Total Femoral Bone Mineral Density Research Articles

Relationship Between Skeletal Muscle Mass Indexes and Muscular Function, Metabolic Profile and Bone Mineral Density in Women with Recommendation for Bariatric Surgery.

Background and aimWe evaluated low skeletal muscle mass (LMM) in women prior to bariatric surgery (BS) through different skeletal muscle mass indexes (MMIs) regarding body fat percentage (BFP), handgrip strength (HS), six-minute walk test (6MWT), metabolic profile and bone mineral density (BMD).MethodsWomen (n=62) were allocated into two groups according to LMM: obesity with low muscle mass (OLMM) or obesity with normal muscle mass (ONMM). LMM was defined by the appendicular skeletal muscle mass (ASM) adjusted for weight (ASM/wt × 100) and ASM adjusted for body mass index (ASM/BMI), considering the lowest quintile of the indexes studied.ResultsOLMM was found in 30.5% by ASM/wt × 100 and 20.3% by ASM/BMI. Using the ASM/wt × 100, OLMM group had a high BFP, low HS and BMD in L1-L4, femoral neck (FN) and total femur (TF) when compared with ONMM (p < 0.05). Using ASM/BMI, OLMM group had increased BFP, reduced HS and 6MWT in comparison to ONMM (p < 0.05). Metabolic profile was similar between OLMM and ONMM groups by the two MMIs. MMIs were negatively correlated with BFP (p < 0.05) and positively correlated with HS (p < 0.05), and none of them with 6MWT (p > 0.05). ASM/wt × 100 was positively correlated with all BMD sites assessed (p < 0.05). There was positive correlation between ASM/wt × 100 and ASM/BMI.ConclusionOLMM identified by the ASM/wt × 100 and ASM/BMI had higher adiposity and lower HS. Using ASM/BMI, we found that OLMN had a poor physical performance, while the ASM/wt × 100 identified a lower BMD at all sites.

Handball practice on bone health of female adolescents: evaluation of an eight-month competitive period

A strategy to prevent bone loss diseases (i.e., osteoporosis) would be to enhance the increase of bone mass during childhood and adolescence. The purpose of this study was to compare bone mineral density (BMD) and bone mineral content (BMC) between female adolescent handball players and peers who did not play (control group), and to assess the changes in BMD and BMC after eight-months of competitive period. Fifty-eight female adolescents (12–17 years old) were allocated into two groups: handball players (HG: n = 27) and control group (CG: n = 31). BMC and BMD were measured using dual-energy X-ray absorptiometry, and z-scores were calculated. Sexual maturity, menarche, peak height velocity (PHV), sun exposure and calcium intake were assessed. At baseline, the handball players showed greater BMC and BMD than control group (p &lt; 0.05). These differences between groups disappeared after adjusting for weight, BMI, menarche and lean soft tissue. After competitive period, significant time-effects for BMC and BMD of total TBLH and lumbar spine (p &lt; 0.01) were observed in the handball players. HG increased BMC and BMD of total body and lumbar spine after eight-month. The Z-score analysis showed significant group effects with greater BMD of total body, lumbar spine, femur and hip than control group. The results showed that after eight-month competitive handball period, there was an increase in BMD of total body for handball players.

The associations among lead exposure, bone mineral density, and FRAX score: NHANES, 2013 to 2014.

Lead exposure has been suspected as a risk factor for osteoporosis. However, in epidemiological studies, the association between environmental lead exposure and bone health were inconsistent. With the decrease of lead exposure in recent decades, we evaluated the association between lead exposure and bone mineral density (BMD) in the general US population in this study. We analyzed data on 1859 adults (aged ≥40 years) from the National Health and Nutrition Examination Survey (NHANES) conducted in 2013-2014 to determine the relationship among lead exposure measured by both blood and urine lead concentration, BMD of total spine and femur, and FRAX score in a cross-sectional study. In premenopausal women, the results showed a 1-unit increase in natural log-transformed blood and urine lead levels was associated with a decrease in total femur BMD of 0.061 g/cm2 (S.E. = 0.015; p = 0.001) and 0.046 g/cm2 (S.E. = 0.018; p = 0.020), respectively. Moreover, in premenopausal women, a 1-unit increase in natural log-transformed blood level was associated with a decrease in total spine BMD of 0.054 g/cm2 (S.E. = 0.019; p = 0.013). Both FRAX scores were positively correlated with blood and urine lead levels in subjects without fractures, while the 10-year hip fracture risk score was positively associated with lead exposure in subjects with a history of fracture or vertebral fracture. In conclusion, lead exposure was associated with decreased total femur and spine BMD, and FRAX score in the general US population. Further research is needed to elucidate the causal relationship among lead exposure, BMD, and fracture risk.

