Bone Mineral Density Status Research Articles

New mandibular indices in cone beam computed tomography to identify low bone mineral density in postmenopausal women

The aim of this study was to evaluate new radiomorphometric indices in cone beam computed tomography (CBCT) for assessing bone mineral density (BMD) status in postmenopausal women. Mandibular inferior cortical bone thickness was evaluated in 48 postmenopausal women in cross-sectional images at 4 sites: (1) symphysis (S): cross-sectional image equidistant from the centers of the right and left mental foramina (MF); (2) anterior (A): 10 mm anterior to the MF; (3) molar (M): 10 mm posterior to the MF; and (4) posterior (P): 25 mm posterior to the MF. Participants underwent dual-energy x-ray absorptiometry and were divided into normal, osteopenia, and osteoporosis groups. In the study, t tests with Bonferroni correction were conducted. Statistical significance was set at P < .017. Receiver operator characteristic (ROC) analyses were performed. Mean S index was significantly lower in osteoporosis than in osteopenia (P=.005). Mean M index was significantly lower in osteopenia (P < .001) and osteoporosis (P=.001) than in normal individuals. Mean P index was significantly lower in osteoporosis than in normal patients (P=.008). ROC values ranged between 0.643 and 0.740. Cortical thicknesses separating normal from abnormal varied from 1.73 mm to 3.37 mm. M and P indices in CBCT may be useful for identifying low BMD in postmenopausal women.

Efficacy of denosumab co-administered with vitamin D and Ca by baseline vitamin D status.

In anti-osteoporosis drug trials, vitamin D and calcium (Ca) are common supplements; however, the optimal dose of each is unclear. Using data from the randomized, double-blind, placebo-controlled DIRECT trial, we assessed whether baseline serum 25-hydroxy vitamin D (25[OH]D) level influences the efficacy of denosumab co-administered with vitamin D and Ca. In this prespecified sub-analysis, subjects with primary osteoporosis who received denosumab or placebo, plus vitamin D (≥ 400IU/day) and Ca (≥ 600mg/day), were classified as 25(OH)D deficient (< 20ng/mL), insufficient (≥ 20 to < 30ng/mL), and sufficient (≥ 30ng/mL). Study endpoints included absolute serum 25(OH)D level at baseline, 12months, and 24months; change in serum 25(OH)D and bone mineral density (BMD) status from baseline; and incidence of new vertebral fractures at 24months. In 475 denosumab-treated and 481 placebo-treated subjects, proportions with deficient/insufficient/sufficient 25(OH)D at baseline were 53.1%/37.1%/9.9% and 50.9%/42.0%/7.1%, respectively. Supplementation significantly increased mean serum 25(OH)D levels; at 24months, mean levels were > 30ng/mL (sufficient) in both treatment groups. Increase in BMD over time was higher in the denosumab group vs. placebo group in all three vitamin D status groups. At month 24, denosumab-treated subjects with deficient/insufficient baseline 25(OH)D had a significantly lower risk of new vertebral fracture vs. placebo-treated subjects. Among DIRECT trial subjects supplemented with ≥ 400IU/day of vitamin D and ≥ 600mg/day of Ca, baseline 25(OH)D sufficiency may not influence the efficacy of denosumab in increasing BMD or preventing vertebral fractures.

The interrelationship of bone and cardiovascular remodeling biomarkers and clinical peculiarities of coronary artery disease in postmenopausal women

