Underwent Bone Densitometry Research Articles

Associations between the VDR Gene rs731236 (TaqI) Polymorphism and Bone Mineral Density in Postmenopausal Women from the RAC-OST-POL.

Postmenopausal osteoporosis is not only related to hormonal factors but is also associated with environmental and genetic factors. One of the latter is the polymorphism of vitamin D receptor (VDR). The aim of the reported study was to comprehensively analyze the VDR gene polymorphic variants rs731236 (TaqI), rs1544410 (BsmI) and rs7975232 (ApaI) in the Polish population of postmenopausal women. The study group consisted of 611 women after menopause (their median age was 65.82 ± 6.29 years). Each of them underwent bone densitometry (DXA) of the non-dominant femoral neck and total hip with a biochemical analysis of vitamin D3 serum concentration and genotyping of the above-mentioned single nucleotide polymorphisms (SNPs); the obtained results were analyzed in the aspect of waist circumference (WC), body mass index (BMI) and past medical history. The genotype prevalence rates of all SNPs were compatible with Hardy-Weinberg equilibrium (p > 0.050). Out of the studied polymorphisms, only rs731236 genotype variants affected DXA, with AG heterozygotes showing the worst bone parameters. Neither patient age nor vitamin D3 concentration, BMI, WC or comorbidities was associated with rs731236 genotype. Out of the polymorphisms studied, only rs731236 genotypes differed among the DXA results, while the AG heterozygotes were characterized by the lowest median bone mineral density.

Características sociodemográficas y salud ósea en adultos argentinos con alimentación basada en plantas

Objective: To analyze the sociodemographic characteristics and bone health among adult consumers of plant-based diets (PBD). Methods: Individuals aged 18 to 75 were invited to complete a self-administered survey via a digital platform. Results: A total of 1151 participants completed the survey; the majority were women [n=958 (83.2%)], young [age (years): 18-25: 35.8%; 26-35: 39.8%, and 36-45: 17.4%] and single (67.1%). The pattern of PBD consumption was mainly represented by veganism (54.0%), followed by lacto-ovo-vegetarianism (27.7%). The primary reason for their dietary choice was animal welfare (83.5%). Adherence to PBD, based on duration (years), was <1: 12.3%; 1-5: 67.4%; 10-15: 14.8%, and >15: 5.5%. 16% of vegans reported having experienced fractures, and 5.1% reported undergoing bone densitometry. Of these, 88.1% reported normal results, and 11.8% presented osteopenia. No cases of osteoporosis were recorded in the survey. Vitamin B12 was the predominant supplement among PBD consumers (61.4%). Conclusions: PBD consumers constitute a significant minority in our country, predominantly composed of women under 35 years old, with a projected increase in the coming years.

Androgen deprivation therapy-related fracture risk in prostate cancer: an insurance claims database study in Japan

IntroductionAndrogen deprivation therapy (ADT) is widely used for the treatment of prostate cancer. ADT is associated with reduced bone density leading to an increased risk of osteoporotic fracture. The objective of this retrospective cohort study was to quantify fracture risk in men treated with ADT for prostate cancer in real-world practice in Japan.Materials and methodsData were extracted from the Japanese Medical Data Vision (MDV) database. Men initiating ADT for treatment of prostate cancer between April 2010 and March 2021 were identified and matched to a cohort of prostate cancer patients not taking ADT using a propensity score. Fracture rates were estimated by a cumulative incidence function and compared between cohorts using a Cox cause-specific hazard model. Information was extracted on demographics, comorbidities and bone densitometry.Results30,561 men with PC starting ADT were matched to 30,561 men with prostate cancer not treated with ADT. Following ADT initiation, <5% of men underwent bone densitometry. Prescription of ADT was associated with an increased fracture risk compared to not taking ADT (adjusted hazard ratio: 1.63 [95% CI 1.52–1.75]).ConclusionADT is associated with a 1.6-fold increase in the risk of osteoporotic fracture in men with prostate cancer. Densitometry in this population is infrequent and monitoring urgently needs to be improved in order to implement effective fracture prevention.

Evaluation of Usage of a Fracture Risk Assessment by FRAX Tool in Adults With Type 2 Diabetes Mellitus.

