Significant Increase In Bone Mineral Density Research Articles

Impact of switching from bisphosphonates to denosumab, teriparatide, or romosozumab in patients with postmenopausal osteoporosis: a case-control study.

To investigate the impact of switching from bisphosphonates (BP) to denosumab (DMAb), teriparatide (TPTD), or romosozumab (ROMO) in postmenopausal osteoporosis. This retrospective, case-controlled, multicenter study included 389 patients who switched from BP to DMAb, TPTD, or ROMO due to treatment inefficacy. Propensity score matching was used to align patient backgrounds, resulting in 45 patients per group. Baseline characteristics included a mean age of 73.8years, prior BP treatment duration of 37.1months, and bone mineral density (BMD) T-scores of -2.8 in the lumbar spine (LS), -2.5 in the total hip (TH), and -2.7 in femoral neck (FN). BMD and bone turnover markers were assessed over 12months. Following the switch from BP, the ROMO group demonstrated a dual effect of decreased bone resorption and increased bone formation markers. The TPTD group exhibited the highest increases in both markers, while the DMAb group suppressed both. After 12months, the ROMO group demonstrated significantly greater BMD increases in the LS (11.4%) compared to the DMAb (6.3%; p < 0.001) and TPTD (5.9%; p < 0.001) groups. Additionally, the ROMO group showed greater increases in the TH (3.3%) than TPTD group (0.8%; p < 0.01). Only the ROMO group showed a significant BMD increase in the FN (2.0%; p < 0.01 from baseline). Significant BMD increases were observed in the LS for all groups, in the TH for the ROMO and DMAb groups, and in the FN for the ROMO group. ROMO showed the most substantial BMD improvements following BP therapy.

The Effect of Exercise to Prevent Osteoporosis on Bone Mineral Density in Women Aged 25-35 Years

Reports of surveys on exercises that can increase bone mineral density (BMD) have already been proven in many studies. One of the efforts to organize formal physical exercise for every level of society is the formation of Senam Pencegahan Osteoporosis (SPO) - Physical Exercise to Prevent Osteoporosis. Is SPO able to increase BMD for women aged 25-35 years? A total of 46 healthy young women ranging from 25 -35 years of age who had never done or even were not involved in any exercise before the time of the study were divided into two groups (23 experimental and 23 control participants) and volunteered to proceed a three times a week of this exercise for 3,5 months. BMD was measured by using Dual Energy X-ray Absorptiometry (DEXA). A significant increase of BMD in the ulna, vertebral lumbar 2, and vertebral lumbar 1-2 was detected in the experimental group. There is a strong indication that SPO can increase BMD, especially in the ulna, which has a high risk of osteoporosis.

Effects of precision health management combined with dual-energy bone densitometer treatment on bone biomarkers in senile osteoporosis patients

This study investigates the effects of precision health management combined with dual-energy X-ray absorptiometry (DXA) therapy on bone biomarkers in elderly osteoporotic patients. 236 elderly patients diagnosed with osteoporosis between May 2020 and November 2021 were enrolled from our hospital. Patients were randomly allocated to either the observation group (n=118), receiving precision health management alongside DXA therapy, or the control group (n=118), receiving standard treatment. Clinical data were compared between the two groups. Protein levels of bone formation markers (BSAP, OC) and bone resorption markers (CTX, DPD, TRAP) were analyzed using Western blotting. Bone mineral density (BMD) was measured using DXA at baseline, 12months, and 24months. Pain levels were assessed using the Visual Analog Scale (VAS) at the same intervals. Osteoporosis knowledge and self-management confidence were evaluated using respective scales before and after intervention. Baseline characteristics did not significantly differ between groups (P>0.05). The observation group exhibited decreased BSAP and increased OC and OC protein expressions compared to the control group (P<0.05). CTX, DPD, and TRAP protein levels were significantly lower in the observation group (P<0.05). Prior to the intervention, there were no significant variations observed in BMD, as well as VAS, knowledge, and self-efficacy scores between the two groups (P>0.05). However, over the course of 12 and 24months, the observation group exhibited significant increases in BMD (P<0.05). VAS scores were notably lower in the observation group during both follow-up assessments (P<0.05). Furthermore, knowledge scores were higher in the observation group at 12 and 24months (P<0.05), while self-efficacy scores showed significant improvement in the observation group at both follow-up intervals (P<0.05). Precision health management combined with DXA therapy positively impacts elderly osteoporotic patients by enhancing bone biomarkers, promoting bone growth, and preventing bone loss. This approach leads to increased BMD, reduced fracture risk, improved pain management, and enhanced knowledge and self-management abilities related to osteoporosis.