ObjectivesTo investigate the interrelationship between bone and cardiovascular remodeling biomarkers and some clinical, laboratory and instrumental parameters of coronary artery disease in postmenopausal women.Material and methodsThe double open cross-sectional monocentric clinical study in parallel groups involved 115 women in the postmenopausal period with coronary artery disease (CAD): stable exertional angina of functional class (FC) II–III (mean age 67.07 ±0.92 years). Depending on the bone mineral density (BMD) state, all patients were divided into 3 groups: group 1 (n = 24) – patients with normal BMD (T-criterion more than 1 SD); group 2 (n = 34) – patients with osteopenia (T-criterion from –1 SD to –2.5 SD); group 3 (n = 44) – patients with osteoporosis (T-criterion less than –2.5 SD). The selected control group consisted of 12 relatively healthy women of the corresponding age. All patients underwent cardiovascular and bone remodeling biomarkers’ assessment, lipid profile tests, daily monitoring of ECG by Holter, two-dimensional echocardiography and pulsed-wave Doppler. Intima-media complex (IMC) measurement, ultrasound densitometry, and the FRAX algorithm were performed.ResultsIn women with coronary artery disease and postmenopausal osteoporosis (PMO), there was a significant increase in the level of bone osteoprotegerin (OPG), osteocalcin and vascular remodeling biomarkers (VEGF-A, homocysteine) in parallel with the progression of BMD disorders. The existence of a correlative dependence between osteoprotegerin level and the 10-year risk of fracture of the radial bone (r = 0.46; p < 0.05) was discovered. A probable interrelationship between the OPG, osteocalcin, VEGF-A and homocysteine level and decrease of the T-criterion was observed. An interrelationship between the bone and cardiovascular remodeling biomarkers and atherogenic dyslipidemia, diastolic dysfunction of the left ventricle, dilatation of the left atrium, thickening of the intima-media complex, arrhythmic complications and vegetative imbalance development was proved (p < 0.05), which confirms their clinical and pathogenic role in patients with CAD and PMO.ConclusionsThe results obtained prove the existing interrelationship of bone and cardiovascular remodeling biomarkers with the state of bone mineral density and clinical peculiarities of coronary artery disease in postmenopausal women.

Comparison of the expression levels of TNF-α, IL-6, hsCRP and sICAM-1 inflammatory factors, bone mineral density and nutritional status between diabetic and normal pregnant women

To compare the ultrasound bone mineral density, nutritional status and inflammatory state of pregnant women with gestational diabetes mellitus (GDM) and those with normal blood glucose. Retrospective analysis of pregnant women who were prenatally examined and delivered in The 5th People's Hospital of Ji'nan from May 2015 to July 2017 was performed, including 68 subjects with normal blood glucose in the control group and 74 subjects with GDM in the experiment group. The bone mineral density, nutritional status and inflammatory state were measured by enzyme-linked immune sorbent assay (ELISA). The bone mineral density of pregnant women with GDM was lower than that of the control group; the incidence of osteoporosis in GDM pregnant women was higher than that in the control group. The energy intake of GDM pregnant women was high, and the usage rate of fruits, sweets, deep-fried products and night snack was higher than that of normal pregnant women. The expression levels of TNF-α, IL-6, hsCRP and sICAM-1 inflammatory factors in GDM pregnant women were significantly higher than those with normal blood glucose. The bone mineral density of pregnant women with GDM is lower than that with normal blood glucose. Therefore, the prevention of GDM in pregnant women is also important for their bone health. GDM pregnant women's health education should be strengthened and reasonable dietary interventions should be carried out as soon as possible. TNF-a, IL-6, hsCRP, and sICAM-1 may be involved in the inflammatory process of GDM.

Associations of dietary vitamin K and bone markers in adult Saudi females

ObjectiveOsteoporosis is a bone disease characterized by bone mass reduction with a prevalence of approximately 34–48% in Saudi Arabia. Many risk factors can increase osteoporosis fracture, including low vitamin K levels. However, its exact role on bone mineral density (BMD) remains under investigated. This study aims to determine whether dietary vitamin K is associated with BMD, inflammation, undercarboxylated osteocalcin (ucOC) and other bone markers among adult Saudi females. MethodsA total of 138 Saudi females aged 25 and above were recruited from different primary health care centers in Riyadh, Saudi Arabia, and were divided according to BMD status (N = 53 normal; N = 85 low BMD). Each participant completed a food frequency questionnaire. Anthropometrics were measured and serum 25(OH)D and vitamin K, bone markers (ucOC and CTX) and cytokines (IL-6, TNF-α) were assessed using assays. ResultsLow dietary vitamin K intakes were observed in both groups, ranging only 16–19 µg/day. A positive association was seen between dietary vitamin K and IL-6 in low BMD group and TNF-α in all participants. No significant association was seen between dietary vitamin K and BMD. ConclusionDietary vitamin K is significantly associated with inflammation and not BMD in adult Saudi females. The alarmingly low dietary vitamin K intake is worth investigating further.