Fragility fractures are increasingly recognized as a complication of type 2 diabetes mellitus (T2DM). The FRAX-Port® is a calculation tool that assesses the 10-year risk of either major and hip fracture, integrating several clinical risk factors, including T2DM. We aimed to evaluate the fracture risk in adults with T2DM and determine the rate of patients at high risk for fracture under anti-osteoporotic therapy. We developed a cross-sectional study, including a convenience sample of adults with T2DM, followed in our tertiary center between 2019 and 2022. Fracture risk was evaluated according to FRAX-Port®. One hundred adults were included, 54% male, with a mean age of 68.4±9.2 years. Respecting fracture risk factors, 17% had a previous fragility fracture, 12% had a history of hip fracture in their parents, 9% had active alcohol consumption, and 4% had active smoking. Additionally, 17% presented secondary osteoporosis, being the most frequent cause of systemic corticosteroid exposure (10%). Regarding diabetes-specific risk factors, 94% had a diabetes duration longer than five years; HbA1c greater than 7% in 70%; 42% had diabetic retinopathy, 33% had diabetic chronic kidney disease, 18% had peripheral neuropathy, and 7% had autonomic neuropathy; 83% were on insulin, 2% on canagliflozin and 1% on pioglitazone. According to the FRAX-Port®, the median probability of major fracture was 6.8% (IQR 6.9), and hip fracture was 2.4% (IQR 3.9). Fracture risk was high, intermediate, and low at 41%, 15%, and 44%, respectively. Lastly, 56% of participants should undergo bone densitometry and 45% had a formal recommendation to begin an anti-osteoporotic treatment. However, only 6% were under anti-osteoporotic therapy: bisphosphonates (5%) and denosumab (1%). More than a third of T2DM patients evaluated had a high fracture risk. We found that FRAX-Port® is an easy-to-apply tool, which helps in the decision to perform densitometry or to institute anti-osteoporotic therapy. Given the increasing prevalence of T2DM and the associated risk of falls, this study highlights the need to recognize the fracture risk in these patients, usually a forgotten complication during the screening of risk factors for adverse events in adults with T2DM.

Investigating the Decreased Bone Density Prevalence in People with Common Risk Factors Referred to Al-Zahra Educational-Medical Center in Isfahan City Years of 2018 and 2019

Introduction: Osteoporosis is a disease in skeletal system that is recognized by a lack of bone density and degeneration of bone tissue and can lead to increase the risk of bone fracture or even death. So, this study was conducted to determine the prevalence of decreased bone density in people with common risk factors referred to Al-Zahra Educational-Medical Center in Isfahan City years 2018-2019.&#x0D; Methods: This was a cross-sectional study. 3780 participants were included in the study by census sampling from April 2018 to March 2019. The risk factors considered in this study included gender, age, menopausal age, body mass index, history of mild trauma or fracture after the age of 40, hip fracture, autoimmune diseases, corticosteroid use, diabetes, hypothyroidism, hyperthyroidism, liver diseases, kidney diseases, malnutrition, alcohol consumption, smoking, and weight loss. Patients underwent bone densitometry. The criterion for diagnosing osteoporosis is T score, which indicated the ratio of an individual's bone density to baseline. Data were collected by a checklist and then analyzed in SPSS software version 16 at a significance level of 0.05.&#x0D; Results: The hip T-score in 1780 (47.1%) individuals and the spine T-score in 1724 (45.6%) individuals were between -1 and -2.5. There was a significant relation among gender, age, height, weight and body mass index, corticosteroid use, chronic kidney disease, premature menopause, hyperthyroidism, weight loss, autoimmune diseases, hip fracture, and the history of trauma or fracture after the age of 40. hip T score, and there was a significant relationship between age, height, weight and body mass index, hyperthyroidism, weight loss, premature menopause, corticosteroid use, (P&gt; 0.05). Spine T score was related to factors such as age, height, weight and body mass index, hyperthyroidism, weight loss, early menopause, corticosteroid use, history of trauma or fracture after 40 years (P&lt;0.05).&#x0D; Conclusion: This study showed that the prevalence of osteoporosis increases with age, and especially women with early menopause, and also in people with a history of trauma or fracture over the age of 40, hip fracture, corticosteroid use, hyperthyroidism, and autoimmune disease, chronic kidney disease, obesity and weight loss are common. Therefore, in order to prevent osteoporosis, necessary measures should be taken to prevent and correct the risk factors.

