Significant Differences In Bone Mineral Density Research Articles

The Severity of Bone Loss in Cushing’s Diseases

<i>Introduction: </i>Endogenous Cushing's syndrome (CS) is a known cause of secondary osteoporosis, characterized by a loss of bone mass and density. Cushing's osteopathy is one of it’s most severe complications. Abnormal bone turnover, decreased bone mineral density (BMD), and increased fracture risk are common effects of glucocorticoid excess. <i>Objectives:</i> The aim of our work is to determine the bone densitometric profile of patients followed for Cushing's disease, to define the characteristics of osteoporosis and osteopenia in these patients, and to analyze the factors influencing BMD. <i>Materials and methods: </i>This is a retrospective descriptive study involving patients followed for Cushing's disease in the endocrinology-diabetology department of the public hospital establishment (EPH) of Bologhine-Algiers, during a period of 10 years, going from the January 2013 to January 2023. <i>Results: </i>58 patients were followed during this period with an average age was 34 years, with a clear female predominance and a sex ratio of ≈ 4. Average Z score was (-1.6) at the vertebral level and (-1.09) at the femoral level. Osteoporosis was found in 44.8% (n = 26) patients and osteopenia in 37.9% (n = 22), while normal BMD was found in 17.24% (n = 10). Note that Z-score values were significantly lower at the lumbar spine than at the femoral neck. No significant difference in BMD was found between eumenorrheic and hypo-/amenorrheic females with Cushing's disease. Our study demonstrated a significant negative correlation between morning plasma cortisol and BMD. While there is a significant positive correlation between BMD and ACTH concentration in CD patients, BMD at the lumbar spine and femoral neck also had a significant positive correlation with weight and BMI. <i>Conclusion:</i> Early detection and management of CS are essential to reduce bone complications. BMD examinations should be performed to enable rapid recognition and intervention for osteoporosis. Lumbar bone loss occurs earlier and more extensively.

Time-Restricted Eating and Bone Health: A Systematic Review with Meta-Analysis.

Time-restricted eating (TRE) has emerged as a dietary strategy that restricts food consumption to a specific time window and is commonly applied to facilitate weight loss. The benefits of TRE on adipose tissue have been evidenced in human trials and animal models; however, its impact on bone tissue remains unclear. To systematically synthesize and examine the evidence on the impact of TRE on bone health (bone mineral content (BMC), bone mineral density (BMD), and bone turnover factors), PubMed, Scopus, Cochrane CENTRAL, and Web of Science databases were systematically explored from inception to 1 October 2023 searching for randomized controlled trials (RCTs) aimed at determining the effects of TRE on bone health in adults (≥18 years). The Cochrane Handbook and the PRISMA recommendations were followed. A total of seven RCTs involving 313 participants (19 to 68 years) were included, with an average length of 10.5 weeks (range: 4 to 24 weeks). Despite the significant weight loss reported in five out of seven studies when compared to the control, our meta-analysis showed no significant difference in BMD (g/cm2) between groups (MD = -0.009, 95% CI: -0.026 to 0.009, p = 0.328; I2 = 0%). BMC and bone turnover markers between TRE interventions and control conditions were not meta-analyzed because of scarcity of studies (less than five). Despite its short-term benefits on cardiometabolic health, TRE did not show detrimental effects on bone health outcomes compared to those in the control group. Nevertheless, caution should be taken when interpreting our results due to the scarcity of RCTs adequately powered to assess changes in bone outcomes.

Analysis of Bone Mineral Density and Bone Quality of Cortical Bone in the Human Hyoid Body and Histological Observation of the Entheses.

The hyoid is the only bone in the human body that is completely independent, not forming a joint with any other bone; its position is maintained by the suprahyoid and infrahyoid muscles, as well as several ligaments. The purpose of this study was to ascertain the effect of the functional pressure arising from these muscles and ligaments on the hyoid body structure from its bone mineral density, bone quality, and histological observations. The area between the mesial-most part of each lesser horn and the center of the hyoid body was divided equally into four measurement regions. We conducted histological investigations at each measurement region and observed the entheses. To analyze bone mass and bone quality, we also measured bone mineral density (BMD) and analyzed biological apatite (BAp) crystallite orientation in the same regions. Histological observations identified periosteal insertions and fibrocartilaginous entheses. There was no significant difference in BMD between any of the measurement regions, but the preferential orientation of BAp crystallites was stronger in the infrahyoid muscles and ligaments, where fibrocartilaginous entheses are found, than in other places. This suggests that the functional pressure at these sites might exert a major effect not only on the morphological characteristics of the entheses but also on bone quality.