Comparative Study on Bone Mineral Densitometry in People Living with HIV with or without Highly Active Antiretroviral Therapy

Abstract Introduction Human immunodeficiency virus (HIV) is a disease that affects millions of people globally and affects almost all the body systems including bone metabolism. Derangement of bone mineral density (BMD) in HIV patients is well established in international literature but least studied in India. Therefore, this study aims to determine the association between BMD change and HIV infection with or without antiretroviral therapy (ART) and compare the different regimens of ART. Materials and Methods The cross-sectional study was conducted at the Department of Medicine and ART Center of Regional Institute of Medical Sciences, Imphal, India. A total of 50 HIV patients were screened by a central dual-energy X-ray absorptiometry (DEXA) examination for measuring BMD. Correlation of BMD with a CD4 count, and different ART regimens were also studied. Results In our study, majority of the patients (29 [58%]) had low BMD. Of the 29 patients, 18 (36%) had osteopenia and 11 (22%) had osteoporosis. Of the ART naïve patients, 81.8% have reduced BMD. Among different ART regimens, tenofovir-based regimes were mostly associated with low BMD (52.4%). A statistically significant association between low CD4 count and low BMD was found. Conclusion Our study concluded that HIV infection is associated with bone loss and low BMD in people living with HIV (PLHIV) irrespective of its treatment with ART. PLHIV are at a greater risk of bone loss secondary to decreased BMD. Among the ART regimens, tenofovir-based regimens are mostly associated with low BMD. Therefore, all HIV patients should be screened by DEXA scan for BMD status, and timely intervention should be started.

Acromegaly is associated with vertebral deformations but not vertebral fractures: Results of a cross-sectional monocentric study.

Patients with acromegaly appear to be at increased risk of vertebral fractures despite normal bone mineral density. We investigated the prevalence of vertebral fractures in a cohort of acromegalic patients under 80 years of age. Monocentric cross-sectional study performed at Nantes University Hospital from 1988 to 2018. Fifty patients (18 females, 32 males) with a median age of 52.3 years (range: 27-78) were included. Radiological vertebral fractures were evaluated on conventional lumbar and thoracic spine radiographs using Genant's semiquantitative fracture assessment. We studied qualitative abnormalities of the spine using three criteria: osteophytes, disc-space narrowing and wedge-shaped vertebrae. We analysed bone mineral density and endocrine status. Three patients (6%) had a vertebral fracture: one grade 1 and two grade 2 according to Genant's assessment, with two osteoporotic and one osteopenic patients. They had no unsubstituted pituitary deficiency. Considering the frank deformations (osteophyte or disc narrowing≥grade 2 or wedge-shaped), the thoracic spine was deformed in 22 patients (44%) and the lumbar spine in 21 patients (42%). Acromegalic patients had a low prevalence of vertebral fractures but had a significant amount of vertebral deformations. We speculate that this high prevalence of frank deformations could explain the previously reported high prevalence of vertebral fractures.

Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects.

The incidence and risk factors for the progression of ossification of the posterior longitudinal ligament (OPLL) have been previously reported in surgically and nonsurgically treated symptomatic patients. However, the correlates of OPLL progression in asymptomatic subjects with OPLL are not well characterized. This study aimed to clarify the incidence and risk factors for OPLL progression in asymptomatic subjects based on whole-body CT. The authors retrospectively reviewed 2585 healthy subjects who underwent whole-body CT at a single health center from September 2007 to December 2011. This study included asymptomatic subjects with OPLL who underwent CT scans twice with an interval of at least 5 years. Progression of OPLL was assessed based on initial and final CT scan. Subjects were divided into two groups: nonprogression (OPLL-NP) and progression (OPLL-P) groups. Clinical characteristics, bone mineral density status, OPLL types, and OPLL involvement of multiple vertebral levels between the two groups were compared. Risk factors for progression of OPLL were identified by logistic regression analysis after propensity score adjustment. Of the 109 subjects with OPLL (91 men and 18 women), 20 (18.3%) exhibited OPLL progression (OPLL-P group). Subjects in the OPLL-P group were significantly younger (p = 0.031), had higher prevalence of multilevel OPLL involvement (p = 0.041) and continuous type of OPLL (p = 0.015), and had higher uric acid (UA) levels (p = 0.004) at the time of initial CT examination compared to the OPLL-NP group. Younger age (adjusted odds ratio [aOR] 0.95, 95% CI 0.90-0.99), OPLL involvement of multiple vertebral levels (aOR 2.88, 95% CI 1.06-7.83), continuous type of OPLL (aOR 4.21, 95% CI 1.35-13.10), and higher UA levels (aOR 2.09, 95% CI 1.24-3.53) were significant risk factors for OPLL progression. Younger age, OPLL involvement of multiple vertebral levels, continuous type of OPLL, and higher UA levels are significant risk factors for OPLL progression in asymptomatic subjects.