Оценка эффективности препаратов золедроновой кислоты для парентерального введения

Bisphosphonates are one of the main drugs for the treatment of postmenopausal osteoporosis. This group of drugs includes zoledronic acid (zoledronate), used for intravenous administration. Zoledronic acid has an antiresorptive effect and is used to treat various bone diseases, including osteoporosis. Currently, generic preparations of zoledronic acid, including Osteostatics, have become widespread. Aim – to compare the effectiveness of the generic preparation of zoledronic acid 5 mg (Osteostatics) with the original preparation of zoledronic acid 5 mg (Aclasta) in postmenopausal osteoporosis. Material and methods. During 2021–2022, we examined 139 patients with postmenopausal osteoporosis. The patients were divided into two groups. The first group (69 people) received a generic drug (generic) of zoledronic acid Osteostatics. The second group (70 people) is the original preparation of zoledronic acid Aclasta. All patients additionally received 1000 mg of calcium carbonate and 2000 IU of vitamin D daily. Patients of both groups repeated measurement of bone mineral density (BMD) 6 and 12 months after infusion of zoledronic acid. Results. After 6 months and 12 months after treatment, both groups showed a statistically significant increase in BMD in both the lumbar spine and hip neck, compared with the baseline level. At the same time, there were no differences between the increase in BMD between the two groups of patients receiving Osteostatics and Aclasta. The dynamics of the increase in BMD after 6 months and 12 months after the infusion of zoledronic acid indicates a similar effectiveness of the original and generic drugs. Conclusion. Effectiveness of the generic preparation of zoledronic acid Osteostatics at a dose of 5 mg is comparable to the original preparation Aclasta.

The Effect of Photobiomodulation on Bone Mineral Density, Serum Vitamin D, and Bone Formation Markers in Individuals with Complete Spinal Cord Injuries with Osteoporosis.

Study design: A quasi-experimental study utilized a matched-pair design, administering photobiomodulation at four-sites on one side of the body and assigning control to the other side at corresponding sites. Objectives: This study aimed to assess photobiomodulation treatment effects on bone mineral density (BMD) measurement using dual-energy X-ray-absorptiometry in individuals with complete spinal cord injury (C.SCI) and osteoporosis. Methods: Eight patients received treatment at four-sites: forearm-mid-distal (MID), proximal-femur, distal-femur, and proximal-tibia, totaling 32 sites. Using an 830 nm gallium-aluminum-arsenide semiconductor laser irradiation was administered three times weekly for 8 weeks. Different doses (energy density) were determined depending on bone depth from skin surface, as assessed by sonography and adjusted through irradiation time to be 8, 10, and 12 J/cm2 for depths <1 cm, between 1 and 1.5 cm, and >1.5 cm, respectively, using 200 mW power to deliver the optimal isodose of laser at each depth of bone within each therapeutic site. BMD was measured at baseline, week 8 of treatment, and week 15 of follow-up. Serum 25-(OH)-vitamin D and bone formation markers including osteocalcin and bone-alkaline-phosphatase (B-ALP) were also assessed at baseline and week 8 of treatment. Results: Significant increases in BMD were noted in proximal-femur and forearm-MID at both week 8 and week 15. Serum 25-(OH)-vitamin D levels significantly increased after treatment. However, no notable changes were observed in distal-femur and proximal-tibia BMD or in osteocalcin and B-ALP levels. Conclusions: Photobiomodulation (830 nm) laser demonstrated efficacy in improving BMD at proximal-femur and forearm-MID in individuals with C.SCI. Moreover, the observed positive influence on vitamin D levels suggests a potential photobiomodulation role, warranting further investigation.

Impact of dairy supplementation on bone acquisition in children's limbs: a 12-month cluster-randomized controlled trial and meta-analysis.