Bone mineral density is preserved in men with idiopathic infertility.

Lower semen quality is associated with increased mortality and morbidity, which may include osteoporosis. To assess whether infertile men have a lower bone mineral density (BMD) compared with fertile men at the time of fertility workup. A total of 146 men from infertile couples with unexplained impaired semen quality, characterized by sperm concentration<20 million/mL, progressive motility<50% or<12% morphologically normal spermatozoa. Men with infertility due to a genetic etiology or a condition that could cause testicular damage were excluded. A total of 271 men from couples with an ongoing naturally conceived pregnancy served as a control group. Lumbar, femoral, and total body BMD were measured by dual X-ray absorptiometry. Infertile men had similar BMD compared with fertile men (Beta coefficient (g/cm2 ) and 95% confidence interval for the difference between the two groups: -0.02 (-0.05; 0.01) for lumbar BMD, -0.02 (-0.05; 0.01) for femoral neck BMD, -0.01 (-0.04; 0.02) for total femur BMD, and -0.01 (-0.03; 0.01) for total body BMD). Semen parameters were not associated with BMD measurements. Furthermore, BMD did not differ between infertile men with the lowest semen quality vs. infertile men with better semen quality nor between infertile men with low testosterone vs. fertile men with normal testosterone levels. Bone mineral density is preserved in men with unexplained infertility at the time of fertility workup.

Association Between Body Composition and Bone Density in Morbidly Obese Women According to Menopausal Status (P01-023-19)

ObjectivesThe study aim was to assess bone mineral density (BMD) and bone turnover in pre- and postmenopausal women with severe obesity. Additionally, we explored the association between soft tissue body composition and BMD according to menopausal status. MethodsThis is a cross-sectional study conducted in pre- (n = 37) and postmenopausal (n = 22) morbid obese (BMI >40 kg/cm2) women. Body composition and BMD at different sites (lumbar spine, proximal femur and forearm) were assessed by dual energy X-ray absorptiometry (DXA). Biochemical markers of bone metabolism (serum CTX and osteocalcin) and serum 25(OH)D were also measured. Differences between pre- and postmenopausal women were analyzed by Student’s t-test. Body composition [lean mass, visceral (VAT) and subcutaneous (SAT) adipose tissue] and other potential factors associated with BMD were investigated by multiple regression. ResultsBMD at all sites evaluated was similar in pre- and postmenopausal women (P > 0.05). Also, no differences between groups were observed for bone turnover markers (P > 0.05). In postmenopausal women, years after menopause was inversely associated with BMD at total body (β = –0.010, P < 0.01) and total femur (β = –0.009, P < 0.05). Serum 25(OH)D was also associated with total femur BMD (β = 0.008, P < 0.01) in postmenopausal women. Lean mass was not associated with BMD in both groups. VAT was directly associated with lumbar spine BMD in postmenopausal women (β = 0.135, P < 0.05). ConclusionsOur results suggest that severe obesity may weaken the impact of menopause on bone mass and turnover. Also, soft tissue body composition appears to poorly influence bone density in these women. Funding SourcesFundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ, Grant number E26/110.764/2013 for FFB).

SAT-525 Risk Factors Associated with Bone Mineral Density in Middle-Aged Women in Southern Brazil: A Population-Based Study

