Ultrasonic Bone Densitometry Research Articles

Association between bone health and dynapenic obesity in postmenopausal women.

The combination of dynapenia (age-related muscle weakness) and obesity is referred to as dynapenic obesity. We examined the associations between dynapenic obesity and cortical bone thickness and trabecular bone density. The participants were 797 community-dwelling postmenopausal women (with an average age of 62.5 years) who were stratified into normopenia without obesity, dynapenia without obesity (dynapenia), normopenia with obesity (obesity) and dynapenia with obesity (dynapenia obesity) groups based on their grip strength and body fat percentage. Cortical bone thickness and trabecular bone density were measured using ultrasonic bone densitometry. The participants were further divided into those with low cortical bone thickness and low trabecular bone density. Logistic regression analysis was used to identify associated factors. Individuals with dynapenia (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.16-2.68), obesity (OR 2.46, 95% CI 1.62-3.75) and dynapenic obesity (OR 4.07, 95% CI 2.44-6.79) all significantly increased the odds of low cortical bone thickness. Conversely, the odds of low trabecular bone density were significantly lower in the obesity group (OR 0.65, 95% CI 0.43-0.99) and dynapenic obesity group (OR 0.60, 95% CI 0.37-0.97). Dynapenic obesity was found to be associated with cortical bone thinning that might compromise bone health. Postmenopausal women with dynapenic obesity might need to be closely monitored for preserving bone health. Geriatr Gerontol Int 2024; 24: 378-384.

Latest technologies of diagnostics and treatment of diseases of the musculoskeletal system

This lesson outlines the latest data on bone structure and physiology, as well as those related to the mechanisms of bone development and regeneration. The most common diseases of musculoskeletal system are caused by genetic and metabolic disorders, infectious agents, andmechanical stress, all of which are discussed. Innovative technologies for diagnosing osteoporosis (X-ray absorptiometry, quantitative computed tomography (QCT), ultrasonic bone densitometry, etc.) are shown. The joints diseases (arthropathies) followed by inflammation are highlighted. The basic principles of conservative and surgical treatment of arthrosis are explored. Different types of bone injuries caused by mechanical stress are thoroughly described as well as the latest technologies and equipment used in modern trauma centers. Basic orthopedic aids for disabled patients are listed. The main directions for improving the diagnosis and conservative treatment of diseases of the musculoskeletal system, as well as methods for prosthetics of large joints are described.

Effect of inhaled corticosteroids on bone mineral density in patients with asthma.

Inhaled corticosteroids (ICS) are a safe treatment for asthma. However, at higher doses, ICS use has been reported to inhibit adrenocortical function. This study aimed to evaluate the effect of ICS on bone mineral density (BMD) in adult patients with asthma. Ultrasonic bone densitometry was performed in 40 patients (14 men, 26 women, mean age 61.2 years, mean duration of asthma 6.19 years) who were receiving ICS for asthma, and the whole bone density, thickness of cortical bone, and density of cancellous bone of the radius was measured. The age-matched mean was set as 100%. Lifetime cumulative dose of ICS was calculated using all past prescriptions. No significant correlations were observed between lifetime cumulative ICS dose and whole bone density (r² = 0.011), cortical bone thickness (r² = 0.022), and cancellous bone density (r² = 0.004). No significant differences were observed between lower and higher lifetime cumulative ICS dose among these BMD parameters (104% vs 97%, 103% vs 99%, and 106% vs 91%, respectively). No significant correlations or differences in lifetime cumulative ICS dose were observed by asthma severity, asthma duration, and pulmonary function. Also, serum markers of bone metabolism showed no significant correlations or differences with lifetime cumulative ICS dose. In the entire study population, long-term ICS use was safe and was not associated with an increased risk of osteoporosis.

Evaluation of myostatin as a possible regulator and marker of skeletal muscle-cortical bone interaction in adults.

