like sarcopenia and that is not predicted by BMI.

Prediction of thigh skeletal muscle mass using dual energy x-ray absorptiometry compared to magnetic resonance imaging after spinal cord injury

Objectives: A rapid decline in lean mass (LM), fat-free mass (FFM) and increased intramuscular fat (IMF) predispose persons with spinal cord injury (SCI) to chronic medical conditions including dyslipidemia, insulin resistance, type 2 diabetes mellitus and cardiovascular disease. (1) To determine the relationship between dual energy x ray absorptiometry (DXA) and gold standard magnetic resonance imaging (MRI) LM values; (2) to develop predictive equations based on this relationship for assessing thigh LM in persons with chronic SCI.Study Design: Cross-sectional predicational design.Settings: Clinical research medical center.Participants: Thirty-two men with chronic (>1 y post-injury) motor complete SCI.Methods: Participants completed total body DXA scans to determine thigh LM and were compared to measurements acquired from trans-axial MRI.Outcome measures: MRI was used to measure whole muscle mass (MMMRI-WM), absolute muscle mass (MMMRI-ABS) after excluding IMF, and knee extensor muscle mass (MMMRI-KE). DXA was used to measure thigh LM (LMDXA) and (FFMDXA). To predict MMMRI-KE, LMDXA was multiplied by 0.52 and yielded LMDXA-KE.Results: LMDXA predicted MMMRI-WM [r2 = 0.90, standard error of the estimate (SEE) = 0.23 kg, P < 0.0001] and MMMRI-ABS (r2 = 0.82, SEE = 0.28 kg, P < 0.0001). LMDXA-KE predicted MMMRI-KE (r2 = 0.78, SEE = 0.16 kg, P < 0.0001).Conclusion: DXA measurements revealed an acceptable agreement with the gold standard MRI and may be a viable alternative for assessing thigh skeletal muscle mass after SCI.

Association between activity energy expenditure and peak oxygen consumption with sarcopenia

BackgroundSedentariness may be an important risk factor for sarcopenia. The aim of this work was to assess the association between muscle mass and strength and markers of usual physical activity such as activity energy expenditure and peak oxygen uptake.MethodsYoung and old participants were assessed measuring body composition by DEXA (double beam X ray absorptiometry), handgrip strength, peak oxygen consumption and workload during an exercise calorimetry in a braked cycle ergometer and a 72 h activity energy expenditure using Actiheart actigraphs. A heart rate/energy expenditure curve derived from the exercise calorimetry was used to calibrate each actigraph. Sarcopenia was defined as having an appendicular fat free mass index below 7.5 kg/m2 and 5.6 kg/m2 in men and women respectively, or a handgrip strength z score below 1, using local normal data or having both parameters below the cutoff points.ResultsWe analyzed data from 192 assessments performed in participants aged 22 to 88 years (106 women). Sarcopenic participants (as determined by muscle mass, strength or both) had a significantly lower peak oxygen uptake and work load and a significantly lower activity energy expenditure. When analyzing lean mass and strength as continuous variables, peak oxygen consumption was a significant predictor of fat free mass in men. Among women, the association was observed only when percentage of muscle mass was expressed as a z score.ConclusionsActivity energy expenditure and peak oxygen consumption are associated with a lower muscle mass and the presence of sarcopenia and should be considered as risk factors for this condition.

The main predictors of the enlargement of ascending aorta in Turner syndrome: a cross-sectional contrast-enhanced magnetic resonance angiography study.

The aim of this study was to identify the main predictors of the enlargement of ascending aorta and to assess the possible relation between reduced bone mineral density and a diameter of ascending aorta in the specific Turner syndrome (TS) population. Fifty adult females diagnosed with TS have been enrolled into the cross-sectional study. Dimensions of ascending aorta have been measured in four positions using thoracic magnetic resonance imaging, Aortic Size Index (ASI) has been calculated. BMD has been assessed on dual-energy-X ray absorptiometry (DXA) in 1-4 lumbar vertebrae and neck of the femur. According to Z Score on DXA two groups have been formed: a group of patients with normal BMD and a group with reduced BMD. Metabolic parameters and the measurements of ascending aorta have been compared between the two groups. Extremely high rate of the dilatation of the root of aorta (up to 50%) was identified in this study. The larger ASI has been found in patients with reduced BMD, negative relation between BMD and ASI has been identified, although after the adjustment for SHRT this correlation remained insignificant. In the multivariate analysis, the main factors affecting ASI were age, body surface area and bicuspid aortic valve. The main factors associated with the enlargement of ascending aorta in Turner syndrome were age, body surface area and bicuspid aortic valve, the relation between diameter of ascending aorta and bone mineral density was not identified.