Epidemiology of Schmorl’s Node in the Thoracic Spine

Study Design. Retrospective observational study. Objective. To describe the epidemiology of Schmorl’s nodes (SN) of primarily developmental cause (SNd) and SN of primarily acquired cause (SNa) separately in the thoracic spine in subjects aged 35-90 years old. Summary of Background Data. The epidemiology of SN and its relationship with age and gender remain controversial. Based on a pathophysiological hypothesis and the different morphological characteristics, two subtypes of SN may exist and should be considered separately. Patients and Methods. Chest CT scans of subjects who came to our institution for health check aged 35-90 years old were retrospectively reviewed. Presence or absence of SN was recorded for each thoracic vertebra. The SNs were further classified into SNd and SNa. The prevalence, location and relationship with age, gender and bone mineral density (BMD) were evaluated separately for the two subtypes. Results. Of the 848 subjects (407 female, mean age, 53±12.2 y) included, 15.7% had SNs. Of the 303 SNs, 49.2% were SNd and 48.5% were SNa. Aging increased the prevalence of SNa while it was not related to the prevalence of SNd. Males had significantly more SNd than females (11.3% vs 4.7%, P<0.001), while the prevalence of SNa was not different between the two genders (10.2% vs 9.1%, P=0.666). A similar distribution of SNd and SNa among thoracic vertebral levels was appreciated, with T9 most frequently involved. Subjects with SNa had lower lumbar BMD than controls (P=0.006), while no significant difference in BMD was found between subjects with SNd and controls (P=0.166). Conclusions. The clinical characteristics of SN differ based on the developmental and acquired subtype, including the relationship with age, gender and BMD. The subtypes may be considered as distinct clinical entities as a result.

Relationships between Bone Mineral Density and Antidepressant Use and Physical Activity in U.S. Adults

Introduction: Osteoporosis is a major public health concern that affects millions of people worldwide. It is a progressive disease characterized by low bone mass and deterioration of bone tissue, leading to an increased risk of fractures. Antidepressant use and physical activity have been suggested as potential modifiable factors that may affect bone mineral density (BMD). However, the relationship between these factors and BMD is not fully understood, and it is uncertain whether these relationships differ for males and females.
 Methods: Using data from the 2011-2018 National Health and Nutrition Examination Surveys, we examined BMD differences in groups among 7,254 adults. Analyses were first conducted by using the Anderson-Darling normality test, T-test, and the Wilcoxon rank-sum test, and then used multivariate linear regressions to investigate its potential associations between antidepressant use and physical activity along with other factors.
 Results: Excluding the underweight adults, there is significant difference in BMD between those with and without depression in the female group (p=0.03), but not in the male group (p=0.54). No significant difference was found between those who used and those who did not use antidepressants, in either group, female (p=0.96) and male (p=0.77). Antidepressant use and low-level physical activity intensity were associated with decreased BMD values (Mean [SD] = -0.0073 [0.0049]).
 Discussion: This study suggests that physical activity may be a potential modifiable factor that could help prevent osteoporosis, particularly in females. On the other hand, antidepressant use, and low-level physical activity may increase the risk of low BMD. These findings highlight the importance of lifestyle modifications in the prevention of negative impact of low BMD. Further studies are needed to explore the impact of different types of antidepressant use in BMD.

Structural and functional state of bone in patients with arteriovenous malformations of the lower extremities

Background. Disruption of regional blood flow in patients with arteriovenous malformations (AVMs) of the lower extremities changes the conditions of bone tissue functioning. The purpose was to study the structural and functional state of bone tissue and its metabolism in patients with AVMs of the lower extremities using dual-energy X-ray absorptiometry and the markers of bone turnover. Materials and methods. Fifteen patients with AVMs had been examined. The clinical class of chronic venous disease (CVD) was evaluated according to CEAP; patients were divided into 2 subgroups: the first one was with CVD C1-C3 and the second one was with CVD C4-C6. Bone mineral density (BMD) was studied based on the X-ray absorptiometry. The level of bone metabolism markers, such as procollagen type 1 N-terminal propeptide (P1NP), C-terminal cross-linking telopeptide of type 1 collagen (β-CTx) and osteocalcin, 25-hydroxyvitamin D (25(ОН)D) and parathyroid hormone were studied. Results. Disturbances of the bone tissue indices of the affected limb were found in 70 % of the patients. Also, the statistically significant difference in BMD of the affected limb compared to the healthy limb was established (р = 0.005). A multidirectional level of P1NP was detected; β-CTx exceeded norm in 80 % of the patients; osteocalcin exceeded norm in 33 % of the cases. In 67 % of the patients, a decrease in serum level of 25(OH)D was noted. Increase of the β-CTx level in the first subgroup and its decrease in the second one was associated with stabilization of the AVMs course and age-related changes in the hormonal background of the patients. Conclusions. Disturbances in the structural state of bone tissue of the affected limb were found in 70 % of the patients; statistically significant difference between the BMD of the affected and healthy limb obviously caused by the influence of regional hemodynamic disturbances. Various deviations of the metabolism markers were found, which indicates the need to develop a system of drug therapy.