Bone mass was recently reported to be related to skeletal muscle mass in humans, and a decrease in cortical bone is a risk factor for osteoporosis. Because circulating myostatin is a factor that primarily controls muscle metabolism, this study examined the role of myostatin in bone mass-skeletal muscle mass interactions. The subjects were 375 middle-aged community residents with no history of osteoporosis or sarcopenia who participated in a health check-up. Cortical bone thickness and cancellous bone density were measured by ultrasonic bone densitometry in a health check-up survey. The subjects were divided into those with low cortical bone thickness (LCT) or low cancellous bone density (LBD) and those with normal values (NCT/NBD). Bone metabolism markers (TRACP-5b, etc.), skeletal muscle mass, serum myostatin levels, and lifestyle were then compared between the groups. The percentage of diabetic participants, TRACP-5b, and myostatin levels were significantly higher, and the frequency of physical activity, skeletal muscle mass, grip strength, and leg strength were significantly lower in the LCT group than in the NCT group. The odds ratio (OR) of high myostatin levels in the LCT group compared with the NCT group was significant (OR 2.17) even after adjusting for related factors. Between the low cancellous bone density (LBD) and normal cancellous bone density (NBD) groups, significant differences were observed in the same items as between the LCT and NCT groups, but no significant differences were observed in skeletal muscle mass and blood myostatin levels. The myostatin level was significantly negatively correlated with cortical bone thickness and skeletal muscle mass. A decrease in cortical bone thickness was associated with a decrease in skeletal muscle mass accompanied by an increase in the blood myostatin level. Blood myostatin may regulate the bone-skeletal muscle relationship and serve as a surrogate marker of bone metabolism, potentially linking muscle mass to bone structure.

Inverse association of plasma leptin with cortical thickness at distal radius determined with a quantitative ultrasound device in patients with type2 diabetes mellitus.

Aims/IntroductionOsteoporosis is known to be intimately related to sympathetic nerve activity. We examined the relationship of plasma leptin with cortical and trabecular bone components in patients with type 2 diabetes mellitus.Materials and MethodsThe present cross‐sectional study included 182 type 2 diabetes mellitus patients (93 men, 89 women). Cortical thickness (CoTh) and trabecular bone mineral density (BMD) were determined at the 5.5% distal radius using an LD‐100 ultrasonic bone densitometry device. Plasma leptin along with physical and laboratory measurements was simultaneously determined.ResultsPlasma leptin, but not body mass index (BMI), was inversely correlated with CoTh (ρ = −0.487, P < 0.001), while BMI, but not plasma leptin, was positively correlated with trabecular BMD (ρ = 0.369, P < 0.001). In multivariable regression analysis, after adjustments for age, sex, duration of diabetes, glycated hemoglobin A1c, albumin, estimated glomerular filtration rate, parathyroid hormone and handgrip strength, plasma leptin was inversely associated with CoTh (β = −0.258, P < 0.001), but not trabecular BMD. Furthermore, plasma leptin level retained a significant association with CoTh after further adjustment for BMI (β = −0.237, P < 0.001) and BMI plus waist‐to‐hip ratio (β = −0.243, P < 0.001). In contrast, the “sex × leptin” interaction was not significant (P = 0.596).ConclusionsLeptin level in plasma, independent of BMI and BMI plus waist‐to‐hip ratio, was shown to be inversely associated with CoTh, but not trabecular BMD, suggesting that hyperleptinemia resulting from obesity might contribute to cortical porosis in patients with type 2 diabetes mellitus.

New methods for the evaluation of bone quality. Bone Quality Evaluation by QUS.

The conventional ultrasonic bone densitometry systems(quantitative ultrasound:QUS)are now popular for the initial screening of osteoporosis. These systems can give us velocity(SOS)and broadband attenuation(BUA)of ultrasonic waves, which propagated in the heel. This paper describes the physical meaning of these parameters and introduces the idea of standardization, s-SOS and s-BUA. In addition, new QUS techniques for the further investigation of bone quality are also introduced. These techniques, two wave phenomenon and Axial Transmission(AT)can induce the individual properties of cortical and cancellous bones by the ultrasonic measurements.