This study evaluated the impact of dairy supplementation on bone acquisition in children's limbs through a cluster-randomized controlled trial and a meta-analysis. The trial involved 315 children (4-6year) from Northwest China, randomized to receive either 390ml of milk daily (n = 215) or 20-30g of bread (n = 100) over 12months. We primarily assessed bone mineral density (BMD) and content (BMC) changes at the limbs, alongside bone-related biomarkers, measured at baseline, the 6th and 12th months. The meta-analysis aggregated BMD or BMC changes in the forearm/legs/calcaneus from published randomized trials involving children aged 3-18years supplemented with dairy foods (vs. control group). Of 278 completed the trial, intention-to-treat analysis revealed significant increases in BMD (4.05% and 7.31%) and BMC (4.69% and 7.34%) in the left forearm at the 6th and 12th months in the milk group compared to controls (P < 0.001). The calcaneus showed notable improvements in BMD (2.01%) and BMC (1.87%) at 6months but not at 12months. Additionally, milk supplementation was associated with beneficial changes in bone resorption markers, parathyroid hormone (- 12.70%), insulin-like growth factor 1 (6.69%), and the calcium-to-phosphorus ratio (2.22%) (all P < 0.05). The meta-analysis, encompassing 894 children, indicated that dairy supplementation significantly increased BMD (SMD, 0.629; 95%CI: 0.275, 0.983) and BMC (SMD, 0.616; 95%CI: 0.380, 0.851) (P < 0.05) in the arms, but not in the legs (P > 0.05). Milk supplementation significantly improves bone health in children's forearms, underscoring its potential as a strategic dietary intervention for bone development. Trial registration NCT05074836.

Remineralization of lytic spinal metastases after radiation therapy – A retrospective cohort study comparing conventional external beam radiation therapy with stereotactic ablative body radiation

Osteolytic spinal metastases (SM) have a higher risk of fracture. In this study we aim to confirm the remineralization of lytic SM after radiation therapy. Secondary the influence of SBRT compared to cEBRT and tumor type will be analyzed. A retrospective cohort study was performed. 87 patients, 100 SM were included. 29 received SBRT, 71 cEBRT. Most common primary tumors were breast (35%), lung (26%) and renal (11%). Both cEBRT and SBRT resulted in a significant increase of bone mineral density (BMD) (83.76 HU±5.72→241.41 HU±22.58 (p<0.001) and 82.45±9.13→179.38±47.83p=0.026). There was a significant increase in absolute difference of BMD between the SM and reference vertebrae (p<0.001). There was no significant difference between SBRT and cEBRT. There was no increase of BMD in renal lytic SM after radiation therapy (pre-treatment: 85.96 HU±19.07; 3m 92.00 HU±21.86 (p=0.882); 6m 92.06 HU±23.94 (p=0.902); 9m 70.44 HU±7.45 (p=0.213); 12m 98.08 HU±11.24 (p=0.740)). In all other primary tumors, a significant increase of BMD after radiation therapy was demonstrated (p<0,05). We conclude that the BMD of lytic SM increases significantly after radiation therapy. Lytic SM of primary renal tumors are the exception; there is no significant remineralization of renal lytic SM after radiation therapy. There is no benefit of SBRT over cEBRT in this remineralization. These findings should be taken into account when deciding on surgery in the potentially unstable group defined by the spinal instability neoplastic score.

Development of Upper-Extremity Morphological Asymmetries in Male and Female Elite Youth Tennis Players: A Longitudinal Study.

This 2-year longitudinal study examined the development of upper-extremity bone mineral density (BMD), bone mineral content (BMC), and lean mass (LM) asymmetry magnitudes in male and female youth tennis players. Dominant and nondominant upper-extremity BMD, BMC, and LM values of 49 male and 31 female players were measured yearly using dual X-ray absorptiometry. From these values, asymmetry magnitudes were calculated and expressed as a percentage. Maturity offset was estimated using anthropometric measurements. Linear mixed effect models examined the development of BMD, BMC, and LM asymmetry magnitudes according to players' maturity offset, sex, and training volume. Adjusted for sex and training volume, a 1-year increment in maturity offset was associated with a significant increase in BMD (1.3% [2.2%]; P < .001) and BMC (0.6% [2.4%]; P = .011) asymmetry magnitudes. Male players displayed significantly higher LM asymmetry magnitudes (Δ3.2% [8.4%]; P = .002) compared with their female counterparts. Training volume was not significantly associated with asymmetry magnitude development. In contrast to LM, male and female youth tennis players' upper-extremity bones are still responsive to mechanical loading with a significant increase in BMD and BMC asymmetry magnitudes according to maturity offset.