Low bone mineral density (BMD) and changes of bone quality are common in postmenopausal women with osteoporosis. Among the factors related to bone loss are the estrogen decrease, aging and alteration of body composition. The aim of this cross-sectional study, nested to the Passo Fundo cohort study1, was to investigate risk factors associated with BMD among midlife women. A total of 301 women were enrolled in which demographic, anthropometric characteristics, use of hormone therapy (HT), physical activity (PA), smoking status and alcohol intake were obtained. Visceral (VAT) and subcutaneous adipose tissue (SAT) areas were measured using CT scanner. Physical activity was obtained by the International Physical Activity Questionnaire (IPAQ) along with dosages of estradiol and vitamin D. BMD was assessed in lumbar spine (LS), femoral neck (FN) and total femur (TF) by DXA and bone mass status were classified according to NOF2. The mean age was 57.5±5.4 years, 83.3% women were postmenopausal, 11.6% presented osteoporosis and 43.7% osteopenia. Women with osteoporosis were older (60.0 ±4.8 vs. 56.4 ± 5.2 years, p=0.001), had lower BMI (24.7 ± 3 vs. 30.0 ± 6.3, p<0.001) and estradiol levels (6.4 ± 4.0 vs. 29.6 ± 65.3, p=0.003) than those with normal bone women. VAT [71.9 (35.9 – 107.5) vs. 146.6 (78.3 – 168.9) vs 218.5 (168.3 – 248.4), p=0.003], SAT [223.5 (80.1 – 238.5) vs 169.3 (110.7 – 287.5) vs 282.5 (252.8 – 392.5) p=0.001] and WC [75.5 (64.4 – 80.7) vs 81 (74 – 89.5) vs 93.6 (86.7 – 98.2) p<0.001] were lower when compared to those with osteopenia or normal bone mass. According to a multiple linear regression model using BMD as the dependent variable, age (p=0.004) had an independent negative contribution and BMI (p=0.009) and VAT (p=0.031) had independent positive contributions to the BMD for all three sites. In addition, METs had an independent positive contribution to TF BMD (p=0.041) and current HT had an independent positive contribution to LS BMD (p=0.012) in a model adjusted for smoking. In conclusion, these results suggest that midlife women with osteoporosis are more frequently older, leaner and postmenopausal than those with normal bone mass. BMD is negatively impacted by age and positively by BMI, visceral adiposity, physical activity and hormonal therapy. (1) Oppermann et al., Women's Midlife Health (2015) (2) Cosman et al., Osteoporos Int DOI 10.1007/s00198-014-2794-2 Sources of Research Support: CNPq, FAPERGS

Bone Mineral Density, TBS, and Body Composition Indexes in Ukrainian Men with Parkinson's Disease.

Introduction Current research studies demonstrate the changes of bone mineral density (BMD) in subjects with Parkinson's disease (PD); however, data about bone quality and body composition (BC) indexes are insufficient. The aim of the study was to assess the parameters of BMD, ВС, and trabecular bone score (TBS) in PD males. Materials and Methods We performed a cross-sectional case-control research design and examined 76 males aged 50–77 years old, who were divided into two groups: first group including men without PD (n=38) and the second group including subjects with PD (n=38). Disease duration was at least 5 years; all PD participants were at levodopa therapy. BMD of lumbar spine, femoral neck, total femur, radius, and total body and TBS Ll−L4 were measured using the DXA method. Whole-body DXA measures were also used for the study of total, lean, and fat masses, skeletal muscle index (SMI), appendicular lean mass index (ALMI), and fat mass index (FMI). Results Our study showed an increased incidence of osteoporosis and significantly lower total body BMD (respectively, 1.20 ± 0.13 and 1.26 ± 0.10 g/cm2, p=0.05), but not lumbar spine and femoral neck BMDs, and higher TBS value in PD men comparing to the control group (respectively, 1.33 ± 0.12 and 1.22 ± 0.18 un., p=0.005). Also, we established significantly decreased lower extremities BMD indexes, but not upper extremities, spine, and trunk BMDs in PD males. The femoral neck, proximal femur, and lower extremities BMD indexes in PD men were reliably lower at the side of predominance of clinical symptoms. Parameters of appendicular lean mass and ALMI in PD males were reliably higher, but fat mass values and FMI were lower compared to the control group in the absence of significant differences in lean mass values and SMI in weight-matched control. Conclusion Due to low BMD values, changes in BC are present in PD males, and appropriate screening and preventive strategies should be instigated to maintain bone health in PD subjects.

The Relationship Between Breast Density, Bone Mineral Density, and Metabolic Syndrome Among Postmenopausal Turkish Women