Bone Mineral Density Evaluation Among Type 2 Diabetic Patients in Rural Haryana, India: An Analytical Cross-Sectional Study.

Background and objective Diabetes is one of the most prevalent diseases globally, affecting almost all organ systems. The relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) has been a matter of controversy, and data from developing countries in this regard is highly scarce. Early detection of low BMD indiabetic patients will help prevent further bone loss and risk of fragility fracture. In this study, we aimed to assess the effect of T2DM on BMD among the rural population of Haryana, India. Materials and methods This was a cross-sectional study involving 850 patients between 25 and 60 years of age, including 425 diabetic and 425 non-diabetic subjects (as controls). Calcaneus BMD was measured by using quantitative ultrasound (QUS), and the data were compared against matched parameters in both groups. Results The mean age of diabetics was 42.21 ± 10.5 years and that of non-diabetics was 42.18 ± 10.4 years. The mean BMI was 27.8 ± 4.17 kg/m2 in diabetics and 21.6 ± 3.32kg/m2 in the non-diabetic control group. BMD values significantly differed between the groups: -4.3 ± 1.23 vs. -2.6 ± 0.34 in diabetics and non-diabetics, respectively (p=0.002). Conclusion A significant difference in BMD was observed between the diabetic andnon-diabetic groups. Based on our findings, We recommend that all type 2 diabetics be screened for osteoporosis so that this silent bone loss can be detected in the early phase itself and appropriate preventive measures can be promptly initiated.

CYP2C19 genotypes and osteoporotic fractures in long-term users of proton pump inhibitors: A hospital-based study.

Proton pump inhibitors (PPIs) are commonly prescribed medications. The existing data suggest that individuals at a high risk of fractures have been exposed to high doses of PPIs for prolonged durations. CYP2C19 plays a pivotal role in metabolism of PPIs and thereby influences their pharmacokinetic profile. Hence, we hypothesize that CYP2C19 genotypes may be associated with fragility fracture among PPIs users due to PPI exposure. This study aimed to investigate the association between CYP2C19 genotypes, bone mineral density (BMD), and osteoporotic fracture in a hospital-based population. This retrospective cohort study enrolled patients who were prescribed long-term PPIs at Taichung Veterans General Hospital using data extracted from the Taiwan Precision Medicine Initiative between January 2010 and April 2021. Associations between CYP2C19 phenotypes, comorbidities, and fractures in PPI users were analyzed. We enrolled 1518 long-term PPI users; 571 (38%), 727 (48%), and 220 (14%) CYP2C19 normal metabolizers (NMs), intermediate metabolizers (IMs), and poor metabolizers (PMs), respectively. Among them, 49 (3.2%) patients developed fractures within the 1-year follow-up period; 20 (3.5%) fractures in NMs, 24 (3.3%) in IMs, and 5 (2.3%) in PMs, respectively. No significant difference was observed among CYP2C19 genotypes and fracture. Additionally, BMD measurements during the 1-year follow-up period were made available among 75 participants. No significant difference in BMD between CYP2C19 PMs and non-PMs was found. This real-world, hospital-based study concludes that CYP2C19 PMs/IMs are not associated with an increased risk for fractures or reduced BMD in individuals on long-term PPI therapy.