Role of radiologic imaging complex in morpho-pathogenetic approach to sanatorium resort intensity regimen selection in patients with dorsopathies

At the present time for sanatorium treatment of dorsopathies no morpho-pathogenetic principles are based on severity of degenerative spine changes. The choice of treatment modalities is provided according only to clinical signs and the fact of degenerative spine disease presence, in spite of limitations and contradictions to some resort procedures because of their mechanisms and peculiarities of therapeutic effects. Materials and methods. Comparison of complex imaging examination and sanatorium resort intensity regimen medical appointments of 952 patients with dorsopathies was provided depending on morphological pattern and severity of degenerative spine changes. Case histories, sanatorium medical outpatient cards and the results of radiologic imaging (computed tomography, magnetic resonance imaging, spondylography and osteodensitom-etry) were analyzed. Results. Three groups of sanatorium resort therapeutic action intensity (maximal, 376 patients; limited, 493 patients; and minimal, 83 patients) for patients with dorsopathies were established. The most significant morphological criteria of patient distribution into appropriate groups were established, such as bone mineral density state, the presence and severity of spinal osteoarthrosis and spondylolisthesis, vertebral-motor segment stability or instability, vertebral body hemangiomas. The size of intervertebral disc extrusions and grade of disc height decreasing played a secondary role. The value of spondylography, computed tomography, magnetic resonance imaging and dual-energy radioabsorptiometry in determination of these criteria is presented, as far as in imaging algorithm of examination of patients with dorsopathies on the pre-sanatorium stage, with calculation of computed tomography and magnetic resonance imaging sensitivity, specificity and accuracy. Discussion. Forming morpho-pathogenetic approach to sanatorium resort treatment of dorsopathy demands essential application of modern radiologic imaging modalities. The presence, type and severity of degenerative spine morphological changes must be as fundamental as clinical and neurological pattern, affecting sanatorium resort intensity regimen selection and treatment modalities and schemes. In basic cases most advisable radiologic imaging pre-sanatorium examination modality should be computed tomography, but others are also necessary to use when concretely indicated.

Determinants of vitamin D supplementation among older adults and its effect on 25(OH)D levels according to bone mineral density status.

Background: although supplementation with vitamin D has been reported as a main determinant of 25-hydroxyvitamin D status [25(OH)D] levels, there are limited data in regard to the factors associated with vitamin D supplementation in older adults. Aims: to examine the characteristics of participants associated with vitamin D supplement use and its effect on 25(OH)D concentrations according to bone mineral density (BMD). Methods: the present analysis was based on data from participants aged 60 years and older in the National Health and Nutrition Examination Survey. Logistic regression models were created to examine the demographic, lifestyle, and health characteristics associated with vitamin D supplementation. Moreover, general linear models were assembled to assess the effect of vitamin D supplement doses on 25(OH)D concentrations according to BMD status. Results: of 5,204 participants, 45.3% reported taking vitamin D supplements, at least 400 IU per day. Overall, women, non-Hispanic whites, college education, former smokers, physical activity, and > 2 comorbidities were variables significantly associated with increased odds of taking vitamin D supplements. Notably, among subjects with osteoporosis, those taking vitamin D supplements between 400 and 800 IU per day had on average 20.7 nmol/L higher 25(OH)D concentrations compared with their non-user counterparts. Conclusions: demographic and healthy lifestyle characteristics are the main determinants of vitamin D supplement use among older adults. Moreover, even among subjects with low bone mass, vitamin D supplements between 400 and 800 IU per day are adequate to reach sufficient 25(OH)D concentrations.

Bone status in young women with rheumatic diseases

Objective: to investigate bone mineral density (BMD) status and the factors influencing the latter in reproductive-aged women with rheumatic diseases (RDs). Subjects and methods . The investigation enrolled 134 women (mean age, 35 [29; 43] years): 94 patients with RDs (rheumatoid arthritis (RA), systemic sclerosis (SS), and psoriatic arthritis (PsA)) and 40 people without RDs. The investigators conducted a survey using a unified questionnaire, spine and proximal femur bone densitometry by dual energy X-ray absorptiometry (Hologic Discovery A Bone densitometer, USA), serum vitamin D measurement, and daily dietary calcium intake estimation. Results and discussion. Reduced BMD was detected significantly more often in the group of patients with RDs compared with the healthy control (25 and 8%, respectively; p=0.0213). It occurred in 48% of patients with RA, in 21% of those with SS, and in 15% of those with PsA. Patients with RDs showed a direct correlation of BMD in all areas of measurement with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. In addition, an inverse correlation was found between proximal femur BMD and RD duration. The patients with SS displayed an inverse relationship between BMD of both proximal femurs and C-reactive protein level; and the women with RA had exhibited this relationship between lumbar spine and femoral neck BMD and ESR. Conclusion. In general, 25% of reproductive-aged women with RDs need osteoporosis monitoring and prevention, and, in the presence of fractures, antiosteoporotic treatment.

