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Sample records for absorptiometry dxa bone

  1. Bone geometry, structure and mineral distribution using Dual energy X ray Absorptiometry (DXA)

    NASA Technical Reports Server (NTRS)

    Whalen, Robert; Cleek, Tammy

    1993-01-01

    Dual energy x-ray absorptiometry (DXA) is currently the most widely used method of analyzing regional and whole body changes in bone mineral content (BMC) and areal (g/sq cm) bone mineral density (BMD). However, BMC and BMD do not provide direct measures of long bone geometry, structure, or strength nor do regional measurements detect localized changes in other regions of the same bone. The capabilities of DXA can be enhanced significantly by special processing of pixel BMC data which yields cross-sectional geometric and structural information. We have extended this method of analysis in order to develop non-uniform structural beam models of long bones.

  2. A study on the effects of a calcium drug on the bone mineral density (BMD) by using dual-energy X-ray Absorptiometry (DXA)

    NASA Astrophysics Data System (ADS)

    Kim, Eun-Hye; Kim, Ho-Sung; Dong, Kyung-Rae; Park, Yong-Soon; Chung, Woon-Kwan; Cho, Jae-Hwan

    2012-12-01

    Measurements of osteoporosis might contain errors caused by the calcium drug used in the prevention and the treatment of osteoporosis. This study conducted a lumbar spine phantom experiment to examine whether a calcium drug can influence the measured values of the bone mineral density (BMD) because of the drug taken by a real patient remaining undigested in the stomach. Dual-energy X-ray Absorptiometry (DXA) was used to measure the BMD for a calcium-drug in an equipment-dedicated lumbar spine phantom and 10 patients selected for the BMD measurement. Three types of drugs that are prescribed in actual clinical practice calcium drugs were used for the phantom experiment, and the drugs were divided into a fixed dose, 1/2 of the fixed dose, 1/4 of the fixed dose and 1/8 of the fixed dose. Without the drugs included, the phantom was scanned 60 times continuously to calculate the baseline BMD. The BMD was measured as the calcium drug coated with paraffin was placed in the lumbar vertebra 2 and the soft tissue region of the phantom. To determine when the drug was invisible to the naked eye are measured, the BMD at different drug dilutions. The measurements were conducted three times to calculate the mean. In the patient experiment, patients were selected who visited hospital after taking the drug before measuring the BMD. After a certain time had passed, the BMD was measured again to examine the difference in images and the change in BMD values due to the calcium-drug intake. The BMD measurements of lumbar 1-4 in the phantom were higher, with statistical significant, than the least significant change (LSC) in the bone region for all three drugs (Ca carbonate, Ca citrate and Ca cholecalciferol), showing a significant increase. On the other hand, there was no significant change in the soft tissue. When Ca Cholecalciferol was used in a fixed dose, the BMD of L2 increased by 11.6%, showing the largest increase among the drugs examined, but only a 2.8% increase in the BMD of L1

  3. Comparison of bone density measurement techniques: DXA and Archimedes' principle.

    PubMed

    Keenan, M J; Hegsted, M; Jones, K L; Delany, J P; Kime, J C; Melancon, L E; Tulley, R T; Hong, K D

    1997-11-01

    The standard method for determination of density (g/cm3) of bones from small animals has been the application of Archimedes' principle. A recent development has been software for the determination of "density" (g/cm2) of small animal bones with dual-energy X-ray absorptiometry (DXA). We compared Archimedes' principle and DXA (Hologic QDR-2000) in the measurement of the densities of whole and hollowed femurs of 5- to 6-month-old retired female breeder rats. In an attempt to ensure detectable treatment differences, rats were used from a low-vitamin D Holtzman and a supplemental-vitamin D Sprague-Dawley colony. Whole femur densities were higher for supplemental-vitamin D colony rats than for low vitamin D rats using both techniques (Archimedes' principle, p < 0.002; DXA, p < 0.005), and the densities from the two techniques were highly correlated (r = 0.82, p < 0.0001). Actual density values were higher for Archimedes' principle than for DXA. Other variables such as femur ash weight and calcium content were also highly correlated to densities with both techniques. Hollowed femur density values were higher than whole femur values with Archimedes' principle but lower with DXA. Colony effects for hollowed femur densities were diminished with Archimedes' principle (p < 0.03) and eliminated with DXA (p < 0.53). Investigation of whole bones is more biologically relevant, and both techniques were effective in detecting differences between whole femurs from low-vitamin D and supplemental-vitamin D colony rats.

  4. BEYOND DXA: ADVANCES IN CLINICAL APPLICATIONS OF NEW BONE IMAGING TECHNOLOGY

    PubMed Central

    Pawlowska, Monika; Bilezikian, John P.

    2017-01-01

    Dual-energy X-ray absorptiometry (DXA) is generally a very useful tool for assessing bone mineral density (BMD) and fracture risk. However, observational studies have shown that in certain instances, BMD as measured by DXA systematically over- or underestimates fracture risk. We herein describe the clinical conundrums encountered when assessing fracture risk by DXA in patients with primary hyperparathyroidism or type 2 diabetes and those of Chinese ethnicity. Furthermore, we discuss how advanced imaging technology that examines skeletal microarchitecture is furthering our understanding of fracture risk in these clinical situations. PMID:27214295

  5. Cortical thickness estimation of the proximal femur from multi-view dual-energy X-ray absorptiometry (DXA)

    NASA Astrophysics Data System (ADS)

    Tsaousis, N.; Gee, A. H.; Treece, G. M.; Poole, K. E. S.

    2013-02-01

    Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 +/- 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 +/- 0:79 mm.

  6. Comparison of DXA Scans and Conventional X-rays for Spine Morphometry and Bone Age Determination in Children.

    PubMed

    Hoyer-Kuhn, Heike; Knoop, Kai; Semler, Oliver; Kuhr, Kathrin; Hellmich, Martin; Schoenau, Eckhard; Koerber, Friederike

    2016-01-01

    Conventional lateral spine and hand radiographs are the standard tools to evaluate vertebral morphometry and bone age in children. Beside bone mineral density analyses, dual-energy X-ray absorptiometry (DXA) measurements with lower radiation exposure provide high-resolution scans which are not approved for diagnostic purposes. Data about the comparability of conventional radiographs and DXA in children are missing yet. The purpose of the trial was to evaluate whether conventional hand and spine radiographs can be replaced by DXA scans to diminish radiation exposure. Thirty-eight children with osteogenesis imperfecta or secondary osteoporosis or short stature (male, n=20; age, 5.0-17.0 yr) were included and assessed once by additional DXA (GE iDXA) of the spine or the left hand. Intraclass correlation coefficients (ICCs) were used to express agreement between X-ray and iDXA assessment. Evaluation of the spine morphometry showed reasonable agreement between iDXA and radiography (ICC for fish-shape, 0.75; for wedge-shape, 0.65; and for compression fractures, 0.70). Bone age determination showed excellent agreement between iDXA and radiography (ICC, 0.97). IDXA-scans of the spine in a pediatric population should be used not only to assess bone mineral density but also to evaluate anatomic structures and vertebral morphometry. Therefore, iDXA can replace some radiographs in children with skeletal diseases.

  7. Dual-Energy X-Ray Absorptiometry: Beyond Bone Mineral Density Determination

    PubMed Central

    2016-01-01

    Significant improvements in dual-energy X-ray absorptiometry (DXA) concerning quality, image resolution and image acquisition time have allowed the development of various functions. DXA can evaluate bone quality by indirect analysis of micro- and macro-architecture of the bone, which and improve the prediction of fracture risk. DXA can also detect existing fractures, such as vertebral fractures or atypical femur fractures, without additional radiologic imaging and radiation exposure. Moreover, it can assess the metabolic status by the measurement of body composition parameters like muscle mass and visceral fat. Although more studies are required to validate and clinically use these parameters, it is clear that DXA is not just for bone mineral densitometry. PMID:26996419

  8. Use of dual-energy X-ray absorptiometry (DXA) for diagnosis and fracture risk assessment; WHO-criteria, T- and Z-score, and reference databases.

    PubMed

    Dimai, Hans P

    2016-12-29

    Dual-energy X-ray absorptiometry (DXA) is a two-dimensional imaging technology developed to assess bone mineral density (BMD) of the entire human skeleton and also specifically of skeletal sites known to be most vulnerable to fracture. In order to simplify interpretation of BMD measurement results and allow comparability among different DXA-devices, the T-score concept was introduced. This concept involves an individual's BMD which is then compared with the mean value of a young healthy reference population, with the difference expressed as a standard deviation (SD). Since the early nineties of the past century, the diagnostic categories "normal, osteopenia, and osteoporosis", as recommended by a WHO working Group, are based on this concept. Thus, DXA is still the globally accepted "gold-standard" method for the noninvasive diagnosis of osteoporosis. Another score obtained from DXA measurement, termed Z-score, describes the number of SDs by which the BMD in an individual differs from the mean value expected for age and sex. Although not intended for diagnosis of osteoporosis in adults, it nevertheless provides information about an individual's fracture risk compared to peers. DXA measurement can either be used as a "stand-alone" means in the assessment of an individual's fracture risk, or incorporated into one of the available fracture risk assessment tools such as FRAX® or Garvan, thus improving the predictive power of such tools. The issue which reference databases should be used by DXA-device manufacturers for T-score reference standards has been recently addressed by an expert group, who recommended use National Health and Nutrition Examination Survey III (NHANES III) databases for the hip reference standard but own databases for the lumbar spine. Furthermore, in men it is recommended use female reference databases for calculation of the T-score and use male reference databases for calculation of Z-score.

  9. Simulated increases in body fat and errors in bone mineral density measurements by DXA and QCT.

    PubMed

    Yu, Elaine W; Thomas, Bijoy J; Brown, J Keenan; Finkelstein, Joel S

    2012-01-01

    Major alterations in body composition, such as with obesity and weight loss, have complex effects on the measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). The effects of altered body fat on quantitative computed tomography (QCT) measurements are unknown. We scanned a spine phantom by DXA and QCT before and after surrounding with sequential fat layers (up to 12 kg). In addition, we measured lumbar spine and proximal femur BMD by DXA and trabecular spine BMD by QCT in 13 adult volunteers before and after a simulated 7.5 kg increase in body fat. With the spine phantom, DXA BMD increased linearly with sequential fat layering at the normal (p < 0.01) and osteopenic (p < 0.01) levels, but QCT BMD did not change significantly. In humans, fat layering significantly reduced DXA spine BMD values (mean ± SD: -2.2 ± 3.7%, p = 0.05) and increased the variability of measurements. In contrast, fat layering increased QCT spine BMD in humans (mean ± SD: 1.5 ± 2.5%, p = 0.05). Fat layering did not change mean DXA BMD of the femoral neck or total hip in humans significantly, but measurements became less precise. Associations between baseline and fat-simulation scans were stronger for QCT of the spine (r(2)= 0.97) than for DXA of the spine (r(2)= 0.87), total hip (r(2) = 0.80), or femoral neck (r(2)= 0.75). Bland-Altman plots revealed that fat-associated errors were greater for DXA spine and hip BMD than for QCT trabecular spine BMD. Fat layering introduces error and decreases the reproducibility of DXA spine and hip BMD measurements in human volunteers. Although overlying fat also affects QCT BMD measurements, the error is smaller and more uniform than with DXA BMD. Caution must be used when interpreting BMD changes in humans whose body composition is changing.

  10. DXA measurements in Rett syndrome reveal small bones with low bone mass.

    PubMed

    Roende, Gitte; Ravn, Kirstine; Fuglsang, Kathrine; Andersen, Henrik; Nielsen, Jytte Bieber; Brøndum-Nielsen, Karen; Jensen, Jens-Erik Beck

    2011-09-01

    Low bone mass is reported in growth-retarded patients harboring mutations in the X-linked methyl-CpG-binding protein 2 (MECP2) gene causing Rett syndrome (RTT). We present the first study addressing both bone mineral density (BMD) and bone size in RTT. Our object was to determine whether patients with RTT do have low BMD when correcting for smaller bones by examination with dual-energy X-ray absorptiometry (DXA). We compared areal BMD (aBMD(spine) and aBMD(total hip) ) and volumetric bone mineral apparent density (vBMAD(spine) and vBMAD(neck) ) in 61 patients and 122 matched healthy controls. Further, spine and hip aBMD and vBMAD of patients were associated with clinical risk factors of low BMD, low-energy fractures, MECP2 mutation groups, and X chromosome inactivation (XCI). Patients with RTT had reduced bone size on the order of 10% and showed lower values of spine and hip aBMD and vBMAD (p < .001) adjusted for age, pubertal status, and body mass index (BMI). aBMD(spine) , vBMAD(spine) , and aBMD(total hip) were associated with low-energy fractures (p < .05). Walking was significantly associated to aBMD(total hip) and vBMAD(neck) adjusted for age and body mass index (BMI). Further, vBMAD(neck) was significantly associated to a diagnosis of epilepsy, antiepileptic treatment, and MECP2 mutation group, but none of the associations with vBMAD(neck) remained clinically significant in a multiple adjusted model including age and BMI. Neither aBMD(spine) , vBMAD(spine) , nor aBMD(total hip) were significantly associated with epilepsy, antiepileptic treatment, MECP2 mutation group, XCI, or vitamin D status. Low bone mass and small bones are evident in RTT, indicating an apparent low-bone-formation phenotype.

  11. Utilization of DXA Bone Mineral Densitometry in Ontario

    PubMed Central

    2006-01-01

    Executive Summary Issue Systematic reviews and analyses of administrative data were performed to determine the appropriate use of bone mineral density (BMD) assessments using dual energy x-ray absorptiometry (DXA), and the associated trends in wrist and hip fractures in Ontario. Background Dual Energy X-ray Absorptiometry Bone Mineral Density Assessment Dual energy x-ray absorptiometry bone densitometers measure bone density based on differential absorption of 2 x-ray beams by bone and soft tissues. It is the gold standard for detecting and diagnosing osteoporosis, a systemic disease characterized by low bone density and altered bone structure, resulting in low bone strength and increased risk of fractures. The test is fast (approximately 10 minutes) and accurate (exceeds 90% at the hip), with low radiation (1/3 to 1/5 of that from a chest x-ray). DXA densitometers are licensed as Class 3 medical devices in Canada. The World Health Organization has established criteria for osteoporosis and osteopenia based on DXA BMD measurements: osteoporosis is defined as a BMD that is >2.5 standard deviations below the mean BMD for normal young adults (i.e. T-score <–2.5), while osteopenia is defined as BMD that is more than 1 standard deviation but less than 2.5 standard deviation below the mean for normal young adults (i.e. T-score< –1 & ≥–2.5). DXA densitometry is presently an insured health service in Ontario. Clinical Need   Burden of Disease The Canadian Multicenter Osteoporosis Study (CaMos) found that 16% of Canadian women and 6.6% of Canadian men have osteoporosis based on the WHO criteria, with prevalence increasing with age. Osteopenia was found in 49.6% of Canadian women and 39% of Canadian men. In Ontario, it is estimated that nearly 530,000 Ontarians have some degrees of osteoporosis. Osteoporosis-related fragility fractures occur most often in the wrist, femur and pelvis. These fractures, particularly those in the hip, are associated with increased

  12. Stochastic predictors from the DXA scans of human lumbar vertebrae are correlated with the microarchitecture parameters of trabecular bone.

    PubMed

    Dong, Xuanliang Neil; Pinninti, Rajeshwar; Tvinnereim, Amy; Lowe, Timothy; Di Paolo, David; Shirvaikar, Mukul

    2015-09-18

    The purpose of this study was to provide a novel stochastic assessment of inhomogeneous distribution of bone mineral density (BMD) from the Dual-energy X-ray Absorptiometry (DXA) scans of human lumbar vertebrae and identify the stochastic predictors that were correlated with the microarchitecture parameters of trabecular bone. Eighteen human lumbar vertebrae with intact posterior elements from 5 cadaveric spines were scanned in the posterior-anterior projection using a Hologic densitometer. The BMD map of human vertebrae was obtained from the raw data of DXA scans by directly operating on the transmission measurements of low- and high-energy X-ray beams. Stochastic predictors were calculated by fitting theoretical models onto the experimental variogram of the BMD map, rather than grayscale images, from DXA scans. In addition, microarchitecture parameters of trabecular bone were measured from the 3D images of human vertebrae acquired using a Micro-CT scanner. Significant correlations were observed between stochastic predictors and microarchitecture parameters. The sill variance, representing the standard deviation of the BMD map to some extent, had significantly positive correlations with bone volume, trabecular thickness, trabecular number and connectivity density. The sill variance was also negatively associated with bone surface to volume ratio and trabecular separation. This study demonstrates that the stochastic assessment of the inhomogeneous distribution of BMD from DXA scans of human lumbar vertebrae can reveal microarchitecture information of trabecular bone. However, future studies are needed to examine the potential of stochastic predictors from routine clinical DXA scans in providing bone fragility information complementary to BMD.

  13. Methodology review: using dual-energy X-ray absorptiometry (DXA) for the assessment of body composition in athletes and active people.

    PubMed

    Nana, Alisa; Slater, Gary J; Stewart, Arthur D; Burke, Louise M

    2015-04-01

    Dual energy X-ray absorptiometry (DXA) is rapidly becoming more accessible and popular as a technique to monitor body composition, especially in athletic populations. Although studies in sedentary populations have investigated the validity of DXA assessment of body composition, few studies have examined the issues of reliability in athletic populations and most studies which involve DXA measurements of body composition provide little information on their scanning protocols. This review presents a summary of the sources of error and variability in the measurement of body composition by DXA, and develops a theoretical model of best practice to standardize the conduct and analysis of a DXA scan. Components of this protocol include standardization of subject presentation (subjects rested, overnight-fasted and in minimal clothing) and positioning on the scanning bed (centrally aligned in a standard position using custom-made positioning aids) as well as manipulation of the automatic segmentation of regional areas of the scan results. Body composition assessment implemented with such protocol ensures a high level of precision, while still being practical in an athletic setting. This ensures that any small changes in body composition are confidently detected and correctly interpreted. The reporting requirements for studies involving DXA scans of body composition include details of the DXA machine and software, subject presentation and positioning protocols, and analysis protocols.

  14. Predicting Bone Mechanical Properties of Cancellous Bone from DXA, MRI, and Fractal Dimensional Measurements

    NASA Technical Reports Server (NTRS)

    Harrigan, Timothy P.; Ambrose, Catherine G.; Hogan, Harry A.; Shackleford, Linda; Webster, Laurie; LeBlanc, Adrian; Lin, Chen; Evans, Harlan

    1997-01-01

    This project was aimed at making predictions of bone mechanical properties from non-invasive DXA and MRI measurements. Given the bone mechanical properties, stress calculations can be made to compare normal bone stresses to the stresses developed in exercise countermeasures against bone loss during space flight. These calculations in turn will be used to assess whether mechanical factors can explain bone loss in space. In this study we assessed the use of T2(sup *) MRI imaging, DXA, and fractal dimensional analysis to predict strength and stiffness in cancellous bone.

  15. Absorbed dose measurements in dual energy X-ray absorptiometry (DXA).

    PubMed

    Bezakova, E; Collins, P J; Beddoe, A H

    1997-02-01

    In this study a predominantly film dosimetric method was used to measure the effective dose from posteroanterior (PA) lumbar spine and proximal femur scans performed on a Lunar DPX-L machine. Because of the very low dose rate in scanning mode, the depth dose data were determined using a stationary detector configuration. The characteristic curve for the film (Kodak TMAT-H) was obtained and depth dose measurements were made using slabs of "solid water". The film was calibrated using a superficial X-ray unit (calibrated against a standard traceable to a national standard). To assess the change in film response with beam hardening at depth, the film was exposed to calibration beams of different half value layer (HVL). The HVL of the DXA beam was determined for surface and depth doses using aluminium filters and a diamond detector (an energy independent device). All measurements were performed three times. Beam size was measured using film, and the scan areas and times were determined by scanning phantoms. The dose from a scan was calculated using Dsc = DTscAb/Asc, where D = dose rate (stationary), Tsc = scan time, Ab = beam area, and Asc = scan area. Organ doses were determined using an anatomical atlas and ICRP 23 female reference. All film measurements had good precision (coefficient of variation < 4%). There was little variation in film sensitivity with change in HVL (< 1% change for the first three HVLs) and consequently no corrections were applied to the depth dose data. Skin entrance dose was 11.5 microGy. Effective dose in females was 0.19 microSv for the PA lumbar spine. For the proximal femur scan, the effective dose was 0.14 microSv (ovaries included) and 0.023 microSv (ovaries excluded) for pre-menopausal and pos-menopausal women, respectively.

  16. DXA performance in a pediatric population: precision of body composition measurements in healthy term-born infants using dual-energy X-ray absorptiometry.

    PubMed

    de Knegt, Victoria Elizabeth; Carlsen, Emma Malchau; Bech Jensen, Jens-Erik; Lade Rasmussen, Anne Mette; Pryds, Ole

    2015-01-01

    Dual-energy X-ray absorptiometry (DXA) has been hailed as a golden standard for measuring body composition in adults but remains to be fully assessed for the infant population. A total of 64 newborn infants were allocated to 1 of 3 groups. All underwent 2 Hologic Discovery A DXA scans. Suboptimal scans were reconstructed, and an investigation into the success of adjustment was carried out. Depending on group, the factors of weight change and repositioning were investigated. Test-retest variation and coefficients of variation for DXA body composition estimates were calculated. Furthermore, the effects of flannel sheets and breast milk were investigated using a pediatric phantom. Reconstruction of suboptimal scans resulted in more accurate body weight estimates. Moderate weight change and repositioning had no significant effect on the variation between scans. No significant body composition changes occurred between scans. The test-retest variation varied between 6.3% and 11.8%. Flannel sheets and breast milk affected DXA results significantly. High precision of DXA measurements was obtained in our newborn population. Reconstructing scans is a viable way of correcting minor movement artifacts. Moderate weight changes and repositioning have no significant effect on DXA results, whereas flannel sheets and milk do.

  17. National protocol for quality assurance in DXA-bone densitometry

    NASA Astrophysics Data System (ADS)

    Slavchev, A.; Avramova-Cholakova, S.; Vassileva, J.

    2008-01-01

    Osteoporosis becomes largely one of the most important socially significant and costly diseases. Modern techniques (DXA, US) are applied for bone densitometry. The paper presents a protocol for quality assurance especially of DXA-bone densitometers including quality control made in compliance with international standards (ISCD, IOF). The methodology has been tested in practice by measurements on site-functional assessment, entrance dose, radiation protection, calibration, in-vitro precision. It is expected to raise the quality of the diagnostic process in concert with the EU Medical Directive 97/43 particularly for population screening and sensitive groups. The protocol is an essential part of the National Program for constraining osteoporosis which has been elaborated at the Ministry of Health and at present under implementation throughout the country. It aims at reducing the risk, factors spreading, at diminishing the fracture risk the morbidity and the mortality from osteoporosis. An integral multidisciplinary approach to the problem solving is applied as well as training on three levels — doctors, patients, population, which effectively will contribute for obtaining real results in preventing osteoporosis.

  18. A long femur scan field does not alter proximal femur bone mineral density measurements by dual-energy X-ray absorptiometry.

    PubMed

    McKiernan, Fergus Eoin; Hocking, Jane; Cournoyer, Susan; Berg, Richard L; Linneman, James

    2011-01-01

    A longer dual-energy X-ray absorptiometry (DXA) femur scan field might be useful for the detection of atypical, subtrochanteric femur fractures (ASFF). Thirty adult subjects underwent triplicate measures of femoral neck (FN) and total hip (TH) bone mineral density (BMD) by DXA using a conventional (i.e., short) and a longer femur scan field. Differences in measured BMD between the 2 scan field lengths were small and less than the precision error inherent in DXA testing. A longer proximal femur scan field does not substantially alter BMD measurements made at the FN and TH and may be useful for the detection of ASFF in clinical practice.

  19. Characterization of Low Bone Mass in Young Patients with Thalassemia by DXA, pQCT and Markers of Bone Turnover

    PubMed Central

    Fung, Ellen B.; Vichinsky, Elliott P.; Kwiatkowski, Janet L.; Huang, James; Bachrach, Laura K.; Sawyer, Aenor J.; Zemel, Babette S.

    2011-01-01

    Previous reports using dual x-ray absorptiometry (DXA) suggest that up to 70% of adults with thalassemia major (Thal) have low bone mass. However, few studies have controlled for body size and pubertal delay, variables known to affect bone mass in this population. In this study, bone mineral content and areal density (BMC, aBMD) of the spine and whole body were assessed by DXA, and volumetric BMD and cortical geometries of the distal tibia by peripheral quantitative computed tomography (pQCT) in subjects with Thal (n=25, 11 male, 10 to 30 yrs) and local controls (n=34, 15 male, 7 to 30 yrs). Z-scores for bone outcomes were calculated from reference data from a large sample of healthy children and young adults. Fasting blood and urine were collected, pubertal status determined by self-assessment and dietary intake and physical activity assessed by written questionnaires. Subjects with Thal were similar in age, but had lower height, weight and lean mass index Z-scores (all p<0.001) compared to controls. DXA aBMD was significantly lower in Thal compared to controls at all sites. Adult Thal subjects (>18 yrs, n=11) had lower tibial trabecular vBMD (p=0.03), cortical area, cortical BMC, cortical thickness, periosteal circumference and section modulus Z-scores (all p<0.01) compared to controls. Cortical area, cortical BMC, cortical thickness, and periosteal circumference Z-scores (p=0.02) were significantly lower in young Thal (≤18 yrs, n=14) compared to controls. In separate multivariate models, tibial cortical area, BMC, and thickness and spine aBMD and whole body BMC Z-scores remained lower in Thal compared to controls after adjustment for gender, lean mass and/or growth deficits (all p<0.01). Tanner stage was not predictive in these models. Osteocalcin, a marker of bone formation, was significantly reduced in Thal compared to controls after adjusting for age, puberty and whole body BMC (p=0.029). In summary, we have found evidence of skeletal deficits that cannot

  20. Quantitative Comparison of 2 Dual-Energy X-ray Absorptiometry Systems in Assessing Body Composition and Bone Mineral Measurements.

    PubMed

    Xu, Wenhua; Chafi, Hatim; Guo, Beibei; Heymsfield, Steven B; Murray, Kori B; Zheng, Jolene; Jia, Guang

    2016-01-01

    Dual-energy X-ray absorptiometry (DXA) is widely used in body composition measurement and evaluation. Because of its numerous applications, the probability of instrument discrepancies has increased dramatically. This study quantitatively compares 2 different DXA systems. In this study, 96 subjects (60 female and 36 male, aged 19-82 years) were recruited and scanned using a General Electric Lunar iDXA and a Hologic Discovery scanner. Four measurements (percent fat, total mass, bone mineral density [BMD], and bone mineral content [BMC]) were quantitatively compared in the whole body and in specific anatomic regions (arms, legs, trunk, android, gynoid, head, ribs, and pelvis). A simple linear regression of each measurement was performed to examine the correlation between the 2 systems. Percent fat, total mass, BMC, and BMD were highly correlated between the 2 DXA systems, with correlation r values greater than 0.854 for both the whole body and the individual anatomic regions except for BMC and BMD in ribs. The high correlation between the 2 DXA systems with systematic differences enabled development of calibration equations for extending the multisystem measurements to advanced quantitative analyses.