Risk factors of vestibular disorders in patients with metabolic disorders in the bone

Actuality: Vestibular disorders of central and peripheral origin are often observed in patients with impaired bone mineral metabolism. Despite the benign nature, they cause significant disturbances in social life. Aim: study clinical and laboratory parameters and vestibular disorders in patients with different forms of benign paroxysmal positional vertigo (BPPV), related to degenerative-dystrophic changes of the musculoskeletal system and identify ways to further correct them. Materials and methods: We have studied 60 patients with BPPV. All patients underwent bone densitometry, examined the loss of bone strength of the spine and hip joint, vestibulometric study. Determined the value of mineral metabolism: the content of calcium and vitamin D in serum. To verify BPPV and its type, patients underwent posit ional tests. Results and discussions: 60 patients who complained of dizziness, on the basis of additional examination was diagnosed with BPPVs. Otitolithithiasis of the posterior semicircular canal was diagnosed in 44 patients, horizontal canal – in 8 patients, cupulo-lithiasis – in 10 patients. Depending on the condition of the vestibular systeme, patients were divided into 2 groups. Group 1 included 24 patients with peripheral vestibular disorders, group 2 included 36 patients with mixed vestibular dysfunction. According to the results of absorption densitometry in patients, mineral metabolism disorders were detected: osteopenia in 41 patients, the average T-test was (-1.9±0.3) SD, osteoporosis – In 19 patients, T-test was (-2.8 ± 0.2) SD. Serum calcium and vitamin D deficiency have been noted in patients with BPPV, indicating impaired mineral metabolism. In order to correct mineral metabolism and antirelapse therapy, patients with BPPV were prescribed vestibuloplegics, calcium, vitamin D for 12 months. Conclusions: studies have found a correlation between BPPV and bone mineral metabolic disorders. It indicated the presence of osteopenia and osteoporosis in patients with DPPD, as well as changes in the levels of mineral metabolism of bone (in addition to calcium and vitamin D in serrum). Such changes in mineral metabolism may be a biomarker of otolithic degeneration, maintain a causal relationship between lower serum vitamin D and calcium levels and the development of BPPV, and cause frequent attacks.

Quality of Life in osteoporotic patients.

Osteoporosis is responsible for fragility fractures, which are associated with impaired quality of life (QoL) and disability. The aim of the study was to evaluate the QoL in patients affected by osteoporosis and possible determinants. One-hundred thirty-four subjects followed at the osteoprosis outpatient clinic at our institution completed the QUALEFFO-41 questionnaire for quality of life. All subjects had undergone bone densitometry measurement and the FRAX index, summarizing the risk of fragility fracture, was calculated for each of them. The QoL in these subjects and its possible determinants were investigated with univariate and multiple linear regression analysis. Subjects with osteoporosis had lower scores in the domains of physical and social function of the QUALEFFO questionnaire in comparison with subjects with normal bome mineral density. Main factors associated with impairment in QoL were high FRAX score and body mass index (BMI). Physical and social function is reduced in osteoporotic subjects. High BMI and an increased risk of fragility fracture were main determinants of impairment in the QoL in this study.

The Economic Burden of Severe Osteoporotic Fractures in the French Healthcare Database: The FRACTOS Study.

Osteoporosis carries a high medical, economic, and societal burden principally because of the risk of severe fractures. The objective of this cost-of-illness study was to describe health resource utilization and associated costs in all patients aged ≥50 years hospitalized for a severe osteoporotic fracture over a 6-year period (2009 to 2014) in France. Data were extracted from the French national healthcare database (SNDS) on all health care resource utilization between the index date (date of hospitalization for first fracture during the enrollment period) and study end (December 31, 2016) or until the patient died. Costing was restricted to direct costs and determined from the payer perspective. Variables related to costs were identified through multivariate logistic regression analysis. A total of 356,895 patients were included (median follow-up 39.1 months). In the year after the index fracture, 36,622 patients (10.5%) were rehospitalized for a fracture-related reason. Only 18,474 (5.3%) underwent bone densitometry and 58,220 (16.7%) received a specific treatment. The total annual per capita osteoporosis-related cost in the year after the index severe osteoporotic fracture was €18,040 (from €8598 for multiple ribs to €21,085 for hip fracture) of which €17,905 was incurred by fracture-related costs. The cost incurred by management of osteoporosis was €135. Over years 2 to 5, the mean annual per capita costs of fracture treatment (€806, mostly attributable to the treatment of refractures) continued to dominate those of osteoporosis management (€99). Total annual cost of care was €1260 million (year 2014). Variables associated with higher cost were older age, male sex, site of fracture, a history of prior osteoporotic fracture, and the number of refracture events. The 5-year cost of severe osteoporotic fractures to the French health care system is high and mostly attributable to the treatment of refractures. Improved fracture prevention measures in patients with osteoporosis is crucial to reduce the economic burden of the disease. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Association between bone mineral density and vertebral fractures among patients with diabetes attending Teaching Hospital Karapitiya