OSTEOPOROSIS

Objectives: To establish a relation between changes in height of body ofmandible on Orthopantomogram (OPG) X-ray with Dual Energy X- ray Absorptiometry (DXA)scan of femoral neck and spine to see whether or not the OPG X-ray can be employed asearly detector and as a screening tool for osteoporosis. Study Design: Cross sectional study.Setting: Dow University of Health Sciences, Karachi Pakistan. Period: December 2011 to March2013. Methods: A sample of 174 females aged 25 to 85 years were divided into premenopausal(Group I) and postmenopausal (Group II) groups. Each group was subdivided into normal (preA, post A), osteopenic, (pre B, post B) and osteoporotic, (pre C, post C) groups by DXA Scan.Mandibular morphological changes seen on OPG X-ray in subgroups of Group I were comparedwith each other and with subgroups of Group II. The parameters that were considered on OPGX-ray were height of body of mandible at inner angle of jaw (HA) and at mental foramen (HF).One Way Analysis Of Variance (ANOVA) and T-test were applied to evaluate intragroup andintergroup significance respectively. Results: The reduction in height at angle (HA) and heightat foramen (HF) showed that there was decrease in the height of body which was a measure ofboth osteoporosis and age. Conclusion: A simple and cost effective method of screening wasestablished.

BODY OF MANDIBLE AND OSTEOPOROSIS

Objectives: To establish a relation between changes in height of body ofmandible on Orthopantomogram (OPG) X-ray with Dual Energy X- ray Absorptiometry (DXA)scan of femoral neck and spine to see whether or not the OPG X-ray can be employed asearly detector and as a screening tool for osteoporosis. Study Design: Cross sectional study.Setting: Dow University of Health Sciences, Karachi Pakistan. Period: December 2011 to March2013. Methods: A sample of 174 females aged 25 to 85 years were divided into premenopausal(Group I) and postmenopausal (Group II) groups. Each group was subdivided into normal (preA, post A), osteopenic, (pre B, post B) and osteoporotic, (pre C, post C) groups by DXA Scan.Mandibular morphological changes seen on OPG X-ray in subgroups of Group I were comparedwith each other and with subgroups of Group II. The parameters that were considered on OPGX-ray were height of body of mandible at inner angle of jaw (HA) and at mental foramen (HF).One Way Analysis Of Variance (ANOVA) and T-test were applied to evaluate intragroup andintergroup significance respectively. Results: The reduction in height at angle (HA) and heightat foramen (HF) showed that there was decrease in the height of body which was a measure ofboth osteoporosis and age. Conclusion: A simple and cost effective method of screening wasestablished.

Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial

ObjectiveTo examine the effect of supplementation with n-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) in pregnancy on anthropometry and body composition in offspring.DesignDouble blinded, randomised controlled trial.SettingCopenhagen Prospective Studies...

Restorative potentiality of S-allylcysteine against diabetic nephropathy through attenuation of oxidative stress and inflammation in streptozotocin-nicotinamide-induced diabetic rats.

In the present study, we evaluated the therapeutic potentiality of S-allylcysteine (SAC) in streptozotocin (STZ)-nicotinamide (NAD)-induced diabetic nephropathy (DN) in experimental rats. SAC was orally administered for 45days to rats with STZ-NAD-induced DN; a metformin-treated group was included for comparison. Effect of SAC on body weight, organ weight, blood glucose, levels of insulin, glycated haemoglobin, and renal biochemical markers was determined. Body composition by total body electrical conductivity (TOBEC) and dual-X ray absorptiometry (DXA), kidney antioxidant analysis, real-time polymerase chain reaction, and western blot analysis of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), nuclear factor kappa B (NF-κB), interleukin (IL)-6, and tumor necrosis factor (TNF)-α; histopathological and scanning electron microscope (SEM) analysis of the kidneys were performed in both control and experimental rats. SAC treatment showed significantly decreased levels of blood glucose, glycated haemoglobin, creatinine, albumin, AST, ALT, creatinine kinase, lactate dehydrogenase, and expressions of NF-κB, IL-6, and TNF-α compared with DN control rats. Furthermore, SAC administration to DN rats significantly improved body composition and antioxidant defense mechanism which was confirmed by the upregulation of mRNA and protein expressions of antioxidant genes. Thus, SAC showed adequate therapeutic effect against DN by downregulation of inflammatory factors and attenuation of oxidative stress. Histological and SEM observations also indicated that SAC treatment notably reverses renal damage and protects the kidneys from hyperglycemia-mediated oxidative damage.