Zinc improves Denosumab and eldecalcitol efficacy for bone mineral density in patients with hypozincemia.

We aimed to investigate the effects of zinc deficiency and zinc medication in osteoporosis patients undergoing denosumab (DMAb). This retrospective study was conducted at a single hospital. The participants were female osteoporosis patients visiting between April 2019 and April 2020. All patients were treated with DMAb and eldecalcitol and recommended zinc-rich food. Based on zinc medication and serum zinc levels at the 12th month of dietary guidance, patients were categorized into the following four groups: hypozincemia with zinc medication, latent zinc deficiency with zinc medication, without zinc medication, and control without zinc medication. Longitudinal serum zinc concentrations, bone mineral density (BMD), and occurrence of fractures were measured. We investigated the factors influencing no response to DMAb and eldecalcitol treatment. Among the 145 patients followed up for 24 months, dietary guidance did not change the serum zinc concentration; however, zinc medication significantly increased these levels. The hypozincemia group did not show a significant BMD increase in the lumbar spine and femoral neck after DMAb and eldecalcitol treatment during dietary guidance; however, zinc medication increased these to the same levels as the other groups. In multivariate analyses, hypozincemia and thyroid disease were identified as the factors affecting no response. While 28.2% of patients with latent zinc deficiency without zinc medication suffered fractures, no fractures occurred in hypozincemia patients with zinc medication. Hypozincemia may reduce the efficacy of DMAb and eldecalcitol in increasing BMD and fracture prevention.

Effect of Plyometrics on Bone Mineral Density in Young Adults: A Systematic Review and Meta-Analysis

ABSTRACT Context Osteoporosis is a chronic bone metabolic disease characterized by decreased bone mass, leading to increased frailty and a subsequent fracture risk. Peak bone mineral density (BMD) is achieved in early adulthood and may be the most important factor leading to the development of osteoporosis in older adults. Objective This study aimed to analyze the effects of plyometrics on BMD in young men and premenopausal women. Design This study used randomized controlled trials found in MEDLINE, Embase, and CINAHL published between January 1, 1990, and November 1, 2022. Keywords included plyometrics, jumping, jump training, bone health, and bone mineral density. Articles were assessed for methodological quality using the Consolidated Standards of Reporting Trials 2010 checklist. Eligibility Criteria Randomized controlled trials investigating BMD in healthy premenopausal women and men between the ages of 18 and 60 yr that compared plyometrics with control were included. Study Selection Two reviewers independently screened 553 abstracts. Main Outcome Measures Mean baseline and follow-up dual-energy x-ray absorptiometry scores and standard deviations were extracted to calculate the standard mean difference. After extraction, the magnitude of difference between control and treatment groups were analyzed using the Hedges and Olkin method for effect size. Results The 12 included studies had high methodological quality. Of the 12 studies, 10 reported statistically significant increase in BMD at ≥1 site when compared with control. Two studies showed equal improvement when compared with resistance-only training. After analysis, a large positive effect size with strongly positive correlation was seen between plyometrics and lumbar spine BMD. Conclusion Plyometric training is a safe and time-efficient method to improve BMD in premenopausal people 18–65 yr old. Large effect sizes were associated with increased training intensity and lasted months after the intervention was complete. Plyometrics seems to be a comparable alternative to resistance training with respect to bone health.

Association between serum insulin-like growth factor-1 and bone mineral density in patients with type 2 diabetes.

Secondary osteoporosis is associated with type 2 diabetes mellitus (T2DM), and there is conflicting evidence regarding the relationship between insulin-like growth factor-1 (IGF-1) and bone mineral density (BMD) in different populations. The objective of this study was to investigate the relationship between serum IGF-1 levels and BMD in patients with T2DM. A retrospective cross-sectional study was performed on a cohort of 363 patients with T2DM, comprising men aged over 50 and women who are postmenopausal. Those with no significant medical history or medication affecting BMD or IGF-1 were considered. Data analyzed included IGF-1 levels, markers of bone metabolism, and measurements of BMD. To account for age and gender variations, we calculated IGF-1 standard deviation scores (IGF-1 SDS) for further investigation. A significant increase in BMD at lumbar spine (LS), femoral neck (FN), and total hip (TH) was observed as IGF-1 SDS tertiles rose. We revealed a nonlinear correlation between IGF-1 SDS and BMD at these sites, with a common inflection point identified at an IGF-1 SDS level of -1.68. Additionally, our multivariate piecewise linear regression analysis highlighted a positive association between IGF-1 SDS and BMD at LS, FN, and TH when IGF-1 SDS exceeded the inflection point (β 0.02, 95% CI 0.01, 0.04 for LS; β 0.02, 95% CI 0.01, 0.03 for FN; β 0.02, 95% CI 0.01, 0.03 for TH). Conversely, below the inflection point, this association was not significant (β -0.04, 95% CI -0.10, 0.01 for LS; β -0.04, 95% CI -0.08, 0.01 for FN; β -0.03, 95% CI -0.08, 0.01 for TH). These findings reveal a nonlinear relationship between IGF-1 SDS and BMD in T2DM patients. Higher serum IGF-1 levels were connected to increased bone density only after surpassing a certain threshold.

Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia.

Osteoporosis and/or bone fractures are indications of parathyroidectomy in primary hyperparathyroidism (PHPT), especially in women. However, the benefit of surgery in patients with osteopenia remains unclear. To evaluate bone mineral density (BMD) and bone remodeling biomarkers changes 1 year after parathyroidectomy in women with PHPT. In the prospective, monocentric, observational prospective cohort with primary hyperparathyroidism patients (CoHPT) cohort, women operated for sporadic PHPT since 2016 with ≥1 year follow-up were included. BMD (dual-X ray absorptiometry) and bone remodeling biomarkers [cross-linked C-telopeptide (CTX), procollagen type 1 N-terminal propeptide (P1NP), and bone-specific alkaline phosphatases] were assessed before and 1 year after parathyroidectomy. Referral center. A total of 177 women with PHPT (62.5 ± 13.3 years, 83.1% menopausal, 43.9% osteopenic, and 45.1% osteoporotic) were included. Parathyroidectomy. BMD change between before and 1 year after parathyroidectomy. Parathyroidectomy resulted in significant increase in BMD and decrease in serum bone remodeling biomarker concentrations. In the 72 patients with baseline osteopenia, mean BMD significantly increased at the lumbar spine [+0.05 g/cm2 (95% confidence interval [CI], 0.03-0.07)], the femoral neck [+0.02 g/cm2 (95% CI 0.00-0.04)], the total hip [+0.02 g/cm2 (95% CI 0.01-0.02)], and the forearm [+0.01 (95% CI 0.00-0.02)], comparable to osteoporotic patients. Among osteopenic patients, those with individual BMD gain (>0.03 g/cm2) at ≥1 site had higher preoperative serum CTX, P1NP, and urine calcium concentrations than those without improvement. Parathyroidectomy significantly improved BMD and remodeling biomarkers in women with osteopenia, thereby supporting the benefit of parathyroidectomy in these patients. Preoperative serum CTX and P1NP concentrations could be useful to predict expected BMD gain.

Bone Mineral Density Derived from Cardiac CT Scans: Using Contrast Enhanced Scans for Opportunistic Screening

Osteoporosis is under-diagnosed and often co-exists with other diseases. Very low bone mineral density (BMD) indicates risk of osteoporosis and opportunistic screening for low BMD in CT-scans has been suggested. In a non-contrast enhanced thoracic CT scan, the scan-field-of-view includes vertebrae enabling BMD estimation. However, many CT scans are obtained by administration of contrast material. If the impact of contrast enhancement on BMD measurements could be quantified, considerably more patients are eligible for screening. This study investigated the impact of intravenous contrast on thoracic BMD measurements in cardiac CT scans pre- and post-contrast, including different contrast trigger levels of 130 and 180 Hounsfield units (HU). BMD was measured using quantitative CT with asynchronous calibration. In 195 participants undergoing cardiac CT (mean age 57±9 years, 37 % females) contrast increased mean thoracic BMD from 116±33 mg/cm3 (non-enhanced CT) to 130±38 mg/cm3 (contrast-enhanced CT) (p<0.001). Using clinical cut-off values for very low (<80 mg/cm3) and low BMD (<120 mg/cm3) showed that 24 % (47/195 participants) were misclassified when BMD was measured on contrast-enhanced CT-scans. Of the misclassified patients, 6 % (12/195 participants) were categorized as having low BMD despite having very low BMD on the non-enhanced images. Contrast-CT using a higher contrast trigger level showed a significant increase in BMD compared to the lower trigger level (119±32 vs. 135±40 mg/cm3, p<0.01). For patients undergoing cardiac CT, using contrast-enhanced images to assess BMD entails substantial overestimation. Contrast protocol trigger levels also affect BMD measurements. Adjusting for these factors is needed before contrast-enhanced images can be used clinically. Osteoporosis is under-diagnosed. Contrast-enhanced CT made to examine other diseases might be utilized simultaneously for bone mineral density (BMD) screening. These scans, however, likely entails overestimation of BMD due to the effect of contrast. Adjusting for this effect is needed before contrast-enhanced images can be implemented clinically for BMD screening.