Introduction: Diabetes mellitus (DM) impairs bone strength resulting in an increased risk of fractures. This study was designed to determine the association between bone mineral density (BMD) and vertebral fractures among a selected group of patients with Type 2 diabetes mellitus. Methods: This cross-sectional study included patients with diabetes, selected from clinic attendees at Teaching Hospital Karapitiya. Serum creatinine, urine microalbumin to creatinine ratio and a lateral radiograph of the thoraco-lumbar spine were done in all patients. Those who were detected to have vertebral fracture/s underwent bone densitometry. BMD was also measured in a group of patients selected from the rest of the group who did not have vertebral fractures and another group of healthy individuals selected from the same community. They were matched for the age and gender. Results: In patients with diabetes (n=160, females 110), the mean (SD) age and the duration of the disease were 62 (10) years and 10 (3) years, respectively. Of patients with diabetes screened, 20 had vertebral fractures (12.5% prevalence). Compared to healthy controls, patients with diabetes without vertebral fractures had significantly low BMDs in the proximal femur but comparatively higher BMD in the total spine. BMDs measured in the total spine and proximal femur were not different between patients with DM vertebral fractures and without vertebral fractures. Conclusions: Our data indicate a 12.5% prevalence of vertebral fracture among patients with DM. Although patients with diabetes in general had lower BMDs in most of the regions examined, there was no significant difference in regional BMDs between those with fractures and without fractures.

Real-world care for individuals aged over fifty with fractures in France: Evidence for a wide care gap-The EPIFRACT Study.

To describe the care trajectories of adults aged ≥50 years with fragility fractures in France. A postal questionnaire was sent to 15,000 individuals aged ≥50 years extracted from a representative panel of the French population (METASKOPE) in April-May 2018. Respondents experiencing a single fragility fracture in the previous three years constituted the study population. Information was collected regarding diagnosis, hospitalisations, physician visits and treatment related to the fractures. 13,914 participants returned a questionnaire (92.8%), of whom 436 reported a single fragility fracture. Their mean age was 68.7±10.3 years. 11.9% of this sample had undergone bone densitometry (DXA) prior to the fracture and 11.9% had received a diagnostic of osteoporosis. Following the fracture, a further 17.4% underwent DXA and 8.5% were diagnosed with osteoporosis. 74.3% of fractures were initially managed in an emergency department and 29.6% led to immediate hospitalisation. Prior to fracture, 3.4% received a specific anti-osteoporotic treatment, 10.1% vitamin D and 6.4% calcium supplementation. After the fracture, these figures rose to 10.8%, 26.8% and 19.0% respectively. 86.2% participants made at least one follow-up visit to a physician. The rate of DXA screening following fragility fractures in subjects over fifty is very low. Most patients with fragility fractures did not receive a diagnosis of osteoporosis. The proportion of patients treated with a specific anti-osteoporotic treatment after a fracture is low even though around half consulted their general practitioner after the fracture. Practice guidelines are thus not being adhered to in everyday clinical practice in France.

Fragility fractures in France: epidemiology, characteristics and quality of life (the EPIFRACT study).