Effect of 12-months testosterone replacement therapy on bone mineral density and markers of bone turnover in testicular cancer survivors – results from a randomized double-blind trial

Background Testicular cancer survivors (TCS) are at risk of Leydig cell insufficiency, which is a condition characterized by elevated luteinising hormone (LH) in combination with low levels of testosterone. It has been suggested that this condition is associated with impaired metabolic profile and low bone mineral density (BMD). The primary aim of the randomized double-blind trial NCT02991209 was to evaluate metabolic profile after 12-months testosterone replacement therapy (TRT) in TCS with mild Leydig cell insufficiency. Here we present the secondary outcomes of changes in BMD and markers of bone turnover. Methodology In total, 69 TCS with mild Leydig cell insufficiency were randomized 1:1 to 12 months TRT (n = 35) (Tostran, gel, 2%, applied transdermally, with a maximum daily dose of 40 mg) or placebo (n = 34). BMD and markers of bone turnover were evaluated at baseline, after 6- and 12-months TRT, and 3-months post-treatment. Linear mixed effects models were used to analyse changes in BMD, N-terminal propeptide of type 1 procollagen (P1NP) and C-terminal telopeptide of type I collagen (CTX). Results After 12 months treatment, TRT was not associated with a statistically significant difference in BMD compared to placebo; total body BMD: 0.01 g/cm2 (95% confidence interval (CI): −0.01 − 0.02), BMD of the lumbar spine: 0.01 g/cm2, (95% CI: −0.01–0.03), BMD of the left femoral neck: 0.00, (95% CI: −0.01–0.02). TRT was associated with a small but statistically significant increase in P1NP: 11.65 µg/L (95% CI: 3.96, 19.35), while there was no difference in CTX. Conclusion 12 months of TRT did not change BMD, while there was as small and clinically irrelevant increase in P1NP compared to placebo in TCS with mild Leydig cell insufficiency. The findings need validation in a larger cohort.

CHARACTERISTICS OF FAT MASS, LEAN MASS, AND BONE MINERAL DENSITY BY DUAL-ENERGY X-RAY ABSORPTIOMETRY IN PEOPLE OVER 40 YEARS OLD WITH METABOLIC SYNDROME

Objectives: To determine the composition of lean mass (LM), fat mass (FM), and bone mineral density by Dual-energy X-ray absorptiometry (DXA) in people over 40 years old with metabolic syndrome (MetS). Subjects and methods: A cross-sectional study on 199 subjects with or without MetS (defined by the 2005 update NCEP ATP III criteria) who were examined and treated at Hai Phong Medical University Hospital from 2017 to 2022. The composition of LM, FM and bone mineral density were measured using DXA. Results: Total FM, total LM in individuals with MetS were higher than those in non-MetS (p < 0.01). FM regions (trunks, android, arms) and A/G FM ratio, LM regions (trunks, android, gynoid), and FM% regions (trunks, android) of MetS subjects were higher than those without MetS (p < 0.01). Nevertheless, legs FM, legs FM%, arms FM%, gynoid FM%, total FM %, legs LM, and arms LM were not different between both groups (p > 0.05). The bone mineral density (BMD) of people with MetS was higher than that of subjects without MetS (p < 0.05) at several positions: ribs and arms, however, stratified by BMI, there was no significant difference in BMD (p > 0.05). Conclusion: Total LM and total FM in MetS subjects were higher than in non-MetS. FM regions (arms, android, trunks) and A/G FM ratio, LM regions (trunks, android, gynoid), and FM% regions (trunks, android) of MetS subjects were higher than those without MetS. Total and regional BMD (ribs, arms) of MetS subjects were higher than those without MetS. However, there was no difference in BMD stratified by BMI between the two groups.

Do Bone Mineral Density, Trabecular Bone Score, and Hip Structural Analysis Differ in Indian Men with Parkinson's Disease? A Case-Control Pilot Study from a Tertiary Center in Southern India.

Parkinson's disease (PD) is a neurodegenerative condition that is characterized by bradykinesia, rigidity, and gait instability. Inherent to this condition is an increased predisposition to falls and fractures. Bone health in Parkinson's disease in India has not been studied thus far. This study aimed to assess the bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA) in Indian men with PD and compare them with matched controls. A case-control study done at a tertiary care center from southern India. Bone biochemistry, BMD, TBS, and HSA were assessed. Among 40 cases and 40 age, gender, and body mass index (BMI)-matched controls, there was no significant difference in BMD between both groups. The mean (SD) TBS at the lumbar spine [1.349 (0.090)] was significantly (P = 0.019) lower in men with PD as compared to matched controls [1.401 (0.089)]. Among the parameters of HSA, the buckling ratios were significantly higher at the femoral neck [11.8 (2.2) vs 9.4 (2.2); P = 0.001] and inter-trochanteric region [9.4 (2.1) vs 7.8 (1.4); P = 0.002] among cases as compared to matched controls. Vitamin D deficiency was significantly higher in this cohort of patients as was bone turnover marker indicating bone loss and a high bone turnover state. A comprehensive bone health assessment comprising BMD, TBS, and HSA may be required to capture all aspects of bone strength in Indian men with PD as BMD assessment as a stand-alone tool may not suffice to obtain all information pertaining to fracture risk in these individuals.