Effect of Growth Hormone and Estrogen Replacement Therapy on Bone Mineral Density in Women with Turner Syndrome: A Meta-Analysis and Systematic Review.

Osteoporosis is a serious implication of Turner syndrome (TS). Common methods for the treatment of TS are growth hormone (GHT) and estrogen replacement therapy (ERT). We examined the relationship between the treatment of TS and bone mineral density (BMD) of the lumbar spine. The purpose of our study was to show the currency of BMD states among patients with TS for treatment with GHT and ERT. We searched databases for studies published from inception to April 2023. The articles were related to TS, osteoporosis, ERT, GHT, BMD and treatment patients with TS. We applied the selection criteria: lumbar spine values at L1-L4; dual-energy X-ray absorptiometry (DXA); treatment which was applied: one group of articles: ERT and two group of articles: GHT; results performed as means ± SD. In total, 79 articles were analyzed, of which 20 studies were included and 5 were considered for meta-analysis. The total number of women in the articles selected was 71. Based on the results of the meta-analysis, the effect of ERT on BMD demonstrated a significant increase in BMD (the standardized mean difference in the random model was 0.593 g/cm2, 95% CI: 0.0705 to 1.116; p = 0.026), which showed that treatment with estrogen particularly increases bone mass during treatment, which contributes to reducing the risk of fractures. The effect of GHT on BMD demonstrated a non-significant decrease in BMD in patients with TS. The results for growth hormone show that this therapy does not improve bone density. However, our review emphasizes the beneficial effect of supplementing growth hormone (GH) on the clinical presentation of TS.

The Effect of Denosumab in Elderly Patients Regarding Bone Density and Fracture Risk.

With an aging population, the importance of treating and diagnosing osteoporosis is increasing. Osteoporosis, previously known as a resorptive change primarily related to endocrinological mechanisms, is also being approached as a phenomenon of senile change. Denosumab is gaining popularity among osteoporosis medications due to its ability to increase bone mineral density (BMD) and the economic benefit arising from the 6-month cycle. In line with previous literature, this study aimed to examine the BMD-augmenting effect of denosumab through which it reduces fracture risk in individuals aged over 80 years. We reviewed patients who received denosumab between 2018 and 2022 with a minimum clinical observation period of 12 months. BMD was measured every 12 months, and patients were classified per their period of denosumab use. Fracture risk was evaluated using the fracture risk assessment tool (FRAX) and fracture incidence during the observation period were assessed. Among 155 patients, a significant increase in BMD was observed at 3 sites: the lumbar spine, femoral neck, and total hip (p<0.001, p<0.001, and p=0.001, respectively). The patients were divided according to the length of clinical follow-up they received, and similar results were found in all subgroups. Fracture risk assessment was performed using FRAX and the incidence of fracture events during follow-up. FRAX significantly decreased in all subgroups except those who received 24 months of follow-up (p=0.003, p=0.41, p=0.001 in the 12, 24, and ≥36 months groups, respectively). Denosumab use resulted in long-term BMD increase and reduced fracture risk in individuals aged 80 and above.

Factors associated with bone response to teriparatide in young postmenopausal women with osteoporosis.