  1. Bone geometry, bone mineral density, and micro-architecture in patients with myelofibrosis: a cross-sectional study using DXA, HR-pQCT, and bone turnover markers.

    PubMed

    Farmer, Sarah; Vestergaard, Hanne; Hansen, Stinus; Shanbhogue, Vikram Vinod; Shanbhoque, Vikram Vinod; Stahlberg, Claudia Irene; Hermann, Anne Pernille; Frederiksen, Henrik

    2015-07-01

    Primary myelofibrosis (MF) is a severe chronic myeloproliferative neoplasm, progressing towards a terminal stage with insufficient haematopoiesis and osteosclerotic manifestations. Whilst densitometry studies have showed MF patients to have elevated bone mineral density, data on bone geometry and micro-structure assessed with non-invasive methods are lacking. We measured areal bone mineral density (aBMD) using dual-energy X-ray absorptiometry (DXA). Bone geometry, volumetric BMD, and micro-architecture were measured using high-resolution peripheral quantitative computed tomography (HR-pQCT). We compared the structural parameters of bones by comparing 18 patients with MF and healthy controls matched for age, sex, and height. Blood was analysed for biochemical markers of bone turnover in patients with MF. There were no significant differences in measurements of bone geometry, volumetric bone mineral density, and micro-structure between MF patients and matched controls. Estimated bone stiffness and bone strength were similar between MF patients and controls. The level of pro-collagen type 1 N-terminal pro-peptide (P1NP) was significantly increased in MF, which may indicate extensive collagen synthesis, one of the major diagnostic criteria in MF. We conclude that bone mineral density, geometry, and micro-architecture in this cohort of MF patients are comparable with those in healthy individuals.

  2. Cross-Calibration of GE Healthcare Lunar Prodigy and iDXA Dual-Energy X-Ray Densitometers for Bone Mineral Measurements

    PubMed Central

    Saarelainen, J.; Hakulinen, M.; Rikkonen, T.; Kröger, H.; Tuppurainen, M.; Koivumaa-Honkanen, H.; Honkanen, R.; Hujo, M.; Jurvelin, J. S.

    2016-01-01

    In long-term prospective studies, dual-energy X-ray absorptiometry (DXA) devices need to be inevitably changed. It is essential to assess whether systematic differences will exist between measurements with the new and old device. A group of female volunteers (21–72 years) underwent anteroposterior lumbar spine L2–L4 (n = 72), proximal femur (n = 72), and total body (n = 62) measurements with the Prodigy and the iDXA scanners at the same visit. The bone mineral density (BMD) measurements with these two scanners showed a high linear association at all tested sites (r = 0.962–0.995; p < 0.0001). The average iDXA BMD values were 1.5%, 0.5%, and 0.9% higher than those of Prodigy for lumbar spine (L2–L4) (p < 0.0001), femoral neck (p = 0.048), and total hip (p < 0.0001), respectively. Total body BMD values measured with the iDXA were −1.3% lower (p < 0.0001) than those measured with the Prodigy. For total body, lumbar spine, and femoral neck, the BMD differences as measured with these two devices were independent of subject height and weight. Linear correction equations were developed to ensure comparability of BMD measurements obtained with both DXA scanners. Importantly, use of equations from previous studies would have increased the discrepancy between these particular DXA scanners, especially at hip and at spine. PMID:27239366

  3. Bone mineral density test

    MedlinePlus

    ... density test; Bone densitometry; DEXA scan; DXA; Dual-energy x-ray absorptiometry; p-DEXA; Osteoporosis-BMD ... most common and accurate way uses a dual-energy x-ray absorptiometry (DEXA) scan. DEXA uses low- ...

  4. Association between bone indices assessed by DXA, HR-pQCT and QCT scans in post-menopausal women.

    PubMed

    Amstrup, Anne Kristine; Jakobsen, Niels Frederik Breum; Moser, Emil; Sikjaer, Tanja; Mosekilde, Leif; Rejnmark, Lars

    2016-11-01

    Quantitative computed tomography (QCT), high-resolution peripheral QCT (HR-pQCT) and dual X-ray absorptiometry (DXA) scans are commonly used when assessing bone mass and structure in patients with osteoporosis. Depending on the imaging technique and measuring site, different information on bone quality is obtained. How well these techniques correlate when assessing central as well as distal skeletal sites has not been carefully assessed to date. One hundred and twenty-five post-menopausal women aged 56-82 (mean 63) years were studied using DXA scans (spine, hip, whole body and forearm), including trabecular bone score (TBS), QCT scans (spine and hip) and HR-pQCT scans (distal radius and tibia). Central site measurements of areal bone mineral density (aBMD) by DXA and volumetric BMD (vBMD) by QCT correlated significantly at the hip (r = 0.74, p < 0.01). Distal site measurements of density at the radius as assessed by DXA and HR-pQCT were also associated (r = 0.74, p < 0.01). Correlations between distal and central site measurements of the hip and of the tibia and radius showed weak to moderate correlation between vBMD by HR-pQCT and QCT (r = -0.27 to 0.54). TBS correlated with QCT at the lumbar spine (r = 0.35) and to trabecular indices of HR-pQCT at the radius and tibia (r = -0.16 to 0.31, p < 0.01). There was moderate to strong agreement between measuring techniques when assessing the same skeletal site. However, when assessing correlations between central and distal sites, the associations were only weak to moderate. Our data suggest that the various techniques measure different characteristics of the bone, and may therefore be used in addition to rather than as a replacment for imaging in clinical practice.

  5. Estimates of volumetric bone density from projectional measurements improve the discriminatory capability of dual X-ray absorptiometry

    NASA Technical Reports Server (NTRS)

    Jergas, M.; Breitenseher, M.; Gluer, C. C.; Yu, W.; Genant, H. K.

    1995-01-01

    To determine whether estimates of volumetric bone density from projectional scans of the lumbar spine have weaker associations with height and weight and stronger associations with prevalent vertebral fractures than standard projectional bone mineral density (BMD) and bone mineral content (BMC), we obtained posteroanterior (PA) dual X-ray absorptiometry (DXA), lateral supine DXA (Hologic QDR 2000), and quantitative computed tomography (QCT, GE 9800 scanner) in 260 postmenopausal women enrolled in two trials of treatment for osteoporosis. In 223 women, all vertebral levels, i.e., L2-L4 in the DXA scan and L1-L3 in the QCT scan, could be evaluated. Fifty-five women were diagnosed as having at least one mild fracture (age 67.9 +/- 6.5 years) and 168 women did not have any fractures (age 62.3 +/- 6.9 years). We derived three estimates of "volumetric bone density" from PA DXA (BMAD, BMAD*, and BMD*) and three from paired PA and lateral DXA (WA BMD, WA BMDHol, and eVBMD). While PA BMC and PA BMD were significantly correlated with height (r = 0.49 and r = 0.28) or weight (r = 0.38 and r = 0.37), QCT and the volumetric bone density estimates from paired PA and lateral scans were not (r = -0.083 to r = 0.050). BMAD, BMAD*, and BMD* correlated with weight but not height. The associations with vertebral fracture were stronger for QCT (odds ratio [QR] = 3.17; 95% confidence interval [CI] = 1.90-5.27), eVBMD (OR = 2.87; CI 1.80-4.57), WA BMDHol (OR = 2.86; CI 1.80-4.55) and WA-BMD (OR = 2.77; CI 1.75-4.39) than for BMAD*/BMD* (OR = 2.03; CI 1.32-3.12), BMAD (OR = 1.68; CI 1.14-2.48), lateral BMD (OR = 1.88; CI 1.28-2.77), standard PA BMD (OR = 1.47; CI 1.02-2.13) or PA BMC (OR = 1.22; CI 0.86-1.74). The areas under the receiver operating characteristic (ROC) curves for QCT and all estimates of volumetric BMD were significantly higher compared with standard PA BMD and PA BMC. We conclude that, like QCT, estimates of volumetric bone density from paired PA and lateral scans are

  6. Agreement Between pQCT- and DXA-Derived Indices of Bone Geometry, Density, and Theoretical Strength in Females of Varying Age, Maturity, and Physical Activity

    PubMed Central

    Dowthwaite, Jodi Noelle; Flowers, Portia PE; Scerpella, Tamara Ann

    2011-01-01

    Measurement of bone mass, geometry, density, and strength are critical in bone research and clinical studies. For peripheral quantitative computed tomography (pQCT), single and repeated measurements are particularly adversely affected by movement and positional variation. Dual-energy X-ray absorptiometry (DXA)–derived indices may alleviate these problems and provide useful alternative assessments. To evaluate this hypothesis, distal radius DXA and pQCT indices were compared in 101 healthy females aged 8.0 to 22.8 years (prepuberty to adulthood), reflecting a broad range of body sizes, physical maturity, and activity exposures. At the diaphysis, correlations were ρ =+0.74 to +0.98, with strong intermethod agreement for most indices. At the metaphysis, correlations were ρ =+0.64 to +0.97; intermethod agreement improved with modifications to the simplified geometric formulas more closely reflecting metaphyseal bone geometry. Further improvements may be possible because skeletal size and maturity-related biases in agreement were detected. Overall, DXA-derived indices may provide a useful assessment of bone geometry, density, and theoretical strength contingent on appropriate consideration of their limitations. PMID:21611973

  7. 3D bone mineral density distribution and shape reconstruction of the proximal femur from a single simulated DXA image: an in vitro study

    NASA Astrophysics Data System (ADS)

    Whitmarsh, Tristan; Humbert, Ludovic; De Craene, Mathieu; del Río Barquero, Luis M.; Fritscher, Karl; Schubert, Rainer; Eckstein, Felix; Link, Thomas; Frangi, Alejandro F.

    2010-03-01

    Area Bone Mineral Density (aBMD) measured by Dual-energy X-ray Absorptiometry (DXA) is an established criterion in the evaluation of hip fracture risk. The evaluation from these planar images, however, is limited to 2D while it has been shown that proper 3D assessment of both the shape and the Bone Mineral Density (BMD) distribution improves the fracture risk estimation. In this work we present a method to reconstruct both the 3D bone shape and 3D BMD distribution of the proximal femur from a single DXA image. A statistical model of shape and a separate statistical model of the BMD distribution were automatically constructed from a set of Quantitative Computed Tomography (QCT) scans. The reconstruction method incorporates a fully automatic intensity based 3D-2D registration process, maximizing the similarity between the DXA and a digitally reconstructed radiograph of the combined model. For the construction of the models, an in vitro dataset of QCT scans of 60 anatomical specimens was used. To evaluate the reconstruction accuracy, experiments were performed on simulated DXA images from the QCT scans of 30 anatomical specimens. Comparisons between the reconstructions and the same subject QCT scans showed a mean shape accuracy of 1.2mm, and a mean density error of 81mg/cm3. The results show that this method is capable of accurately reconstructing both the 3D shape and 3D BMD distribution of the proximal femur from DXA images used in clinical routine, potentially improving the diagnosis of osteoporosis and fracture risk assessments at a low radiation dose and low cost.

  8. Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard.

    PubMed

    Pickhardt, Perry J; Lee, Lawrence J; del Rio, Alejandro Muñoz; Lauder, Travis; Bruce, Richard J; Summers, Ron M; Pooler, B Dustin; Binkley, Neil

    2011-09-01

    The purpose of this study was to evaluate the utility of lumbar spine attenuation measurement for bone mineral density (BMD) assessment at screening computed tomographic colonography (CTC) using central dual-energy X-ray absorptiometry (DXA) as the reference standard. Two-hundred and fifty-two adults (240 women and 12 men; mean age 58.9 years) underwent CTC screening and central DXA BMD measurement within 2 months (mean interval 25.0 days). The lowest DXA T-score between the spine and hip served as the reference standard, with low BMD defined per World Health Organization as osteoporosis (DXA T-score ≤ -2.5) or osteopenia (DXA T-score between -1.0 and -2.4). Both phantomless quantitative computed tomography (QCT) and simple nonangled region-of-interest (ROI) multi-detector CT (MDCT) attenuation measurements were applied to the T(12) -L(5) levels. The ability to predict osteoporosis and low BMD (osteoporosis or osteopenia) by DXA was assessed. A BMD cut-off of 90 mg/mL at phantomless QCT yielded 100% sensitivity for osteoporosis (29 of 29) and a specificity of 63.8% (143 of 224); 87.2% (96 of 110) below this threshold had low BMD and 49.6% (69 of 139) above this threshold had normal BMD at DXA. At L(1) , a trabecular ROI attenuation cut-off of 160 HU was 100% sensitive for osteoporosis (29 of 29), with a specificity of 46.4% (104 of 224); 83.9% (125 of 149) below this threshold had low BMD and 57.5% (59/103) above had normal BMD at DXA. ROI performance was similar at all individual T(12) -L(5) levels. At ROC analysis, AUC for osteoporosis was 0.888 for phantomless QCT [95% confidence interval (CI) 0.780-0.946] and ranged from 0.825 to 0.853 using trabecular ROIs at single lumbar levels (0.864; 95% CI 0.752-0.930 at multivariate analysis). Supine-prone reproducibility was better with the simple ROI method compared with QCT. It is concluded that both phantomless QCT and simple ROI attenuation measurements of the lumbar spine are effective for BMD screening at CTC

  9. Reconstructing the 3D shape and bone mineral density distribution of the proximal femur from dual-energy X-ray absorptiometry.

    PubMed

    Whitmarsh, Tristan; Humbert, Ludovic; De Craene, Mathieu; Del Rio Barquero, Luis M; Frangi, Alejandro F

    2011-12-01

    The accurate diagnosis of osteoporosis has gained increasing importance due to the aging of our society. Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is an established criterion in the diagnosis of osteoporosis. This measure, however, is limited by its two-dimensionality. This work presents a method to reconstruct both the 3D bone shape and 3D BMD distribution of the proximal femur from a single DXA image used in clinical routine. A statistical model of the combined shape and BMD distribution is presented, together with a method for its construction from a set of quantitative computed tomography (QCT) scans. A reconstruction is acquired in an intensity based 3D-2D registration process whereby an instance of the model is found that maximizes the similarity between its projection and the DXA image. Reconstruction experiments were performed on the DXA images of 30 subjects, with a model constructed from a database of QCT scans of 85 subjects. The accuracy was evaluated by comparing the reconstructions with the same subject QCT scans. The method presented here can potentially improve the diagnosis of osteoporosis and fracture risk assessment from the low radiation dose and low cost DXA devices currently used in clinical routine.

  10. Is bone mineral density measurement using dual-energy X-ray absorptiometry affected by gamma rays?

    PubMed

    Xie, Liang-Jun; Li, Jian-Fang; Zeng, Feng-Wei; Jiang, Hang; Cheng, Mu-Hua; Chen, Yi

    2013-01-01

    The objective of this study was to determine whether the gamma rays emitted from the radionuclide effect bone mineral density (BMD) measurement. Nine subjects (mean age: 56 ± 17.96 yr) scheduled for bone scanning underwent BMD measurement using dual-energy X-ray absorptiometry (DXA) (Hologic/Discovery A) before and 1, 2, and 4 h after injection of technetium-99m-methylene diphosphonate (99mTc-MDP). Ten subjects (mean age: 41 ± 15.47 yr) scheduled for therapy of differentiated thyroid carcinoma with iodine-131 underwent BMD measurement before and 2 h after therapeutic radionuclide administration. All patients were given whole body BMD measurement, including head, arm, ribs, lumbar spine, pelvis, and leg sites. Besides, patients who referred to radioiodine therapy were given total hip and femoral neck BMD measurement as well. No statistically significant changes in BMD values were detected after 99mTc-MDP and iodine-131 administration for all measurement sites (p > 0.05), and individual difference of BMD before and after radionuclide imaging or therapy was less than the least significant change in lumbar spine, total hip, and femoral neck. In conclusion, BMD measurements are not influenced by the gamma rays emitted from technetium-99m and iodine-131. DXA bone densitometry may be performed simultaneously with bone scanning and radioiodine therapy.

  11. Random field assessment of inhomogeneous bone mineral density from DXA scans can enhance the differentiation between postmenopausal women with and without hip fractures.

    PubMed

    Dong, Xuanliang Neil; Pinninti, Rajeshwar; Lowe, Timothy; Cussen, Patricia; Ballard, Joyce E; Di Paolo, David; Shirvaikar, Mukul

    2015-04-13

    Bone mineral density (BMD) measurements from Dual-energy X-ray Absorptiometry (DXA) alone cannot account for all factors associated with the risk of hip fractures. For example, the inhomogeneity of bone mineral density in the hip region also contributes to bone strength. In the stochastic assessment of bone inhomogeneity, the BMD map in the hip region is considered as a random field and stochastic predictors can be calculated by fitting a theoretical model onto the experimental variogram of the BMD map. The objective of this study was to compare the ability of bone mineral density and stochastic assessment of inhomogeneous distribution of bone mineral density in predicting hip fractures for postmenopausal women. DXA scans in the hip region were obtained from postmenopausal women with hip fractures (N=47, Age: 71.3±11.4 years) and without hip fractures (N=45, Age: 66.7±11.4 years). Comparison of BMD measurements and stochastic predictors in assessing bone fragility was based on the area under the receiver operating characteristic curves (AUC) from logistic regression analyses. Although stochastic predictors offered higher accuracy (AUC=0.675) in predicting the risk of hip fractures than BMD measurements (AUC=0.625), this difference was not statistically significant (p=0.548). Nevertheless, the combination of stochastic predictors and BMD measurements had significantly (p=0.039) higher prediction accuracy (AUC=0.748) than BMD measurements alone. This study demonstrates that stochastic assessment of bone mineral distribution from DXA scans can serve as a valuable tool in enhancing the prediction of hip fractures for postmenopausal women in addition to BMD measurements.

  12. Agreement between bioelectrical impedance and dual energy X-ray absorptiometry in assessing fat, lean and bone mass changes in adults after a lifestyle intervention.

    PubMed

    Macfarlane, Duncan J; Chan, Natalie T-Y; Tse, Michael A; Joe, Glen M

    2016-01-01

    We aimed to assess the agreement of a commercially available bioelectrical impedance analysis (BIA) device in measuring changes in fat, lean and bone mass over a 10-week lifestyle intervention, with dual energy X-ray absorptiometry (DXA) as reference. A sample of 136 volunteers (18-66 years) underwent a physical activity intervention to enhance lean mass and reduce fat mass. BIA (Tanita BC545) and DXA (Hologic Explorer) measures of whole-body composition were taken at baseline and at the end of the intervention. After an average of 74 ± 18 days intervention, DXA showed significant changes in 2 of 3 outcome variables: reduced fat mass of 0.802 ± 1.092 kg (P < 0.001), increased lean mass of 0.477 ± 0.966 kg (P < 0.001); minor non-significant increase of 0.007 ± 0.041 kg of bone mass (P = 0.052). The respective changes in BIA measures were a significant reduction of 0.486 ± 1.539 kg fat (P < 0.001), but non-significant increases of 0.084 ± 1.201 kg lean mass (P = 0.425), and 0.014 ± 0.091 kg bone (P = 0.074). Significant, but moderately weak, correlations were seen in absolute mass changes between DXA and BIA: 0.511 (fat), 0.362 (lean) and 0.172 (bone). Compared to DXA, BIA demonstrated mediocre agreement to changes in fat mass, but poor agreement to lean mass changes. BIA significantly underestimated the magnitude of changes in fat and lean mass compared to DXA.

  13. Can geometry-based parameters from pQCT and material parameters from quantitative ultrasound (QUS) improve the prediction of radial bone strength over that by bone mass (DXA)?

    PubMed

    Hudelmaier, M; Kuhn, V; Lochmüller, E M; Well, H; Priemel, M; Link, T M; Eckstein, F

    2004-05-01

    The diagnosis of osteoporosis is generally based on the assessment of bone mineral content with dual X-ray absorptiometry (DXA) but does not account for the spatial distribution and inherent material properties of the tissue. Peripheral quantitative computed tomography (pQCT) permits one to measure the compartment-specific density and geometry-based parameters of cortical bone. Quantitative ultrasound (QUS) parameters are associated with material properties of cortical bone. The purpose of this study was to test the hypothesis that pQCT and cortical QUS provide additional information to DXA in predicting structural strength of the distal radius. The intact right arm and the isolated left radius were harvested from 70 formalin-fixed cadavers (age 79+/-11 years). The bone mineral content (BMC) was assessed with DXA at the radial metaphysis and shaft. pQCT was also used at the metaphysis and the shaft, while QUS was employed only at the shaft. The failure loads of the radius were assessed by use of a 3-point bending test (isolated radius) and a complex fall simulation (intact arm). The BMC (DXA) displayed a correlation of r=0.96 with the failure moments in 3-point bending ( P<0.001). The correlation between failure load and geometry-based parameters (pQCT) ranged from r=0.85 to r=0.96 and was r=0.64 for the speed of sound (QUS) ( P <0.001). Cortical thickness (pQCT) improved the prediction marginally (r=0.964) in combination with DXA. For the fall simulation, the correlation coefficients were r=0.76 for BMC (DXA) of the shaft, r=0.83 for metaphyseal bone content (pQCT), r=0.55 for QUS, and ranged from r=0.59 to r=0.74 for geometry-based parameters at the shaft (pQCT). pQCT and QUS parameters provided no significant improvement versus DXA alone. Measurement of bone mass by DXA or pQCT thus appears to be sufficient as a surrogate of mechanical strength and fracture risk of the distal radius.

  14. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children?

    PubMed Central

    Hirsch, R.; Nogueira, R. C.; Beck, B. R.

    2016-01-01

    Objectives The aim of the current study was to assess whether calcaneal broadband ultrasound attenuation (BUA) can predict whole body and regional dual-energy x-ray absorptiometry (DXA)-derived bone mass in healthy, Australian children and adolescents at different stages of maturity. Methods A total of 389 boys and girls across a wide age range (four to 18 years) volunteered to participate. The estimated age of peak height velocity (APHV) was used to classify children into pre-, peri-, and post-APHV groups. BUA was measured at the non-dominant heel with quantitative ultrasonometry (QUS) (Lunar Achilles Insight, GE), while bone mineral density (BMD) and bone mineral content (BMC) were examined at the femoral neck, lumbar spine and whole body (DXA, XR-800, Norland). Associations between BUA and DXA-derived measures were examined with Pearson correlations and linear regression. Participants were additionally ranked in quartiles for QUS and DXA measures in order to determine agreement in rankings. Results For the whole sample, BUA predicted 29% of the study population variance in whole body BMC and BMD, 23% to 24% of the study population variance in lumbar spine BMC and BMD, and 21% to 24% of the variance in femoral neck BMC and BMD (p < 0.001). BUA predictions were strongest for the most mature participants (pre-APHV R2 = 0.03 to 0.19; peri-APHV R2 = 0.05 to 0.17; post-APHV R2 = 0.18 to 0.28) and marginally stronger for girls (R2 = 0.25-0.32, p < 0.001) than for boys (R2 = 0.21-0.27, p < 0.001). Agreement in quartile rankings between QUS and DXA measures of bone mass was generally poor (27.3% to 38.2%). Conclusion Calcaneal BUA has a weak to moderate relationship with DXA measurements of bone mass in children, and has a tendency to misclassify children on the basis of quartile rankings. Cite this article: B. K. Weeks, R. Hirsch, R. C. Nogueira, B. R. Beck. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass

  15. Prenatal pesticide exposure and PON1 genotype associated with adolescent body fat distribution evaluated by dual X-ray absorptiometry (DXA).

    PubMed

    Tinggaard, J; Wohlfahrt-Veje, C; Husby, S; Christiansen, L; Skakkebaek, N E; Jensen, T K; Grandjean, P; Main, K M; Andersen, H R

    2016-07-01

    Many modern pesticides have endocrine disrupting abilities and early-life exposure may affect growth and disease risk later in life. Previously, we reported associations between prenatal pesticide exposure and higher childhood body fat content measured by anthropometry. The associations were affected by child PON1 Q192R genotype. We aimed to study whether prenatal pesticide exposure was still associated with body fat content and distribution in the children at puberty and the potential impact of both maternal and child PON1 Q192R genotype. In this prospective cohort study of 247 children born by occupationally exposed or unexposed women (greenhouse workers and controls) two follow-up examinations (age 10-15 and 11-16 years) including simple anthropometry, skinfold measurements, pubertal staging and blood sampling were performed. Total and regional fat% was determined by dual X-ray absorptiometry (DXA) at age 10-15. Prenatal pesticide exposure was associated with increased total, android, and gynoid fat percentage (DXA) at age 10-15 years after adjustment for sex, socioeconomic status, and puberty (all β = 0.5 standard deviation score (SDS) p < 0.05). Stratified by sex, the associations were significant in girls (total fat: β = 0.7 SDS, android-gynoid ratio: β = 0.1, both p < 0.05), but not in boys. Carrying the R-allele (child or mother, separately, or both) augmented the differences between exposed and unexposed children (total fat: β = 1.0 SDS, β = 0.8 SDS, p < 0.05, respectively, and β = 1.2 SDS, p < 0.01). No exposure-related differences were found if either the child or mother had the QQ wild-type. At age 11-16, exposed children tended to have a higher total fat% estimated by skinfolds than unexposed children (p = 0.06). No significant associations between prenatal exposure and body mass index or waist circumference were found. Prenatal pesticide exposure was associated with higher adolescent body fat content, including android

  16. A multinational study to develop universal standardization of whole-body bone density and composition using GE Healthcare Lunar and Hologic DXA systems.

    PubMed

    Shepherd, John A; Fan, Bo; Lu, Ying; Wu, Xiao P; Wacker, Wynn K; Ergun, David L; Levine, Michael A

    2012-10-01

    Dual-energy x-ray absorptiometry (DXA) is used to assess bone mineral density (BMD) and body composition, but measurements vary among instruments from different manufacturers. We sought to develop cross-calibration equations for whole-body bone density and composition derived using GE Healthcare Lunar and Hologic DXA systems. This multinational study recruited 199 adult and pediatric participants from a site in the US (n = 40, ages 6 through 16 years) and one in China (n = 159, ages 5 through 81 years). The mean age of the participants was 44.2 years. Each participant was scanned on both GE Healthcare Lunar and Hologic Discovery or Delphi DXA systems on the same day (US) or within 1 week (China) and all scans were centrally analyzed by a single technologist using GE Healthcare Lunar Encore version 14.0 and Hologic Apex version 3.0. Paired t-tests were used to test the results differences between the systems. Multiple regression and Deming regressions were used to derive the cross-conversion equations between the GE Healthcare Lunar and Hologic whole-body scans. Bone and soft tissue measures were highly correlated between the GE Healthcare Lunar and Hologic and systems, with r ranging from 0.96 percent fat [PFAT] to 0.98 (BMC). Significant differences were found between the two systems, with average absolute differences for PFAT, BMC, and BMD of 1.4%, 176.8 g and 0.013 g/cm(2) , respectively. After cross-calibration, no significant differences remained between GE Healthcare Lunar measured results and the results converted from Hologic. The equations we derived reduce differences between BMD and body composition as determined by GE Healthcare Lunar and Hologic systems and will facilitate combining study results in clinical or epidemiological studies.

  17. Effect of ¹⁸F-FDG administration on measurements of bone mineral density and body composition by dual-energy X-ray absorptiometry.