The relationship between metabolic syndrome (MetS) and menopause remains unclear. The effects of MetS on breast and bone density in this group of women are also not fully elucidated. Herein, we aimed to investigate the relationship between components of the MetS, mammographic breast density (MBD), and vertebral/femoral bone mineral density (BMD) in postmenopausal Turkish women. The study group consisted of postmenopausal women with MetS whereas controls postmenopausal women without MetS. All consecutive women who applied to our center for routine postmenopausal follow up and met the inclusion criteria, between July 2013 and October 2015 were included in the study. Menopause was defined as the cessation of menstruation for at least 1 year, and we used the definition of the MetS suggested by a joint interim statement. BMD of the spine and femur was measured by dual energy X-ray absorptiometry. The medical records of 390 postmenopausal were retrospectively reviewed. No significant differences were observed between the groups in terms of age, menopause type, and menopause duration (p > 0.05). Decreased MBD (for grade 1–2 and 3–4 densities) was associated with increased MetS risk (p = 0.017). Total femoral BMD, total lumber BMD, femoral neck BMD were significantly higher in postmenopausal women with MetS (p < 0,005). This study is the first report focusing on the relationship between MetS and breast/bone density. According to the results of our study, the presence of MetS in postmenopausal periods has a positive effect on both MBD and BMD.

Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables.

The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.

Analgesic effects of minodronate in a rat chronic pain model.

We evaluated the analgesic effects of minodronate, alendronate and pregabalin on mechanical and thermal allodynia, as well as changes in bone mineral density and skeletal muscle volume caused by chronic constriction injury (CCI) in an ovariectomized rat. Ovariectomy was performed on four-week-old female Wistar rats. Thereafter, at 8-weeks of age, the left sciatic nerve was ligated to create the chronic pain model (CCI limb), and sham surgery was performed on the right hindlimb. In all rats, either minodronate (0.15 mg/kg/week), alendronate (0.15 mg/kg/week), pregabalin (10 mg/kg/week), or their vehicle was administered for 2 weeks starting on the 0th day of CCI. Behavioral evaluations, with von Frey testing and the hot plate test, were performed on days 0, 7 and 14. After 2 weeks, bilateral femurs and tibialis anterior muscles were harvested for bone mineral density and cross sectional area measurements, respectively. Two weeks treatment with minodronate significantly improved mechanical and thermal allodynia evaluated by the von Frey and hot plate tests in the CCI limb (P < 0.05). Minodronate and alendronate treatment for 2 weeks significantly increased total femoral bone mineral density in the CCI limb compared with pregabalin or vehicle treatment (P < 0.01). Cross sectional area of the CCI limb in the minodronate group was significantly larger than that of the alendronate group (P < 0.05) and pregabalin group (P < 0.05). Two-week treatment with minodronate, but not alendronate or pregabalin, improved mechanical and thermal allodynia caused by CCI in ovariectomized rats.

Prevalence of low bone mass and changes in vitamin D levels in human immunodeficiency virus-infected adults unexposed to antiretrovirals.

The prevalence of low bone mass is 3 times higher in people living with human immunodeficiency virus (PLWH) and using antiretrovirals than in the HIV-unaffected population. Changes in vitamin D levels is one of the factors associated with decreased bone mass. The objective of this study is to evaluate the low bone mass and altered vitamin D levels in PLWH who have not been exposed to antiretrovirals. A cross-sectional study was carried out with HIV-infected individuals between the ages of 18 and 55 years immediately prior to the start of antiretroviral therapy in a specialized reference center focusing on infectious and parasitic diseases. Results of clinical examination (patient's weight, height, blood pressure, and clinical history), laboratory tests, and X-ray absorptiometry, were collected. Sixty patients were included, with a mean age of 34 years. Nine (16.7%) patients presented with low bone mass and 4 (7.1%) patients showed low total femur BMD. Analysis revealed that 23.3% and 36.7% of the patients had deficient and insufficient levels of 25-hydroxyvitamin D3, respectively. Our study population presented with compromised bone health and with low bone mineral density and 25-(OH)-vitamin D levels.

Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis.

Due to absence of concern and proper guidelines, management of bone loss or osteoporosis in PVO is often neglected or delayed. A retrospective cohort study was planned to investigate differences in bone mineral density (BMD) in PVO patients with osteoporosis according to the timing of osteoporosis treatment. The PVO cohort consisted of 192 patients with osteoporosis who visited our institution between January 2003 and March 2015 and received bisphosphonate treatment for osteoporosis. According to the interval between PVO diagnosis and initiation of bisphosphonate, the patients were divided into three groups: group A (within 6weeks after PVO diagnosis), group B (between 6weeks and 3months after diagnosis), and group C (more than 3months after PVO diagnosis). The percent increase in total femoral BMD in group A was significantly larger than that in group B at 2-year follow-up (p = 0.036). Similarly, the percent increase in trochanteric (p = 0.008) and total femoral (p = 0009) BMD in group A was significantly larger than that in group C at 2-year follow-up. Even after multivariate adjustment, total femoral BMD changes were significantly associated with the treatment group. Group B (odds ratio = 2.824, p = 0.013) and group C (odds ratio = 3.591, p = 0.001) were more significantly associated with total femoral BMD decreases at 2-year follow-up compared with group A. Early bisphosphonate treatment within 6weeks after PVO diagnosis (group A) was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment (groups B and C).