To estimate the incidence of fragility fractures in France and to describe the characteristics of individuals with such fractures and of their fractures. In April-May 2018, a postal survey was performed in France targeting a representative panel of 15,000 individuals aged ≥ 50years, who were invited to complete a questionnaire. If they reported experiencing a fracture in the previous 3years, they were asked to provide information on demographics, fracture type, risk factors for fractures and osteoporosis diagnosis. Only fragility fractures were considered, and these were classified as major (associated with increased mortality) or minor, based on the fracture site. Around 13,914 panellists returned an exploitable questionnaire (92.8%). About 425 participants reported ≥ 1 fragility fracture (453 fractures), corresponding to a 12-month incidence rate of 1.4% [95%CI: 1.2, 1.6]. Incidence was higher in women (1.99% [1.87, 2.05]) than in men (0.69% [0.38, 0.86]) and increased with age. Around 157 fractures (34.6%) were classified as major. Participants reporting major fractures were older than those reporting minor fractures (mean age: 72.6 ± 11.3 vs 67.1 ± 10.6) and more likely to report previous corticosteroid use (odds ratio: 1.90 [95%CI: 1.13, 3.18]). No other patient characteristic was associated with fracture severity. About 117 participants with fractures (27.5%) had undergone bone densitometry, and 97 (22.8%) declared having received a diagnosis of osteoporosis. Around 340,000 people aged ≥ 50years living at home in France are estimated to experience osteoporotic fractures each year. However, > 75% of panellists reporting fractures were never diagnosed with osteoporosis and thus did not have the opportunity to receive appropriate care.

Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease

Background:A high prevalence of osteopenia and osteoporosis is observed in patients with Inflammatory Bowel Disease (IBD).Objective:The aim of our study was to investigate the prevalence of bone loss, bone remodeling and risk factors in Tunisian patient with IBD.Patients and Methods:The study included 40 patients with IBD and 32 age- and sex-matched healthy controls subjects. All participants underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine. Serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin(OC), and urinary degradation products of C-terminal telopeptide of type I collagen (CTXI) were measured in all participants to assess the bone metabolism status.Results:Twelve (30%) patients were normal, 32.5% were osteopenic and 37.5% were osteoporotic. Osteoporosis was more frequent in IBD patients than controls (p=0.0001). Age and inflammation were associated with low bone mineral density (BMD). Mean calcium, phosphorus and alkaline phosphatase levels were similar in both groups. Median 25(OH) D levels were significantly lower in IBD patients compared with controls (p=0.0001). Median urinary CTXI levels were significantly higher in IBD patients compared with healthy controls (p=0.007). No significant differences between IBD patients and controls concerning the median serum OC and PTH levels were found.Conclusion:In our study, there is a high prevalence of low BMD in IBD patients and an increase in bone resorption without a change of bone formation. Low BMI and hypovitaminoses D were identified as risk factors for low BMD.

Sarcopenia in Brazilian rural and urban elderly women: Is there any difference?

There are many studies concerning sarcopenia prevalence from all over the world. However, to our knowledge, only two compared urban and rural sarcopenia and to date, none have been conducted in the Americas. The aim of this study was to evaluate the prevalence of sarcopenia in a convenience sample of women ≥60 y of age who underwent bone densitometry and live in urban and rural areas of southern Brazil. This was a cross-sectional study comprising 205 women ≥60 y of age who had undergone bone densitometry. Sarcopenia was defined according to the criteria recommended by the European Working Group on Sarcopenia in Older People. The diagnosis combined the evaluation of muscle mass (assessed by dual-energy x-ray absorptiometry), muscle strength (measured using a manual digital dynamometer), and muscular performance (evaluated by the 4-m walking speed test). Sociodemographic data, smoking status, chronic conditions, number of falls and fractures in the past year, and level of physical activity also were collected. Sarcopenia was present in 2.4% of the total sample. Urban and rural populations significantly differed in terms of schooling (P < 0.001), occupation (P = 0.010), socioeconomic status (P = 0.001), and smoking status (P = 0.006). The environment in which the women lived was independently associated with sarcopenia (odds ratio, 9.561; 95% confidence interval, 1.021-89.523; P = 0.048). The prevalence of sarcopenia was significantly higher in the urban women than in the rural group (5.7 versus 0.7%, respectively; P = 0.047). After multivariate analysis, the environment of the women's residence remained independently associated with sarcopenia. Urban elderly women are more vulnerable to sarcopenia than rural elderly women.

Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity.