    PubMed

    Kim, Dae-Weung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Seong Su; Mo, Eun Hee; Lee, Chun Ho; Kim, Chang Guhn

    2013-01-01

    The purpose of this study was to determine whether antecedent administration of ¹⁸F-fluorodeoxyglucose (FDG) used in positron emission tomography (PET) scanning results in corruption of bone mineral density (BMD) and body composition measured by dual-energy X-ray absorptiometry (DXA) system. DXA measurements of BMD and body composition had been performed twice, before and after ¹⁸F-FDG PET scan in 30 patients. The comparison of pre-values and post-values of all BMD values showed a decrease after the injection. However, only the decrease of whole-body BMD (WB-BMD) was statistically significant (p < 0.05). Whole-body fat mass had increased and whole-body lean body mass had decreased after the injection of ¹⁸F-FDG, and these were statistically significant (p < 0.05). There is statistically significant correlation between the injected ¹⁸F-FDG dose and a decrease of WB-BMD (r = -0.405; p < 0.05). The findings of this study suggest that when both ¹⁸F-FDG PET and DXA measurements for whole-body composition are performed in close-time proximity, ¹⁸F-FDG PET scans should follow the DXA measurement. Otherwise, BMD measurements of total femur or lumbar spine could be followed by ¹⁸F-FDG PET in close-time proximity.

  18. Relationships among dual-energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA), and ultrasound measurements of body composition of swine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In three separate studies (156 pigs total), DXA, BIA, and ultrasound were compared as methods for measuring live body composition of pigs at 60 and 100-110 kg BWt. DXA measured total body fat and lean content, BIA measurements of resistance (Rs) and reactance (Xc) were used to calculate total body l...

  19. Assessment of age and sex by means of DXA bone densitometry: application in forensic anthropology.

    PubMed

    Castillo, Rafael Fernández; Ruiz, Maria del Carmen López

    2011-06-15

    Today we are witnessing a genuine revolution in diagnostic imaging techniques. Dual X-ray absorptiometry (DEXA) quantifies bone mineral density (BMD) and bone mineral content (BMC). This technique has rarely been used in Forensic Anthropology, although its practical application has been demonstrated by various authors. In this article, we look into the conduct of bone mineral density in the femoral neck, the trochanter, the intertrochanter, the proximal femur and Ward's triangle, in relation to anthropometric age and sex parameters. The research was carried out on 70 persons - 38 men and 32 women - and the results obtained show significant correlations between bone mineral density measurements and anthropometric values. The research demonstrates bone mineral density to be a useful technique for sex and age data in forensic anthropology, particularly in the measurements observed in the Ward's triangle area.

  20. Photon absorptiometry for non-invasive measurement of bone mineral content

    SciTech Connect

    Gupta, S.; Luna, E.; Belsky, J.; Gelfman, N.; Miller, K.; Davies, T.

    1984-08-01

    Bone mineral content of the distal radius was determined in 106 patients by single photon absorptiometry using iodine-125 monochromatic source. The technique provided a reliable means to assess the degree of mineral loss in conditions such as osteoporosis, renal osteodystrophy in patients on chronic maintenance dialysis, subjects on long-term steroid therapy, and those with diabetes mellitus. It is more sensitive than conventional radiography and completely noninvasive compared to bone biopsy. It is suggested that photon absorptiometry is a simple, sensitive, and reliable technique for assessment and follow-up of the bone mineral content in a host of disorders associated with bone demineralization.

  1. Usefulness of calcaneal quantitative ultrasound stiffness for the evaluation of bone health in HIV-1-infected subjects: comparison with dual X-ray absorptiometry

    PubMed Central

    Fantauzzi, Alessandra; Floridia, Marco; Ceci, Fabrizio; Cacciatore, Francesco; Vullo, Vincenzo; Mezzaroma, Ivano

    2016-01-01

    Objectives With the development of effective treatments and the resulting increase in life expectancy, bone mineral density (BMD) alteration has emerged as an important comorbidity in human immunodeficiency virus type-1 (HIV-1)-infected individuals. The potential contributors to the pathogenesis of osteopenia/osteoporosis include a higher prevalence of risk factors, combined antiretroviral therapy (cART)-exposure, HIV-1 itself and chronic immune activation/inflammation. Dual-energy X-ray absorptiometry (DXA) is the “gold standard” technique for assessing bone status in HIV-1 population. Methods We conducted a cross-sectional study to investigate bone mineral status in a group of 158 HIV-1-infected subjects. The primary endpoint was the feasibility of calcaneal quantitative ultrasound (QUS) as a screening tool for BMD. All subjects were receiving stable cART and were virologically suppressed (HIV-RNA <37 copies/mL) from at least 12 months. Calcaneal QUS parameters were analyzed to obtain information on bone mass and microarchitecture. The results were compared with those obtained by DXA. Results No correlations were found between DXA/QUS parameters and demographic or HIV-1-specific characteristics, also including cART strategies. In the univariate analyses BMD, QUS indexes, and Fracture Risk Assessment Tool scores conversely showed significant associations with one or more demographic or HIV-1-related variables. Moreover, a significant relationship between calcaneal quantitative ultrasound index/stiffness and femoral/lumbar BMD values from DXA was described. The multivariate analysis showed an independent association between calcaneal quantitative ultrasound index/stiffness and body mass index, higher CD4+ T-cell numbers and low 25-OH D2/D3 vitamin D levels <10 ng/mL (P-values: 0.004, 0.016, and 0.015, respectively). Conclusion As an alternative and/or integrative examination to DXA, calcaneal QUS could be proposed as a useful screening in HIV-1-infected

  2. Dual X-Ray Absorptiometry Whole Body Composition of Bone Tissue in Rheumatoid Arthritis – a Cross-Sectional Study

    PubMed Central

    POPESCU, Claudiu; BOJINCA, Violeta; OPRIS, Daniela; IONESCU, Ruxandra

    2015-01-01

    Objectives: Previous studies of bone tissue in rheumatoid arthritis (RA) using dual X-ray absorptiometry (DXA) concentrated on regions of interest that were used to diagnose osteoporosis. This study aimed to compare the whole body bone tissue (wbBT) of RA patients with healthy subjects and to identify the RA variables which significantly predict wbBT. Methods: The study was cross-sectionally designed to include postmenopausal RA patients and age-matched healthy female controls. All 107 RA patients and all 104 controls underwent clinical examination, laboratory tests and whole body DXA composition, which recorded total and regional bone indices. Non-parametric standard statistical test and regression models after data normalization were used to assess correlations, associations and differences. Results: Compared to controls, RA patients had significantly lower whole body and regional bone mass (14.9 kg compared to 15.5 kg; p = 0.031). Disease duration (r = -0.402 ; p < 0.001), C-reactive protein (r = -0.279; p = 0.015) and inflammation (2.5% wbBT compared to 2.9%; p = 0.043), radiographic damage (14.3 kg compared to 16.2 kg; p < 0.001), disease activity scores (r = -0.275 ; p = 0.018 for HAQ) are significantly correlated/associated with lower wbBT. Clinical structural damage is associated with lower wbBT and it can significantly predict them (R2 = 0.014; p = 0.001), while glucocorticoid treatment, even in low doses, was associated with lower wbBT percent (2.6% compared to 2.8%; p = 0.045). Treatment with biologics was associated with a lower rate of whole body osteoporosis (0% compared to 22.2%; p = 0.013). Conclusions: The main associated factors with the generalized bone loss in female RA patients are disease duration and disease activity. Clinical structural damage is the most powerful predictor of the whole body bone loss. These results suggest a general disturbance of skeletal bone metabolism in RA and could explain a greater risk of fragility fractures of non

  3. Measurement of bone by dual-photon absorptiometry (DPA) and dual-energy X-ray absorptiometry (DEXA).

    PubMed

    Mazess, R B; Barden, H S

    1988-01-01

    Bone densitometry is essential for (a) confirming a diagnosis of osteoporosis, (b) determining the degree of osteopenia and risk of fracture, and (c) monitoring the response of bone to therapeutic agents. Fracture risk at specific axial fracture sites (spine, proximal femur), is associated directly with bone mineral density (BMD) at these sites. ROC analysis demonstrates that the diagnostic sensitivity of spine and femur BMD for spine and/or femur fracture is substantially superior to BMD of appendicular sites in the immediate postmenopausal period. Femoral neck BMD affords high diagnostic sensitivity for proximal femur fracture even in the elderly. Recent prospective studies have shown that bone densitometry can predict future fractures in postmenopausal women. Conventional DPA with 153Gd provides high accuracy for total body, spine, and femur BMD with adequate clinical precision of 1%, 2% and 3%, respectively. Dual-energy x-ray absorptiometry (DEXA), using either switched kVp or by k-edge filtering, offers better precision; typically the precision error is halved. The higher flux available from x-ray sources provides other advantages over DPA, including: improved spatial resolution (2 vs 4 mm), reduced radiation exposure (1 vs 2 mrem), and decreased scan times (3 to 10X). Improved DPA systems, with automatic gain stabilization to minimize drift, could offer clinical precision comparable to DEXA but the scan time and spatial resolution remain as before. Both DPA and DEXA allow detection of therapeutic efficacy in individual patients over the first year or two of therapy.

  4. 3D-DXA: Assessing the Femoral Shape, the Trabecular Macrostructure and the Cortex in 3D from DXA images.

    PubMed

    Humbert, Ludovic; Martelli, Yves; Fonolla, Roger; Steghofer, Martin; Di Gregorio, Silvana; Malouf, Jorge; Romera, Jordi; Barquero, Luis Miguel Del Rio

    2017-01-01

    The 3D distribution of the cortical and trabecular bone mass in the proximal femur is a critical component in determining fracture resistance that is not taken into account in clinical routine Dual-energy X-ray Absorptiometry (DXA) examination. In this paper, a statistical shape and appearance model together with a 3D-2D registration approach are used to model the femoral shape and bone density distribution in 3D from an anteroposterior DXA projection. A model-based algorithm is subsequently used to segment the cortex and build a 3D map of the cortical thickness and density. Measurements characterising the geometry and density distribution were computed for various regions of interest in both cortical and trabecular compartments. Models and measurements provided by the "3D-DXA" software algorithm were evaluated using a database of 157 study subjects, by comparing 3D-DXA analyses (using DXA scanners from three manufacturers) with measurements performed by Quantitative Computed Tomography (QCT). The mean point-to-surface distance between 3D-DXA and QCT femoral shapes was 0.93 mm. The mean absolute error between cortical thickness and density estimates measured by 3D-DXA and QCT was 0.33 mm and 72 mg/cm(3). Correlation coefficients (R) between the 3D-DXA and QCT measurements were 0.86, 0.93, and 0.95 for the volumetric bone mineral density at the trabecular, cortical, and integral compartments respectively, and 0.91 for the mean cortical thickness. 3D-DXA provides a detailed analysis of the proximal femur, including a separate assessment of the cortical layer and trabecular macrostructure, which could potentially improve osteoporosis management while maintaining DXA as the standard routine modality.

  5. Irreversible bone loss in osteomalacia. Comparison of radial photon absorptiometry with iliac bone histomorphometry during treatment.

    PubMed Central

    Parfitt, A M; Rao, D S; Stanciu, J; Villanueva, A R; Kleerekoper, M; Frame, B

    1985-01-01

    We examined the relationships between the changes in bone mineral deficit in the radius, determined by single-energy photon absorptiometry at standard proximal and distal sites, and in the ilium, determined by bone histomorphometry, during the treatment of osteomalacia of diverse etiology in 28 patients. In the ilium, relative osteoid volume decreased by 75-80% in both cortical bone (from 6.0% to 1.5%) and trabecular bone (from 30.1% to 6.6%) during a mean treatment duration of 2 yr. There was also a significant fall in iliac cortical porosity from 10.3% to 7.8%. As a result, mineralized bone volume increased by 7.5% in cortical and by 40.1% in trabecular bone; the cortical and trabecular increments were correlated (r = 0.69, P less than 0.001). The properly weighted increase for the entire tissue sample was 18.6%. By contrast, there was no change in bone mineral at either radial site, although there was a 2% increase at both sites when allowance was made for age-related bone loss during treatment. The proximal and distal age-adjusted increments was correlated (r = 0.76, P less than 0.001), but there was no correlation between the changes in any photon absorptiometric and any histomorphometric index. In that iliac cortical bone turnover in normal subjects was 7.2%/yr, we estimated the rate of bone turnover to be less than 2%/yr at both proximal and distal radial sites, including any trabecular bone present at the distal site. Compared to appropriate control subjects, the bone mineral deficits fell during treatment from 19.2% to 17.1% at the proximal radius (greater than 95% cortical bone) and from 20.5% to 18.5% at the distal radius (greater than 75% cortical bone). In the ilium the deficits, assuming attainment of normal values for osteoid volume and cortical porosity, fell from 41.7% to 36.1% in cortical and from 31.5% to 6.3% in trabecular bone, the properly weighted combined deficit falling from 38.6% to 27.7%. The irreversible iliac cortical deficit was

  6. Comparison of dual-energy x-ray absorptiometry and dual photon absorptiometry for bone mineral measurements of the lumbar spine

    SciTech Connect

    Wahner, H.W.; Dunn, W.L.; Brown, M.L.; Morin, R.L.; Riggs, B.L.

    1988-11-01

    A new x-ray-based (dual-energy x-ray absorptiometry (DEXA)) instrument for measurement of bone mineral in the spine and hips was compared with a commercial dual photon absorptiometry (DPA) instrument that uses a 153Gd source (DP3, Lunar Radiation Corporation). Measurements were made on phantoms and lumbar spines of patients to study accuracy, precision, limitations, and compatibility of results between instruments. Both instruments measure bone mineral of integral bone in terms of area bone density with an entrance exposure of less than 5 mR. For spinal bone mineral measurements, the DEXA instrument had a shorter scanning time and higher resolution images than the DPA system. The DEXA instrument also showed better precision in a spine phantom and reduced influence of thickness for patient measurement. For bone mineral content, accuracy was about equal for both instruments; for measurements of the area of the region of interest, accuracy was better with the DEXA instrument. With both instruments, fat had little effect on bone mineral density in bone phantom studies. Measurements on both instruments were influenced by the location of a bone phantom within the photon beam. Results in patients showed good correlation (r = 0.988) for bone mineral density. Measurements of bone mineral density in patients were consistently lower with the DEXA instrument because of better accuracy in area measurements. The new x-ray-based instrument is a major advance in bone mineral absorptiometry and provides improved, yet less expensive, measurements in research and clinical applications.

  7. The prediction of total skeletal muscle mass in a Caucasian population - comparison of Magnetic resonance imaging (MRI) and Dual-energy X-ray absorptiometry (DXA).

    PubMed

    Geisler, Corinna; Pourhassan, Maryam; Braun, Wiebke; Schweitzer, Lisa; Müller, Manfred J

    2017-03-01

    Dual-energy X-ray (DXA) is an alternative to magnetic resonance imaging (MRI) to measure skeletal muscle mass. DXA assesses lean body mass (LBM), and MRI measures skeletal muscle mass (SMM). Kim et al. (Am J Clin Nutr 2002; 76: 378; J Appl Physiol (1985) 2004; 97: 655) developed MRI-based algorithms to estimate whole-body SMM by DXA. These algorithms were based on an ethnically mixed study population (Kim et al., Am J Clin Nutr 2002; 76: 378; J Appl Physiol (1985) 2004; 97: 655). It is unclear whether Kim's algorithms are accurate in an exclusive Caucasian population. The aim of our study was to validate Kim's equation in a Caucasian population of 346 subjects. SMMMRI was assessed using MRI, and LBM and BMCDXA were measured by DXA and fat mass (FMADP ) by air-displacement plethysmographie (ADP). SMMMRI and predicted SMM were highly correlated (r = 0·944; P<0·05). The standard error of estimate of the regression equation was 2·4 kg. However, Bland-Altman plots showed a significant (P<0·001) systematic bias between SMMMRI (median 25·1 kg; IQ 20·2-31·1 kg) and predicted SMM (median 26·3 kg; IQ 22·6-33·0 kg), overestimating SMM by 9·8%. Multiple regression analyses showed that weight explained 4·4% of the variance in the differences between SMMMRI and predicted SMM with the major part unexplained. Kim's algorithm has a systematic unexplained bias and is not recommended in Caucasians.

  8. The effect of 99mTc on dual-energy X-ray absorptiometry measurement of body composition and bone mineral density.

    PubMed

    Fosbøl, Marie Øbro; Dupont, Anders; Alslev, Louise; Zerahn, Bo

    2013-01-01

    Whether the γ-emission by radioisotopes influences the outcome of dual-energy X-ray absorptiometry (DXA) measurements is not fully elucidated. The aim of this study was to evaluate the effect of antecedent administration of 99mTc on DXA measurements regarding body composition and bone mineral density (BMD) using a K-edge filter scanner. The phantom measurements were performed by placing a urinary bladder phantom containing 40 mL of radioisotope solution on the pelvic region of a whole-body phantom. Twenty-seven patients attending our department for a routine examination involving the administration of a tracer marked with 99mTc were included. The patients underwent a whole-body DXA scan before and within 2 h after tracer injection using a GE/Lunar Prodigy scanner. Control scans were performed on 40 volunteers, who had not received any radioactive tracer. In both phantom and patient measurements, we found a significant dose-related decrease in fat mass and BMD and a corresponding increase in fat-free mass (p < 0.001). Based on the linear regression analysis, we suggest upper dose limits for the measurement of BMD at 0.77 μSv/h and body composition at 0.21 μSv/h (dose rate measured at a distance of 1m from the patient). Caution should be taken when interpreting the results of DXA scans performed in close temporal proximity to procedures involving the administration of 99mTc.

  9. Assessment of EchoMRI-AH versus dual-energy X-ray absorptiometry by iDXA to measure human body composition

    PubMed Central

    Marlatt, Kara L.; Greenway, Frank; Ravussin, Eric

    2017-01-01

    Background Comparison of percent fat mass across different body composition analysis devices is important given variation in technology accuracy and precision, as well as the growing need for cross-validation of devices often applied across longitudinal studies. Subjects/Methods We compared EchoMRI-AH and Lunar iDXA quantification of percent body fat (PBF) in 84 adults (43M, 41F) with mean age 39.7±15.9 y and BMI 26.2±5.3 kg/m2. Results PBF correlated strongly between devices (r>0.95, p<0.0001). A prediction equation was derived in half of the subjects, and the other half were used to cross-validate the proposed equation (EchoMRI-AH PBF=[0.94*iDXA PBF]+[0.14*Age]+[3.3*Female]−8.83). Mean PBF difference (predicted–measured) in the validation group was not different from 0 (diff=0.27%, 95%CI: −0.42–0.96, p=0.430). Bland-Altman plots showed a bias with higher measured PBF on EchoMRI-AH versus iDXA in all 84 subjects (β=0.13, p<0.0001). Conclusions The proposed prediction equation was valid in our cross-validation sample, and has the potential to be applied across multicenter studies. PMID:27901030

  10. Relationship between alveolar bone measured by /sup 125/I absorptiometry with analysis of standardized radiographs: 1. Magiscan

    SciTech Connect

    Hausmann, E.; Ortman, L.F.; McHenry, K.; Fallon, J.

    1982-05-01

    Previous studies have shown that /sup 125/I absorptiometry gives an accurate and sensitive measure of alveolar bone mass. The purpose of this study was to determine the relationship between alveolar bone mass determined by /sup 125/I absorptiometry and bone density obtained by analysis of standardized intraoral radiographs by the Magiscan System. A defect of increasing size was made at one site of the alveolar bone in a human skull. The amount of bone remaining at each step was calculated using /sup 125/I absorptiometry. Standardized radiographs were also taken at each step and the relative density in the area of the defect was determined by the Magiscan System. The Magiscan's System Computer Memory permits analysis of identical areas on a longitudinal series of films of the same alveolar bone location. The results indicate that in estimating amounts of alveolar bone the Magiscan analysis of standardized intraoral radiography is similar in sensitivity and accuracy to /sup 125/I absorptiometry.

  11. Precision and accuracy of in vivo bone mineral measurement in rats using dual-energy X-ray absorptiometry.

    PubMed

    Rozenberg, S; Vandromme, J; Neve, J; Aguilera, A; Muregancuro, A; Peretz, A; Kinthaert, J; Ham, H

    1995-01-01

    The aim of this study was to evaluate the precision and accuracy of dual-energy X-ray absorptiometry (DXA) for measuring bone mineral content at different sites of the skeleton in rats. In vitro the reproducibility error was very small (< 1%), but in vivo the intra-observer variability ranged from 0.9% to 6.0%. Several factors have been shown to affect in vivo reproducibility: the reproducibility was better when the results were expressed as bone mineral density (BMD) rather than bone mineral content (BMC), intra-observer variability was better than the inter-observer variability, and a higher error was observed for the tibia compared with that for vertebrae and femur. The accuracy of measurement at the femur and tibia was assessed by comparing the values with ash weight and with biochemically determined calcium content. The correlation coefficients (R) between the in vitro BMC and the dry weight or the calcium content were higher than 0.99 for both the femur and the tibia. SEE ranged between 0.0 g (ash weight) and 2.0 mg (Ca content). Using in vitro BMC, ash weight could be estimated with an accuracy error close to 0 and calcium content with an error ranging between 0.82% and 6.80%. The R values obtained between the in vivo and in vitro BMC were 0.98 and 0.97 respectively for femur and tibia, with SEE of 0.04 and 0.02 g respectively. In conclusion, the in vivo precision of the technique was found to be too low. To be of practical use it is important in the design of experimentation to try to reduce the measurement error.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Photon absorptiometry

    SciTech Connect

    Velchik, M.G.

    1987-01-01

    Recently, there has been a renewed interest in the detection and treatment of osteoporosis. This paper is a review of the merits and limitations of the various noninvasive modalities currently available for the measurement of bone mineral density with special emphasis placed upon the nuclear medicine techniques of single-photon and dual-photon absorptiometry. The clinicians should come away with an understanding of the relative advantages and disadvantages of photon absorptiometry and its optimal clinical application. 49 references.

  13. Noninvasive Ultrasound Imaging for Bone Quality Assessment Using Scanning Confocal Acoustic Diagnosis, μCT, DXA Measurements, and Mechanical Testing

    NASA Astrophysics Data System (ADS)

    Qin, Yi-Xian; Xia, Yi; Lin, Wei; Mittra, Erik; Rubin, Clint; Gruber, Barry

    Osteoporosis is a disease characterized by decreased bone mass and progressive deterioration of the microstructure, affecting both mineral density and bone's fragility. Current diagnoses are only measuring apparent bone mineral density (AppBMD). Using our newly developed scanning confocal acoustic diagnostic (SCAD) system, we evaluated the ability of quantitative ultrasound in noninvasively predicting bone's quantity and quality on 19 human cadaver calcanei. Results show that ultrasound attenuation image on intact calcaneus represents bone mass distribution. High correlation (R=0.82) exists between SCAD determined broadband ultrasound attenuation (BUA) and DXA determined AppBMD at the calcaneus, as well as in the AppBMD result at femoral neck (R=0.81). SCAD determined BUA and ultrasound velocity (UV) are highly correlated with the micro-CT and mechanical testing determined bone quantity and quality parameters. These results suggest that image-based quantitative ultrasound is able to identify ROI and predict both bone mass and strength.

  14. Evaluation of mandibular bone mineral density using the dual-energy X-ray absorptiometry technique in edentulous subjects living in an endemic fluorosis region

    PubMed Central

    Buyukkaplan, US; Guldag, MU

    2012-01-01

    Objectives Fluoride is one of the biological trace elements with a strong affinity for osseous, cartilaginous and dental tissue. The dental and skeletal effects of high fluoride intake have already been studied in the literature, but little is known about the effects of high fluoride intake on edentulous mandibles. The purpose of this study was to evaluate the effects of high fluoride intake on mandibular bone mineral density (BMD) measured by the dual-energy X-ray absorptiometry (DXA) technique in edentulous individuals with systemic fluorosis. Methods 32 people who were living in an endemic fluorosis area since birth and 31 people who were living in a non-endemic fluorosis area since birth (control group) participated in this study. Systemic fluorosis was diagnosed in the patients using the sialic acid (NANA)/glycosaminoglycan (GAG) ratio. The BMDs of the mandibles were determined by the DXA technique. Results The serum NANA/GAG ratios in the fluorosis group were significantly lower than those in the control group (p < 0.001). There was also a statistically significant difference in mandibular BMD measurements (p < 0.05) between the systemic fluorosis and control groups, as measured by the DXA technique. Mandibular body BMD measurements were higher in the fluorosis group (1.25 ± 0.24 g cm−2) than in the control group (1.01 ± 0.31 g cm−2). Conclusions The results of the study showed that fluoride intake higher than the optimum level causes increased mandibular BMD in edentulous individuals. Further dose-related studies are needed to determine the effects of high fluoride intake on bony structures of the stomatognathic system. PMID:22241885

  15. Discriminative ability of total body bone-mineral measured by dual photon absorptiometry.

    PubMed

    Gotfredsen, A; Pødenphant, J; Nilas, L; Christiansen, C

    1989-04-01

    We investigated the discriminative ability of total body bone-mineral expressed as the total body bone-density (TBBD) measured by dual photon absorptiometry (DPA) in 79 healthy premenopausal women, 27 healthy postmenopausal women, and 120 female osteoporotic fracture patients presenting with either Colles' fracture, vertebral fracture or femoral neck-fracture. TBBD was compared to the bone-mineral density of the lumbar spine (BMDspine) also measured by DPA, and to the bone-mineral content of the forearms (BMCforearm) measured by single photon absorptiometry (SPA). TBBD, BMDspine and BMCforearm showed that all the fracture patient groups had significantly reduced bone-mass. Using receiver operating characteristic (ROC) analysis, we found that TBBD had a tendency towards better discriminative ability than BMDspine or BMCforearm with regard to the discrimination between healthy premenopausal women and the three types of osteoporotic fractures (not significant in spinal fracture patients). BMCforearm had an intermediate position, whereas BMDspine had the smallest discriminative ability. TBBD also discriminated better between healthy postmenopausal women and hip-fracture patients than BMDspine or BMCforearm, whereas there was no significant difference between the three methods regarding the discrimination between the healthy postmenopausal women and the Colles' and spinal fracture patients. We conclude that the TBBD measurement by DPA has a discriminative potential which is better than the local spine or forearm measurements.

  16. Bone densitometry.

    PubMed

    Chun, Kwang J

    2011-05-01

    Conventional radiographic methods allow physicians to visualize bone structure. However, they do not offer information on the bone mineral density (BMD), which can facilitate early diagnosis and treatment of osteoporosis. Bone densitometry, by contrast, helps to detect bone mineral loss at an early stage because it provides accurate quantitative measurement of BMD. With an emphasis on quantification, shorter scanning time and precision, scientists have been developing BMD measurement devices that use absorption technique. They first developed single-energy absorptiometry (single-photon absorptiometry) by using I-125, which could measure BMD of peripheral bones. Single-photon absorptiometry was replaced by dual-energy absorptiometry (dual photon absorptiometry [DPA]) that used gadolinium-153. DPA had greater accuracy in measuring the BMD of central skeletal bones. Single-energy x-ray absorptiometry was also developed but it had limitations in measuring central skeletal BMD. In the mid-1980s, dual-energy x-ray absorptiometry (DXA) was introduced and widely accepted for the early detection, treatment, and follow-up study of osteoporosis. There are several reasons for the popularity. DXA can measure BMD of posteroanterior spine and hip in a much shorter time than DPA while being capable of measuring BMD of peripheral bones. Other advantages include very low radiation doses to the patients, high image resolution, precision, and stable calibration of the instruments. In recent years, DXA has also been applied to lateral spine for the density of trabecular bone, to the whole body for the measurement of total body bone density and for the body composition, and to the spine for the vertebral fracture assessment. Still, posteroanterior spine and hip scans remain the most common applications of DXA because data on the normal range of BMD of the skeletal sites for different age, sex, and ethnic groups are compiled and made available with the devices, which gives the physician

  17. Relationship between alveolar bone measured by /sup 125/I absorptiometry with analysis of standardized radiographs: 2. Bjorn technique

    SciTech Connect

    Ortman, L.F.; McHenry, K.; Hausmann, E.