Features of lumbar spine texture extracted from routine MRI correlate with bone mineral density and can potentially differentiate patients with and without fragility fractures in the spine

The use of routine magnetic resonance imaging (MRI) to potentially assess skeletal fragility has been widely studied in osteoporosis. The aim of this study was to evaluate bone texture attributes (TA) from routine lumbar spine (LS) MRI and their correlation with vertebral fragility fractures (VFF) and bone mineral density (BMD). Sixty-four post-menopausal women were submitted to LS densitometry, total spine radiographs, and routine T2-weighted LS MRI. Twenty-two TA were extracted with the platform IBEX from L3 vertebra. The statistical difference was evaluated using ANOVA and Duncan's post-test. Correlation analyses were performed using Spearman's coefficient. Statistical significance was considered when P<0.05. The results did not show a significant difference in BMD between the women with and without fractures. Two bone TA (cluster tendency and variance) were significantly lower in the fracture group. Cluster tendency with VFF in osteopenia was 1.54±1.37 and in osteoporosis was 1.11±58. Cluster tendency without VFF in osteopenia was 2.23±1.38 and in osteoporosis was 1.88±1.14). Variance with VFF in osteopenia was 1.44±1.37 and in osteoporosis was 1.13±59. Variance without VFF in osteopenia was 2.34±1.38 and in osteoporosis was 1.89±1.14. There was a significant correlation between BMD and cluster prominence (r=0.409), cluster tendency (r=0.345), correlation (r=0.570), entropy (r=0.364), information measure corr1 (r=0.378), inverse variance (r=0.449), sum entropy (r=0.320), variance (r=0.338), sum average (r=-0.274), and sum variance (r=-0.266). Our results demonstrated the potential use of TA extracted from routine MRI as a biomarker to assess osteoporosis and identify the tendency of skeletal fragility vertebral fractures.

Association of serum levels of Visfatin, Intelectin-1, RARRES2 and their genetic variants with bone mineral density in postmenopausal females.

Adipokines are engaged in bone physiology and regulate bone mineral density (BMD) by playing protective or cynical role in bone metabolism. The study is designed to measure and compare BMD, adipokines (retinoic acid receptor responder protein-2 RARRES2, visfatin and Intelectin-1) and their genetic variants in postmenopausal osteoporotic, osteopenic and non-osteoporotic females. This comparative study included postmenopausal non-osteoporotic (n=72), osteopenic (n=72) and osteoporotic (n=100) females with two years of amenorrhea and age between 50 to 70 years. Gold standard DXA was used to measure BMD. Hardy-Weinberg equilibrium was established. Kruskal-Wallis test for comparisons, logistic and multivariate regression analysis were used to rule out the predictors of BMD. On comparing the three groups, significant differences were observed in serum RARRES2 (p <0.001) and serum visfatin (p=0.050). The significant positive predictor of BMD at lumbar spine and total hip was serum visfatin. BMD at right and left femoral neck was predicted negatively by serum chemerin while BMD at left femoral neck was also predicted positively by serum calcium levels. There was significant difference in BMD at right femoral neck (p = 0.033) between rs7806429 genotypes. The odds of having low BMD increases with increasing serum levels of chemerin and decreasing serum levels of visfatin and calcium. The adipokines RARRES2 and visfatin are associated with BMD. RARRES2 is an independent negative and visfatin is positive predictor of BMD in postmenopausal females. BMD at right femoral neck was significantly low in RARRES2 rs7806429 TC heterozygotes.