Osteoporosis is frequently neglected in patients with COPD. We aimed at evaluating the rate of osteoporosis, fractures, and low lean mass in patients with COPD. Ninety-nine patients with COPD (53 women, 64.5 ± 9.6years old, and 46 men, 65.9 ± 8.0years old) underwent bone densitometry (DXA) with body composition analyses. Healthy individuals (N = 57) not exposed to tobacco matched by sex, age, and body mass index (BMI) were used as controls. Spirometry, routine laboratory workout, and conventional thoracolumbar radiography surveying for vertebral deformities were performed in all patients. Osteoporosis was found in 40.4% of the COPD patients against only 13.0% of the healthy controls (p = 0.001). Vertebral fractures were seen in 24.4% of the men and 22.0% of the women with COPD. Disease severity (GOLD 3 and 4) was significantly associated with higher risk of vitamin D deficiency (p = 0.032), lower BMD (both men and women at all sites), higher frequency of osteoporosis (in women at all sites), lower skeletal mass index, and higher rate of low lean mass (in both men and women) than healthy controls and COPD patients with milder disease (GOLD 1 and 2). Age was a main predictor of vertebral fractures (OR = 1.164 (1.078-9.297); p < 0.001), while high plasma iPTH (OR = 1.045 (1.005-1.088); p = 0.029) and low ALM (OR = 0.99965 (0.99933-0.99997); p = 0.031) were predictors of non-vertebral fractures. Highly prevalent in COPD, osteoporosis and low lean mass were associated with FEV1% < 50%. Age, low lean mass, high iPTH, and low bone mass were all significantly associated with fractures in COPD patients.

Association between serum cystatin C and bone mineral density in Korean adults.

BackgroundSerum cystatin C has been known as a novel marker of preclinical renal dysfunction, and higher cystatin C levels are associated with increased risks of hip and nonvertebral fractures. However, there are few reports on the association between serum cystatin C and bone mineral density (BMD), especially in the Asian population. We evaluated the association between cystatin C levels and BMD of the spine and hip in Korean adults.MethodsA cross-sectional study was performed in 865 Korean adults (325 men and 540 women) who participated in a comprehensive medical examination program and underwent bone densitometry. Renal function was assessed by the estimated glomerular filtration rate (eGFR), which was calculated using an equation based on creatinine (eGFRcre) and cystatin C (eGFRcys).ResultsThe serum cystatin C level was negatively correlated with different types of BMD, including the lowest lumbar, total lumbar, femoral neck, and total femur BMD, in women, but not in men. Higher cystatin C levels were associated with a higher prevalence of osteoporosis in women (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.69–8.03; P=0.001), but not in men (OR, 0.85; 95% CI, 0.30–2.38; P=0.761). However, this association was attenuated in the multivariable model adjusted for age, body mass index, serum 25-hydroxyvitamin D3, and creatinine (OR, 1.01; 95% CI, 0.38–2.71) in women. In addition, the eGFRcys showed a stronger positive correlation with BMD than the eGFRcre.ConclusionOur findings suggest that serum cystatin C levels might help identify women with osteoporosis who are susceptible to fractures.

Frailty in HIV infected people: a new risk factor for bone mineral density loss.

The study aims to assess the association between bone mineral density (BMD) and frailty in a cohort of HIV-infected patients. A cross-sectional study in an HIV outpatient unit where nearly 1000 patients are monitored. Study participants undergoing bone densitometry were proposed an evaluation of frailty using criteria of the Cardiovascular Health Study (CHS) and the Study of Osteoporotic Fractures (SOF). Frailty markers were weight-loss, self-reported exhaustion, physical activity, grip strength, chair stands, and slow gait. Patients' characteristics were collected from an electronic medical record. Associations of frailty with BMD and osteoporosis were tested using multivariate linear and logit regression models, respectively. In total, 175 HIV-infected patients, 121 (69.14%) men, were analyzed. Prevalence of frailty markers, osteopenia, and osteoporosis were comparable among sexes. Despite a younger age, spinal and femoral neck BMD were lower in women (P < 0.05). Linear regression model adjusting by age, duration of HIV follow-up, BMI, smoking status, osteoarthritis, osteoporosis treatment, and the age at menopause showed a negative association of spinal and femoral BMD with frailty according to SOF criteria in women (P < 0.05). In men, SOF-defined frailty was associated with osteoporosis (odds ratio 28.79; 95% confidence interval 2.15-386.4) in a model adjusting for age, duration of HIV follow-up, CD4 nadir, CD4 T-cell count, tobacco consumption, exposure to tenofovir (TDF) and protease inhibitors. No significant associations were found between BMD and CHS-defined frailty. Our study shows that frailty according to SOF criteria is associated with low spinal BMD values in female and osteoporosis in male HIV-infected patients.

Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry

ObjectivesThe accuracy of patients' perception of risk is important for decisions about treatment in many diseases. We framed the risk of fracture and benefits of treatment in different ways and...

Coronary Artery Calcium Score and Bone Metabolism: A Pilot Study in Postmenopausal Women.