Japanese female Kendo practitioners are associated with high radial bone mineral density

ABSTRACTOsteopenia is a condition in which bone mineral density (BMD) is lower than normal. Exercise increases BMD in both the young and adults. This study aimed to compare the radial apparent BMD (aBMD) in Japanese females who are Kendo practitioners (KPs) and those with no regular exercise habits (no-REH). The analysis participants consisted of 45 KPs (mean age: 49.4 years old) and 110 no-REH (mean age: 48.8 years old). Radial aBMD was measured using an ultrasonic bone densitometry system. Radial aBMD in KPs was 196.1 ± 33.9 mg/cm3, and was 182.9 ± 45.3 mg/cm3 in no-REH participants. KPs had significantly higher BMD than no-REH participants. In KPs, left radial aBMD was 196.1 ± 33.9 mg/cm3, and right radial aBMD was 184.5 ± 37.7 mg/cm3. The left radius was also significantly higher than the right radius with respect to aBMD in KPs. After adjusting for age, body mass index, menstrual status, parous women and frequency of milk and dairy intake, the odds ratio (OR) of osteopenia associated with no-REH was 6.58 (95% confidence interval (CI): 1.72–25.1) and the prevalence ratio (PR) of osteopenia associated with no-REH was 4.12 (95% CI: 1.23–13.7). Therefore, the Kendo practice may have a protective efficacy for osteopenia in women.

Bone quantitative ultrasound

The conventional ultrasonic bone densitometry system can give us information of bone as ultrasonic wave velocity and attenuation. However, the data reflect both structural and material properties of bone. In order to focus only on the bone matrix properties without the effect of bone structure, studies of microscopic Brillouin scattering technique are introduced. The wave velocity in a trabecula was anisotropic and depended on the position and structure of the cancellous bone. The glycation also affected on the wave velocities in bone. As a new bone quality, the piezoelectricity of bone is also discussed.

Serologically Determined Gastric Mucosal Condition Is a Predictive Factor for Osteoporosis in Japanese Men.

There are few reports about the influence of Helicobacter pylori infection and/or atrophic gastritis on bone conditions in Japan. To assess whether the combination of serologically determined Helicobacter pylori infection and atrophic gastritis is available as a biomarker for bone conditions. We studied 230 men in their 50s and 60s. Helicobacter pylori infection was determined using serum antibody to this bacterium. Atrophic gastritis was diagnosed on the basis of the serum pepsinogen I and II criteria. The characteristics of the participants' bone were measured at the radius using an ultrasonic bone densitometry system. The risks of low trabecular bone density, low elastic modulus of trabecular bone, and low cortical thickness among subjects who were positive for Helicobacter pylori infection and/or atrophic gastritis relative to those who were not were calculated. Helicobacter pylori infection significantly increased the risk of low trabecular bone density (odds ratio 1.83, 95 % confidence interval 1.04-3.21, P = 0.03). Atrophic gastritis significantly increased the risk of low trabecular bone density (2.22, 1.17-4.22, 0.01). Compared with anti-Helicobacter pylori antibody (-) and atrophic gastritis (-) subjects, anti-Helicobacter pylori antibody (+) and atrophic gastritis (+) subjects were a significant high-risk group for low trabecular bone density (2.65, 1.27-5.55, 0.01). A serological diagnosis of Helicobacter pylori infection and atrophic gastritis, which is utilized for risk assessment of gastric cancer, was suggested to be useful for risk assessment of osteoporosis.

Decreased cortical thickness, as estimated by a newly developed ultrasound device, as a risk for vertebral fracture in type 2 diabetes mellitus patients with eGFR of less than 60 mL/min/1.73 m2.