Efficacy of the combination of Tenghuangjiangu tablets, alfacalcidol capsules and caltrate D3 tablets in osteoporotic vertebral compression fracture, and their effects on bone metabolic indices

Purpose: To investigate the efficacy of the combination of Tenghuangjiangu tablets, Alfacalcidol capsules and Caltrate D3 tablets in osteoporotic vertebral compression fracture (OVCF) and their effects on bone metabolic indices. &#x0D; Methods: Ninety-six patients with OVCF were randomly categorized into study group (SG) and control group (CG). Patients in the CG orally took Caltrate D3 tablets, while those in the SG were given Tenghuangjiangu tablets and Alfacalcidol capsules in addition to caltrate D3 tablets. The Bone mineral density (BMD) values and the treatment efficacy were compared. The levels of bone metabolism markers (PINP, β-CTX, BGP, NBAP), CT and PTH were determined using electrochemiluminescence immunoassay, while Ca2+ levels were assessed using liquid level detection. The incidence of adverse reactions (re-fracture, gastrointestinal reaction, hypotension and abnormal coagulation function) were compared. &#x0D; Results: Treatment efficacy in the SG was 91.67 %, which was significantly higher than that in the CG (81.25 %; p &lt; 0.05). Before treatment, the two groups showed no significant differences in BMD, PINP, β-CTX, BGP, NBAP, Ca2+, CT, and PTH levels (p &gt; 0.05). After treatment, the SG exhibited significantly higher BMD, PINP, BGP, NBAP, Ca2+ and CT levels, and showed lower β-CTX and PTH levels than the CG (p &lt; 0.05). The SG exhibited a significantly lower incidence rate of adverse reactions than that the CG (p &lt; 0.05). &#x0D; Conclusion: The combination of Tenghuangjiangu tablets, Alfacalcidol capsules, and Caltrate D3 tablets, improves bone metabolic indices, bone density and treatment efficacy while reducing the incidence rate of adverse reactions.

OR25-6 In Men on Testosterone Therapy, Baseline Testosterone Level of &amp;lt;264 ng/dL is Associated with Greater Improvement in Body Composition, While Level of ≥264 ng/dL Favors Improvement in Metabolic Profile

Abstract Context Male hypogonadism adversely affects body composition, bone mineral density (BMD), and metabolic health. A previous report showed that pre-treatment testosterone (T) levels of &amp;lt;200 ng/dL is associated with greater improvement in spine BMD with T therapy. However, to date, there is no study investigating whether baseline T levels also influences body composition and metabolic response to T therapy. Objective To determine if there are differences in the changes in body composition, metabolic profile, and bone turnover markers, in addition to BMD, in response to T therapy in men with baseline T level of &amp;lt; 264 ng/dL compared to those with levels ≥264ng/dL Methods: Secondary analysis of single-arm, open-label clinical trial (NCT01378299) on pharmacogenetics of response to T therapy conducted between 2011-2016 involving 105 men (40-74 years old), with average morning T &amp;lt; 300 ng/dL, given intramuscular T cypionate 200 mg every 2 weeks for 18 months. Subjects were divided into those with baseline T levels of &amp;lt; 264 ng/dL (N=43) and those with ≥264 ng/dL (N=57). T and estradiol (E2) were measured by liquid chromatography/mass spectrometry; serum bone turnover markers (C-telopeptide [CTX], osteocalcin, sclerostin), adiponectin, and leptin by enzyme-linked immunosorbent assay; glycated hemoglobin (HbA1c) by high-performance liquid chromatography, areal BMD, and body composition by dual-energy x-ray absorptiometry (DXA). Results Men with T &amp;lt; 264 ng/dL showed greater increases in total fat-free mass (FFM) at 18 months compared to those with T ≥ 264 ng/dL (4.2±4.1 vs 2.7±3.8%; p=0.047) and unadjusted appendicular FFM at 6 and 18 months (8.7±11.5 vs 4.4±4.3%, 7.3±11.6 vs 2.4±6.8%; p=0.033 and p=0.043, respectively). Men with T ≥ 264 ng/dL showed significant decreases in HbA1c at 12 months (-3.1±9.2 vs 3.2±13.9%; p=0.005), fasting glucose at 18 months (-4.2±31.9 vs 13.0±57.3%; p=0.040), LDL at 6 months (-6.4±27.5 vs 12.8±44.1%; p=0.034), leptin at 18 months (-40.2±35.1 vs -27.6±31.0%; p=0.034) compared to those with T &amp;lt; 264 ng/dL. No significant differences in BMD and bone turnover markers were observed. Conclusion T therapy results in improvement in body composition irrespective of baseline T levels but T &amp;lt;264 ng/dL is associated with greater improvement in FFM, whereas T level of ≥264 ng/dL favors improvement in metabolic profile. Presentation: Monday, June 13, 2022 12:15 p.m. - 12:30 p.m.