Changes in bone density and bone turnover in patients with rheumatoid arthritis treated with rituximab, results from an exploratory, prospective study.

Data describing the effect of in vivo B cell depletion on general bone loss in patients with rheumatoid arthritis (RA) are limited. Given the pathogenetic role of B cells in RA, it is tempting to speculate that B cell depletion might have a beneficial effect on bone loss. We prospectively investigated the changes in bone mineral density (BMD), bone turnover, inflammation and disease activity before and after rituximab in 45 RA patients over a 12 month period, 36 patients of whom completed the study and were included in the analysis. There was no significant change in our primary endpoint; lumbar spine BMD after 12 months. However, we found a significant decrease in neck of femur (mean -0.017 g/cm2, 95% CI -0.030, -0.004 p = 0.011) and total femur BMD (mean -0.016 g/cm2, 95% CI -0.025, -0.007 p = 0.001). Additionally, there was a significant increase in procollagen type 1 amino-terminal propeptide (P1NP) and bone specific alkaline phosphatase (BAP); biomarkers of bone formation (median change from baseline to 12 months; P1NP 11.3 μg/L, 95% CI -1.1, 24.8 p = 0.025; BAP 2.5 μg/L, 95% CI 1.2, 3.6 p = 0.002), but no significant change in bone resorption or osteocyte markers. The fall in BMD occurred despite improvement in disease control. Post-menopausal women had the lowest mean lumbar spine, femoral and forearm BMD at baseline and after 12 months, additionally they had a higher level of bone turnover throughout the study. In conclusion, BMD was maintained at the lumbar spine and forearm, but fell at the femur sites. A high prevalence of vitamin D deficiency was observed and these patients had lower BMD and evidence of higher bone turnover.

Impact of vitamin C on teriparatide treatment in the improvement of bone mineral density, strength, and quality in vitamin C-deficient rats.

Age-related decreases in serum levels of vitamin C (VC) may negatively affect the efficacy of anti-osteoporotic pharmacotherapy. The purpose of this study was to evaluate the effects of VC and teriparatide (TPTD) on bone mineral density (BMD), strength, and quality in VC-deficient osteogenic disorder Shionogi (ODS) rats. Six-month-old female ODS rats were divided into an untreated ODS control group, a VC group, a TPTD group, and a VC + TPTD group, based on the administration of VC and TPTD (n = 10 each). VC was given as 2.0mg/ml supplemented water. TPTD was administered subcutaneously once a week at 30µg/kg body weight. After 12weeks of treatment, BMDs of the femur and lumbar spine, bone strengths of the femoral diaphysis and metaphysis, and cancellous bone quality of proximal tibiae as estimated by Fourier transform infrared spectroscopy (FTIR) were compared between groups. Compared to the ODS control group, the VC group showed significantly higher total femoral BMD, but the TPTD group showed significantly higher femoral and lumbar spinal BMD, maximum load of femoral metaphysis, and hydroxyapatite (HA) crystallinity by FTIR (p < 0.05). In addition to the increases shown in the TPTD group, the VC + TPTD group also showed significantly higher stiffness of the femoral diaphysis and breaking energy of the femoral metaphysis compared to the ODS control group (p < 0.05). These results indicated that TPTD alone increased cancellous/cortical BMD and cancellous bone strength with improvement of HA crystallinity in ODS rats, but addition of VC supplementation further improved cortical bone strength.

Bone Mineral Density in Collegiate Dance Majors Compared to Healthy Controls.