Correlation of age at menopause with bone mineral density in post-menopausal women: A prospective study

Background: Osteoporosis is a major public health problem as it is associated with substantial morbidity and socioeconomic burden. Aims and Objective: To correlate the age at menopause with bone mineral density in post menopausal woman. Materials and Methods: Two hundred postmenopausal women were studied at the Department of Obstetrics and Gynaecology, King Georges Medical University, Lucknow, between September 2015 to August 2016. A detailed questionnaire was filled which included details of demographic factors of the patient, detailed reproductive history including parity, number of living children, age at menarche, age at menopause, years since menopause, whether menopause was natural or surgical. BMD was measured in each woman at lumbar spine (L1-L4) by lunar Prodigy dual energy X Ray absorptiometry. Results: A total of 72 (36%) women had osteopenia and remaining 123 (61.5%) had osteoporosis. Only 5 (2.5%) women had normal BMD status. Maximum (n=121) were in the 51-60 years age group. There was no significant relation between age and BMD. Proportion of women with osteoporosis was significantly higher in rural (70.3%) as compared to urban (41.9%) areas (p=0.001). Osteoporosis was seen in 82.6%women with > 4 parity (p=0.049). Mean age of menopause in women with normal BMD, osteopenia and osteoporosis was 44.60, 45.51and 43.85 years respectively. No significant association between period since menopause and BMD status could be seen. No significant association was observed either for total or for any of the BMD strata (p>0.05).With increasing duration since menopause a significant decline in T scores was observed (p=0.023) on overall assessment. However, this association was not significant statistically for different BMD strata (p>0.05). Conclusion: The prevalence of osteoporosis was higher as compared to the world prevalence. The correlation between the age at menopause and BMD was significant in accordance with the various worldwide studies.

Relationship between vertebral CT values and bone mineral density in patients with chronic obstructive pulmonary disease

Objective: To explore a simple method for early detection of osteoporosis in patients with chronic obstructive pulmonary disease (COPD), by analyzing the correlation between computed tomography (CT) values of the thoracolumbar vertebrae and dual energy X ray absorptiometry (DXA). Methods: 86 patients with acute exacerbation of COPD were included in this study. The average age of the patients, including 57 males and 29 females, was 74±10 years. They all received chest CT and DXA examination within 1 month after admission. The relation between each CT value from 6(th) thoracic vertebrae (T6) to 1(st) lumbar (L1) and T-score measured by DXA was analyzed by linear correlation analysis with SPSS 17.0 software. Results: The mean CT value of T6-L1 was significantly lower in patients with osteoporosis than that in patients with normal bone mineral density (P<0.05). The CT values of T6-L1 were positively correlated with T-score (P<0.001). The ROC curve analysis of T6-L1 CT value showed that the area under ROC curve of L1 CT value was the largest, and therefore the accuracy of diagnosis of osteoporosis by L1 CT value was better.A L1 CT value lower than 100 HU was proposed as the threshold for lower bone mass or osteoporosis in the patients. Conclusion: It is possible to detect osteoporosis in patients with COPD through evaluating the CT values of T6-L1. This method could potentially reduce X-ray irradiation and expense. Early detection and intervention in patients with COPD and osteoporosis could improve the prognosis of patients.

Effect of a resistance exercise program for sarcopenic elderly women: quasi-experimental study

Abstract Introduction: Resistance training is quoted as one of the best pathways to manage sarcopenia and progressive resistance training is supposed to improve muscle mass, strength and performance in older adults. Objective: The aim was to examine the impact of a progressive resistance exercise program (PREP) on muscle and function performance in sarcopenic community-dwelling elder women. Methods: Quasi-experimental study (pre - post intervention). Participated 18 sarcopenic community-dwelling elder women (65 years or older). PREP based on 75% of the participant’s maximum load (12/wk, 3 times/wk). Main outcome measures: muscle strength of knee extensors (isokinetic dynamometry), muscle mass (dual-x ray absorptiometry - DXA), functional performance (Short Physical Performance Battery - SPPB). Paired t-test was used to evaluate differences pre and post intervention. Results: Improvements on power (p = 0.01) and peak torque (p = 0.01) were observed when measured by the isokinetic dynamometer at low speed (60º/s). Improvements on DXA (pre PREP: 5.49 kg/m2 vs. post PREP: 6.01 kg/m2; p = 0.03) and SPPB scores (pre PREP: 9.06 vs. post PREP: 10.28; p = 0.01) were also observed. Conclusion: The PREP was able to improve muscle and functional performance in sarcopenic community-dwelling elder women. This program should be considered in clinical practice.