SCREENING OF OSTEOPOROSIS IN MEN

Underestimation of the disease osteoporosis in men is a serious problem, as osteoporotic fractures among men are frequent and they are accompanied by serious complications. Conducting DXA scans in men in Bulgaria is important to determine the state of their bone health.&#x0D; The aim of the study was to assess the bone mineral density (BMD) and T-score of the lumbar spine and of the hip through dual-energy X-ray absorptiometry (DXA) in men and to compare their values ​​in different age groups.&#x0D; Object of the study. Height, weight, body mass index (BMI) were assessed in 359 men with a mean age of 56 years (yrs.) ± 14 yrs., BMD and T-score of the lumbar spine and femoral neck were also examined.&#x0D; Methodology. Men are divided into the following age decades: 20-29 yrs., 30-39 yrs., 40-49 yrs., 50-59 yrs., 60-69 yrs., 70-79 yrs. and ≥80 yrs. Statistical program SPSS version 19.0 was used to access the data. The ANOVA test analyzes was applied to investigate if there are any statistically significant differences in BMD and T-score of the lumbar spine and femoral neck between the different age decades.&#x0D; Results and conclusions. 264 men were evaluated for total BMD of the lumbar spine and 95 men had results for BMD of the femoral neck. The mean total BMD of the lumbar spine differed significantly between the individual age decades in men (p = 0.000). The mean BMD values ​​of the femoral neck did not differ significantly in the different age decades in men (p = 0.07). 34 of 264 men (12.9%) were diagnosed with lumbar spine osteoporosis and 13 out of 93 men (14%) were diagnosed with femoral neck osteoporosis. The data obtained show a widespread prevalence of osteoporosis among men with a predominance of low values ​​of BMD on the axial skeleton in the age range between 60 and 79 years.

Baseline Testosterone Predicts Body Composition and Metabolic Response to Testosterone Therapy.

ContextMale hypogonadism adversely affects body composition, bone mineral density (BMD), and metabolic health. A previous report showed that pre-treatment testosterone (T) levels of <200 ng/dl is associated with greater improvement in spine BMD with T therapy. However, to date, there is no study that investigates whether baseline T levels also influence body composition and metabolic response to T therapy.ObjectiveThe aim of this study is to determine if there are differences in the changes in body composition, metabolic profile, and bone turnover markers, in addition to BMD, in response to T therapy in men with a baseline T level of <264 ng/dl compared to those with levels ≥264 ng/dl.MethodsThis is a secondary analysis of a single-arm, open-label clinical trial (NCT01378299) on pharmacogenetics of response to T therapy conducted between 2011 and 2016 involving 105 men (40–74 years old), with average morning T < 300 ng/dl, given intramuscular T cypionate 200 mg every 2 weeks for 18 months. Subjects were divided into those with baseline T levels of <264 ng/dl (N = 43) and those with ≥264 ng/dl (N = 57). T and estradiol (E2) were measured by liquid chromatography/mass spectrometry; serum bone turnover markers (C-telopeptide [CTX], osteocalcin, and sclerostin), adiponectin, and leptin were measured by enzyme-linked immunosorbent assay; glycated hemoglobin (HbA1c) was measured by high-performance liquid chromatography; and areal BMD and body composition was measured by dual-energy x-ray absorptiometry (DXA).ResultsMen with T < 264 ng/dl showed greater increases in total fat-free mass (FFM) at 18 months compared to those with T ≥ 264 ng/dl (4.2 ± 4.1 vs. 2.7 ± 3.8%; p = 0.047) and unadjusted appendicular FFM at 6 and 18 months (8.7 ± 11.5 vs. 4.4 ± 4.3%, 7.3 ± 11.6 vs. 2.4 ± 6.8%; p = 0.033 and p = 0.043, respectively). Men with T ≥ 264 ng/dl showed significant decreases in HbA1c at 12 months (−3.1 ± 9.2 vs. 3.2 ± 13.9%; p = 0.005), fasting glucose at 18 months (−4.2 ± 31.9 vs. 13.0 ± 57.3%; p = 0.040), LDL at 6 months (−6.4 ± 27.5 vs. 12.8 ± 44.1%; p = 0.034), and leptin at 18 months (−40.2 ± 35.1 vs. −27.6 ± 31.0%; p = 0.034) compared to those with T < 264 ng/dl. No significant differences in BMD and bone turnover markers were observed.ConclusionT therapy results in improvement in body composition irrespective of baseline T levels but T < 264 ng/dl is associated with greater improvement in FFM, whereas a T level of ≥264 ng/dl favors improvement in metabolic profile.