The bone mineral density (BMD) status of dancers is currently unknown. Some research indicates that female dancers have no difference or higher BMD than non-dancers. Other evidence indicates they have lower BMD, predisposing them to osteoporosis and fractures later in life. These differences among studies may be due to differences in dancer type, age, level, and lack of control of confounding variables. Few studies have been completed on college-level dancers. To evaluate BMD in female college-level dance majors. 20 female multi-genre collegiate dance majors and 12 female non-dancer control subjects participated in the study. Each participant underwent three consecutive dual energy x-ray absorptiometry scans to determine BMD of the total body, dual femurs, and lumbar spine. Statistical analysis was completed by an independent samples t-test. The lumbar spine demonstrated a significant difference between groups (p=0.011), with dancers showing greater BMD (1.32±0.10 vs 1.21±0.12 g/cm2). There was no significant difference between groups for total body or dual femur BMD (p=0.104 and 0.175, respectively). College-level dancers may have higher BMD of their lumbar spine than non-dancers, but not in other areas. This area may have increased BMD due to loading from dance activity and warrants further investigation.

Serum copper levels are associated with bone mineral density and total fracture

BackgroundBoth copper deficiency and overexposure have been associated with adverse health effects. Evidence linking copper to bone mineral density (BMD) and total fracture, however, is limited. MethodsThis nationally representative cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey (2011–2014) in the United States. Using unadjusted and multivariate adjusted logistic regression analyses and a two-piecewise linear regression model with a smoothing function, we evaluated the associations between serum copper levels, bone mineral density and total fracture in 722 participants. ResultsThe study sample (n = 722, mean age: 56.47 ± 11.55 y) represented a population of which 47.2% were men; 43.91% were non-Hispanic white, 18.84% non-Hispanic black and 13.71% Mexican American; 25.9% had total fracture. In the multivariate logistic regression analysis, individuals in the lowest category (<98.5 μg/dL) of serum copper concentration had 0.049 g/cm2 lower total femur BMD and 0.045 g/cm2 lower femoral neck BMD than those in the second concentration category (98.5–114 μg/dL). Individuals in the highest category (≥134 μg/dL) of serum copper concentration had an approximately 4-fold increase in the risk of total fracture than those in the second concentration category. There were no significant associations between per 10 μg/dL increases in serum copper levels and total fracture in multivariate logistic regression analysis after multivariate adjustment (all p > 0.05). However, a differential association between serum copper levels and total fractures between men and women was observed (odds ratio = 1.81, 95% confidence interval 1.08–3.03, p = 0.026 for men and odds ratio = 1.07, 95% confidence interval 0.86–1.32, p = 0.552 for women). ConclusionModerate serum copper levels are critically important for bone health. Lower serum copper levels are significantly associated with decreased BMD in the total femur and femoral neck. Higher serum copper levels are significantly associated with increased total fracture, especially in men. The Translational Potential of this ArticleThe impact of serum copper concentrations on bone mineral density and total fracture can provide insights into clinical application of copper-containing supplements and biomaterials.

Contribution of Android and Gynoid Adiposity to Bone Mineral Density in Healthy Postmenopausal Thai Women

Dual-energy X-ray absorptiometry (DXA) is one of the major tools for assessing the whole body and regional body composition and body adiposity. Various body composition parameters including android fat mass (AFM), gynoid fat mass (GFM), and android-to-gynoid fat ratio (AG fat ratio) obtained from whole body DXA can be used as a reliable surrogate marker for regional body composition analysis. This study aimed to explore the contribution of android and gynoid adiposity to bone mineral density (BMD) in healthy postmenopausal Thai women. This cross-sectional study enrolled 1448 healthy Thai women, ages 40–90 without medication history or known disease affecting the BMD. Lumbar spine (LS), total femur, and femoral neck BMDs, AFM, GFM, and AG fat ratio were measured by DXA. To evaluate the contribution of android and gynoid adiposity with various measures of BMDs, univariable and multivariable linear regression analyses were used to estimate the regression coefficients. AFM, GFM, and AG fat ratio had a significant positive association with BMD of all measured sites (p < 0.001) in the univariate analysis. The strongest association was found between AG fat ratio and LS BMD (β = 0.156, p ≤ 0.001). In multivariate linear regression analysis, the results continued to show a positive association between AFM and GFM at all skeletal sites after adjusting for age, height, and total body lean mass. Relationship between AG fat ratio and BMD was found only in LS region. GFM had a strongest positive effect with BMD at the LS, total femur, and femoral neck regions. Higher android and gynoid adiposity was associated with higher BMD. GFM rather than AFM shows the strongest positive association with BMDs in postmenopausal Thai women.

Association of dietary patterns of American adults with bone mineral density and fracture.