    1982-05-01

    The Bjorn technique is widely used in periodontal studies as a standardized measure of alveolar bone. Recent studies have demonstrated the feasibility of using /sup 125/I absorptiometry to measure bone mass. The purpose of this study was to compare /sup 125/I absorptiometry with the Bjorn technique in detecting small sequential losses of alveolary bone. Four periodontal-like defects of incrementally increasing size were produced in alveolar bone in the posterior segment of the maxilla of a human skull. An attempt was made to sequentially reduce the amount of bone in 10% increments until no bone remained, a through and through defect. The bone remaining at each step was measured using /sup 125/I absorptiometry. At each site the /sup 125/I absorptiometry measurements were made at the same location by fixing the photon source to a prefabricated precision-made occlusal splint. This site was just beneath the crest and midway between the borders of two adjacent teeth. Bone loss was also determined by the Bjorn technique. Standardized intraoral films were taken using a custom-fitted acrylic clutch, and bone measurements were made from the root apex to coronal height of the lamina dura. A comparison of the data indicates that: (1) in early bone loss, less than 30%, the Bjorn technique underestimates the amount of loss, and (2) in advanced bone loss, more than 60% the Bjorn technique overestimates it.

  18. Technical principles of dual energy x-ray absorptiometry.

    PubMed

    Blake, G M; Fogelman, I

    1997-07-01

    Since its introduction nearly ten years ago, dual-energy x-ray absorptiometry (DXA) has become the single most widely used technique for performing bone densitometry studies. One reason for its popularity is the ability of DXA systems to measure bone mineral density (BMD) in the spine and proximal femur, the two most common sites for osteoporotic fractures. Other advantages of DXA include the exceptionally low radiation dose to patients, short scan times, high resolution images, good precision and inherent stability of calibration. For these reasons DXA scans are widely used to diagnose osteoporosis, assist making decisions in treatment, and as a follow-up response to therapy. Another important application has been the use of DXA in many clinical trials of new treatments for osteoporosis. Since the first generation pencil beam DXA systems became available, the most significant technical innovation has been the introduction of fan beam systems with shorter scan times, increased patient throughput, and improved image quality. New clinical applications include the measurement of lateral spine and total body BMD, body composition, and vertebral morphometry. Despite these advances, posteroanterior (PA) spine and proximal femur scans remain the most widely used application because of their utility in treatment decisions and monitoring response to therapy.

  19. Dual X-ray absorptiometry accurately predicts carcass composition from live sheep and chemical composition of live and dead sheep.

    PubMed

    Pearce, K L; Ferguson, M; Gardner, G; Smith, N; Greef, J; Pethick, D W

    2009-01-01

    Fifty merino wethers (liveweight range from 44 to 81kg, average of 58.6kg) were lot fed for 42d and scanned through a dual X-ray absorptiometry (DXA) as both a live animal and whole carcass (carcass weight range from 15 to 32kg, average of 22.9kg) producing measures of total tissue, lean, fat and bone content. The carcasses were subsequently boned out into saleable cuts and the weights and yield of boned out muscle, fat and bone recorded. The relationship between chemical lean (protein+water) was highly correlated with DXA carcass lean (r(2)=0.90, RSD=0.674kg) and moderately with DXA live lean (r(2)=0.72, RSD=1.05kg). The relationship between the chemical fat was moderately correlated with DXA carcass fat (r(2)=0.86, RSD=0.42kg) and DXA live fat (r(2)=0.70, RSD=0.71kg). DXA carcass and live animal bone was not well correlated with chemical ash (both r(2)=0.38, RSD=0.3). DXA carcass lean was moderately well predicted from DXA live lean with the inclusion of bodyweight in the regression (r(2)=0.82, RSD=0.87kg). DXA carcass fat was well predicted from DXA live fat (r(2)=0.86, RSD=0.54kg). DXA carcass lean and DXA carcass fat with the inclusion of carcass weight in the regression significantly predicted boned out muscle (r(2)=0.97, RSD=0.32kg) and fat weight, respectively (r(2)=0.92, RSD=0.34kg). The use of DXA live lean and DXA live fat with the inclusion of bodyweight to predict boned out muscle (r(2)=0.83, RSD=0.75kg) and fat (r(2)=0.86, RSD=0.46kg) weight, respectively, was moderate. The use of DXA carcass and live lean and fat to predict boned out muscle and fat yield was not correlated as weight. The future for the DXA will exist in the determination of body composition in live animals and carcasses in research experiments but there is potential for the DXA to be used as an online carcass grading system.

  20. Dual photon absorptiometry using a gadolinium-153 source applied to measure equine bone mineral content

    NASA Astrophysics Data System (ADS)

    Moure, Alessandro; Reichmann, Peter; Remigio Gamba, Humberto

    2003-12-01

    The application of the dual photon absorptiometry (DPA) technique, using gadolinium-153 as the photon source, to evaluate the bone mineral density (BMD) of the third metacarpal bone of horses is presented. The radiation detector was implemented with a NaI(TI) scintillator coupled to a 14 stage photomultiplier. A modular mechanical system allows the position of the prototype to be adjusted in relation to the animal. A moveable carrier makes it possible to scan the third metacarpal with a velocity adjustable between 1 and 12 mm s-1, in steps of 1 mm s-1, for a total distance of 250 mm. The prototype was evaluated with a phantom of the third metacarpal bone made of perspex and aluminium, and in vitro with a transverse slice of the third metacarpal bone of a horse. The tests showed that the prototype has an accuracy and precision of, approximately, 10% and 6%, respectively, for a 6 s acquisition time. Preliminary studies carried out in three foals from birth to one year of age indicated that the prototype is well suited to in vivo and in situ analysis of the BMD of the third metacarpal bones of horses, making it possible to evaluate the changes of BMD levels on a monthly basis. Also, results indicated an exponential behaviour of the BMD curve during the first year of life of the studied horses.

  1. Bone Densitometry in Children.

    PubMed

    Adams, Judith E

    2016-07-01

    Maximizing peak bone mass in childhood is relevant to optimizing bone health in later life, so the study of the skeleton in children in health and disease is important. Dual-energy X-ray absorptiometry (DXA) is the most widely used clinical tool for the assessment of bone status in children. Technological developments in DXA enable vertebral fracture assessment at much lower ionizing radiation doses than spinal radiographs. Quantitative computed tomography remains predominantly a research tool but has some advantages over DXA in not being size dependent. High-resolution peripheral computed tomography measures trabecular and cortical bone microstructure but is technically challenging, particularly in children, and not widely available, so it is unlikely to be used in clinical practice. Other quantitative techniques (quantitative magnetic resonance imaging, digital X-ray absorptiometry, quantitative ultrasound) have been applied in children but remain research applications, and they are only covered briefly in this review.

  2. Assessing body composition in healthy newborn infants: reliability of dual-energy x-ray absorptiometry.

    PubMed

    Godang, Kristin; Qvigstad, Elisabeth; Voldner, Nanna; Isaksen, Gunhild A; Frøslie, Kathrine F; Nøtthellen, Jacob; Henriksen, Tore; Bollerslev, Jens

    2010-01-01

    Dual-energy X-ray absorptiometry (DXA) is used to measure body composition in newborns; however, data on DXA accuracy are limited. We investigated the reliability of body composition measurements by DXA. The present study included 207 normal-term newborn babies, recruited from a larger study on the determinants of birth weight in healthy pregnancies (STORK) between 2005 and 2008. Reliability analysis of total fat mass (FM(DxA)), fat-free mass, lean mass (LM(DxA)), bone mineral content (BMC), and bone mineral density (BMD) were based on 2 DXA scans of 50 neonates. We also performed a comparison analysis for DXA (FM(DxA)) measurements and caliper (CLP) or circumference (CF) measurements of trunk and extremities (performed on all neonates, n=207). Reliability: All intraclass correlation coefficients (ICC) were satisfactory to excellent for total body and the extremity-compartment FM(DxA), LM(DxA), BMD, and BMC; ICC ranged from 0.86 to 0.96 but with a lower ICC for trunk FM(DxA). For comparison analysis, the Pearson correlation coefficients for CLP vs DXA and CF vs DXA ranged from 0.48 to 0.79 and 0.41 to 0.77, respectively. Quadriceps CLP and CF measurements correlated best with the most reliable DXA results, whereas more modest correlations were found for the trunk region. DXA measurements of body composition demonstrated good reliability and can be used as a reference method in neonates. CLP and CF measurements are appropriate for larger cohorts or when DXA is unavailable, and they provide fair rough estimations of fat mass.

  3. Unexplained high BMD in DXA-scanned patients is generalized throughout the skeleton and characterized by thicker cortical and trabecular bone.

    PubMed

    Lomholt, S; Amstrup, A K; Moser, E; Jakobsen, N F B; Mosekilde, L; Vestergaard, P; Rejnmark, L

    2015-04-01

    Unexplained high bone mineral density (BMD) is a rare condition and the mechanisms responsible are yet to be described in detail. The aim of the study was to identify patients with unexplained high BMD from a local DXA database and compare their radiological phenotype with an age- and a gender-matched group of population-based controls. We defined high BMD as a DXA Z-score ≥ + 2.5 at the total hip and lumbar spine. We characterized the findings as "unexplained" if no osteodegenerative changes, bone metabolic disease, or arthritis at the hip or lumbar spine was observed. All participants were investigated with high-resolution peripheral quantitative computed tomography (HR-pQCT), QCT, DXA, fasting blood samples, a 24-h urine sample, and questionnaires. The DXA database contained data on 25,118 patients. Initially, 138 (0.55%) potential participants with high BMD were identified, and during the study ten additional cases were identified from new DXA scans. Sixty-seven patients accepted to participate in the study, and among these we identified 15 women and one man with unexplained high BMD. These 15 women had higher BMD throughout the skeleton relative to controls, similar area/volume at the hip and the distal extremities, a higher number of trabeculae, which was thicker than in the controls, and a higher finite element estimated bone strength. The 15 women were heavier and had a higher fat mass then controls. We conclude that patients with unexplained high BMD have a generalized high BMD phenotype throughout their skeleton, which is characterized with a denser microarchitecture.

  4. Treatment of subclinical hypothyroidism does not affect bone mass as determined by dual-energy X-ray absorptiometry, peripheral quantitative computed tomography and quantitative bone ultrasound in Spanish women

    PubMed Central

    Roncero-Martin, Raul; Calderon-Garcia, Julian F.; Santos-Vivas, Mercedes; Vera, Vicente; Martínez-Alvárez, Mariana; Rey-Sanchez, Purificación

    2015-01-01

    Introduction The results of studies examining the influence of subclinical hypothyroidism (SCH) and levothyroxine (L-T4) replacement therapy on bone have generated considerable interest but also controversy. The present research aims to evaluate the effects of L-T4 treatment on different skeletal sites in women. Material and methods A group of 45 premenopausal (mean age: 43.62 ±6.65 years) and 180 postmenopausal (mean age: 59.51 ±7.90 years) women with SCH who were undergoing L-T4 replacement therapy for at least 6 months were compared to 58 pre- and 180 postmenopausal women with SCH (untreated) matched for age. The mean doses of L-T4 were 90.88 ±42.59 µg/day in the premenopausal women and 86.35 ±34.11 µg/day in the postmenopausal women. Bone measurements were obtained using quantitative bone ultrasound (QUS) for the phalanx, dual-energy X-ray absorptiometry (DXA) for the lumbar spine and hip, and peripheral quantitative computed tomography (pQCT) for the non-dominant distal forearm. Results No differences were observed between patients and untreated controls in these bone measurements except in the bone mineral density (BMD) of the spine (p = 0.0214) in postmenopausal women, which was greater in treated women than in untreated controls. Conclusions Our results indicate that adequate metabolic control through replacement treatment with L-T4 in pre- and postmenopausal women does not affect bone mass. PMID:26528344

  5. Dual energy x-ray absorptiometry: the effects of beam hardening on bone density measurements.

    PubMed

    Blake, G M; McKeeney, D B; Chhaya, S C; Ryan, P J; Fogelman, I

    1992-01-01

    X-ray tubes have superseded radionuclide sources for dual photon absorptiometry of the spine and hip. However, the use of a polyenergetic spectrum is a potential source of error for x-ray absorptiometers since beam hardening may result in a nonlinear measurement scale for bone mineral density (BMD). A quantitative study of the effects of beam hardening on measurements made with a commercial dual energy x-ray scanner has been performed. Bone was represented by layers of aluminum of linearly increasing thickness which were scanned under water thicknesses ranging from 0 to 25 cm to represent different body thicknesses of soft tissue. Beam hardening had two effects on measured BMD: (i) at a constant true BMD, measured BMD varied with water thickness; (ii) at a constant water thickness, the BMD scale was not precisely linear. For conditions appropriate to spine and hip studies (BMD) values in the range 0.7 to 1.4 g/cm2 and body thickness between 15 and 25 cm) the maximum deviation of measured BMD from a linear scale was 0.023 g/cm2, while the root-mean-square deviation (0.01 g/cm2) was comparable to the measurement precision for a spine or femoral neck scan (about 1%). The largest departures from linearity were found to occur at the thinnest water thicknesses for BMD values in the range 0.2 to 0.6 g/cm2. The effect of scale nonlinearity on the results of longitudinal studies was examined: for a spine scan at 20-cm body thickness, measured changes in BMD slightly overestimated the true change and implied an error of 0.15%/year for a measurement of a true rate of loss of 3% year in a postmenopausal woman.

  6. Total and regional body volumes derived from dual-energy X-ray absorptiometry output.

    PubMed

    Wilson, Joseph P; Fan, Bo; Shepherd, John A

    2013-01-01

    Total body volume is an important health metric used to measure body density, shape, and multicompartmental body composition but is currently only available through underwater weighing or air displacement plethysmography (ADP). The objective of this investigation was to derive an accurate body volume from dual-energy X-ray absorptiometry (DXA)-reported measures for advanced body composition models. Volunteers received a whole body DXA scan and an ADP measure at baseline (N = 25) and 6 mo (N = 22). Baseline measures were used to calibrate body volume from the reported DXA masses of fat, lean, and bone mineral content. A second population (N = 385) from the National Health and Nutrition Examination Survey was used to estimate the test-retest precision of regional (arms, legs, head, and trunk) and total body volumes. Overall, we found that DXA-volume was highly correlated to ADP-volume (R² = 0.99). The 6-mo change in total DXA-volume was highly correlated to change in ADP-volume (R² = 0.98). The root mean square percent coefficient of variation precision of DXA-volume measures ranged from 1.1% (total) to 3.2% (head). We conclude that the DXA-volume method can measure body volume accurately and precisely, can be used in body composition models, could be an independent health indicator, and is useful as a prospective or retrospective biomarker of body composition.

  7. In vivo precision of the GE lunar iDXA for the assessment of lumbar spine, total hip, femoral neck, and total body bone mineral density in severely obese patients.

    PubMed

    Carver, Tamara E; Christou, Nicolas V; Court, Olivier; Lemke, Hannah; Andersen, Ross E

    2014-01-01

    No study has evaluated the precision of the GE Lunar iDXATM (GE Healthcare) in measuring bone mineral density (BMD) among severely obese patients. The purpose of the study was to evaluate the precision of the GE Lunar iDXATM for assessing BMD, including the lumbar spine L1-L4, L2-L4, the total hip, femoral neck, and total body in a severely obese population (body mass index [BMI]>40 kg/m(2)). Sixty-four severely obese participants with a mean age of 46 ± 11 yr, BMI of 49 ± 6 kg/m(2), and a mean body mass of 136.8 ± 20.4 kg took part in this investigation. Two consecutive iDXA scans (with repositioning) of the total body (total body BMD [TBBMD]), lumbar spine (L1-L4 and L2-L4), total hip (total hip BMD [THBMD]), and femoral neck (femoral neck BMD [FNBMD]) were conducted for each participant. The coefficient of variation (CV), the root mean square (RMS) averages of standard deviations of repeated measurements, the corresponding 95% least significant change, and intraclass correlations (ICCs) were calculated. In addition, analysis of bias and coefficients of repeatability were calculated. The results showed a high level of precision for total body (TBBMD), lumbar spine (L1-L4), and total hip (THBMD) with values of RMS: 0.013, 0.014, and 0.011 g/cm(2); CV: 0.97%, 1.05%, and 0.99%, respectively. Precision error for the femoral neck was 2.34% (RMS: 0.025 g/cm(2)) but still represented high reproducibility. ICCs in all dual-energy X-ray absorptiometry measurements were 0.99 with FNBMD having the lowest at 0.98. Coefficients of repeatability for THBMD, FNBMD, L1-L4, L2-L4, and TBBMD were 0.0312, 0.0688, 0.0383, 0.0493, and 0.0312 g/cm(2), respectively. The Lunar iDXA demonstrated excellent precision for BMD measurements and is the first study to assess reproducibility of the GE Lunar iDXA with severely obese adults.

  8. Automated assessment of exclusion criteria for DXA lumbar spine scans.

    PubMed

    Barden, Howard S; Markwardt, Paul; Payne, Randy; Hawkins, Brent; Frank, Matt; Faulkner, Kenneth G

    2003-01-01

    Modern bone densitometry systems using dual-energy X-ray absorptiometry (DXA) automatically analyze lumbar spine scans and provide clinically important information concerning spine bone mineral density (BMD) and fracture risk. Lumbar spine BMD accurately reflects skeletal health and fracture risk in most cases, but degenerative diseases associated with aging may lead to the formation of reactive bone (osteophytes) and other confounding conditions that elevate BMD without a concomitant increase in bone strength or decrease in fracture risk. Automated densitometry software known as computer-aided densitometry (CAD) (GE Medical Systems Lunar) assists the user in identifying scans with common acquisition and analysis irregularities known to influence BMD values. Visual examination of 231 female spine scans measured with DXA found abnormal conditions that could influence BMD results in 29% of scans. The sensitivity and specificity of several criteria for identifying scans with conditions that could influence BMD were determined. A good criterion for identifying scans with abnormal conditions was a T-score difference of greater than 0.9 or 1.0 between L1-L4 mean and individual vertebrae. Criteria for excluding affected vertebrae were determined. Exclusion of affected vertebrae resulted in a mean BMD decrease of nearly 0.6 SD (T-score) among affected scans.

  9. Quantitating the effect of prosthesis design on femoral remodeling using high-resolution region-free densitometric analysis (DXA-RFA).

    PubMed

    Farzi, Mohsen; Morris, Richard M; Penny, Jeannette; Yang, Lang; Pozo, Jose M; Overgaard, Søren; Frangi, Alejandro F; Wilkinson, J Mark

    2017-02-07

    Dual energy X-ray absorptiometry (DXA) is the reference standard method used to study bone mineral density (BMD) after total hip arthroplasty (THA). However, the subtle, spatially-complex changes in bone mass due to strain-adaptive bone remodeling relevant to different prosthesis designs are not readily resolved using conventional DXA analysis. DXA region free analysis (DXA RFA) is a novel computational image analysis technique that provides a high-resolution quantitation of periprosthetic BMD. Here we applied the technique to quantitate the magnitude and areal size of periprosthetic BMD changes using scans acquired during two previous randomized clinical trials (2004 to 2009); one comparing three cemented prosthesis design geometries, and the other comparing a hip resurfacing versus a conventional cementless prosthesis. DXA RFA resolved subtle differences in magnitude and area of bone remodeling between prosthesis designs not previously identified in conventional DXA analyses. A mean bone loss of 10.3%, 12.1%, and 11.1% occurred for the three cemented prostheses within a bone area fraction of 14.8%, 14.4%, and 6.2%, mostly within the lesser trochanter (P < 0.001). For the cementless prosthesis, a diffuse pattern of bone loss (-14.3%) was observed at the shaft of femur in a small area fraction of 0.6% versus no significant bone loss for the hip resurfacing prosthesis (P < 0.001). BMD increases were observed consistently at the greater trochanter for all prostheses except the hip-resurfacing prosthesis, where BMD increase was widespread across the metaphysis (P < 0.001). DXA RFA provides high-resolution insights into the effect of prosthesis design on the local strain environment in bone. This article is protected by copyright. All rights reserved.

  10. Can forearm bone mineral density be measured with dxa in the supine position? A study in Chinese population.

    PubMed

    Zhao, Jinhua; Xing, Yan; Zhou, Qi; Jin, Wenya; Wacker, Wynn; Barden, Howard S

    2010-01-01

    The purpose of our study was to confirm that forearm bone mineral density (BMD) results obtained with the patient in the supine position are equivalent to results obtained with patient in the sitting position. The subjects were a Chinese sample of 82 healthy adults (35 males and 47 females; age: 22.5-59.8 yr; body mass index: 17.6-32.4). Forearm BMD was measured by dual-energy X-ray absorptiometry, with the forearm positioned in the sitting and supine positions. Repeated measurements were available for some subjects, and the average of the repeats for those subjects were used in the analysis. The standard enCORE software (GE Lunar, Madison, WI) adjustment for supine position was applied to the BMD values obtained in the supine position for 33% radius, ultradistal (UD) radius, and radius total regions of interest (ROIs) to give sitting-equivalent values. The supine sitting-equivalent results were regressed on the sitting values through the origin. There were statistically significant differences in the UD and total-radius forearm results between supine sitting-equivalent BMD and sitting BMD. The correlation coefficients of UD and total radius were 0.967 and 0.976, respectively. There was no significant difference between supine sitting-equivalent BMD and sitting BMD in the 33% radius forearm BMD. The correlation coefficient of 33% radius was 0.956. For Chinese subjects, there was no significant difference in BMD for the 33% radius, the only ROI recommended for diagnosis by ISCD. Forearm scans could be accomplished with the patient suitably positioned for the routine lumbar spine and proximal femur scans.

  11. Dual-energy X-ray absorptiometry of birds: an examination of excised skeletal specimens.

    PubMed

    Dirrigl, F J; Dalsky, G P; Warner, S E

    2004-08-01

    The ability of dual-energy X-ray absorptiometry (DXA) to measure bone mineral content and density of bird bones has received little attention. This paper represents the first comprehensive study of the methods, precision, and reproducibility of DXA (GE-Lunar DPX-L) for the uniquely shaped, thin and pneumatic bones of birds. Skeletal elements and portions represented by 26 regions of interest (ROIs) are presented and evaluated for the gallinaceous bird species, wild turkey (Meleagris gallopavo), ruffed grouse (Bonasa umbellus) and bobwhite quail (Colinus virginianus). Using Lunar small animal software and the methods described in this paper, photodensitometry of bird bones is possible and opens new opportunities for using birds in clinical models in veterinarian science, osteoporosis studies, space biology, and even archaeological and paleontological research.

  12. Comparison of femoral neck BMD evaluation obtained using Lunar DXA and QCT with asynchronous calibration from CT colonography.

    PubMed

    Pickhardt, Perry J; Bodeen, Gabriel; Brett, Alan; Brown, J Keenan; Binkley, Neil

    2015-01-01

    For patients undergoing screening computed tomography colonography (CTC), an opportunity exists for bone mineral density (BMD) screening without additional radiation exposure using quantitative computed tomography (QCT). This study investigated the use of dual-energy X-ray absorptiometry (DXA)-equivalent QCT Computed Tomography X-Ray Absorptiometry (CTXA) analysis at the hip obtained using CTC examinations using a retrospective asynchronous calibration of patient scans. A cohort of 33 women, age 61.3 (10.6) yr (mean [standard deviation]), had routine CTC using various GE LightSpeed CT scanner models followed after 0-9 mo by a DXA hip BMD examination using a GE Lunar Prodigy machine. Areal bone mineral density (aBMD) and T-scores of the proximal femur were measured from either prone or supine CTC examinations using Mindways QCT Pro software following standard workflow except that the CT scanners were asynchronously calibrated by phantoms scanned retrospectively of the CTC examination without the subject present. CTXA and DXA aBMD were highly correlated (R2=0.907) with a linear relationship of DXA_BMD=1.297*CTXA_BMD+0.048. The standard error of estimate (SEE) on the linear fit was 0.053 g/cm2. CTXA and DXA T-scores showed a linear relationship of DXA_T-score=1.034*CTXA_T-score+0.3 and an SEE of 0.379 T-scores. CTXA and DXA aBMD and T-score measurements showed good correlation despite asynchronous scan acquisition and retrospective QCT calibration. The SEE of 0.053 g/cm2 is on par with the literature comparing Hologic and Lunar DXA devices. The observed relationship between CTXA and Lunar DXA aBMD matches predictions from published cross-calibrations relating CTXA to DXA aBMD measurement. Thus, opportunistic use of CTXA T-scores obtained at the time of CTC could enhance osteoporosis screening.

  13. Dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and micro-computed tomography techniques are discordant for bone density and geometry measurements in the guinea pig.

    PubMed

    Mak, Ivy L; DeGuire, Jason R; Lavery, Paula; Agellon, Sherry; Weiler, Hope A

    2016-05-01

    This study aims to examine agreement among bone mineral content (BMC) and density (BMD) estimates obtained using dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), and micro-computed tomography (μCT) against high-resolution μCT and bone ash of the guinea pig femur. Middle-aged (n = 40, 86 weeks) male guinea pigs underwent in vivo followed by ex vivo DXA (Hologic QDR 4500A) scanning for intact and excised femur BMC and areal density. To assess bone architecture and strength, excised femurs were scanned on pQCT (Stratec XCT 2000L) as well as on two μCT scanners (LaTheta LCT-200; Skyscan 1174), followed by three-point bending test. Reproducibility was determined using triplicate scans; and agreement assessed using Bland-Altman plots with reference methods being high-resolution μCT (Skyscan) for BMD and bone ashing for BMC. All techniques showed satisfactory ex vivo precision (CV 0.05-4.3 %). However, bias compared to the reference method was highest (207.5 %) in trabecular bone volume fraction (BV/TV) measured by LaTheta, and unacceptable in most total femur and cortical bone measurements. Volumetric BMD (vBMD) and BV/TV derived by LaTheta and pQCT at the distal metaphysis were biased from the Skyscan by an average of 49.3 and 207.5 %, respectively. Variability of vBMD, BV/TV and cross-sectional area at the diaphysis ranged from -5.5 to 30.8 %. LaTheta best quantified total femur BMC with an upper bias of 3.3 %. The observed differences among imaging techniques can be attributable to inherent dissimilarity in construction design, calibration, segmentation and scanning resolution used. These bone imaging tools are precise but are not comparable, at least when assessing guinea pig bones.

  14. Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance.

    PubMed

    Lewiecki, E Michael; Binkley, Neil; Morgan, Sarah L; Shuhart, Christopher R; Camargos, Bruno Muzzi; Carey, John J; Gordon, Catherine M; Jankowski, Lawrence G; Lee, Joon-Kiong; Leslie, William D

    2016-01-01

    Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.