Carotid plaque and lumbar bone mineral density status in post-menopausal women: An age-matched, analytical cross-sectional study.

Objective To explore the association between carotid plaque and lumbar spine osteoporosis in post-menopausal women. Study design Age-matched, cross-sectional study. Main outcome measures Carotid plaque and carotid intima media thickness were measured with B-mode ultrasound. Lumbar spine bone mineral density was measured with dual-energy X-ray absorptiometry. Prevalence odds ratios and the respective 95% confidence intervals (95%CI) were calculated to determine the association. Results Seventy-two post-menopausal women with lumbar spine osteoporosis and 72 post-menopausal women with normal lumbar spine bone mineral density were enrolled. The adjusted prevalence odds ratio of carotid plaque presence in post-menopausal women with lumbar spine osteoporosis was 1.73 (95%CI; 0.60 to 4.94) when compared to post-menopausal women with normal lumbar spine bone mineral density. The presence of vulnerable plaque was greater in post-menopausal women with lumbar spine osteoporosis; however, the difference was not statistically significant after adjusting for other risk factors of cardiovascular disease (odds ratio 1.31; 95%CI; 0.39 to 4.43). There was no significant difference in carotid intima media thickness between the two groups. Multiple logistic regression analysis with backward elimination in assessment of potential risk factors for the presence of carotid plaque showed that the year since menopause, family history of cardiovascular disease and systolic blood pressure were nominally significant associated factors with a respective adjusted odds ratio of 1.06 (95%CI; 1.01 to 1.12), 6.23 (95%CI; 1.65 to 23.46) and 1.03 (95%CI; 1.01 to 1.06). Conclusions The current study indicates that lumbar spine osteoporosis is not associated with the presence of carotid plaque, whereas year since menopause, family history of cardiovascular disease and systolic blood pressure are associated factors.

Bone Health and BMD Research in Pediatric and Adolescent Individuals with ASD: Current Data, Evaluation, and Next Steps

Austin spectrum disorder (ASD) is a complex neurodevelopmental disorder that can include impairments in communication skills and social interaction as well as behavioral challenges. Recent research has evaluated bone health and bone mineral density (BMD) in cohorts of pediatric, adolescent, and young adult participants. Consistent findings across publications indicate that individuals with ASD have decreased BMD when compared to non-ASD age-matched peers. Factors raised in the literature for consideration of impact on BMD status include dietary intake, feeding behavior, nutrient status, gastrointestinal (GI) symptoms and diagnoses, physical activity, and prescription medication usage. This review aims to provide a comprehensive overview of published research evaluating BMD in those with ASD, analyze potential issues of correlation with lowered BMD in this population, offer perspective for future research consideration, and propose evaluation and intervention strategies to address and potentially ameliorate both the short-term and long-term impact of decreased BMD in children and adolescents.

Prevalence of Osteoporosis in Patients with Distal Radius Fracture from Low-Energy Trauma.

Introduction: Osteoporosis is a devastating problem leading to significant morbidity and mortality. Patients with osteoporosis usually present with fractures from low-energy trauma and falls, commonly of the distal radius, which may precede more severe fractures like fracture of the neck of femur, but data from Thailand are limited. The objective of our study was to determine the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma. Materials and Methods: This was a descriptive retrospective study, performed at Thammasat University Hospital in Thailand, from January 2011 to June 2017. Patients aged more than 50 years with distal radial fractures from low-energy trauma with available bone mineral density (BMD) result were included. Patients with known secondary causes of osteoporosis were excluded. Patients were grouped by age, sex, and BMD status (normal, osteopenic and osteoporotic).Results: One hundred out of 351 patients with distal radial fractures had bone mineral density data but only 79 (73 females) met the inclusion criteria. Most patients were aged 60-69 years old (n=31, 42.5%). 47 (59.5%) patients were osteoporotic, 23 (29.1%) osteopenic, and 9 (11.4%) were normal. Seven (6 osteoporotic) patients suffered a more severe fracture subsequently. No deaths were recorded.Conclusion: Our study found a high rate of osteoporosis mostly in females, consistent with published literature. Assessing BMD is crucial in middle age and elderly patients with fractures to better manage osteoporosis and prevent more severe fractures in the future.