In a representative sample of US adults, we investigated the associations of nutrient patterns (NP) with bone mineral density (BMD) and fractures. Cross-sectional. US community-based National Health and Nutrition Examination Survey (NHANES). Participants with measured data on dietary intake and BMD from 2005 to 2010 were included. Principal components analysis was used to identify NP. BMD was measured using dual-energy X-ray absorptiometry. ANCOVA, adjusted logistic and linear regression models were employed, accounting for the complex survey design and sample weights. We included a total of 18 318 participants, with 47·0 % (n 8607) being men. The mean age was 45·8 years with no sex difference. Three NP emerged, explaining 55·9 % of the variance in nutrient consumption. Multivariable-adjusted linear regressions revealed significant inverse associations between the 'high-energy' NP (rich in carbohydrates and sugar, total fat and saturated fat) and total femur, femoral neck, trochanter and intertrochanter BMD (β coefficient: -0·029, -0·025, -0·034 and -0·021, respectively, all P<0·001), while there were significant associations between the 'nutrient-dense' NP (rich in vitamins, minerals and fibre) and 'healthy fat' NP (high dietary PUFA and MUFA) and BMD at total femur, femoral neck, trochanter and intertrochanter (all P<0·001). In adjusted logistic regression models, the odds of hip, wrist or spine fractures did not vary significantly across NP quartiles. Nutrient-dense and healthy fat NP are associated with higher BMD at various bone sites, while the high-energy NP is inversely associated with BMD measures.

Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen.

Cross-sex hormone therapy (CSHT) has been associated with changes in bone and lean/fat mass. This study assessed bone mineral density (BMD), appendicular lean mass (ALM), and total fat mass in transwomen undergoing CSHT. We evaluated 142 transwomen (mean age: 33.7±10.3years; BMI: 25.4±4.6; 86.6% with previous CSHT) during the first 3months of regular oestrogen treatment (with or without anti-androgens). A reference group including 22 men and 17 cis women was also studied. Clinical and hormonal evaluation and dual-energy X-ray absorptiometry (DXA). Bone mineral density was similar in trans and reference women, and lower at all sites in transwomen vs men. Low bone mass for age was observed in 18% of transwomen at baseline vs none of the reference women or men. Appendicular lean mass and total fat mass were positively correlated with L1-L4 BMD, explaining 14.9% of the observed variation in lumbar spine BMD and 20.6% of the variation in total femur BMD. Appendicular lean mass was similar in trans and reference women, and lower in transwomen vs men. Total fat mass was lower in trans vs reference women. Densitometry was repeated after a mean of 31.3±6.5months in 46 transwomen. There was a significant increase in total fat mass and a significant decrease in ALM. Bone mineral density remained stable over time. The fairly high prevalence of low bone mass in this sample of transwomen from southern Brazil seems to be related to lower ALM. Non-pharmacological lifestyle-related strategies for preventing bone loss could be beneficial for transgender women receiving long-term CSHT.

Mortality following benign sacral insufficiency fracture and associated risk factors.

There are no data about mortality after sacral insufficiency fractures. The purposes of this study were to investigate the mortality rate among sacral insufficiency fracture patients and to identify risk factors associated with mortality. This is a retrospective cohort study of patients diagnosed with sacral insufficiency fracture via radiological exam in a single institute from 2001 to 2014, excluding patients with pathological sacral fracture due to metastasis or primary tumor. Mortality and its predisposing factors were analyzed based on a review of electronic medical records and mortality data provided by the Korean Statistical Information Service. Kaplan-Meier survival analysis and Cox regression analysis were used for statistical analysis. A total of 325 patients were included (275 women and 50 men). The mean age at the time of diagnosis was 69.4years. One hundred and forty patients (43.1%) had a history of malignancy, and 71 patients (21.8%) had undergone pelvic radiation therapy before fracture diagnosis. Twenty-one patients (6.5%) underwent sacroplasty, and the others underwent conservative management after fracture diagnosis. The mean follow-up was 51.5months, and a total of 101 patients died at the final follow-up. The 6-month mortality rate was 9.8%, the 1-year mortality rate was 17.5%, and the 3-year mortality rate was 25.5%. Sex- and age-adjusted standardized mortality ratio (SMR) increased after fractures. The overall SMR is 8.9 at 3months decreasing to 4.5 at 2years. Multivariable Cox regression analysis showed that significant factors associated with increased mortality were male gender, malignancy history, lumbosacral fusion with distal fusion level S1, stroke history, low total femur bone mineral density score, and low body mass index. Like other types of osteoporotic fractures, sacral insufficiency fractures are associated with increased mortality.