  15. Estimation of percentage body fat by dual-energy x-ray absorptiometry: evaluation by in vivo human elemental composition

    NASA Astrophysics Data System (ADS)

    Wang, ZiMian; Heymsfield, Steven B.; Chen, Zhao; Zhu, Shankuan; Pierson, Richard N.

    2010-05-01

    Dual-energy x-ray absorptiometry (DXA) is widely applied for estimating body fat. The percentage of body mass as fat (%fat) is predicted from a DXA-estimated RST value defined as the ratio of soft tissue attenuation at two photon energies (e.g., 40 keV and 70 keV). Theoretically, the RST concept depends on the mass of each major element in the human body. The DXA RST values, however, have never been fully evaluated by measured human elemental composition. The present investigation evaluated the DXA RST value by the total body mass of 11 major elements and the DXA %fat by the five-component (5C) model, respectively. Six elements (i.e. C, N, Na, P, Cl and Ca) were measured by in vivo neutron activation analysis, and potassium (i.e. K) by whole-body 40K counting in 27 healthy adults. Models were developed for predicting the total body mass of four additional elements (i.e. H, O, Mg and S). The elemental content of soft tissue, after correction for bone mineral elements, was used to predict the RST values. The DXA RST values were strongly associated with the RST values predicted from elemental content (r = 0.976, P < 0.001), although there was a tendency for the elemental-predicted RST to systematically exceed the DXA-measured RST (mean ± SD, 1.389 ± 0.024 versus 1.341 ± 0.024). DXA-estimated %fat was strongly associated with 5C %fat (24.4 ± 12.0% versus 24.9 ± 11.1%, r = 0.983, P < 0.001). DXA RST is evaluated by in vivo elemental composition, and the present study supports the underlying physical concept and accuracy of the DXA method for estimating %fat.

  16. Estimation of percentage body fat by dual-energy x-ray absorptiometry: evaluation by in vivo human elemental composition.

    PubMed

    Wang, ZiMian; Heymsfield, Steven B; Chen, Zhao; Zhu, Shankuan; Pierson, Richard N

    2010-05-07

    Dual-energy x-ray absorptiometry (DXA) is widely applied for estimating body fat. The percentage of body mass as fat (%fat) is predicted from a DXA-estimated R(ST) value defined as the ratio of soft tissue attenuation at two photon energies (e.g., 40 keV and 70 keV). Theoretically, the R(ST) concept depends on the mass of each major element in the human body. The DXA R(ST) values, however, have never been fully evaluated by measured human elemental composition. The present investigation evaluated the DXA R(ST) value by the total body mass of 11 major elements and the DXA %fat by the five-component (5C) model, respectively. Six elements (i.e. C, N, Na, P, Cl and Ca) were measured by in vivo neutron activation analysis, and potassium (i.e. K) by whole-body (40)K counting in 27 healthy adults. Models were developed for predicting the total body mass of four additional elements (i.e. H, O, Mg and S). The elemental content of soft tissue, after correction for bone mineral elements, was used to predict the R(ST) values. The DXA R(ST) values were strongly associated with the R(ST) values predicted from elemental content (r = 0.976, P < 0.001), although there was a tendency for the elemental-predicted R(ST) to systematically exceed the DXA-measured R(ST) (mean +/- SD, 1.389 +/- 0.024 versus 1.341 +/- 0.024). DXA-estimated %fat was strongly associated with 5C %fat (24.4 +/- 12.0% versus 24.9 +/- 11.1%, r = 0.983, P < 0.001). DXA R(ST) is evaluated by in vivo elemental composition, and the present study supports the underlying physical concept and accuracy of the DXA method for estimating %fat.

  17. Cost effectiveness analysis of BMD referral for DXA using ultrasound as a selective pre-screen in a group of women with low trauma Colles' fractures.

    PubMed

    Sim, M F; Stone, M; Johansen, A; Evans, W

    2000-01-01

    Measurements of bone density (BMD) are central to the World Health Organisation (WHO) approach to the definition of osteoporosis. Dual energy X- ray absorptiometry (DXA) remains the gold standard technique for measuring the bone mineral density (BMD) but Quantitative Ultrasound (QUS) is an attractive alternative method of bone assessment because it is easy to use and relatively inexpensive. It has been suggested that QUS could be used as a selective population pre-screen, to maximise the cost effectiveness of referral for DXA assessment of BMD. We set out to examine how such an approach might perform in the assessment of women with low trauma Colles' fracture. In 46 women aged 50-80 (mean 67) years we used DXA to measure BMD at lumbar spine and hip, and heel bone ultrasound to measure Broad Band Attenuation (BUA) and Velocity of Sound (VOS). We calculated local costs of pounds sterling 45 for DXA and pounds sterling 15 for QUS. We identified a BUA threshold of 60 dB/MHz as most cost effective as pre-screen, and calculated a sensitivity of 93% and specificity of 84% in identifying those subjects who were subsequently identified as having osteoporosis by DXA. DXA assessment of all patients had a cost of pounds sterling 77 per osteoporotic subject identified. We examined the cost-effectiveness of using QUS as a pre-screen, only referring subjects for more expensive DXA assessment if BUA was less than 60 dB/MHz. However this approach had no advantage, still costing pounds sterling 78 per osteoporotic subject identified. QUS assessment does not appear cost-effective as a pre-screen for DXA, even in this high risk group of women with low trauma Colles' fracture. A QUS pre-screen would only be cost-effective if the scan could be performed at a substantially lower cost.

  18. Validation of dual x-ray absorptiometry for body-composition assessment of rats exposed to dietary stressors.

    PubMed

    Lukaski, H C; Hall, C B; Marchello, M J; Siders, W A

    2001-01-01

    Evidence of the validity and accuracy of dual x-ray absorptiometry (DXA) to measure soft-tissue composition of laboratory rats with altered body composition associated with nutritional perturbations is lacking. We compared DXA determinations made in prone and supine positions with measurements of chemical composition of 49 male, weanling Sprague-Dawley rats that were fed the basal AIN-93 growth diet, were fed the basal diet modified to contain 30% fat, were fasted for 2 d, were limit fed 6 g of the basal diet daily for 1 wk, or were treated with furosemide (10 mg/kg intraperitoneally 2 h before DXA). DXA produced similar estimates of body mass and soft-tissue composition in the prone and supine positions. DXA estimates of body composition were significantly correlated with reference composition values (R(2) = 0.371-0.999). DXA discriminated treatment effects on body mass, fat-free and bone-free mass, fat mass, and body fatness; it significantly underestimated body mass (1% to 2%) and fat-free and bone-free mass (3%) and significantly overestimated fat mass and body fatness (3% to 25%). The greatest errors occurred in treatment groups in which body mass was diminished and body hydration was decreased. These findings suggest that DXA can determine small changes in fat-free, bone-free mass in response to obesity and weight loss. Errors in DXA determination of fat mass and body fatness associated with extra corporeal fluid and dehydration indicate the need for revision of calculation algorithms for soft-tissue determination.

  19. Dual-energy X-ray absorptiometry body composition in patients with secondary osteoporosis.

    PubMed

    Messina, Carmelo; Monaco, Cristian Giuseppe; Ulivieri, Fabio Massimo; Sardanelli, Francesco; Sconfienza, Luca Maria

    2016-08-01

    Due to the tight relationship between bone and soft tissues, there has been an increased interest in body composition assessment in patients with secondary osteoporosis as well as other pathological conditions. Dual-energy X-ray absorptiometry (DXA) is primarily devoted to the evaluation of bone mineral status, but continuous scientific advances of body composition software made DXA a rapid and easily available technique to assess body composition in terms of fat mass and lean mass. As a result, the International Society for Clinical Densitometry (ISCD) recently developed Official Positions regarding the use of this technique for body composition analysis. According to ISCD paper, indications are mainly limited to three conditions: HIV patients treated with antiretroviral agents associated with a risk of lipoatrophy; obese patients undergoing treatment for high weight loss; patients with sarcopenia or muscle weakness. Nevertheless, there are several other interesting clinical applications that were not included in the ISCD position paper, such as body composition assessment in patients undergoing organ transplantation, pulmonary disease as well as all those chronic condition that may lead to malnutrition. In conclusion, DXA body composition offers new diagnostic and research possibilities for a variety of diseases; due to its high reproducibility, DXA has also the potential to monitor body composition changes with pharmacological, nutritional or physic therapeutic interventions. ISCD addressed and recommended a list of clinical condition, but the crescent availability of DXA scans and software improvements may open the use of DXA to other indication in the next future. This article provides an overview of DXA body composition indications in the management of secondary osteoporosis and other clinical indications in adults.

  20. TIBIAL PLATEAU PROXIMAL AND DISTAL BONE BEHAVE SIMILARLY: BOTH ARE ASSOCIATED WITH FEATURES OF KNEE OSTEOARTHRITIS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is a growing imperative to understand how changes in peri-articular bone relate to pathological progression of knee osteoarthritis (KOA). Peri-articular bone density can be measured using dual x-ray absorptiometry (DXA). The medial:lateral tibial BMD ratio (M:L BMD) is associated with MRI and...

  1. Distal metacarpal bone mineral density by dual energy X-ray absorptiometry (DEXA) scan. Methodological investigation and application in rheumatoid arthritis.

    PubMed

    Florescu, A; Pødenphant, J; Thamsborg, G; Hansen, M; Leffers, A M; Andersen, V

    1993-01-01

    Dual energy X-ray absorptiometry scanning was performed along the axis of the third metacarpal bone of the non-dominant hand and including metacarpal bones 2, 3, 4 and 5. The Bone Mineral Density (BMD) was calculated for the distal 1/4 of each metacarpal bone. Ten patients with seropositive, erosive rheumatoid arthritis (RA) and 10 healthy, sex- and age-matched persons were investigated twice. The average BMD in RA patients was 73.6% of the value found in normals. The coefficient of variation on double determinations (in patients and controls) was 0.9-3.0%. We suggest that dual energy X-ray absorptiometry scanning with the scanning procedure proposed here may be an important instrument for the quantification of disease progression.

  2. Effect of a novel procedure for limiting motion on body composition and bone estimates by dual-energy X-ray absorptiometry in children.

    PubMed

    Rawal, Rita; Miller, Freeman; Modlesky, Christopher M

    2011-10-01

    We studied the effect of using the BodyFIX (Medical Intelligence Inc, Schwabmunchen, Germany) to immobilize children during a dual-energy X-ray absorptiometry scan on body composition and bone estimates. Overestimates of soft tissue and bone introduced by the BodyFIX were avoided by using a modified version of the system or were corrected by using mathematical models developed in this study.

  3. Comparison of peripheral quantitative computed tomography forearm bone density versus DXA in rheumatoid arthritis patients and controls.

    PubMed

    Juhász, B; Gulyás, K; Horváth, Á; Pethő, Z; Bhattoa, H P; Váncsa, A; Szekanecz, É; Horváth, C; Kocsis, J; Horváth, Z; Hodosi, K; Szántó, S; Szűcs, G; Szekanecz, Z

    2017-04-01

    Rheumatoid arthritis (RA) has been associated with osteoporosis. Quantitative computed tomography (QCT) is capable of assessing bone density and composition. We found lower bone density in RA compared to controls. Age and RA duration influenced bone density. QCT may be useful to assess bone metabolism in RA.

  4. Longitudinal DXA Studies: Minimum scanning interval for pediatric assessment of body fat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The increased prevalence of obesity in the United States, has led to the increased use of dual-energy X-ray absorptiometry (DXA) for assessment of body fat mass (TBF) in pediatric populations. We examined DXA precision, in order to determine suitable scanning intervals for the measurement of change...

  5. A comparative study of dual-X-ray absorptiometry and quantitative ultrasonography for the evaluating bone status in subjects with Rett syndrome.

    PubMed

    Caffarelli, C; Hayek, J; Tomai Pitinca, M D; Nuti, R; Gonnelli, S

    2014-09-01

    Rett syndrome, an X-linked neurodevelopmental disorder primarily affecting girls, is frequently characterized by a reduced bone mineral density (BMD) with an increased risk of fragility fractures. The aim of the study was to assess bone status by DXA technique and by quantitative ultrasound (QUS) in subjects with Rett syndrome and to evaluate which DXA or QUS parameters better correlate with clinical features. In 156 Rett subjects (mean age 13.6 ± 8.2 years) and in 62 controls, we measured BMD at femoral neck (BMD-FN) and at total femur (BMD-TF). Apparent volumetric bone mineral density (vBMAD) was also calculated. In all subjects, QUS parameters at phalanges by Bone Profiler-IGEA (amplitude-dependent speed of sound: AD-SoS and bone transmission time: BTT) were evaluated. We found that both DXA parameters and QUS parameters were significantly lower in Rett subjects than in controls. All clinical characteristics were positively correlated to BMD-FN, BMD-TF, AD-SoS, and BTT (p < 0.001) but not with vBMAD-FN. All ultrasonographic parameters were significantly correlated to BMD-FN and BMD-TF, whereas vBMAD-FN showed only positive significant correlation with densitometric parameters (p < 001). In Rett subjects BMD-FN was predicted primarily by weight and movement capacity, whereas vBMAD-FN was predicted by weight, height, and calcium intake. Moreover, AD-SoS was predicted by weight, height, and age, while BTT was predicted only by height. In conclusion, in our study the performance of QUS at phalanges was similar to those of BMD at femur, therefore, both areal BMD at femur and QUS at phalanges (AD-SoS and BTT) may be equally useful in the evaluation of skeletal status in Rett patients.

  6. Bone and Celiac Disease.

    PubMed

    Zanchetta, María Belén; Longobardi, Vanesa; Bai, Julio César

    2016-04-01

    More than 50% of untreated patients with celiac disease (CD) have bone loss detected by bone densitometry (dual-energy X-ray absorptiometry:DXA). Moreover, patients with CD are more likely to have osteoporosis and fragility fractures, especially of the distal radius. Although still controversial, we recommend DXA screening in all celiac disease patients, particularly in those with symptomatic CD at diagnosis and in those who present risk factors for fracture such as older age, menopausal status, previous fracture history, and familial hip fracture history. Bone microarchitecture, especially the trabecular network, may be deteriorated, explaining the higher fracture risk in these patients. Adequate calcium and vitamin D supplementation are also recommended to optimize bone recovery, especially during the first years of gluten free diet (GFD). If higher fracture risk persists after 1 or 2 years of GFD, specific osteoactive treatment may be necessary to improve bone health.

  7. Magnetic resonance imaging of the calcaneus: preliminary assessment of trabecular bone-dependent regional variations in marrow relaxation time compared with dual X-ray absorptiometry

    NASA Technical Reports Server (NTRS)

    Guglielmi, G.; Selby, K.; Blunt, B. A.; Jergas, M.; Newitt, D. C.; Genant, H. K.; Majumdar, S.

    1996-01-01

    RATIONALE AND OBJECTIVES: Marrow transverse relaxation time (T2*) in magnetic resonance (MR) imaging may be related to the density and structure of the surrounding trabecular network. We investigated regional variations of T2* in the human calcaneus and compared the findings with bone mineral density (BMD), as measured by dual X-ray absorpiometry (DXA). Short- and long-term precisions were evaluated first to determine whether MR imaging would be useful for the clinical assessment of disease status and progression in osteoporosis. METHODS: Gradient-recalled echo MR images of the calcaneus were acquired at 1.5 T from six volunteers. Measurements of T2* were compared with BMD and (for one volunteer) conventional radiography. RESULTS: T2* values showed significant regional variation; they typically were shortest in the superior region of the calcaneus. There was a linear correlation between MR and DXA measurements (r = .66 for 1/T2* versus BMD). Differences in T2* attributable to variations in analysis region-of-interest placement were not significant for five of the six volunteers. Sagittal MR images had short- and long-term precision errors of 4.2% and 3.3%, respectively. For DXA, the precision was 1.3% (coefficient of variation). CONCLUSION: MR imaging may be useful for trabecular bone assessment in the calcaneus. However, given the large regional variations in bone density and structure, the choice of an ROI is likely to play a major role in the accuracy, precision, and overall clinical efficacy of T2* measurements.

  8. Measurement error of DXA: interpretation of fat and lean mass changes in obese and non-obese children.

    PubMed

    Wosje, Karen S; Knipstein, Brittany L; Kalkwarf, Heidi J

    2006-01-01

    Information on reproducibility of dual-energy X-ray absorptiometry (DXA) measurements is essential because DXA is frequently used by clinicians and researchers to assess body composition changes. We estimated measurement error and absolute and relative smallest detectable differences (SDDs) for fat, lean, and bone mass in children. The SDD is the change necessary to be confident that the change is not a consequence of measurement error. Duplicate whole body DXA (Hologic QDR 4500A, Hologic Inc., Waltham, MA) scans were obtained on 32 obese and 34 non-obese children ages 6-19 yr. Absolute (kg) and relative (coefficient of variation) measurement error and SDD were calculated. Absolute SDDs for fat and lean were higher for obese (1.39 and 1.30 kg, respectively) than for non-obese children (0.42 and 0.47 kg, respectively). The %SDD for fat was lower for obese (3.58%) than non-obese children (5.24%), but for lean the %SDD was higher for obese (2.60%) than non-obese children (1.32%). The SDDs for bone mass were similar for obese and non-obese children. An obese child must lose or gain more absolute fat and lean mass than a non-obese child to be confident that the change is not a reflection of measurement error. Overall, SDD values for fat, lean, and bone mass are low.

  9. Comparison of dual-photon absorptiometry systems for total-body bone and soft tissue measurements: Dual-energy X-rays versus gadolinium 153

    SciTech Connect

    Russell-Aulet, M.; Wang, J.; Thornton, J.; Pierson, R.N. Jr. )

    1991-04-01

    A total of 81 subjects (41 males and 40 females) were scanned by dual-photon absorptiometry by 153Gd source (DPA; Lunar DP4) and by dual-energy x-ray absorptiometry (DEXA; Lunar-DPX) within a 24 h period. Total-body bone mineral density (TBMD), calcium content (Ca), and soft tissue mass (ST) were determined with a precision of about 1-1.5% using DPA and 0.5-1.0% using DEXA. Measurements of TBMD, Ca, ST, bone area (area), percentage fat, and regional bone mineral densities (BMD) were compared. Paired t-tests showed small but significant differences between all measurements. Correlations (r) for TBMD, Ca, area, ST, percentage fat, arm BMD, leg BMD, and trunk BMD were 0.99, 0.99, 0.97, 0.99, 0.97, 0.99, 0.99, and 0.98. There were small systematic differences for TBMD (less than 1%), calcium (3%), bone area (3%), soft tissue mass (7%), and percentage fat (9%) between the two approaches. Regression equations are given relating these measurements.

  10. Precision Error in Dual-Energy X-Ray Absorptiometry Body Composition Measurements in Elite Male Rugby League Players.

    PubMed

    Barlow, Matthew J; Oldroyd, Brian; Smith, Debbie; Lees, Matthew J; Brightmore, Amy; Till, Kevin; Jones, Benjamin; Hind, Karen

    2015-01-01

    Body composition analysis using dual-energy X-ray absorptiometry (DXA) is becoming increasingly popular in both clinical and sports science settings. Obesity, characterized by high fat mass (FM), is associated with larger precision errors; however, precision error for athletic groups with high levels of lean mass (LM) are unclear. Total (TB) and regional (limbs and trunk) body composition were determined from 2 consecutive total body scans (GE Lunar iDXA) with re-positioning in 45 elite male rugby league players (age: 21.8 ± 5.4 yr; body mass index: 27.8 ± 2.5 kg m(-1)). The root mean squared standard deviation (percentage co-efficient of variation) were TB bone mineral content: 24g (1.7%), TB LM: 321 g (1.6%), and TB FM: 280 g (2.3%). Regional precision values were superior for measurements of bone mineral content: 4.7-16.3 g (1.7-2.1%) and LM: 137-402 g (2.0-2.4%), than for FM: 63-299 g (3.1-4.1%). Precision error of DXA body composition measurements in elite male rugby players is higher than those reported elsewhere for normal adult populations and similar to those reported in those who are obese. It is advised that caution is applied when interpreting longitudinal DXA-derived body composition measurements in male rugby players and population-specific least significant change should be adopted.

  11. Experimental assessment of bone mineral density using quantitative computed tomography in holstein dairy cows

    PubMed Central

    MAETANI, Ayami; ITOH, Megumi; NISHIHARA, Kahori; AOKI, Takahiro; OHTANI, Masayuki; SHIBANO, Kenichi; KAYANO, Mitsunori; YAMADA, Kazutaka

    2016-01-01

    The aim of this study was to assess the measurement of bone mineral density (BMD) by quantitative computed tomography (QCT), comparing the relationships of BMD between QCT and dual-energy X-ray absorptiometry (DXA) and between QCT and radiographic absorptiometry (RA) in the metacarpal bone of Holstein dairy cows (n=27). A significant positive correlation was found between QCT and DXA measurements (r=0.70, P<0.01), and a significant correlation was found between QCT and RA measurements (r=0.50, P<0.01). We conclude that QCT provides quantitative evaluation of BMD in dairy cows, because BMD measured by QCT showed positive correlations with BMD measured by the two conventional methods: DXA and RA. PMID:27075115

  12. Rural vs. non-rural differences and longitudinal bone changes by DXA and pQCT in men aged 20-66 years: A population-based study.

    PubMed

    Specker, Bonny L; Wey, Howard E; Binkley, Teresa L; Beare, Tianna M; Minett, Maggie; Weidauer, Lee

    2015-10-01

    The purpose of this research was to determine whether there were differences in estimated means and rates of change in BMC, bone area, BMD and measures of bone geometry among men (n=544) from three distinct populations (Hutterite [rural], rural non-Hutterite, non-rural), and whether activity levels or calcium intake explain these population differences. Men were enrolled in the South Dakota Rural Bone Health Study and followed for 7.5 years to estimate means and rates of change in bone mass, density, size and geometry. Femoral neck (FN) and spine measurements were obtained every 18 months by DXA and distal radius (4% and 20%) measurements by pQCT. Activity measurements and calcium intake were obtained quarterly for the first 3 years and at 54, 72, and 90 months. Rural men had greater percent time in moderate plus vigorous activity (mean ± SD: 22 ± 10 vs. 15 ± 8%, p<0.001) and greater lean mass (69 ± 9 vs. 66 ± 10 kg, p=0.05) than non-rural men. Both rural populations (Hutterite and rural men) had larger femoral neck (FN) bone area and greater 20% radius cross-sectional area than non-rural men ([least square means ± SE] FN area: 5.90 ± 0.02 and 5.86 ± 0.02 vs. 5.76 ± 0.03 cm(2), p<0.001 and p=0.03 respectively and cross-sectional area: 171.0 ±1.3 and 165.5 ± 1.5 vs. 150.3 ± 1.6mm(2), both p<0.001). Despite lower cortical vBMD in Hutterite and rural men compared to non-rural men (1182 ± 2 and 1187 ± 2 vs. 1192 ± 2 mm(2), p<0.001 and p=0.06 respectively), bone strength (pSSI) was greater (429 ± 5 and 422 ± 5 vs. 376 ± 6 mm(3), both p<0.001). The rates of change in femoral neck BMC and aBMD and trabecular vBMD also differed by rural lifestyle, with greater losses among non-rural men in their 20s and 60s compared to both Hutterite and rural populations (time-by-age-by-group interactions, both p<0.01). Physical activity was not found to be a potential mediator of population differences. Baseline calcium intake was associated with FN aBMD (p=0.04), and

  13. Rural vs. non-rural differences and longitudinal bone changes by DXA and pQCT in men aged 20-66 years: A population-based study☆

    PubMed Central

    Specker, Bonny L.; Wey, Howard E.; Binkley, Teresa L.; Beare, Tianna M.; Minett, Maggie; Weidauer, Lee

    2015-01-01

    The purpose of this research was to determine whether there were differences in estimated means and rates of change in BMC, bone area, BMD and measures of bone geometry among men (n = 544) from three distinct populations (Hutterite [rural], rural non-Hutterite, non-rural), and whether activity levels or calcium intake explain these population differences. Men were enrolled in the South Dakota Rural Bone Health Study and followed for 7.5 years to estimate means and rates of change in bone mass, density, size and geometry. Femoral neck (FN) and spine measurements were obtained every 18 months by DXA and distal radius (4% and 20%) measurements by pQCT. Activity measurements and calcium intake were obtained quarterly for the first 3 years and at 54, 72, and 90 months. Rural men had greater percent time in moderate plus vigorous activity (mean ± SD: 22 ± 10 vs. 15 ±8%, p < 0.001) and greater lean mass (69 ± 9 vs. 66 ± 10 kg, p = 0.05) than non-rural men. Both rural populations (Hutterite and rural men) had larger femoral neck (FN) bone area and greater 20% radius cross-sectional area than non-rural men ([least square means ± SE] FN area: 5.90 ± 0.02 and 5.86 ± 0.02 vs. 5.76 ± 0.03 cm2, p < 0.001 and p = 0.03 respectively and cross-sectional area: 171.0 ± 1.3 and 165.5 ± 1.5 vs. 150.3 ± 1.6 mm2, both p < 0.001). Despite lower cortical vBMD in Hutterite and rural men compared to non-rural men (1182 ± 2 and 1187 ± 2 vs. 1192 ± 2 mm2, p < 0.001 and p = 0.06 respectively), bone strength (pSSI) was greater (429 ± 5 and 422 ± 5 vs. 376 ± 6 mm3, both p < 0.001). The rates of change in femoral neck BMC and aBMD and trabecular vBMD also differed by rural lifestyle, with greater losses among non-rural men in their 20s and 60s compared to both Hutterite and rural populations (time-by-age-by-group interactions, both p < 0.01). Physical activity was not found to be a potential mediator of population differences. Baseline calcium intake was associated with FN aBMD (p

  14. Association between Body Mass Index and Bone Mineral Density in Patients Referred for Dual-Energy X-Ray Absorptiometry Scan in Ajman, UAE.

    PubMed

    Fawzy, Tarek; Muttappallymyalil, Jayakumary; Sreedharan, Jayadevan; Ahmed, Amal; Alshamsi, Salma Obaid Saeed; Al Ali, Mariyam Saif Salim Humaid Bin Bader; Al Balsooshi, Khawla Ahmed

    2011-01-01

    Body Mass Index (BMI) is a good indicator for measurements of Bone Mineral Density (BMD) which measures the density of minerals present in the bones using a special scan. This study was conducted to assess the association between BMI and status of BMD among 101 individuals who underwent Dual-Energy X-ray Absorptiometry (DEXA) scan. 39 subjects had normal and 62 had low bone mineral density. BMD was low in 82.4% of people with normal BMI, 78.1% among overweight, and 44.2% among obese. There was a statistically significant association between these two variables (P < .001). Low BMD was recorded in 59.1% of females and 76.9% of males. Association between advancing age and lower BMI is an important risk factor in the occurrence of low BMD.

  15. Nutritional secondary hyperparathyroidism in two cats: evaluation of bone mineral density with dual-energy X-ray absorptiometry and computed tomography.