To investigate the factors associated with changes in vertebral bone mineral density during teriparatide treatment. Single centre, longitudinal study involving 145 osteoporotic postmenopausal women treated with teriparatide. Clinical evaluation, bone mineral density (BMD) measurements assessment and laboratory analyses were performed at baseline then after 12 and 18months of treatment. Bone non-response to treatment was defined as no significant increase in BMD at 18months as compared to baseline. Of the 145 women initially included, 109 completed the 18-month course of the treatment. 75% of them had a history of prior osteoporotic treatment. Baseline mean age was 60 ± 8years. Mean baseline vertebral T-score was -3.7 ± 0.7 and 83 (76%) women had suffered at least one vertebral fracture. At the end of treatment, 18 women (17%) were classified as non-responders. In the responder group (n = 91), vertebral BMD increased by 0.091 ± 0.04g/cm2 (12.2 ± 5.3%). Clinical characteristics, baseline BMDs and the percentage of women previously treated with bisphosphonates as well as the duration of prior treatment did not significantly differ between the two groups of responders and non-responders. At baseline, non-responders had significant mean lower C-terminal fragment of type 1 collagen (CTX) values than responders (p < 0.01). Only baseline CTX values (r = 0.30 p < 0.01) were independently correlated to vertebral BMD changes during teriparatide treatment. A minority of treated women had no vertebral densitometric gain after 18months of teriparatide therapy. Low levels of baseline bone remodeling were the main factor associated with poor response to treatment.

A 2-Year Longitudinal Study of Bone Mineral Density in Collegiate Distance Runners.

Brimacomb, OE, Martinez, MP, McCormack, WP, and Almstedt, HC. A 2-year longitudinal study of bone mineral density in collegiate distance runners. J Strength Cond Res 37(8): 1654-1659, 2023-The purpose of this investigation was to examine changes in bone mineral density (BMD) of male and female collegiate distance runners over 2 years. Bone mineral density of 29 collegiate distance runners (16 men and 13 women) were measured 5 times over 24 months using dual-energy x-ray absorptiometry (DXA) at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultradistal (UD) forearm. Repeated-measures multivariate analysis of covariance, with bone-free lean mass (BFLM) as covariate, was used to compare mean BMD values. Adjusted for BFLM, there were no significant differences ( p > 0.05) in BMD at any site between sexes. There were no significant differences at the AP or LAT spine, FN, or WB between visit 1 and 5 for either sex. There was a significant increase in BMD ( p = 0.044) at the UD forearm over 2 years in males. However, 56% of the men ( n = 9) had a Z-score < -1.0 at the UD forearm. Seven of 11 women had Z-scores < -1.0 at the LAT spine and 4 of 13 had Z-scores < -1.0 at the AP spine. There were no significant changes in BMD at any site over the 2-year time frame, except a significant increase in BMD at the nondominant forearm in men. The spine appears to be an area of concern for women in this study when examining Z-score results. Coaches and medical staff need to continually educate collegiate endurance athletes about the importance of achieving and maintaining BMD through their college years.

Bone resorption during therapy with denosumab in patients with rheumatoid arthritis, positive for the main immunological markers

Objective. Inflammation in rheumatoid arthritis (RA) leads to the development of local and generalized bone loss. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACCP) are believed to play a negative role in the radiological progression of RA. The use of such antiresorptive therapy as denosumab – monoclonal antibodies to RANKL (receptor activator of nuclear factor kappa-B ligand), reduces the activity of osteoclasts, increases bone mineral density (BMD), and also potentially affects the erosive process at RA. The aim of the study is to evaluate the effect of denosumab therapy on BMD and erosion count in patients with RA and osteoporosis (OP) in consideration of the positivity in the RF and ACCP in serum and the baseline RA activity. Materials and methods. The 12-month prospective study of the efficacy of denosumab therapy (60 mg subcutaneously every 6 months) in patients with RA and OP included 66 postmenopausal women; age – 59.4±7.5 years, duration of RA – 17.8±10.6 years, RF-positive – 47 (72%) patients, ACCP-positive – 48 (74%) patients. At baseline and after 12 months, dual-energy X-ray absorptiometry was performed with an assessment of BMD in the lumbar spine (L1– L4), proximal femur (hip neck and total hip), distal forearm; X-ray of the hands and distal parts of the feet in direct projection, followed by assessment of erosive-destructive changes according to the Sharp/van der Heijde method. Results. A significant increase in BMD was established in all studied sites of the skeleton despite the positivity of the RF and ACCP (for the hip neck p=0.05), while a significant increase in BMD in the RF- and ACCP-negative group was detected only in L1–L4 site. The progression of the increase in erosion count was noted in the RF- and ACCP-positive group while in the RF- and ACCP-negative group this indicator did not change. Regardless of the baseline activity of RA (by DAS28 (Disease Activity Score 28)) the BMD of most parts of the skeleton were stabilized. In patients with moderate RA activity, BMD increased significantly in L1–L4 in both groups: RF- and ACCP-positive and -negative , as well as in the total hip – in RF- and ACCP-positive group. The dynamics of the erosion count in RA patients did not depend on the baseline degree of DAS28 activity, no significant changes were detected in the analyzed groups. Conclusions. RF and ACCP positivity in serum in patients with RA and OP treated with denosumab did not have a negative effect on the dynamics of BMD, while the number of erosions increased. The baseline RA activity level did not affect the dynamics of the erosion count and the dynamics of BMD in most subgroups – BMD levels have been increased or stabilized.