SummaryCortical porosity is increasingly recognized as an important risk for fracture in DM patients. The present study demonstrated that decreased cortical thickness, assessed using a newly developed quantitative ultrasonic bone densitometry, is a significant risk factor for vertebral fractures in type 2 diabetes mellitus patients with stage 3 or higher chronic kidney disease, but not in those without.IntroductionCortical porosity is increasingly recognized as an important risk factor for fracture in type 2 diabetes mellitus (T2DM) patients as well as in stage 3 chronic kidney disease (CKD) patients in whom serum parathyroid hormone (PTH) starts to increase. The present study aimed to clarify whether the coexistence of CKD might affect the relationship of decreased cortical thickness (CoTh) in the development of vertebral fractures (VF) in T2DM patients.MethodsIn this cross-sectional study, trabecular bone mineral density (TrBMD), elastic modulus of trabecular bone (EMTb), and CoTh were estimated with a new quantitative ultrasound bone densitometry in 173 T2DM patients. VFs were identified radiographically.ResultsThirty-nine patients (22.5 %) had VF. Those with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (low eGFR) showed a significantly higher VF rate (32.4 %) than those with eGFR ≥60 mL/min/1.73 m2 (high eGFR, 16.2 %). Serum PTH was significantly higher with low eGFR than with high eGFR. In those with high eGFR, EMTb was significantly lower in VF(+) than VF(−). In those with low eGFR, TrBMD, EMTb, and CoTh were significantly lower in VF(+) than in VF(−). In a multivariate logistic regression analysis, EMTb was independently and significantly associated with VF in T2DM patients with a high eGFR, in contrast to those with only CoTh with VF in T2DM with low eGFR.ConclusionThis study demonstrated CoTh as a factor independently associated with VF in T2DM patients with low eGFR and increasing serum PTH levels.Electronic supplementary materialThe online version of this article (doi:10.1007/s00198-014-2843-x) contains supplementary material, which is available to authorized users.

SP1-21 Correlation of mild bone fragility and related indicators of biological markers or ultrasonic bone densitometry in a normal Japanese population

IntroductionMild bone fragility has the potential to become a significant national problem given the ageing society as it is a pre-curser of osteoporosis.MethodsTrabecular bone mineral density (BMD), bone elastic modulus...

P2-73 Evaluation of bone fragility of Japanese women according to the range of age: correlation with menopausal reference, bone related indicators and biomarkers

IntroductionTo clarify characteristics of bone fragility in middle-aged Japanese women, we have examined the correlation between bone quality by novel ultrasonic bone densitometry system and several biochemical markers of bone...

Myanmar Experience with Serum IGF-1, Salmon Calcitonin and Postmenopausal Osteoporosis

A great deal of information has been obtained on the system of growth hormone and IGF-1 in development of osteoporosis. The imbalance of this system may be the cause of diseases of neonatal period as well as disease associated with aging. In old age, the synthesis of IGF - 1 declines as well as the action of this peptide on tissues. The aim of this study is to find out the association between serum IGF-1 levels and bone mineral density. Sixty postmenopausal non osteoporotic women and sixty postmenopausal osteoporotic women were selected for this study. Out of 60 cases, 50 postmenopausal osteoporotic women completed the study. Bone mineral density (BMD) of postmenopausal women with symptom of osteoporosis was measured by ultrasonic bone densitometry (UBIS5000).Postmenopausal women with BMD results of T score ≤ - 2.5 were selected as cases and that of > - 1 were selected as controls. Serum IGF -1 level was measured by ELISA method after removal of IGFBP from IGF - 1. In this study, both base line BMD and serum IGF-1 level of the osteoporotic women were significantly lower than that of non osteoporotic women (p < 0.05). BMD and serum IGF-1 level in 3 months after calcitonin injection of osteoporotic women were significantly higher (p < 0.001) than that of baseline BMD and serum IGF-1 level. There was positive correlation between baseline serum IGF-1 and BMD level in postmenopausal osteoporotic women (r = 0.470, p = 0.001) as well as in control (r = 0.288, p= 0.025). It is hoped that this study will serve as ground for further study in the related fields, and thus, as part for the development of applications in the management of postmenopausal osteoporotic women.