    PubMed

    Dimopoulou, M; Kirpensteijn, J; Nielsen, D H; Buelund, L; Hansen, M S

    2010-01-01

    Two three-month-old, intact female Abyssinian cats were presented with a history of lameness, constipation and ataxia. The cats had been fed a diet composed almost exclusively of meat. Both showed severe osteopenia and multiple pathological fractures on radiography. Following euthanasia of the more severely affected cat, postmortem examination revealed changes consistent with nutritional secondary hyperparathyroidism and fibrous osteodystrophy, such as cortical thinning, massive connective tissue invasion in the diaphysis of long bones, and hypertrophy of the chief cells in both parathyroid glands. After introducing a balanced commercial diet to the surviving cat, bone mineralisation improved from the baseline value, and at subsequent examinations at three, six and 22 weeks later, as indicated by bone mineral density measurements obtained by dual-energy X-ray absorptiometry and computed tomography.

  16. Comparison of Anthropometry to Dual Energy X-Ray Absorptiometry: A New Prediction Equation for Women

    ERIC Educational Resources Information Center

    Ball, Stephen; Swan, Pamela D.; DeSimone, Rosemarie

    2004-01-01

    The purpose of this study was to assess the accuracy of three recommended anthropometric equations for women and then develop an updated prediction equation using dual energy x-ray absorptiometry (DXA). The percentage of body fat (%BF) by anthropometry was significantly correlated (r = .896-. 929; p [is less than] .01) with DXA, but each equation…

  17. Premenopausal and postmenopausal changes in bone mineral density of the proximal femur measured by dual-energy X-ray absorptiometry.

    PubMed

    Ravn, P; Hetland, M L; Overgaard, K; Christiansen, C

    1994-12-01

    Total and regional bone mineral density (BMD) of the proximal femur was measured by DXA in 1238 healthy white women. In the 389 premenopausal women, aged 21-54 years, no bone loss was observed before the menopause, except in the femoral neck and Ward's triangle, in which BMD decreased by 0.3%/year (SEE 0.2-0.9%/year, p < 0.001) and 0.6%/year (SEE 0.4-0.8%/year, p < 0.001), respectively. In the postmenopausal women aged 48-75 years, there was a highly significant exponential decay in BMD with age and years since menopause (YSM) in all regions (-0.58 < r < -0.48, p < 0.001). However, YSM was a better predictor of BMD than age. The decrease in BMD in the first 5 years postmenopause reached values of 9-13%. The estimated bone loss after 20 years was 17-30%, greatest in Ward's triangle and smallest in the intertrochanteric region. BMD correlated highly significantly with BMI (0.26 < r < 0.48, p < 0.001). In conclusion, the present study indicates a stable premenopausal bone mass of the proximal femur and a postmenopausal bone loss, which is influenced mainly by YSM within the first 10-15 years after menopause. BMD correlated with body mass index (BMI) in the postmenopausal years, confirming that low BMI constitutes a potential risk factor for osteoporosis.

  18. Evaluation of the effects of hypergravity exposure and caging restraint on bone mineralization in the Beagle by in vivo photon absorptiometry

    NASA Technical Reports Server (NTRS)

    Fisher, G. L.; Berding, K. L.; Goldman, M.

    1975-01-01

    Photon absorptiometry was used to evaluate bone mineral kinetics associated with normal development and the possible perturbations to bone development resulting from hypergravity exposure over a period of six months in developing Beagles. A series of seven measurements were performed at specific times with the first measurement prior to treatment and subsequent measurements at 2, 5, 9, 14, 20 and 26 weeks from the onset of the experiment. Four groups of six male Beagle pups, ranging in age from 85 to 92 days were studied. Two groups were chronically exposed to hypergravity treatments by centrifugation of 2.0 G (18.0 RPM, 11.7 ft radius) and 2.6 G (18.0 RPM, 19.8 ft radius) for the 26 week period. A third group of six dogs served as a caged control to evaluate possible changes due to confinement in small plexiglass cages similar to those of the centrifuge. Thus this control group was subjected to limited exercise due to caging restraint. The fourth group of animals was housed in open runs to allow exercise without the spatial confinement of the smaller plexiglass cages. Results show highly significant differences in body weight, bone length, increase in bone density of control group relative to other groups, and a decrease in bone mineral content in the two gravity treated groups.

  19. The Ability of Lumbar Spine DXA and Phalanx QUS to Detect Previous Fractures in Young Thalassemic Patients With Hypogonadism, Hypothyroidism, Diabetes, and Hepatitis-B: A 2-Year Subgroup Analysis From the Taranto Area of Apulia Region

    PubMed Central

    Neglia, Cosimo; Peluso, Angelo; di Rosa, Salvatore; Ferrarese, Antonio; Di Tanna, Gianluca; Caiaffa, Vincenzo; Benvenuto, Marco; Cozma, Alexandru; Chitano, Giovanna; Agnello, Nadia; Paladini, Daniele; Baldi, Nicola; Distante, Alessandro; Piscitelli, Prisco

    2013-01-01

    Background: Osteoporosis is a leading cause of morbidity in patients affected by β-thalassemia major or intermediate; we aimed to assess the association between demineralization observed in young thalassemic patients. Methods: A total of 88 patients with β-thalassemia were recruited at Microcitemia Center of Taranto Hospital under the Prevention Osteoporosis and Fractures research project from 2008 to 2010. All the patients were screened with both dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS). T score and Z score values were obtained for each subject. Results: The overall prevalence of demineralization was 84% with DXA and 70% with QUS, whereas normality was found in 16% of patients screened with DXA and in 30% of cases with QUS. Hypogonadism, hypothyroidism, diabetes mellitus, hepatitis-B, and the presence of previous fragility fractures were significantly associated with the demineralization status (lower T scores values) both with DXA and QUS. Conclusion: Our data confirm that DXA and QUS examinations are both useful for detecting bone demineralization in thalassemic patients. PMID:23652868

  20. Skeletal Recovery Following Long-Duration Spaceflight Missions as Determined by Preflight and Postflight DXA Scans of 45 Crew Members

    NASA Technical Reports Server (NTRS)

    Sibonga, J. D.; Evans, H. J.; Sung, H. G.; Spector, E. R.; Lang, T. F.; Oganov, V. S.; Bakulin, A. V.; Shackelford, L. C.; LeBlanc, A. D.

    2006-01-01

    Introduction: The loss of bone mineral in astronauts during spaceflight has been investigated throughout the more than 40 years of bone research in space. Consequently, it is a medical requirement at NASA that changes in bone mass be monitored in crew members by measurements of bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA). This report is the first to evaluate medical data to address the recovery of bone mineral that is lost during spaceflight. Methods: DXA scans are performed before and after flight in astronauts who serve on long-duration missions (4-6 months) to ensure that medical standards for flight certification are met, to evaluate the effects of spaceflight and to monitor the restoration to preflight BMD status after return to Earth. Through cooperative agreements with the Russian Space Agency, the Bone and Mineral Lab at NASA Johnson Space Center (Houston, TX), also had access to BMD data from cosmonauts who had flown on long-duration missions yielding data from a total of 45 individual crew members. Changes in BMD (between 56 different sets of pre- and postflight measurements) were plotted as a function of time (days after landing); plotted data were fitted to an exponential mathematical model that determined i) BMD change at day 0 after landing and ii) the number of days after which 50% of the lost bone was recovered ("Recovery Half-Life"). These fits were performed for BMD of the lumbar spine, trochanter, pelvis, femoral neck and calcaneus. Results: In sum, averaged losses of bone mineral after spaceflight ranged between 2-9% for sites in the axial and appendicular skeleton. The fitted postflight BMD values predicted a 50% recovery of bone loss for all sites within 9 months.

  1. Bone Density in Peripubertal Boys with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Neumeyer, Ann M.; Gates, Amy; Ferrone, Christine; Lee, Hang; Misra, Madhusmita

    2013-01-01

    We determined whether bone mineral density (BMD) is lower in boys with autism spectrum disorders (ASD) than controls, and also assessed variables that may affect BMD in ASD. BMD was measured using dual energy X-ray absorptiometry (DXA) in 18 boys with ASD and 19 controls 8-14 years old. Boys with ASD had lower BMD Z-scores at the spine, hip and…

  2. Are adult patients with Laron syndrome osteopenic? A comparison between dual-energy X-ray absorptiometry and volumetric bone densities.

    PubMed

    Benbassat, Carlos A; Eshed, Varda; Kamjin, Moshe; Laron, Zvi

    2003-10-01

    Severe short stature resulting from a deficiency in IGF-I is a prominent feature of Laron syndrome (LS). Although low bone mineral density (BMD) has been noted in LS patients examined by dual energy x-ray absorptiometry (DEXA), this technique does not take volume into account and may therefore underestimate the true bone density in patients with small bones. The aim of the present study was to evaluate the BMD yielded by DEXA in our LS patients using estimated volumetric values. Volumetric density was calculated with the following formulas: bone mineral apparent density (BMAD) = bone mineral content (BMC)/(area)(3/2) for the lumbar spine and BMAD = BMC/area(2) for the femoral neck. The study sample included 12 patients (mean age, 43.9 yr; mean height, 123.7 cm). Findings were compared with 10 osteopenic subjects without developmental abnormalities (mean age, 56 yr; mean height, 164.8 cm) and 10 healthy control subjects matched for sex and age to the LS patients (mean height, 165.5 cm). BMAD in the LS group was 0.201 +/- 0.02 g/cm(3) at the lumbar spine and 0.201 +/- 0.04 g/cm(3) at the femoral neck; corresponding values for the osteopenic group were 0.130 +/- 0.01 and 0.140 +/- 0.01 g/cm(3), and for the controls, 0.178 +/- 0.03 and 0.192 +/- 0.02 g/cm(3). Although areal BMD was significantly lower in the LS and osteopenic subjects compared with controls (P < 0.02) at both the lumbar spine and femoral neck, BMAD was low (P < 0.01) in the osteopenic group only. In conclusion, DEXA does not seem to be a reliable measure of osteoporosis in patients with LS.

  3. Generalized equations for estimating DXA percent fat of diverse young women and men: The Tiger Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Popular generalized equations for estimating percent body fat (BF%) developed with cross-sectional data are biased when applied to racially/ethnically diverse populations. We developed accurate anthropometric models to estimate dual-energy x-ray absorptiometry BF% (DXA-BF%) that can be generalized t...

  4. Solid anthropomorphic infant whole body DXA phantom: Design, evaluation, and multisite testing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dual energy X-ray absorptiometry (DXA) requires phantoms for quality control and cross-calibration. No commercially available phantoms are designed specifically for infant whole-body scanning. We fabricated a phantom closely matching a 7-kg human infant in body habitus using PVC, nylon-mix, and poly...

  5. Measurement precision of body composition variables in elite wheelchair athletes, using dual-energy X-ray absorptiometry.

    PubMed

    Keil, Mhairi; Totosy de Zepetnek, Julia O; Brooke-Wavell, Katherine; Goosey-Tolfrey, Victoria L

    2016-01-01

    The purpose of this study was to assess the reproducibility of body composition measurements by dual-energy X-ray absorptiometry (DXA) in 12 elite male wheelchair basketball players (age 31 ± 7 years, BMI 21 ± 2 kg/m(2) and onset of disability 25 ± 9 years). Two whole body scans were performed on each participant in the supine position on the same day, using Lunar Prodigy Advance DXA (GE Lunar, Madison, WI, USA). Participants dismounted from the scanning table and were repositioned in-between the first and second scan. Whole body coefficient of variation (CV) values for bone mineral content (BMC), fat mass (FM) and soft tissue lean mass (LTM) were all <2.0%. With the exclusion of arm FM (CV = 7.8%), CV values ranged from 0.1 to 3.7% for all total body and segmental measurements of BMC, FM and LTM. The least significant change that can be attributed to the effect of treatment intervention in an individual is 1.0 kg, 1.1 kg, 0.12 kg for FM, LTM, and BMC, respectively. This information can be used to determine meaningful changes in body composition when assessed using the same methods longitudinally. Whilst there may be challenges in the correct positioning of an individual with disability that can introduce greater measurement error, DXA is a highly reproducible technique in the estimation of total and regional body composition of elite wheelchair basketball athletes.

  6. Repeatability of Volume and Regional Body Composition Measurements of the Lower Limb Using Dual-energy X-ray Absorptiometry.

    PubMed

    Gjorup, Caroline A; Zerahn, Bo; Juul, Sarah; Hendel, Helle W; Christensen, Karl Bang; Hölmich, Lisbet R

    Lower limb lymphedema is a dynamic condition in which tissue composition and volume measurements are affected. Various definitions of lower limb lymphedema exist but volume differences between the limbs are widely used. It is therefore necessary to have a readily available noninvasive measurement technique allowing multiple measurements of the lower limbs. This study investigated the repeatability of duplicate volume and regional body composition measurements of the lower limb using the GE Lunar Prodigy dual-energy X-ray absorptiometry (DXA) scanner Prodigy (GE Medical Systems, Madison, WI). Twenty-seven participants (54 limbs), 14 women and 13 men aged 33-71 years with body mass index ranging from 14 to 32 kg/m(2) were recruited. Duplicate whole-body DXA scans were performed with repositioning between examinations. Regions of interest were manually drawn for the thigh, lower leg, and foot, and total volume was calculated using the density of bone mineral content, fat, and lean mass. The repeatability of the volume of the lower limb and regional thigh and lower leg tissue composition (bone mineral content, fat, and lean mass) was good with intraclass correlation coefficient values of 0.97 to 0.99, and narrow limits of agreement on the Bland-Altman plots. These results confirm DXA to be a highly repeatable method for volume and tissue composition measurements of the lower limb. In a population at risk of lymphedema, DXA offers a clinically readily available noninvasive method allowing multiple measurements of volume and tissue composition on a routine basis, important for diagnosing, monitoring, managing, and researching lymphedema.

  7. Bone density in patients with chondromalacia patella.

    PubMed

    Salehi, Iraj; Khazaeli, Shabnam; Hatami, Parta; Malekpour, Mahdi

    2010-06-01

    Chondromalacia of the patella is the most common cause of anterior knee pain in young women. The etiology of the disease is not well-understood but the initial lesion is a disorganization of collagenous structures. Since the disease is proposed to be due to generalized constitutional disturbance, we postulated that bony structures could also be involved. To investigate this hypothesis we measured the bone density of 286 patients with the diagnosis of chondromalacia of the patella during a 4-year period using dual energy X-ray absorptiometry (DXA) method. We found a significant number of patients having low bone densities. This problem was more pronounced in men and in younger age groups. We suggest base-line bone density evaluation in all patients, treatment of osteopenia or osteoporosis in select patients and regular follow-ups using DXA.

  8. National Health and Nutrition Examination Survey whole-body dual-energy X-ray absorptiometry reference data for GE Lunar systems.

    PubMed

    Fan, Bo; Shepherd, John A; Levine, Michael A; Steinberg, Dee; Wacker, Wynn; Barden, Howard S; Ergun, David; Wu, Xin P

    2014-01-01

    The National Health and Nutrition Examination Survey (NHANES 1999-2004) includes adult and pediatric comparisons for total body bone and body composition results. Because dual-energy x-ray absorptiometry (DXA) measurements from different manufacturers are not standardized, NHANES reference values currently are applicable only to a single make and model of Hologic DXA system. The purpose of this study was to derive body composition reference curves for GE Healthcare Lunar DXA systems. Published values from the NHANES 1999-2004 survey were acquired from the Centers for Disease Control and Prevention website. Using previously reported cross-calibration equations between Hologic and GE-Lunar, we converted the total body and regional bone and soft-tissue measurements from NHANES 1999-2004 to GE-Lunar values. The LMS (LmsChartMaker Pro Version 3.5) curve fitting method was used to generate GE-Lunar reference curves. Separate curves were generated for each sex and ethnicity. The reference curves were also divided into pediatric (≤20 years old) and adult (>20 years old) groups. Adult reference curves were derived as a function of age. Additional relationships of pediatric DXA values were derived as a function of height, lean mass, and bone area. Robustness was tested between Hologic and GE-Lunar Z-score values. The NHANES 1999-2004 survey included a sample of 20,672 participants' (9630 female) DXA scans. A total of 8056 participants were younger than 20 yr and were included in the pediatric reference data set. Participants enrolled in the study who weighed more than 136 kg (over scanner table limit) were excluded. The average Z-scores comparing the new GE-Lunar reference curves are close to zero, and the standard deviation of the Z-scores are close to one for all variables. As expected, all measurements on the GE-Lunar reference curves for participants younger than 20 yr increase monotonically with age. In the adult population, most of the curves are constant at younger

  9. A novel approach to fracture-risk-assessment in osteoporosis by ROI-oriented application of the Minkowski-functionals to dual x-ray absorptiometry scans of the hip

    NASA Astrophysics Data System (ADS)

    Boehm, Holger F.; Panteleon, Alexandra; Vogel, Tobias; Burklein, Dominik; Reiser, Maximilian

    2008-03-01

    Fractures of the proximal femur represent the worst complication in osteoporosis with a mortality rate of up to 50% during the first post-traumatic year. Bone mineral density (BMD) as obtained from dual energy x-ray absorptiometry (DXA) is a good predictor of fracture risk. However, there is a considerable overlap in the BMD-results between individuals who have fractured and those who have not. As DXA uses highly standardized radiographic projection images to obtain the densitometric information, it can be postulated that these images contain much more information than just mineral density. Lately, geometric dimensions, e.g. hip axis length (HAL) or femoral neck axis length (FNAL), are considered in conjunction with BMD, which may allow to enhance the predictive potential of bone mass measurements. In recent studies we sucessfully introduced a novel methodology for topological analysis of multi-dimensional graylevel datasets, that, for instance, allows to predict the ultimate mechanical strength of femoral bone specimens. The new topolocial parameters are based on the so called Minkowski Functionals (MF), which represent a set of topographical descriptors that can be used universally. Since the DXA-images are multi-graylevel datasets in 2D obtained in a standardized way, they are ideally suited to be processed by the new method. In this study we introduce a novel algorithm to evaluate DXA-scans of the proximal femur using quantitative image analysis procedures based on the MF in 2D. The analysis is conducted in four defined regions of interest in analogy to the standard densitometric evaluation. The objective is to provide a tool to identifiy individuals with critically reduced mechanical competence of the hip. The result of the new method is compared with the evaluation bone mineral density obtained by DXA, which - at present - is the clinical standard of reference.

  10. [Investigation of mineral density and the bone structure following 105 day experiment in an isolated environment (MARS-105)].

    PubMed

    Prostiakov, I V; Novikov, V E; Morukov, B V

    2010-01-01

    Healthy volunteers' bone system investigation was performed before and after 105 days experiment in an isolated environment (MARS-105) using dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). Volumetric bone mineral density (VBMD), bone mineral density (BMD), structural parameters of radius and tibia were evaluated. There were no significant BMD changes revealed in skeletal parts critical in terms of biomechanical properties. pQCT examination noted microarchitecture deterioration of radius that was reflected in decreasing of trabecular number and increasing of bone tissue inhomogeneity. Decreasing VBMD both cortical and trabecular bone were revealed for tibia. Unexpectedly, increasing oftrabecular number and decreasing of inhomogeneity were revealed for tibia. Experiment showed that only the complex investigation including DXA and pQCT measurements gives an idea about bone system changes under simulated experiment conditions.

  11. A systematic quality assurance study in bone densitometry devices

    NASA Astrophysics Data System (ADS)

    Tuncman, Duygu; Kovan, Hatice; Kovan, Bilal; Demir, Bayram; Turkmen, Cuneyt

    2015-07-01

    Osteoporosis is the most common metabolic bone disease and can result in devastating physical, psychosocial, and economic consequences. It occurs in women after menopause and affects most elderly. Dual-energy x-ray absorptiometry (DXA) is currently the most widely used method for the measurement of areal Bone Mineral Density (BMD) (g/cm2) .DXA is based on the variable absorption of X-ray by the different body components and uses high and low energy X-ray photons. There are two important values in the assessment of the DXA. These values are T-score and Z-score. The T-score is calculated by taking the difference between a patient's measured BMD with the mean BMD of the young normal population, matched for gender and ethnicity, and then by dividing the difference with the standard deviation (SD) of the BMD of the young normal population. T-score and also Z-score are directly depends on the Bone Mineral Density (BMD). BMD measurements should be made periodically in a patient life. But mostly, it is not possible with the same device. Therefore, in this study, for the quality assurance of bone densitometry devices, we evaluated the BMD results measured in the different Bone Densitometry (DXA) devices using a spine phantom.

  12. Current methods and advances in bone densitometry

    NASA Technical Reports Server (NTRS)

    Guglielmi, G.; Gluer, C. C.; Majumdar, S.; Blunt, B. A.; Genant, H. K.

    1995-01-01

    Bone mass is the primary, although not the only, determinant of fracture. Over the past few years a number of noninvasive techniques have been developed to more sensitively quantitate bone mass. These include single and dual photon absorptiometry (SPA and DPA), single and dual X-ray absorptiometry (SXA and DXA) and quantitative computed tomography (QCT). While differing in anatomic sites measured and in their estimates of precision, accuracy, and fracture discrimination, all of these methods provide clinically useful measurements of skeletal status. It is the intent of this review to discuss the pros and cons of these techniques and to present the new applications of ultrasound (US) and magnetic resonance (MRI) in the detection and management of osteoporosis.

  13. Dual-energy X-ray absorptiometry derived structural geometry for stress fracture prediction in male U.S. Marine Corps recruits.

    PubMed

    Beck, T J; Ruff, C B; Mourtada, F A; Shaffer, R A; Maxwell-Williams, K; Kao, G L; Sartoris, D J; Brodine, S

    1996-05-01

    A total of 626 U.S. male Marine Corps recruits underwent anthropometric measurements and dual-energy X-ray absorptiometry (DXA) scans of the femoral midshaft and the distal third of the tibia prior to a 12 week physical training program. Conventionally obtained frontal plane DXA scan data were used to measure the bone mineral density (BMD) as well as to derive the cross-sectional area, moment of inertia, section modulus, and bone width in the femur, tibia, and fibula. During training, 23 recruits (3.7%) presented with a total of 27 radiologically confirmed stress fractures in various locations in the lower extremity. After excluding 16 cases of shin splints, periostitis, and other stress reactions that did not meet fracture definition criteria, we compared anthropometric and bone structural geometry measurements between fracture cases and the remaining 587 normals. There was no significant difference in age (p = 0.8), femur length (p = 0.2), pelvic width (p = 0.08), and knee width at the femoral condyles (p = 0.06), but fracture cases were shorter (p = 0.01), lighter (p = 0.0006), and smaller in most anthropometric girth dimensions (p < 0.04). Fracture case bone cross-sectional areas (p < 0.001), moments of inertia (p < 0.001), section moduli (p < 0.001), and widths (p < 0.001) as well as BMD (p < 0.03) were significantly smaller in the tibia and femur. After correcting for body weight differences, the tibia cross-sectional area (p = 0.03), section modulus (p = 0.05), and width (p = 0.03) remained significantly smaller in fracture subjects. We conclude that both small body weight and small diaphyseal dimensions relative to body weight are factors predisposing to the development of stress fractures in this population. These results suggest that bone structural geometry measurements derived from DXA data may provide a simple noninvasive methodology for assessing the risk of stress fracture.

  14. Estimation of In Vivo Bone Strength Using Ultrasound Signals

    NASA Astrophysics Data System (ADS)

    Nogata, Fumio; Shimamoto, Akira; Habu, Toshihiko

    A new method for estimating in vivo bone strength using ultrasound inspection is described, which can allow diagnose of osteoporosis from the viewpoint of mechanical integrity. The method was based on the two-dimensional area fraction of bone calculated from the difference in the speed of ultrasound propagation through cancellous bone. Then bulk Young's modulus was calculated for various architectures of the cancellous bone with the bone area fraction (S) using finite element method. Since there was a good relationship between the BMD (bone mineral density) by DXA (dual energy x-ray absorptiometry) method and the bone area fraction by ultrasound inspection, the technique also allows the estimation of in vivo BMD of the spine, which has been traditionally used at medical area to diagnose osteoporosis. Note that the periodic estimation of the bulk Young's modulus and strength applying the technique is effective to predict the fracture risk for in vivo bone.

  15. Optimizing Bone Health in Duchenne Muscular Dystrophy

    PubMed Central

    Buckner, Jason L.; Bowden, Sasigarn A.; Mahan, John D.

    2015-01-01

    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA), as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA. PMID:26124831

  16. Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos).

    PubMed

    Tenenhouse, A; Joseph, L; Kreiger, N; Poliquin, S; Murray, T M; Blondeau, L; Berger, C; Hanley, D A; Prior, J C

    2000-01-01

    The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study which will measure the incidence and prevalence of osteoporosis and fractures, and the effect of putative risk factors, in a random sample of 10,061 women and men aged > or = 25 years recruited in approximately equal numbers in nine centers across Canada. In this paper we report the results of studies to establish peak bone mass (PBM) which would be appropriate reference data for use in Canada. These reference data are used to estimate the prevalence of osteoporosis and osteopenia in Canadian women and men aged > or = 50 years. Participants were recruited via randomly selected household telephone listings. Bone mineral density (BMD) of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry using Hologic QDR 1000 or 2000 or Lunar DPX densitometers. BMD results for lumbar spine and femoral neck were converted to a Hologic base. BMD of the lumbar spine in 578 women and 467 men was constant to age 39 years giving a PBM of 1.042 +/- 0.121 g/cm2 for women and 1.058 +/- 0.127 g/cm2 for men. BMD at the femoral neck declined from age 29 years. The mean femoral neck BMD between 25 and 29 years was taken as PBM and was found to be 0.857 +/- 0.125 g/cm2 for women and 0.910 +/- 0.125 g/cm2 for men. Prevalence of osteoporosis, as defined by WHO criteria, in Canadian women aged > or = 50 years was 12.1% at the lumbar spine and 7.9% at the femoral neck with a combined prevalence of 15.8%. In men it was 2.9% at the lumbar spine and 4.8% at the femoral neck with a combined prevalence of 6.6%.

  17. Associations between pQCT-based fat and muscle area and density and DXA-based total and leg soft tissue mass in healthy women and men

    PubMed Central

    Sherk, Vanessa D; Thiebaud, Robert S; Chen, Zhaojing; Karabulut, Murat; Kim, So Jung; Bemben, Debra A

    2015-01-01

    Peripheral Quantitative Computed Tomography (pQCT) can be used for muscle and fat area and density assessments. These may independently influence muscle and fat mass measurements from Dual Energy X-ray Absorptiometry (DXA). Objective To determine associations between pQCT-derived soft tissue density and area measures and DXA-derived soft tissue mass. Methods Linear regression models were developed based on BMI and calf fat and muscle cross-sectional area (FCSA and MCSA) and density measured by pQCT in healthy women (n=76) and men (n=82) aged 20–59 years. Independent variables for these models were leg and total bone-free lean mass (BFLM) and fat mass (FM) measured by DXA. Results Sex differences (p<0.01) were found in both muscle (Mean±SE: Women: 78.6±0.4; Men: 79.9 ± 0.2 mg/cm3) and fat (Women: 0.8±0.4 Men: 9.1±0.6 mg/cm3) density. BMI, fat density, and age (R2=0.86, p<0.01) best accounted for the variability in total FM. FCSA, BMI, and fat density explained the variance in leg FM (R2=0.87, p<0.01). MCSA and muscle density explained the variance in total (R2=0.65, p<0.01) and leg BFLM (R2=0.70, p<0.01). Conclusion Calf muscle and fat area and density independently predict lean and fat tissue mass. PMID:25524966

  18. Precision errors, least significant change, and monitoring time interval in pediatric measurements of bone mineral density, body composition, and mechanostat parameters by GE lunar prodigy.