Changes in bone mineral density after allogenic stem cell transplantation.

Osteoporosis is a complication after allogenic stem cell transplantation (alloSCT). The purpose of this study was to assess changes in bone mineral density (BMD) 6 months and 3 years after alloSCT, as well as predictors of bone loss. A longitudinal, prospective, single-center study was conducted at Lille University Hospital between 2005 and 2016. Clinical, biological, radiologic (thoracic and lumbar spine) and densitometric (DXA) assessments were carried out at baseline (pre-transplant), 6 months and 3 years. Patients with myeloma were not included. Two hundred and fifty-eight patients were included (144 men). Among them, 60.1% had leukemia and 65.8% of them, acute myeloid leukemia. At baseline, 6 months and 3 years, DXA-confirmed that osteoporosis was observed in 17%, 22.8% and 17.5% of the patients, respectively, mainly at the femoral neck. At baseline, 6 months and 3 years, 9 (8.5%), 53 (21.5%) and 38 (16.7%) patients, respectively, were receiving anti-osteoporotic treatment. From baseline to 6-month follow-up, BMD decreased significantly (p&lt;0.001) at the lumbar spine (-36 [95%CI; -51 to -20] mg/cm² of hydroxyapatite), femoral neck (-43 [95%CI; -57 to -29] mg/cm² of hydroxyapatite) and total hip (-53 [95%CI; -68 to -39] mg/cm² of hydroxyapatite). From 6-month to 3-year follow-up, a significant increase in BMD was observed at the lumbar spine only (+31 [95%CI; 20 to 42] mg/cm² of hydroxyapatite, p&lt;0.001). At all 3 sites, changes in BMD did not differ between patients treated or untreated by anti-osteoporotic treatment from 6-month to 3 year follow-up. Incident fractures were found in 4.1% and 5.7% of the patients at 6 months and 3 years, respectively. Between baseline and 6 months, bone loss at all 3 sites was associated with corticosteroid intake. At the total hip, 23.3% of the decrease in BMD from baseline to 6 months was due to an active hematological disease (p&lt;0.05), a bone marrow stem cells (p&lt;0.01) and a corticosteroid intake (p&lt;0.01). Our study found evidence of bone fragility in alloSCT patients. Low BMD persisted at the hip 3 years after transplantation due to slower improvement at this site.

Effects of Rapid Weight Loss following Iron Supplementation on Bone Mineral Density and Serum Osteocalcin Levels in University Wrestlers

This experiment is designed for bone health in wrestlers and martial arts athletes who lose weight with Rapid Weight Loss (RWL). To clarify the effect of iron intake on the relationship between weight loss and bone densityFor athletes using the RWL strategy, iron intake was observed for bone mineral density (BMD), serum osteocalcin (OC) level, and serum iron marker. This study was conducted on 23 wrestlers (13 males and 10 females). It was divided into the trial 1 (iron intake and weight loss) and the trial 2 (only weight loss). In addition, between the first and second experiments, a washout period was given for 3 weeks} in order to eliminate the medicinal effect. All measurements were performed in the same group. However, the OC levels were reduced following RWL. In case of the males, the intake group after weight loss demonstrated a significant increase in BMD (p&lt;0.05). Correlation analysis of the data for the male group showed significant correlations between serum OC and iron contents (p&lt;0.05), total BMD and TIBC(total iron binding capacity) (p&lt;0.05), and transferrin and iron concentrations (p&lt;0.05). In the female group, serum OC and iron (p&lt;0.01), transferrin and TIBC(total iron binding capacity) (p&lt;0.01) showed correlations. In addition, between serum OC and ferritin (p&lt;0.05), total BMD and ferritin (p&lt;0.05), TIBC and iron (p&lt;0.05) were shown to have some degree of correlation in the global evaluations.