Novel ultrasonic bone densitometry based on two longitudinal waves: significant correlation with pQCT measurement values and age-related changes in trabecular bone density, cortical thickness, and elastic modulus of trabecular bone in a normal Japanese population

A reference database for trabecular bone density, cortical thickness, and elastic modulus of trabecular bone for a novel ultrasonic bone densitometry system (LD-100) based on two longitudinal waves (fast and slow) was determined over a wide age range in a normal Japanese population. A novel ultrasonic bone densitometry system (LD-100 system) was applied to create a reference database for trabecular bone density (TBD), cortical thickness (CoTh), and elastic modulus of trabecular bone (EMTb) for this device over a wide age range in a normal Japanese population. In a comparative study between LD-100 and peripheral quantitative computed tomography (pQCT) systems, 52 individuals were examined by both systems at the same radius simultaneously. To create a reference database, a total of 2,380 healthy subjects (1,179 men, 1,201 women), ages 18-99 years, were examined using the LD-100 system. Highly significant correlations between the LD-100 and pQCT systems were found in TBD (r = 0.877, p < 0.001) and CoTh (r = 0.723, p < 0.001). For the reference database, peak values of TBD, CoTh, and EMTb were observed at 30-34 years (255.09 mg/cm(3)), 20-24 years (5.23 mm), and 20-24 years (4.09 GPa) in men, and at 25-29 years (209.24 mg/cm(3)), 25-29 years (3.98 mm), and 20-24 years (3.33 GPa) in women, respectively. The TBD fell significantly (p < 0.05) beginning at 55-59 years in both sexes, with a relatively rapid decrease in women. The CoTh showed a significant decrease beginning at 40-44 years in men and 50-54 years in women. The EMTb showed a significant decrease beginning at 40-44 years in men and 55-59 years in women. The LD-100 system is a useful bone densitometry device and the database of age-related changes in TBD, CoTh, and EMTb established in this study will provide fundamental data for future studies related to bone status.

Observation of Ultrasonic Fields Transmitted through Bovine Cortical or Cancellous Bones by the Schlieren Method

Ultrasonic wave fields at 1.03 and 3.5 MHz were visualized by the schlieren method after they had traveled through bovine cortical or cancellous bones. Schlieren images showed that wavefronts were distorted at both frequencies when they traveled through a cortical bone of a bovine limb. After traveling through cancellous bones, wavefronts at 1.03 MHz were almost undistorted, but those at 3.5 MHz showed distortions depending on the condition of the bone. These results indicate that correction is required with regard to ultrasound-receiving geometry to improve the accuracy of attenuation measurement in ultrasonic bone densitometry.

Measurement of human trabecular bone by novel ultrasonic bone densitometry based on fast and slow waves

Two longitudinal transmitted waves, fast and slow waves, were observed by employing a new quantitative ultrasound (QUS) method. The trabecular bone measurements generated by this method reflect three-dimensional structural information, and the new QUS parameters were able to identify vertebral fractures. The aims were to identify new quantitative ultrasound (QUS) parameters that based on new QUS method reflecting not only bone volume but also the microstructures of trabecular bone ex vivo and to observe how much they predict fracture risk in vivo. Ex vivo measurement: Three human femoral heads were used for the experiment. Attenuation of the slow wave, attenuation of the fast wave, speed of the slow wave, speed of the fast wave (SOFW), bone mass density of trabecular bone, and elastic modulus of the trabecular bone (EMTb) of each specimen were obtained using a new QUS method and compared with three-dimensional structural parameters measured by micro-computed tomography. In vivo measurement: Eighty-nine volunteers were enrolled, and the bone status in the distal radius was measured using a new QUS method. These parameters were compared with data evaluated by peripheral quantitative computed tomography and dual X-ray absorptiometry. Ex vivo measurement: SOFW and EMTb showed correlations with the parameter of trabecular anisotropy. In vivo measurement: The new QUS parameters were able to identify vertebral fractures. The newly developed QUS technique reflects the three-dimensional structure and is a promising method to evaluate fracture risk.