MON-PO448: Bone Mineral Density Status and Evolution in Severely Malnourished Adult Patients with Anorexia Nervosa

MON-PO448: Bone Mineral Density Status and Evolution in Severely Malnourished Adult Patients with Anorexia Nervosa

Significant association between skeletal bone mineral density and moderate to severe periodontitis in fair oral hygiene individuals.

This cross-sectional study aimed to investigate the association between skeletal bone mineral density (BMD) and periodontitis in Thai adults and elders. This study comprised 3282 participants aged 30-82years. BMD was assessed at 3 skeletal sites using dual-energy X-ray absorptiometry. Each participant's BMD status was classified as normal, osteopenia or osteoporosis. Periodontal assessments were the number of remaining teeth, plaque score, probing depth and clinical attachment level (CAL). The participants were classified into no/mild or moderate/severe periodontitis groups. The mean periodontal variables between BMD categories were compared. The association between the BMD status and moderate/severe periodontitis was analyzed using binary logistic regression. Among the BMD categories, the greatest mean CAL and the lowest mean number of remaining teeth were found in the osteoporosis group. The mean CAL difference between the osteoporosis and normal BMD groups was 0.3mm. In 337 participants with a plaque score of less than 40%, there was a significant association between osteoporosis and moderate/severe periodontitis. Skeletal BMD in the osteoporosis range was associated with moderate/severe periodontitis in individuals with fair oral hygiene, suggesting the benefit of special attention to the skeletal bone health of these individuals.

Association between serum vitamin B6 concentration and risk of osteoporosis in the middle-aged and older people in China: a cross-sectional study

ObjectiveTo determine the relationship between serum vitamin B6 (Vit B6) concentration and the status of bone mineral density and identify the relationship between serum Vit B6 and bone metabolism parameters...

Neutrophil-to-Lymphocyte Ratio, Mediterranean Diet, and Bone Health in Coeliac Disease Patients: A Pilot Study

Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (n = 50), who had been on a strict GFD by at least 6 months, were recruited. The degree of adherence to the Mediterranean diet was calculated with two different scores: the Mediterranean Diet Score (MDS-14), assessed through the validated 14-item questionnaire of the PREDIMED study, and the MEDScore (Score-55) proposed by Panagiotakos. The latter includes the consumption of unrefined cereals (UC). High percentages of osteopenia and osteoporosis were found within the recruited subjects, who furnished the reports of bone mineral density (BMD), in particular in postmenopausal (Post-M) women. Recent NLR was higher in subjects with osteoporosis compared to osteopenia and normal BMD. However, retrospective analysis showed both increase and decrease in NLR after GFD, with no significant differences between Marsh grade, anemia, and BMD status. Moreover, premenopausal previous pregnancy (Pre-MPP) and Post-M had higher NLR at diagnosis compared to Men and premenopausal (Pre-M), but higher differences were observed in recent NLR between Pre-MPP and Men only. Chocolate consumption was associated with lower recent NLR, whereas the latter was correlated with Score-55, but not with MDS-14. Moreover, refined cereal consumption was correlated with recent NLR. Although large prospective studies are needed in order to clarify the relationship between UC and NLR in coeliac patients, in this pilot study, we have investigated for the first time the relationship between NLR, dietary habit, and osteoporosis in coeliac disease.

Bone mineral density status and the need for anti-osteoporotic therapy in postmenopausal women with systemic scleroderma

The article is devoted to the study of bone mineral density in patients with systemic scleroderma (SSD) and the identification of persons, who needs the anti-osteoporotic treatment. A total of 170 postmenopausal women were examined: 103 patients with SSD and 67 patients without inflammatory rheumatic diseases. Osteoporosis (OP) was detected in 49.5% in the patient group and in 31% in the control group (p &lt;0.05). The correlation relation between the bone mineral density (BMD) and body mass index was found to be direct, and the one between BMD and the duration of the disease and the cumulative dose of glucocorticoids was found to be inverse. The blood vitamin D level (25(OH)D) was significantly lower in patients than in controls (19.3 ± 7.4 ng/ml and 23.3 ± 8.6 ng/ml, respectively), and among individuals with SSD it was significantly lower in patients with OP than in patients without OP (p &lt;0.05). 85% examined patients with SSD needed the anti-osteoporotic therapy. Treatment with the generic alendronate in the form of effervescent tablets to prepare Binosto buffer solution was effective and safe in patients with SSD with esophageal hypotension.

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.