Significance of Measuring Lumbar Spine 3-Dimensional Computed Tomography Hounsfield Units to Predict Screw Loosening

Osteoporosis is a well-known risk factor of screw loosening. Classically, dual-energy x-ray absorptiometry (DEXA) scan is an easy and cost-effective method of detecting bone mineral density (BMD). However, T-score on DEXA scan can be overestimated in patients with degenerative changes of the spine. Our objective was to identify correlation between Hounsfield unit (HU) measured by 3-dimensional computed tomography (3D-CT) and screw loosening. A total of 113 patients treated with lumbosacral spinal fusion were reviewed and categorized into a screw loosening group and a normal group to compare their average values of preoperative CT HU. Screw loosening was defined as radiolucent area around screw that was thicker than 1 mm with a "double halo sign". There were statistically significant differences in patient age and steroid use between screw loosening and non-loosening groups. There was no significant difference in BMD or T-score between the 2 groups. However, HU values measured in axial, coronal, and sagittal images were significantly different between the 2 groups. In the receiver operating characteristic for HU values measured in CT images, the greatest area under the curve was 0.774 and that was in case of Hounsfield unit measured by axial CT images from L1 to L4. Preoperative CT HU is associated with screw loosening. It can be a better predictor of screw loosening than DEXA scan. The best predictor of screw loosening in this study is the average value of HU from L1 to L4 in axial cut.

Trabecular Bone Score and Osteoprotegerin as Useful Tools in the Assessment of Bone Deterioration in Acromegaly.

PurposeThis study aimed to assess bone mineral density (BMD) and trabecular bone score (TBS) in 61 patients from the acromegaly group (AG) with regard to the activity of the disease in comparison to 42 patients—control group (CG). We also analyzed selected bone markers and their association with BMD and TBS.Materials and MethodsLumbar spine and femoral neck BMD measurements were performed. TBS values were obtained. Serum concentrations of selected bone markers, including osteoprotegerin (OPG), were measured.ResultsWe revealed a difference in TBS values between the AG and CG as well as between the TCA (treatment-controlled acromegaly) vs. CG and TCA+CA (cured acromegaly) vs. CG. We did not observe any statistically significant difference in BMD. OPG had a lower concentration in the CG compared to the AG. TBS correlated negatively with OPG in the AG (r = −0.31, p = 0.01) and in the TCA+ CA group (r = −0.3, p = 0.01).ConclusionsThe acromegalic patients have altered bone microstructure as indicated by the decreased TBS regardless of the activity of the disease and BMD. OPG could be a marker of the destruction of the bone microstructure, but further studies are needed.

Does a Monoblock Acetabular Component With a Ceramic Liner Cause More Pelvic Bone Loss Than a Conventional Modular Cementless Acetabular Component? A 2-Year Randomized Clinical Trial.

Ceramic-on-ceramic bearings permit the use of large femoral head size while maintaining a favorable effect on wear rates. However, because of increased device rigidity, periprosthetic bone quality could be negatively affected due to stress shielding. The purpose of this study is to assess pelvic periprosthetic bone remodeling around a monoblock ceramic-on-ceramic acetabular component compared to that around a conventional modular metal-on-polyethylene device. Participants were randomized to receive hip replacement using either a porous-coated, modular metal-on-polyethylene acetabular component (n= 46) or a hydroxyapatite and titanium-coated monoblock shell with an integrated ceramic-on-ceramic bearing (n= 40). Radiographic assessments were completed preoperatively and postoperatively, and measurements of bone mineral density (BMD) using dual-energy X-ray absorptiometry with region free analysis were performed postoperatively and over 2-years of follow-up. There was no significant difference in BMD between the 2 groups at baseline or over the following 2 years. At follow-up, complete shell-to-bone contact without a radiolucent line was observed in 26 (67%) of the modular devices and in 37 (93%) of monoblock (P < .001). The modular device was an independent predictor of radiolucent lines (odds ratio 19.1, P= .007). No cases underwent revision surgery for acetabular loosening. Both the porous-coated modular and hydroxyapatite-coated monoblock acetabular components showed successful clinical results at short-term follow-up with no difference in pixel-level BMD. Using a large head monoblock device does not appear to be associated with an adverse effect on the local bone environment when compared to a modular device. NCT: NCT01558752.