Osteoporosis in urban post-menopausal women of the Philippines: prevalence and risk factors

SummaryThe prevalence of osteoporosis was assessed among post-menopausal women dwelling in an urban community of Davao, Philippines using quantitative ultrasonic bone densitometry and its predictors were investigated. The prevalence of osteoporosis was 19.8%. Advancing age, lower body weight, and higher educational attainment were identified as the independent predictors of osteoporosis.IntroductionThis cross-sectional study assessed the prevalence of osteoporosis among post-menopausal women dwelling in an urban community of the Philippines and investigated the risk factors for osteoporosis using a quantitative ultrasonic bone densitometer.MethodsThe study site was an area with high population density in Davao, the Philippines. Data collection was based on a structured questionnaire interview, and measurements of body size and speed of sound (SOS) at the calcaneus. The SOS T-score was calculated using the young adult mean (YAM) SOS based on data from 905 women aged 20 years and over residing in the community. The data for 339 post-menopausal women were analyzed to identify the prevalence of osteoporosis and its predictors in this study. The predictors of osteoporosis were determined by logistic regression analysis.ResultsThe majority of the women lived on low-incomes. The prevalence of osteoporosis was 19.8% in post-menopausal women. Age in 1 year increments (odds ratio [OR] 1.168), body weight (OR 0.954), and duration of education in years (OR 1.132) were predictors of osteoporosis.ConclusionsThis study identified body weight as a modifiable risk factor of osteoporosis for post-menopausal women. Longitudinal observation of the same participants will be necessary to confirm these findings.

Modeling of Ultrasonic Wave Propagation Path through Cancellous Bone and Quantitative Estimation of Bone Density and Bone Quality

Osteoporosis is a disease characterized by decreasing bone density, and is assessed by the bone mass density of cancellous bone. An X-ray method is widely used for noninvasive measurement of bone mass density [mg/cm3]. An ultrasonic method has the potential to evaluate the elastic properties, however measured ultrasonic parameters are the slope of frequency dependent attenuation (BUA [dB/MHz]) and the speed of sound (SOS [m/s]), not the bone mass density [mg/cm3]. In previous study, two longitudinal waves, the fast and slow waves, were observed in cancellous bone. In this study, the propagation path through cancellous bone is modeled to specify the causality between ultrasonic wave parameters and bone density. Then bone density and bone elasticity are quantitatively formulated. A novel ultrasonic bone densitometry, prototype LD-100, have been developed. The bone density [mg/cm3] and the bone elasticity [GPa] are evaluated by ultrasonic parameters based on the fast and slow waves in cancellous bone using a modeling of ultrasonic wave propagation path.

Development of Novel Ultrasonic Bone Densitometry Using Acoustic Parameters of Cancellous Bone for Fast and Slow Waves

A novel ultrasonic bone densitometer, prototype LD-100, has been developed to overcome problems inherent in an ultrasonic method and to obtain bone mass density in the unit of mg/cm3 and bone elasticity in the unit of GPa with a spatial resolution comparable to that of the peripheral quantitative computed tomography (pQCT) system. Bone mass density and bone elasticity are evaluated using ultrasonic parameters based on fast and slow waves in cancellous bone using a modeling of ultrasonic wave propagation path. A good reproducibility of measured values and two-dimensional (2D) imaging of bone density and bone quality are realized by two scannings with an automatic measurement algorithm.

飲料水の成分並びに日常生活習慣等と骨密度の関連

In order to elucidate the influence of drinking water components and lifestyle on bone density, we carried out chemical analysis of the water drunk by 463 adult females (mean age: 49.9 ± 11.0 years) living in Saitama Prefecture, together with questionnaire survey and ultrasonic bone densitometry measurement. It was found that, in both pre- and post-menopausal women, the larger the body weight the higher the bone density. In the pre-menopausal group, furthermore, bone density tended to increase as the subjects did more frequently out-door activities and as Ca concentration in their drinking water was higher. In the post-menopausal women, higher bone density was associated with higher intake of milk and dairy products at present. According to statistical analysis, the factors whose correlations with bone density were greater in the order: frequency of out-door activities, Ca concentration in drinking water, and body weight for pre-menopausal women; body weight, and the consumption of milk and dairy products for post-menopausal women. Our present results indicated that, in addition to physical factors and lifestyle, Ca concentration in water was related to bone density, though only among women before menopause. In this particular area, therefore, the quality of drinking water might be an important factor which is related to bone density.