    PubMed

    Jaworski, Maciej; Pludowski, Pawel

    2013-01-01

    Dual-energy X-ray absorptiometry (DXA) method is widely used in pediatrics in the study of bone density and body composition. However, there is a limit to how precise DXA can estimate bone and body composition measures in children. The study was aimed to (1) evaluate precision errors for bone mineral density, bone mass and bone area, body composition, and mechanostat parameters, (2) assess the relationships between precision errors and anthropometric parameters, and (3) calculate a "least significant change" and "monitoring time interval" values for DXA measures in children of wide age range (5-18yr) using GE Lunar Prodigy densitometer. It is observed that absolute precision error values were different for thin and standard technical modes of DXA measures and depended on age, body weight, and height. In contrast, relative precision error values expressed in percentages were similar for thin and standard modes (except total body bone mineral density [TBBMD]) and were not related to anthropometric variables (except TBBMD). Concluding, due to stability of percentage coefficient of variation values in wide range of age, the use of precision error expressed in percentages, instead of absolute error, appeared as convenient in pediatric population.

  19. Agreement of bioelectric impedance analysis and dual-energy X-ray absorptiometry for body composition evaluation in adults with cystic fibrosis.

    PubMed

    Ziai, S; Coriati, A; Chabot, K; Mailhot, M; Richter, M V; Rabasa-Lhoret, R

    2014-09-01

    Malnutrition in cystic fibrosis (CF) is associated with increased mortality and can lead to fat-free (FFM) and fat mass (FM) loss. Dual-energy X-ray absorptiometry (DXA) is used and validated to measure FFM and FM. DXA's high cost has led to the utilization of less costly techniques such as bioelectrical impedance analysis (BIA). The aim of this study was to determine the agreement of FFM, FM and %FM measurements taken with DXA and BIA in adults with CF. We measured FFM, FM and %FM in 34 adults with CF with a leg-to-leg BIA and an iDXA and determined agreement using Bland-Altman analysis. While DXA and BIA measurements were well correlated (r > 0.8), mean biases between both methods were between 8 and 11%. BIA underestimated FM and %FM and overestimated FFM. In a clinical research setting where these measurements are used to phenotype patients, BIA cannot replace DXA.

  20. Association between Bone Mass and Dental Hypomineralization.

    PubMed

    van der Tas, J T; Elfrink, M E C; Vucic, S; Heppe, D H M; Veerkamp, J S J; Jaddoe, V W V; Rivadeneira, F; Hofman, A; Moll, H A; Wolvius, E B

    2016-04-01

    The aim of this study was to examine the association between the bone mass (bone mineral content [BMC]) and hypomineralized second primary molars (HSPMs)/molar incisor hypomineralization (MIH) in 6-y-old children. This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort study, starting from fetal life until adulthood in Rotterdam, Netherlands. The European Academy of Pediatric Dentistry criteria were used to score the intraoral photographs on the presence or absence of HSPMs and MIH. Bone mass was measured with a dual-energy x-ray absorptiometry (DXA) scan. Intraoral photographs and DXA scans were available in 6,510 6-y-old children. Binary logistic regression models were used to study the association between the bone mass and HSPMs/MIH. In total, 5,586 children had their second primary molars assessed and a DXA scan made; 507 children were diagnosed with HSPM. Of 2,370 children with data on their permanent first molars, 203 were diagnosed with MIH. In the fully adjusted model, children with lower BMC (corrected for bone area) were more likely to have HSPMs (odds ratio, 1.13; 95% confidence interval, 1.02 to 1.26 per 1-standard deviation decrease). A lower BMC (corrected for bone area) was not associated with MIH (odds ratio, 1.02; 95% confidence interval, 0.87 to 1.20 per 1-standard deviation decrease). We observed a negative association between BMC (corrected for bone area) and HSPMs. No association was found between BMC (corrected for bone area) and MIH. Future research should focus on investigating the mechanism underlying the negative association between the bone mass and HSPMs. Our study, in a large population of 6-y-old children, adds the finding that BMC (corrected for bone size) is associated with HSPMs but not with MIH in childhood.

  1. A biomechanical perspective on bone quality

    PubMed Central

    Hernandez, C.J.; Keaveny, T.M

    2007-01-01

    Observations that dual-energy x-ray absorptiometry (DXA) measures of areal bone mineral density cannot completely explain fracture incidence after anti-resorptive treatment have led to renewed interest in bone quality. Bone quality is a vague term, but generally refers to the effects of skeletal factors that contribute to bone strength but are not accounted for by measures of bone mass. Since a clinical fracture is ultimately a mechanical event, it follows then that any clinically relevant modification of bone quality must change bone biomechanical performance relative to bone mass. In this perspective, we discuss a framework for assessing the clinically relevant effects of bone quality based on two general concepts: 1) the biomechanical effects of bone quality can be quantified from analysis of the relationship between bone mechanical performance and bone density; and 2) because of its hierarchical nature, biomechanical testing of bone at different physical scales (<1mm, 1mm, 1 cm, etc.) can be used to isolate the scale at which the most clinically relevant changes in bone quality occur. As an example, we review data regarding the relationship between the strength and density in excised specimens of trabecular bone and highlight the fact that it is not yet clear how this relationship changes during aging, osteoporosis development, and anti-resorptive treatment. Further study of new and existing data using this framework should provide insight into the role of bone quality in osteoporotic fracture risk. PMID:16876493

  2. The effect of lead in bone densitometry

    NASA Astrophysics Data System (ADS)

    Popovic, Marija; McNeill, Fiona E.; Webber, Colin E.; Chettle, David R.

    2004-01-01

    Dual energy X-ray absorptiometry (DXA) is presently considered the standard technique for diagnosis of osteoporosis. It has been suggested that the presence of lead interferes with the accurate measurement of bone mineral density (BMD) by DXA because of the increased attenuation and that an accurate measurement of BMD cannot be determined unless the patient's bone lead content of patients is known. We performed DXA measurements on plaster of Paris phantoms and a Hologic Spine phantom in combination with polyester resin doped with various concentrations of lead. At lead levels which correspond to bone concentrations in occupationally exposed individuals, the suggested increase in densitometric BMD was not detected. Numerical calculations show that the effect of the lead depends upon the two energies of the X-ray beam of a particular device. The discrepancy between the actual and the densitometric BMD increases linearly and is about 0.3% at 100 ppm. Such change cannot be detected by the Hologic QDR 4500A, the device used for this experiment.

  3. Black hole artifacts-a new potential pitfall for DXA accuracy?

    PubMed

    Morgan, Sarah L; Lopez-Ben, Robert; Nunnally, Nancy; Burroughs, Leandria; Fineberg, Naomi; Tubbs, R Shane; Yester, Michael V

    2008-01-01

    Certain types of metallic objects apparently have high attenuation (a white image) on dual-energy X-ray absorptiometry (DXA) scan images, but instead show up as black (black hole artifacts). When small, these artifacts may easily be missed on visual inspection. We hypothesized that such "black hole" artifacts could have a significant effect on bone mineral density (BMD) results. Human use approval (Institutional Review Board [IRB]) was obtained to publish patient scans and an IRB waiver was obtained for nonhuman research. We placed individual surgical clips and cassettes of clips of tantalum, stainless steel and titanium, and a bullet over the third lumbar vertebra (L3) of a Hologic spine phantom. In addition, 4 or 8 individual tantalum or stainless steel clips and tantalum squares were placed over L3 of cadaveric spines (high-density spine L1-L4 BMD=1.049 g/cm2) and low-density spine BMD (L1-L4 BMD=0.669 g/cm2) with attached soft tissues. Stainless steel and titanium clips scanned as white objects with DXA. A bullet and tantalum clips scanned black (black holes). All clip types were visible on single-energy scans as white objects. Eight tantalum clips significantly lowered L3 BMD compared to 4 or 0 clips in the high-density spine. There were no significant differences in BMD L1-L4 between 0, 4, and 8 tantalum clips in the high-density spine. In the low-density spine, 8 tantalum clips over L3 had significantly lower BMD compared to 4 tantalum clips overlying L3 and 4 clips lateral to L3 and 4 clips over L3. All of these scenarios had lower L3 BMD than no tantalum clips overlying L3. The BMD of L1-L4 was lowest with 8 clips at L3, but was not significantly different than no clips overlying L3. Eight tantalum clips lateral to L3 was significantly higher than no clips over L3. Black hole artifacts can occur in DXA scans containing certain metals like tantalum surgical clips. Although these surgical clips could decrease BMD at a localized area, they do not

  4. [Bone loss and bone metabolism in astronauts during long-duration space flight].

    PubMed

    Ohshima, Hiroshi

    2006-01-01

    Significant bone loss is one of the most serious medical concerns during long-duration space flight. This article provides the results of bone loss and bone metabolism obtained from American and Russian long-duration human space flight. Bone loss in astronauts before and after long-duration space flight was evaluated by dual energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). DXA revealed bone loss at rates of 0.9%/month in the lumbar spine and 1.5%/month in the femoral neck. QCT revealed cortical, trabecular and integral BMD in the femoral neck at rates of 0.5%/month, 2.5%/month, and 1.5%/month, respectively. Biochemical markers of bone resorption increased during space flight and several months after landing. Bone formation marker was unchanged during space flight, but since 3 weeks after landing it was significantly higher than before flight. A calcium kinetics study confirmed that bone resorption increased, and intestinal calcium absorption decreased during space flight.

  5. Correlation of visceral adipose tissue measured by Lunar Prodigy dual X-ray absorptiometry with MRI and CT in older men.

    PubMed

    Cheung, A S; de Rooy, C; Hoermann, R; Gianatti, E J; Hamilton, E J; Roff, G; Zajac, J D; Grossmann, M

    2016-08-01

    Quantification of abdominal visceral adipose tissue (VAT) is important to understand obesity-related comorbidities. We hypothesized that dual X-ray absorptiometry (DXA) measurements of VAT would correlate with traditional gold standards of magnetic resonance imaging (MRI) and computed tomography (CT) in older men. Deming regression and Bland-Altman plots were used to assess the agreement between VAT measured simultaneously by DXA and MRI (n=95) in a cohort of older males participating in a randomized trial of testosterone replacement for diabetes. We also correlated DXA with single-slice CT (n=102) in a cohort of older males undergoing testosterone deprivation for prostate cancer. Lunar Prodigy DXA scanners using enCORE software was used to measure VAT. DXA VAT volume strongly correlated with MRI VAT volume (r=0.90, P<0.0001) and CT VAT area (r=0.83, P<0.0001). As DXA assesses VAT volume in a smaller compartment than MRI, Bland-Altman analysis demonstrated DXA systematically underestimated VAT by an approximately 30% proportional bias. DXA VAT volume measured by Lunar Prodigy DXA scanners correlate well with gold standard MRI and CT quantification methods, and provides a low radiation, efficient, cost-effective option. Future clinical studies examining the effects of interventions on body composition and regional fat distribution may find DXA an appropriate volumetric method to quantify VAT.

  6. Non-invasive methods for the determination of body and carcass composition in livestock: dual-energy X-ray absorptiometry, computed tomography, magnetic resonance imaging and ultrasound: invited review.

    PubMed

    Scholz, A M; Bünger, L; Kongsro, J; Baulain, U; Mitchell, A D

    2015-07-01

    The ability to accurately measure body or carcass composition is important for performance testing, grading and finally selection or payment of meat-producing animals. Advances especially in non-invasive techniques are mainly based on the development of electronic and computer-driven methods in order to provide objective phenotypic data. The preference for a specific technique depends on the target animal species or carcass, combined with technical and practical aspects such as accuracy, reliability, cost, portability, speed, ease of use, safety and for in vivo measurements the need for fixation or sedation. The techniques rely on specific device-driven signals, which interact with tissues in the body or carcass at the atomic or molecular level, resulting in secondary or attenuated signals detected by the instruments and analyzed quantitatively. The electromagnetic signal produced by the instrument may originate from mechanical energy such as sound waves (ultrasound - US), 'photon' radiation (X-ray-computed tomography - CT, dual-energy X-ray absorptiometry - DXA) or radio frequency waves (magnetic resonance imaging - MRI). The signals detected by the corresponding instruments are processed to measure, for example, tissue depths, areas, volumes or distributions of fat, muscle (water, protein) and partly bone or bone mineral. Among the above techniques, CT is the most accurate one followed by MRI and DXA, whereas US can be used for all sizes of farm animal species even under field conditions. CT, MRI and US can provide volume data, whereas only DXA delivers immediate whole-body composition results without (2D) image manipulation. A combination of simple US and more expensive CT, MRI or DXA might be applied for farm animal selection programs in a stepwise approach.

  7. Comparison of total and segmental body composition using DXA and multifrequency bioimpedance in collegiate female athletes.

    PubMed

    Esco, Michael R; Snarr, Ronald L; Leatherwood, Matthew D; Chamberlain, Nik A; Redding, Melvenia L; Flatt, Andrew A; Moon, Jordan R; Williford, Henry N

    2015-04-01

    The purpose of this investigation was to determine the agreement between multifrequency bioelectrical impedance analysis (BIA) and dual-energy x-ray absorptiometry (DXA) for measuring body fat percentage (BF%), fat-free mass (FFM), and total body and segmental lean soft tissue (LST) in collegiate female athletes. Forty-five female athletes (age = 21.2 ± 2.0 years, height = 166.1 ± 7.1 cm, weight = 62.6 ± 9.9 kg) participated in this study. Variables measured through BIA and DXA were as follows: BF%, FFM, and LST of the arms (ARMS(LST)), the legs (LEGS(LST)), the trunk (TRUNK(LST)), and the total body (TOTAL(LST)). Compared with the DXA, the InBody 720 provided significantly lower values for BF% (-3.3%, p < 0.001) and significantly higher values for FFM (2.1 kg, p < 0.001) with limits of agreement (1.96 SD of the mean difference) of ±5.6% for BF% and ±3.7 kg for FFM. No significant differences (p < 0.008) existed between the 2 devices (InBody 720-DXA) for ARMS(LST) (0.05 kg), TRUNK(LST) (0.14 kg), LEGS(LST) (-0.4 kg), and TOTAL(LST) (-0.21 kg). The limits of agreement were ±0.79 kg for ARMS(LST), ±2.62 kg for LEGS(LST), ±3.18 kg for TRUNK(LST), and ±4.23 kg for TOTAL(LST). This study found discrepancies in BF% and FFM between the 2 devices. However, the InBody 720 and DXA appeared to provide excellent agreement for measuring total body and segmental LST. Therefore, the InBody 720 may be a rapid noninvasive method to assess LST in female athletes when DXA is not available.

  8. Experimental investigation of bone mineral density in Thoroughbreds using quantitative computed tomography

    PubMed Central

    YAMADA, Kazutaka; SATO, Fumio; HIGUCHI, Tohru; NISHIHARA, Kaori; KAYANO, Mitsunori; SASAKI, Naoki; NAMBO, Yasuo

    2015-01-01

    ABSTRACT Bone mineral density (BMD) is one of the indications of the strength and health. BMD measured by quantitative computed tomography (QCT) was compared with that measured by dual energy X-ray absorptiometry (DXA) and radiographic bone aluminum equivalence (RBAE). Limbs were removed from horses that had been euthanized for reasons not associated with this study. Sixteen limbs (left and right metacarpals and metatarsals) from 4 horses were used to compare BMD as measured by QCT with those measured by DXA and RBAE. There was a strong correlation between BMD values measured by QCT and those measured by DXA (R2=0.85); correlation was also observed between values obtained by QCT and those obtained by RBAE (R2=0.61). To investigate changes in BMD with age, 37 right metacarpal bones, including 7 from horses euthanized because of fracture were examined by QCT. The BMD value of samples from horses dramatically increased until 2 years of age and then plateaued, a pattern similar to the growth curve. The BMD values of bone samples from horses euthanized because of fracture were within the population range, and samples of morbid fracture were not included. The relationship between BMD and age provides a reference for further quantitative studies of bone development and remodeling. Quantitative measurement of BMD using QCT may have great potential for the evaluation of bone biology for breeding and rearing management. PMID:26435681

  9. Determination of thigh volume in youth with anthropometry and DXA: agreement between estimates.

    PubMed

    Coelho-E-Silva, Manuel J; Malina, Robert M; Simões, Filipe; Valente-Dos-Santos, João; Martins, Raul A; Vaz Ronque, Enio R; Petroski, Edio L; Minderico, Claudia; Silva, Analiza M; Baptista, Fátima; Sardinha, Luís B

    2013-01-01

    This study examined the agreement between estimates of thigh volume (TV) with anthropometry and dual-energy x-ray absorptiometry (DXA) in healthy school children. Participants (n=168, 83 boys and 85 girls) were school children 10.0-13.9 years of age. In addition to body mass, height and sitting height, anthropometric dimensions included those needed to estimate TV using the equation of Jones & Pearson. Total TV was also estimated with DXA. Agreement between protocols was examined using linear least products regression (Deming regressions). Stepwise regression of log-transformed variables identified variables that best predicted TV estimated by DXA. The regression models were then internally validated using the predicted residual sum of squares method. Correlation between estimates of TV was 0.846 (95%CI: 0.796-0.884, Sy·x=0.152 L). It was possible to obtain an anthropometry-based model to improve the prediction of TVs in youth. The total volume by DXA was best predicted by adding body mass and sum of skinfolds to volume estimated with the equation of Jones & Pearson (R=0.972; 95%CI: 0.962-0.979; R (2)=0.945).

  10. Association of Coronary Aortic Calcium with Abdominal Aortic Calcium Detected on Lateral Dual Energy X-Ray Absorptiometry Spine Images

    PubMed Central

    Schousboe, John T.; Claflin, Diane; Barrett-Connor, Elizabeth

    2009-01-01

    The association of abdominal aortic calcium (AAC) on lateral spine bone densitometry with coronary artery calcium (CAC) has not been reported. We studied 33 men and 73 women who had CAC scored with electron beam computed tomography at the 8th visit of the Rancho Bernardo study and lateral spine dual energy x-ray absorptiometry (DXA) images fully evaluable for AAC done at the 9th study visit. The association between CAC level and AAC tertile was assessed by ordinal logistic regression. The odds ratio of having a higher level of CAC score for those in the top tertile of AAC score (24-point scale score ≥ 5) was 6.42 (95% C.I. 2.28 – 18.1) and on an 8-point scale (score ≥ 3) was 3.38 (95% C.I. 1.26 – 9.07), compared to those with AAC scores in the bottom tertiles, adjusted for age, sex, systolic blood pressure, total and high density lipoprotein (HDL) cholesterol, smoking status, and diabetes. A 24-point AAC score of ≥ 5 had a sensitivity of 65% and a specificity of 70% to detect a high CAC score (≥ 400 units). An 8-point AAC score ≥ 3 had a sensitivity of 45% and a specificity of 78%. In conclusion, a high level of AAC on lateral spine DXA is strongly associated with coronary artery disease and may be commonly encountered since bone densitometry is indicated in all women age ≥ 65 and all men age ≥ 70. Its presence should be reported to the patient's physician to identify and manage modifiable risk factors. PMID:19616658

  11. Relationships among diet, physical activity, and dual plane dual-energy X-ray absorptiometry bone outcomes in pre-pubertalgirls.

    PubMed

    Ren, Jie; Brann, Lynn S; Bruening, Kay S; Scerpella, Tamara A; Dowthwaite, Jodi N

    2017-12-01

    In pre-pubertal girls, nutrient intakes and non-aquatic organized activity were evaluated as factors in vertebral body bone mass, structure, and strength. Activity, vitamin B12, and dietary fiber predicted bone outcomes most consistently. Exercise and vitamin B12 appear beneficial, whereas high fiber intake appears to be adverse for vertebral body development.

  12. Periprosthetic bone density changes after MiniHipTM cementless femoral short stem: one-year results of dual-energy X-ray absorptiometry study

    PubMed Central

    Ercan, Ahmet; Sokkar, Sherif M.; Schmid, Gebhard; Filler, Timm J.; Abdelkafy, Ashraf; Jerosch, Joerg

    2016-01-01

    Introduction: The purpose of the current study was to investigate the reaction of the femur to the implantation of the MiniHipTM in terms of: (1) bone density change during one year; (2) correlations between stem length, CCD (caput-collum-diaphyseal), femoral offset, T-value, and bone density; (3) other co-variables that influence the change of bone density. Patients and methods: MiniHipTM implant was performed for 62 patients. The age range of the patients who underwent treatment was 25–78 years. Periprothestic bone density was determined within two weeks postoperatively, after three, six, and twelve months utilizing the DEXA scan. Results: The highest change was observed in the first three months post-implantation, while significant decrease in density was recorded at proximal Gruen zones 1, 2, and 7, and at distal Gruen zone 4. The decrease in density reached a plateau between the third and sixth months after operation. Afterwards, bone density recovered up to the 12th postoperative month. The correlation analysis showed significant difference between Gruen zone 1 and stem size and CCD. The same significant trend was not reached for Gruen zone 7. Femoral offset showed no correlation. Covariance analysis was unable to establish connection of the results with diagnosis, pairings, or gender. Discussion: MiniHipTM densitometric results are promising and comparable to good results of the other representatives of the femoral neck partially-sustaining short stem prostheses with a lower proximal bone density reduction. Periprosthetic bone resorption is a multifactorial process where stem size, CCD angle, and patient-specific variables such as T-value have an impact on the periprosthetic bone remodeling. In particular, this applies to Gruen zone 1. PMID:27855776

  13. Evaluating accuracy of structural geometry by DXA methods with an anthropometric proximal femur phantom.

    PubMed

    Khoo, B C C; Beck, T J; Brown, K; Price, R I

    2013-09-01

    DXA-derived bone structural geometry has been reported extensively but lacks an accuracy standard. In this study, we describe a novel anthropometric structural geometry phantom that simulates the proximal femur for use in assessing accuracy of geometry measurements by DXA or other X-ray methods. The phantom consists of seven different interchangeable neck modules with geometries that span the range of dimensions in an adult human proximal femur, including those representing osteoporosis. Ten repeated hip scans of each neck module using two current DXA scanner models were performed without repositioning. After scanner specific calibration, hip structure analysis was used to derive structural geometry. Scanner performance was similar for the two manufacturers. DXA-derived HSA geometric measurements were highly correlated with values derived directly from phantom geometry and position; R² between DXA and phantom measures were greater than 94% for all parameters, while precision error ranged between 0.3 and 3.9%. Despite high R² there were some systematic geometry errors for both scanners that were small for outer diameter, but increasing with complexity of geometrical parameter; e.g. buckling ratio. In summary, the anthropometric phantom and its fabrication concept were shown to be appropriate for evaluating proximal femoral structural geometry in two different DXA systems.

  14. Assessment of trabecular bone quality in human cadaver calcaneus using scanning confocal ultrasound and dual x-ray absorptiometry (DEXA) measurements

    NASA Astrophysics Data System (ADS)

    Qin, Yixian; Xia, Yi; Lin, Wei; Rubin, Clinton; Gruber, Barry

    2004-10-01

    Microgravity and aging induced bone loss is a critical skeleton complication, occurring particularly in the weight-supporting skeleton, which leads to osteoporosis and fracture. Advents in quantitative ultrasound (QUS) provide a unique method for evaluating bone strength and density. Using a newly developed scanning confocal acoustic diagnostic (SCAD) system, QUS assessment for bone quality in the real body region was evaluated. A total of 19 human cadaver calcanei, age 66 to 97 years old, were tested by both SCAD and nonscan mode. The scanning region covered an approximate 40×40 mm2 with 0.5 mm resolution. Broadband ultrasound attenuation (BUA, dB/MHz), energy attenuation (ATT, dB), and ultrasound velocity (UV, m/s) were measured. The QUS properties were then correlated to the bone mineral density (BMD) measured by DEXA. Correlations between BMD and QUS parameters were significantly improved by using SCAD as compared to nonscan mode, yielding correlations between BMD and SCAD QUS parameters as R=0.82 (BUA), and R=0.86 (est. BMD). It is suggested that SCAD is feasible for in vivo bone quality mapping. It can be potentially used for monitoring instant changes of bone strength and density. [Work supported by the National Space Biomedical Research Institute (TD00207), and New York Center for Biotechnology.

  15. Recommendations for evaluation and management of bone disease in HIV.

    PubMed

    Brown, Todd T; Hoy, Jennifer; Borderi, Marco; Guaraldi, Giovanni; Renjifo, Boris; Vescini, Fabio; Yin, Michael T; Powderly, William G

    2015-04-15

    Thirty-four human immunodeficiency virus (HIV) specialists from 16 countries contributed to this project, whose primary aim was to provide guidance on the screening, diagnosis, and monitoring of bone disease in HIV-infected patients. Four clinically important questions in bone disease management were identified, and recommendations, based on literature review and expert opinion, were agreed upon. Risk of fragility fracture should be assessed primarily using the Fracture Risk Assessment Tool (FRAX), without dual-energy X-ray absorptiometry (DXA), in all HIV-infected men aged 40-49 years and HIV-infected premenopausal women aged ≥40 years. DXA should be performed in men aged ≥50 years, postmenopausal women, patients with a history of fragility fracture, patients receiving chronic glucocorticoid treatment, and patients at high risk of falls. In resource-limited settings, FRAX without bone mineral density can be substituted for DXA. Guidelines for antiretroviral therapy should be followed; adjustment should avoid tenofovir disoproxil fumarate or boosted protease inhibitors in at-risk patients. Dietary and lifestyle management strategies for high-risk patients should be employed and antiosteoporosis treatment initiated.

  16. Associations Between Sedentary Time, Physical Activity, and Dual-Energy X-ray Absorptiometry Measures of Total Body, Android, and Gynoid Fat Mass in Children.

    PubMed

    McCormack, Lacey; Meendering, Jessica; Specker, Bonny; Binkley, Teresa

    2016-01-01

    Negative health outcomes are associated with excess body fat, low levels of physical activity (PA), and high sedentary time (ST). Relationships between PA, ST, and body fat distribution, including android and gynoid fat, assessed using dual-energy X-ray absorptiometry (DXA) have not been measured in children. The purpose of this study was to test associations between levels of activity and body composition in children and to evaluate if levels of activity predict body composition by DXA and by body mass index percentile in a similar manner. PA, ST, and body composition from 87 children (8.8-11.8 yr, grades 3-5, 44 boys) were used to test the association among study variables. Accelerometers measured PA and ST. Body composition measured by DXA included bone mineral content (BMC) and fat and lean mass of the total body (TB, less head), android, and gynoid regions. ST (range: 409-685 min/wk) was positively associated with TB percent fat (0.03, 95% confidence interval [CI]: 0.00-0.05) and android fat mass (1.5 g, 95% CI: 0.4-3.0), and inversely associated with the lean mass of the TB (-10.7 g, 95% CI: -20.8 to -0.63) and gynoid regions (-2.2 g, 95% CI: -4.3 to -0.2), and with BMC (-0.43 g, 95% CI: 0.77-0.09). Moderate-to-vigorous PA was associated with lower TB (-53 g, 95% CI: -87 to -18), android (-5 g, 95% CI: -8 to -2]), and gynoid fat (-6 g, 95% CI: -11 to -0.5). Vigorous activity results were similar. Light PA was associated with increased TB (17.1 g, 95% CI: 3.0-31.3) and gynoid lean mass (3.9 g, 95% CI: 1.0-6.8) and BMC (0.59 g, 95% CI: 0.10-1.07). In boys, there were significant associations between activity and DXA percent body fat measures that were not found with the body mass index percentile. Objective measures of PA were inversely associated with TB, android, and gynoid fat, whereas ST was directly associated with TB percent fat and, in particular, android fat. Activity levels predict body composition measures by DXA and, in

  17. Reliability of 2 Different Positioning Protocols for Dual-Energy X-ray Absorptiometry Measurement of Body Composition in Healthy Adults.