BackgroundSince 1991 many studies evaluated the link between cardiovascular diseases and osteoporosis, two age-related conditions, but the main common pathologic pathway has not been determined yet. The histological similarity between arterial calcified plaque and bone matrix and involvement of similar cells and mediators provide a special field of research. Therefore in the present study, we aimed to evaluate the relationship between coronary artery calcium score (CACS) as a surrogate marker of atherosclerosis and bone mediators and parameters in postmenopausal women.MethodsEleven postmenopausal women who had CACS higher than 80 were enrolled into the study and underwent bone densitometry. In addition, their serum and urine samples were taken for measuring osteoprotegerin, osteocalcin, and β cross laps. Patients' 10-year probability of fracture was calculated by the World Health Organization fracture-risk assessment tool (FRAX).ResultsThe regression analysis of our results showed the association between CACS and OC (std β=0.66, 95% confidence interval [CI] 5.47-72.27, P=0.027), femoral bone density (std β=−0.6, 95% CI -6864.34-14.27, P=0.05) and T-score (std β=−0.6, 95% CI −773.08-1.28, P=0.05) which remained significant after adjustment for age, weight, years since menopause and body mass index. No association was found between CACS and osteoprotegerin, spinal bone density and FRAX score.ConclusionsIn conclusion, this pilot study with small sample size showed the potential association between CACS and osteocalcin, femoral bone density and T-score. However, the relationship between CACS and osteoprotegerin, receptor activator of nuclear factor-kappa B ligand, FRAX score and other bone parameters remain to be clarified in larger sample size studies.

Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul

ObjectiveTo investigate the association between body mass index (BMI) and bone mineral density (BMD) in postmenopausal women. MethodsObservational study with postmenopausal women who underwent bone densitometry in Palmeira das Missões – RS. Sociodemographic data, risk for osteoporosis and food intake were assessed through a specific form. BMI was calculated according to WHO criteria. The assessment of BMD was performed by dual-energy X-ray absorptiometry (DXA) and classified according to WHO. Statistical analysis was performed using prevalence ratios (PR) and their respective 95% confidence intervals for the factors studied. Variables associated with p<0.20 with the different outcomes (osteopenia and osteoporosis) were included in a Poisson regression model with robust variance to adjust for potential confounding factors. A 5% significance level was considered. Results393 postmenopausal women with a mean age of 59.6±8.2 years participated.After the adjustments, the normal weight women had 1.2 times the prevalence of osteopenia of obese women (PR=1.2; CI 95% 1.3–1.5). Considering osteoporosis, the PR of euthophic women was twice the PR of obese women (PR=2; CI 95% 1.4–2.9) and was 1.7 times greater for overweight group compared to obese category (PR=1.7; CI 95% 1.2–2.5). ConclusionObese women had lower prevalence of osteopenia compared with normal weight subjects and also with lower prevalence of osteoporosis as compared to normal- and overweight women.

Associação entre o índice de massa corporal e osteoporose em mulheres da região noroeste do Rio Grande do Sul

ObjectiveTo investigate the association between body mass index (BMI) and bone mineral density (BMD) in postmenopausal women. MethodsObservational study with postmenopausal women who underwent bone densitometry in Palmeira das Missões ‐ RS. Sociodemographic data, risk for osteoporosis and food intake were assessed through a specific form. BMI was calculated according to WHO criteria. The assessment of BMD was performed by Dual‐energy X‐ray absorptiometry (DXA) and classified according to WHO. Statistical analysis was performed using prevalence ratios (PR) and their respective 95% confidence intervals for the factors studied. Variables associated with p<0.20 with the different outcomes (osteopenia and osteoporosis) were included in a Poisson regression model with robust variance to adjust for potential confounding factors. A 5% significance level was considered. Results393 postmenopausal women with a mean age of 59.6±8.2 years participated.After the adjustments, the normal weight women had 1.2 times the prevalence of osteopenia of obese women (PR=1.2; CI 95% 1.3‐1.5). Considering osteoporosis, the PR of euthophic women was twice the PR of obese women (PR=2; CI 95% 1.4‐2.9) and was 1.7 times greater for overweight group compared to obese category (PR=1.7; CI 95% 1.2‐2.5). ConclusionObese women had lower prevalence of osteopenia compared with normal weight subjects and also with lower prevalence of osteoporosis as compared to normal‐ and overweight women.