Semi-automated approach in the evaluation of low bone mass using clavicle radiogrammetry technique

Background: Low bone mineral density increasing with age is a universally observed phenomenon. This leads to osteoporosis, which is a regressive change that occurs in the bone and it is diagnosed before the occurrence of fractures. The dual energy x -ray absorptiometry (DXA) is considered to be the standard measurement for the detection of bone mineral density (BMD).Objectives: To measure the various bone mass indices in the clavicle bone by radiogrammetric method from a posterior-to-anterior (PA) view of chest digital X-ray using semi- automated method.Methods: Forty women whose mean age was found to be 46.05±15.53 years were included in this study. For the total population (n=40), the right femur BMD was acquired by DXA scanner. The digital chest radiographs were taken for all the subjects. In all cases, the geometrical variables such as periosteal width (CLR-D), endosteal width (CLR-d), cortical thickness (CLR-CT) and percentage cortical thickness %(CLR-CT) were measured in the right clavicle bone region by semi-automated method approach developed in MATLAB software.Results: The CLR-CT (r=0.77) as well as with % CLR-CT (r=0.72) has provided statistically significant correlation (p &lt; 0.01) with the total hip BMD in the total population studied. The pre-menopausal and post-menopausal of the studied population demonstrated a high significance value of (p &lt; 0.01).Conclusion: The semi-automated measurement of low bone mass indices in clavicle radiogrammetry will be useful in the evaluation of low bone mass in post-menopausal women and elderly aged population. This method can be used as a screening tool for mass population, especially in rural India.

Bone densitometry status and its associated factors in peri and post menopausal females: A cross sectional study from a tertiary care centre in India

ObjectiveOsteoporosis is a skeletal disorder characterized by diminished bone strength that increases the risk of fracture at instances of trivial trauma. Asians have a lower bone mass than the west. The present study was designed to add data from India on women above the age of 40 years with respect to low bone mineral density (BMD) and its associated high risk factors. Materials and MethodsAfter a written informed consent, a detailed history was taken. Basal metabolic index was recorded, and biochemical and endocrine tests were done, followed by dual X ray absorptiometry scan. ResultsAverage age of the study population was 46.54 years and BMI 26.58. The prevalence of osteopenia in the study was 36%, and that of osteoporosis, 4%; the overall prevalence of low BMD being 40%. Proportion of women with low BMD increased with advancing age and menopausal status. On endocrine evaluation, 53.44% cases with insufficient vitamin D, 62.5% with hyperparathyroidism, 100% with hypothyroidism, 75% with hyperthyroidism suffered from low BMD. Among chronic diseases, 75% women with diabetes, 33.3% with hypertension, 25% with deranged liver function and 50% with rheumatoid arthritis were found to have low BMD. 46.75% women with sun exposure less than one hour daily had poor bone mineralization. The proportion of women with normal BMD decreased from 84.09% to 43.33% with decrease in daily physical work. On logistic regression analysis, insufficient serum vitamin D concentrations, less physical work and inadequate sun exposure were found to be significantly associated with low BMD. ConclusionLow BMD is not a disorder confined to postmenopausal women alone. It is widely prevalent in women above 40 years of age. Screening women above 40 in the absence of any high risk factors has the potential of nipping this silent killer in the bud.

Evaluation of the relationship between muscle mass and serum myostatin levels in chronic hemodialysis patients.

The loss of muscle mass and cachexia is commonly seen in hemodialysis (HD) patients and contribute to morbidity and mortality. The exact mechanism of this fact is multifactorial and still unclear. Myostatin, a transforming growth factor-ß family ligand, is released from the skeletal and heart muscle and may be responsible for muscle degradation and atrophy. The aim of this study is evaluation of the relationship between muscle mass and serum myostatin level in chronic HD patients. One hundred and forty HD patients (79 males, 28 diabetic, mean age; 53.96 ± 13.6) were included in this cross-sectional study. Muscle mass measurement was made with dual energy-X ray absorptiometry. Appendicular skeletal muscle index (ASMI) was used as a muscle mass indicator. The anthropometric and biochemistry data were obtained. Serum myostatin levels were determined by an ELISA kit. Serum myostatin levels were elevated when compared to controls (P <0.001), but no significant correlation with ASMI was observed (P = 0.624). ASMI significantly correlated with serum creatinine (P <0.001), creatine phosphokinase (P <0.001), prealbumin (P <0.012), albumin (P <0.039), transferrin (P <0.001), phosphorus (P <0.001), Ca×P (P <0.012), inversely with Kt/V (P <0.001); not with BUN (P = 0.739), parathyroid hormone (P = 0.698), 25-hydroxyvitamin D (P = 0.603), bicarbonate (P = 0.062); such that these parameters also have influence on muscle mass regulation. Our study indicated that myostatin levels were high in HD patients but had no relation with ASMI. Myostatin is a well-known regulator of muscle mass so further studies are needed to demonstrate possible relationship.