    PubMed

    Kerr, Ava; Slater, Gary J; Byrne, Nuala; Nana, Alisa

    2016-01-01

    Dual-energy X-ray absorptiometry (DXA) is an accepted time-efficient method of body composition assessment for total body and regional fat mass (FM), lean mass (LM), and bone mineral content (BMC), but for longitudinal monitoring the measurements must be sufficiently reliable. The aim of this study was to compare the reliability of a new positioning protocol (Nana et al) with the current reference (National Health and Nutrition Examination Survey [NHANES]) protocol and investigate their within-protocol precision. Thirty healthy adults (16 females and 14 males) underwent 4 whole-body DXA scans in succession with full repositioning between scans. The scan order was randomized, with 2 scans undertaken in accordance with the current NHANES protocol and 2 using the Nana et al protocol. Magnitudes of typical errors of measurement and changes in the mean of DXA body composition estimates were assessed as standardized effect sizes. The Nana et al protocol repositioning produced trivial typical errors for total body across all LM estimates except for FM in the arms and trunk which were moderately substantial. The NHANES protocol produced similar typical errors for all measurements in LM except for FM and BMC in the trunk and arms which were substantially larger than the smallest worthwhile effect. The difference between protocols produced substantially large typical errors in estimations of both total body FM and regional FM and BMC, but differences in LM were all less than the smallest worthwhile effect. Although both protocols demonstrated acceptable intratest reliability, the Nana et al protocol produced enhanced precision in regional (arms and trunk) FM and BMC. The protocols were substantially different in body composition assessment especially for FM and thus should not to be interchanged. Anecdotally, subjects felt more comfortable and supported during the scan with the Nana et al protocol.

  18. Effects of high-intensity resistance training on bone mineral density in young male powerlifters.

    PubMed

    Tsuzuku, S; Ikegami, Y; Yabe, K

    1998-10-01

    The effects of high-intensity resistance training on bone mineral density (BMD) and its relationship to strength were investigated. Lumbar spine (L2-L4), proximal femur, and whole body BMD were measured in 10 male powerlifters and 11 controls using dual-energy X-ray absorptiometry (DXA). There were significant differences in lumbar spine and whole body BMD between powerlifters and controls, but not in proximal femur BMD. A significant correlation was found between lumbar spine BMD and powerlifting performance. These results suggest that high-intensity resistance training is effective in increasing the lumbar spine and whole body BMD.

  19. Dual X-ray absorptiometry

    NASA Astrophysics Data System (ADS)

    Altman, Albert; Aaron, Ronald

    2012-07-01

    Dual X-ray absorptiometry is widely used in analyzing body composition and imaging. Both the method and its limitations are related to the Compton and photoelectric contributions to the X-ray attenuation coefficients of materials.

  20. Creation of an age-adjusted, dual-energy x-ray absorptiometry-derived trabecular bone score curve for the lumbar spine in non-Hispanic US White women.

    PubMed

    Simonelli, Christine; Leib, Edward; Mossman, Ned; Winzenrieth, Renaud; Hans, Didier; McClung, Michael

    2014-01-01

    The trabecular bone score (TBS, Med-Imaps, Pessac, France) is an index of bone microarchitecture texture extracted from anteroposterior dual-energy X-ray absorptiometry images of the spine. Previous studies have documented the ability of TBS of the spine to differentiate between women with and without fractures among age- and areal bone mineral density (aBMD)-matched controls, as well as to predict future fractures. In this cross-sectional analysis of data collected from 3 geographically dispersed facilities in the United States, we investigated age-related changes in the microarchitecture of lumbar vertebrae as assessed by TBS in a cohort of non-Hispanic US white American women. All subjects were 30 yr of age and older and had an L1-L4aBMDZ-score within ±2 SD of the population mean. Individuals were excluded if they had fractures, were on any osteoporosis treatment, or had any illness that would be expected to impact bone metabolism. All data were extracted from Prodigy dual-energy X-ray absorptiometry devices (GE-Lunar, Madison, WI). Cross-calibrations between the 3 participating centers were performed for TBS and aBMD. aBMD and TBS were evaluated for spine L1-L4 but also for all other possible vertebral combinations. To validate the cohort, a comparison between the aBMD normative data of our cohort and US non-Hispanic white Lunar data provided by the manufacturer was performed. A database of 619 non-Hispanic US white women, ages 30-90 yr, was created. aBMD normative data obtained from this cohort were not statistically different from the non-Hispanic US white Lunar normative data provided by the manufacturer (p = 0.30). This outcome thereby indirectly validates our cohort. TBS values at L1-L4 were weakly inversely correlated with body mass index (r = -0.17) and weight (r = -0.16) and not correlated with height. TBS values for all lumbar vertebral combinations decreased significantly with age. There was a linear decrease of 16.0% (-2.47 T-score) in TBS at

  1. Bone imaging and fracture risk assessment in kidney disease.

    PubMed

    Jamal, Sophie A; Nickolas, Thomas L

    2015-06-01

    Fractures are more common and are associated with greater morbidity and morality in patients with kidney disease than in members of the general population. Thus, it is troubling that in chronic kidney disease (CKD) patients there has been a paradoxical increase in fracture rates over the past 20 years compared to the general population. Increased fracture incidence in CKD patients may be driven in part by the lack of screening for fracture risk. In the general population, dual energy X-ray absorptiometry (DXA) is the clinical standard to stratify fracture risk, and its use has contributed to decreases in fracture incidence. In contrast, in CKD, fracture risk screening with DXA has been uncommon due to its unclear efficacy in predicting fracture and its inability to predict type of renal osteodystrophy. Recently, several prospective studies conducted in patients across the spectrum of kidney disease have demonstrated that bone mineral density measured by DXA predicts future fracture risk and that clinically relevant information regarding fracture risk is provided by application of the World Health Organization cutoffs for osteopenia and osteoporosis to DXA measures. Furthermore, novel high-resolution imaging tools, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), have been used to elucidate the effects of kidney disease on cortical and trabecular microarchitecture and bone strength and to identify potential targets for strategies that protect against fractures. This review will discuss the updated epidemiology of fractures in CKD, fracture risk screening by DXA, and the utility of state-of-the art imaging methods to uncover the effects of kidney disease on the skeleton.

  2. Performance of five phalangeal QUS parameters in the evaluation of gonadal-status, age and vertebral fracture risk compared with DXA.

    PubMed

    Albanese, Carlina V; Cepollaro, Chiara; de Terlizzi, Francesca; Brandi, Maria Luisa; Passariello, Roberto

    2009-04-01

    The aim of this cross-sectional study was to study the value of five different quantified ultrasound (QUS) parameters-amplitude-dependent speed of sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), fast-wave amplitude (FWA), bone transmission time (BTT) and signal dynamic (SDY)-measured at the phalanges of the hand in discriminating women with vertebral fracture and their relationship with some determinants of bone mass, in particular age and gonadal status compared with lumbar spine and hip dual-energy x-ray absorptiometry (DXA). We included 791 women aged 35-84 y, divided into pre-menopause, early menopause and late postmenopause groups on the basis of gonadal status and years since menopause (YSM). The presence of vertebral fracture was evaluated radiographically. All QUS parameters were very sensitive to changes in early postmenopause, with a doubled decrease in early postmenopausal with respect to late postmenopause. In particular AD-SoS and BTT decreases were markedly high in the early postmenopause group. In the late menopause group, similar decreases were observed for AD-SoS, UBPI and hip bone mineral density (BMD). In the multiple logistic model, DXA and QUS significantly discriminate women with and without fractures (p < 0.0001); odds ratio (OR) was higher at lumbar spine BMD (OR 4.01), FWA (OR 3.88), AD-SoS (OR 3.81) and total hip BMD (OR 3.77). Even adjusting the logistic model for age, height, weight, lumbar spine and total hip BMD, all QUS parameters remained significantly predictive of vertebral fracture. AD-SoS showed the best performances both in terms of OR and ROC analysis. QUS parameters show a different behavior in evaluating the effect on bone mass of the time since menopause; AD-SoS and BTT showed a high sensitivity to first changes in bone tissue after menopause. After correction for potential confounders, AD-SoS showed the same ability of lumbar spine BMD in discriminating women with or without vertebral fractures and in the prediction

  3. Cross-sex pattern of bone mineral density in early onset gender identity disorder.

    PubMed

    Haraldsen, I R; Haug, E; Falch, J; Egeland, T; Opjordsmoen, S

    2007-09-01

    Hormonally controlled differences in bone mineral density (BMD) between males and females are well studied. The effects of cross-sex hormones on bone metabolism in patients with early onset gender identity disorder (EO-GID), however, are unclear. We examined BMD, total body fat (TBF) and total lean body mass (TLBM) in patients prior to initiation of sex hormone treatment and during treatment at months 3 and 12. The study included 33 EO-GID patients who were approved for sex reassignment and a control group of 122 healthy Norwegians (males, n=77; females, n=45). Male patients (n=12) received an oral dose of 50 mug ethinylestradiol daily for the first 3 months and 100 mug daily thereafter. Female patients (n=21) received 250 mg testosterone enantate intramuscularly every third week. BMD, TBF and TLBM were estimated using dual energy X-ray absorptiometry (DXA). In male patients, the DXA measurements except TBF were significantly lower compared to their same-sex control group at baseline and did not change during treatment. In female patients, the DXA measurements were slightly higher than in same-sex controls at baseline and also remained unchanged during treatment. In conclusion, this study reports that body composition and bone density of EO-GID patients show less pronounced sex differences compared to controls and that bone density was unaffected by cross-sex hormone treatment.

  4. Assessment of bone quality in osteoporosis treatment with bone anabolic agents: Really something new?

    PubMed

    Ulivieri, Fabio Massimo; Caudarella, Renata; Camisasca, Marzia; Cabrini, Daniela Maria; Merli, Ilaria; Messina, Carmelo; Piodi, Luca Petruccio

    2016-12-01

    Osteoporosis is a chronic pathologic condition, particularly of the elderly, in which a reduction of bone mineral density (BMD) weakens bone, leading to the so-called fragility fractures, most often of spine and femur. The gold standard exam for the quantitative measurement of BMD is the dual X-ray photon absorptiometry (DXA), a radiological method. However, a relevant number of fragility fractures occurs in the range of normal BMD values, meaning that also qualitative aspects of bone play a role, namely bone architecture and bone geometry. Bone structure is investigated by microCT and histomorphometry, which necessitate an invasive approach with a biopsy, usually taken at the iliac crest, not the typical site of fragility fractures. New tools, trabecular bone score (TBS) and hip structural analysis (HSA), obtained during DXA, can supply informations about bone structure of spine and femur, respectively, in a not invasive way. Therapy of osteoporosis is based on two types of drugs leading to an increase of BMD: antiresorptive and anabolic treatments. The antiresorptive drugs inhibit the osteoclasts, whereas teriparatide and, in part, strontium ranelate ameliorate bone structure. The present review deals with the relation between the anabolic drugs for osteoporosis and the cited new tools which investigate bone architecture and geometry, in order to clarify if they represent a real advantage in monitoring efficacy of osteoporosis' treatment. Data from the studies show that increases of TBS and HSA values after anabolic therapy are small and very close to their least significant change at the end of the usual period of treatment. Therefore, it is questionable if TBS and HSA are really helpful in monitoring bone quality and in defining reduction of individual fragility fracture risk during osteoporosis treatment with bone anabolic agents.

  5. Relationship between mechanical properties and bone mineral density of human femoral bone retrieved from patients with osteoarthritis.

    PubMed

    Haba, Yvonne; Lindner, Tobias; Fritsche, Andreas; Schiebenhöfer, Ann-Kristin; Souffrant, Robert; Kluess, Daniel; Skripitz, Ralf; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    The objective of this study was to analyse retrieved human femoral bone samples using three different test methods, to elucidate the relationship between bone mineral density and mechanical properties. Human femoral heads were retrieved from 22 donors undergoing primary total hip replacement due to hip osteoarthritis and stored for a maximum of 24 hours postoperatively at + 6 °C to 8 °C.Analysis revealed an average structural modulus of 232±130 N/mm(2) and ultimate compression strength of 6.1±3.3 N/mm(2) with high standard deviations. Bone mineral densities of 385±133 mg/cm(2) and 353±172 mg/cm(3) were measured using thedual energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT), respectively. Ashing resulted in a bone mineral density of 323±97 mg/cm(3). In particular, significant linear correlations were found between DXA and ashing with r = 0.89 (p < 0.01, n = 22) and between structural modulus and ashing with r = 0.76 (p < 0.01, n = 22).Thus, we demonstrated a significant relationship between mechanical properties and bone density. The correlations found can help to determine the mechanical load capacity of individual patients undergoing surgical treatments by means of noninvasive bone density measurements.

  6. A DXA Whole Body Composition Cross-Calibration Experience: Evaluation With Humans, Spine, and Whole Body Phantoms.

    PubMed

    Krueger, Diane; Libber, Jessie; Sanfilippo, Jennifer; Yu, Hui Jing; Horvath, Blaine; Miller, Colin G; Binkley, Neil

    2016-01-01

    New densitometer installation requires cross-calibration for accurate longitudinal assessment. When replacing a unit with the same model, the International Society for Clinical Densitometry recommends cross-calibrating by scanning phantoms 10 times on each instrument and states that spine bone mineral density (BMD) should be within 1%, whereas total body lean, fat, and %fat mass should be within 2% of the prior instrument. However, there is limited validation that these recommendations provide adequate total body cross-calibration. Here, we report a total body cross-calibration experience with phantoms and humans. Cross-calibration between an existing and new Lunar iDXA was performed using 3 encapsulated spine phantoms (GE [GE Lunar, Madison, WI], BioClinica [BioClinica Inc, Princeton, NJ], and Hologic [Hologic Inc, Bedford, MA]), 1 total body composition phantom (BioClinica), and 30 human volunteers. Thirty scans of each phantom and a total body scan of human volunteers were obtained on each instrument. All spine phantom BMD means were similar (within 1%; <-0.010 g/cm2 bias) between the existing and new dual-energy X-ray absorptiometry unit. The BioClinica body composition phantom (BBCP) BMD and bone mineral content (BMC) values were within 2% with biases of 0.005 g/cm2 and -3.4 g. However, lean and fat mass and %fat differed by 4.6%-7.7% with biases of +463 g, -496 g, and -2.8%, respectively. In vivo comparison supported BBCP data; BMD and BMC were within ∼2%, but lean and fat mass and %fat differed from 1.6% to 4.9% with biases of +833 g, -860 g, and -1.1%. As all body composition comparisons exceeded the recommended 2%, the new densitometer was recalibrated. After recalibration, in vivo bias was lower (<0.05%) for lean and fat; -23 and -5 g, respectively. Similarly, BBCP lean and fat agreement improved. In conclusion, the BBCP behaves similarly, but not identical, to human in vivo measurements for densitometer cross-calibration. Spine phantoms, despite good

  7. Fundamental Movement Skill Proficiency and Body Composition Measured by Dual Energy X-Ray Absorptiometry in Eight-Year-Old Children

    ERIC Educational Resources Information Center

    Slotte, Sari; Sääkslahti, Arja; Metsämuuronen, Jari; Rintala, Pauli

    2015-01-01

    Objective: The main aim was to examine the association between fundamental movement skills (FMS) and objectively measured body composition using dual energy X-ray absorptiometry (DXA). Methods: A study of 304 eight-year-old children in Finland. FMS were assessed with the "Test of gross motor development," 2nd ed. Total body fat…

  8. Dual energy x-ray laser measurement of calcaneal bone mineral density

    NASA Astrophysics Data System (ADS)

    Hakulinen, M. A.; Saarakkala, S.; Töyräs, J.; Kröger, H.; Jurvelin, J. S.

    2003-06-01

    In dual energy x-ray absorptiometry (DXA) the photon attenuation is assumed to be similar in soft tissue overlying, adjacent to and inside the measured bone. In the calcaneal dual energy x-ray laser (DXL) technique, this assumption is not needed as attenuation by soft tissues at the local bone site is determined by combining DXA and heel thickness measurements. In the present study, 38 subjects were measured with DXL Calscan, Lunar PIXI and Lunar DPX-IQ DXA instruments and Hologic Sahara ultrasound instrument, and the performance and agreement of the instruments were analysed. Furthermore, numerical simulations on the effect of non-uniform fat-to-lean tissue ratio within soft tissue in heel were conducted. In vivo short-term precision (CV%, sCV%) of DXL Calscan (1.24%, 1.48%) was similar to that of Lunar PIXI (1.28%, 1.60%). Calcaneal areal bone mineral densities (BMD, g cm-2) measured using DXL Calscan and Lunar PIXI predicted equally well variations in BMD of femoral neck (r2 = 0.63 and 0.52, respectively) or lumbar spine (r2 = 0.61 and 0.64, respectively), determined with Lunar DPX-IQ. BMD values measured with DXL Calscan were, on average, 19% lower (p < 0.01) than those determined with Lunar PIXI. Interestingly, the difference in BMD values between instruments increased as a function of body mass index (BMI) (r2 = 0.17, p < 0.02) or heel thickness (r2 = 0.37, p < 0.01). Numerical simulations suggested that the spatial variation of soft tissue composition in heel can induce incontrollable inaccuracy in BMD when measured with the DXA technique. Theoretically, in contrast to DXA instruments, elimination of the effect of non-uniform soft tissue is possible with DXL Calscan.

  9. Reproducibility and accuracy of body composition assessments in mice by dual energy x-ray absorptiometry and time domain nuclear magnetic resonance.

    PubMed

    Halldorsdottir, Solveig; Carmody, Jill; Boozer, Carol N; Leduc, Charles A; Leibel, Rudolph L

    2009-01-01

    OBJECTIVE: To assess the accuracy and reproducibility of dual-energy absorptiometry (DXA; PIXImus(™)) and time domain nuclear magnetic resonance (TD-NMR; Bruker Optics) for the measurement of body composition of lean and obese mice. SUBJECTS AND MEASUREMENTS: Thirty lean and obese mice (body weight range 19-67 g) were studied. Coefficients of variation for repeated (x 4) DXA and NMR scans of mice were calculated to assess reproducibility. Accuracy was assessed by comparing DXA and NMR results of ten mice to chemical carcass analyses. Accuracy of the respective techniques was also assessed by comparing DXA and NMR results obtained with ground meat samples to chemical analyses. Repeated scans of 10-25 gram samples were performed to test the sensitivity of the DXA and NMR methods to variation in sample mass. RESULTS: In mice, DXA and NMR reproducibility measures were similar for fat tissue mass (FTM) (DXA coefficient of variation [CV]=2.3%; and NMR CV=2.8%) (P=0.47), while reproducibility of lean tissue mass (LTM) estimates were better for DXA (1.0%) than NMR (2.2%) (

    DXA overestimated (vs chemical composition) LTM (+1.7 ± 1.3 g [SD], ~ 8%, P <0.001) as well as FTM (+2.0 ± 1.2 g, ~ 46%, P <0.001). NMR estimated LTM and FTM virtually identical to chemical composition analysis (LTM: -0.05 ± 0.5 g, ~0.2%, P =0.79) (FTM: +0.02 ± 0.7 g, ~15%, P =0.93). DXA and NMR-determined LTM and FTM measurements were highly correlated with the corresponding chemical analyses (r(2)=0.92 and r(2)=0.99 for DXA LTM and FTM, respectively; r(2)=0.99 and r(2)=0.99 for NMR LTM and FTM, respectively.) Sample mass did not affect accuracy in assessing chemical composition of small ground meat samples by either DXA or NMR. CONCLUSION: DXA and NMR provide comparable levels of reproducibility in measurements of body composition lean and obese mice. While DXA and NMR measures are highly correlated with chemical analysis measures, DXA consistently

  10. Reproducibility and accuracy of body composition assessments in mice by dual energy x-ray absorptiometry and time domain nuclear magnetic resonance

    PubMed Central

    Halldorsdottir, Solveig; Carmody, Jill; Boozer, Carol N.; Leduc, Charles A.; Leibel, Rudolph L.

    2011-01-01

    Objective To assess the accuracy and reproducibility of dual-energy absorptiometry (DXA; PIXImus™) and time domain nuclear magnetic resonance (TD-NMR; Bruker Optics) for the measurement of body composition of lean and obese mice. Subjects and measurements Thirty lean and obese mice (body weight range 19–67 g) were studied. Coefficients of variation for repeated (x 4) DXA and NMR scans of mice were calculated to assess reproducibility. Accuracy was assessed by comparing DXA and NMR results of ten mice to chemical carcass analyses. Accuracy of the respective techniques was also assessed by comparing DXA and NMR results obtained with ground meat samples to chemical analyses. Repeated scans of 10–25 gram samples were performed to test the sensitivity of the DXA and NMR methods to variation in sample mass. Results In mice, DXA and NMR reproducibility measures were similar for fat tissue mass (FTM) (DXA coefficient of variation [CV]=2.3%; and NMR CV=2.8%) (P=0.47), while reproducibility of lean tissue mass (LTM) estimates were better for DXA (1.0%) than NMR (2.2%) (

    DXA overestimated (vs chemical composition) LTM (+1.7 ± 1.3 g [SD], ~ 8%, P <0.001) as well as FTM (+2.0 ± 1.2 g, ~ 46%, P <0.001). NMR estimated LTM and FTM virtually identical to chemical composition analysis (LTM: −0.05 ± 0.5 g, ~0.2%, P =0.79) (FTM: +0.02 ± 0.7 g, ~15%, P =0.93). DXA and NMR-determined LTM and FTM measurements were highly correlated with the corresponding chemical analyses (r2=0.92 and r2=0.99 for DXA LTM and FTM, respectively; r2=0.99 and r2=0.99 for NMR LTM and FTM, respectively.) Sample mass did not affect accuracy in assessing chemical composition of small ground meat samples by either DXA or NMR. Conclusion DXA and NMR provide comparable levels of reproducibility in measurements of body composition lean and obese mice. While DXA and NMR measures are highly correlated with chemical analysis measures, DXA consistently overestimates LTM

  11. Periprosthetic bone loss: diagnostic and therapeutic approaches

    PubMed Central

    Cavalli, Loredana; Brandi, Maria Luisa

    2014-01-01

    Total joint replacement surgery is being performed on an increasingly large part of the population. Clinical longevity of implants depends on their osseointegration, which is influenced by the load, the characteristics of the implant and the bone-implant interface, as well as by the quality and quantity of the surrounding bone. Aseptic loosening due to periprosthetic osteolysis is the most frequent known cause of implant failure. Wear of prosthetic materials results in the formation of numerous particles of debris that cause a complex biological response. Dual-energy X-ray Absorptiometry (DXA) is regarded as an accurate method to evaluate Bone Mineral Density (BMD) around hip or knee prostheses. Further data may be provided by a new device, the Bone Microarchitecture Analysis (BMA), which combines bone microarchitecture quantification and ultra high resolution osteo-articular imaging. Pharmacological strategies have been developed to prevent bone mass loss and to extend implant survival. Numerous trials with bisphosphonates show a protective effect on periprosthetic bone mass, up to 72 months after arthroplasty. Strontium ranelate has been demonstrated to increase the osseointegration of titanium implants in treated animals with improvement of bone microarchitecture and bone biomaterial properties. PMID:25642325

  12. Body composition analysis of inter-county Gaelic athletic association players measured by dual energy X-ray absorptiometry.

    PubMed

    Davies, Robert W; Toomey, Clodagh; McCormack, William; Hughes, Katie; Cremona, Alexandra; Jakeman, Philip

    2016-01-01

    Gaelic Football and Hurling are two sporting codes within the Gaelic Athletic Association. The purpose of this study was to report the body composition phenotype of inter-county Gaelic athletic association players, comparing groups by code and field position. 190 senior, male, outfield inter-county players (144 hurlers and 46 Gaelic footballers) were recruited. Stature and body mass was measured, estimates of three components of body composition, i.e., lean mass, fat mass and bone mineral content was obtained by dual energy X-ray absorptiometry (DXA), and normative data for Gaelic athletic association athletes by code and position was compared. Other than in the midfield, there was limited difference in body composition between codes or playing position. Stature-corrected indices nullified any existing group differences between midfielders for both codes. Further comparisons with a non-athletic control group (n = 431) showed no difference for body mass index (BMI); however, the athletic group has a lower fat mass index, with a greater lean mass in accounting for the matched BMI between groups. In addition to providing previously unknown normative data for the Gaelic athletic association athlete, a proportional and independent tissue evaluation of body composition is given.

  13. An evaluation of sex and body weight determination from the proximal femur using DXA technology and its potential for forensic anthropology.

    PubMed

    Wheatley, Bruce P

    2005-01-29

    Dual energy X-ray absorptiometry (DXA) is a rarely used technology in forensic anthropology. These densitometers quantify bone mineral density (BMD) and bone mineral content (BMC) and thus introduce new variables which are important for the application of forensic anthropology. This study investigates the importance of these variables and of this technology using bone scans of the proximal femur in sex and body weight determination. Two data sets from studies conducted at the University of Alabama at Birmingham were examined. The first study had 41 White patients, of which there were 17 males and 24 females, ranging in age from 61 to 79 years and in weight from 99 to 242 lb. The following variables were utilized from the DXA scans: BMD in the femoral neck, greater trochanter and in Ward's triangle. A manual ruler in the software facilitated measurements on the minimum neck diameter and shaft diameter just below the lesser trochanter from each scan. The second study had 128 female patients, 71 of which were Black and 57 were White. They ranged in age from 23 to 47 1/2 years and they weighed between 31 1/2 and 98 1/4 kg. The same variables were examined on these DXA scans as in the first study, with the addition of BMC of the femoral neck and the deletion of the minimum shaft diameter below the lesser trochanter. The first study showed statistically significant sex determination relationships (p < 0.02, t-tests for equality of means) at the supero-inferior femoral neck and lesser trochanter diameters, and from BMD at the femoral neck, trochanter, and Ward's triangle. Discriminant function analysis correctly classified sex over 92% of the original grouped cases using these variables. Multiple regression analysis using body weight as the dependent variable and various measures of the proximal femur as independent variables shows that while they are statistically significant and they have reasonably high R2 values up to 0.49; nevertheless, their standard errors of the

  14. Dual x-ray absorptiometry

    NASA Astrophysics Data System (ADS)

    Altman, Albert; Aaron, Ronald

    2011-04-01

    Dual x-ray absorptiometry is widely used in analyzing body composition and imaging. We discuss the physics of the method and exhibit its limitations and show it is related to the Compton and photoelectric contributions to the x-ray absorption coefficients of materials.

  15. Accuracy of high-resolution peripheral quantitative computed tomography for measurement of bone quality.

    PubMed

    MacNeil, Joshua A; Boyd, Steven K

    2007-12-01

    The introduction of three-dimensional high-resolution peripheral in vivo quantitative computed tomography (HR-pQCT) (XtremeCT, Scanco Medical, Switzerland; voxel size 82 microm) provides a new approach to monitor micro-architectural bone changes longitudinally. The accuracy of HR-pQCT for three important determinants of bone quality, including bone mineral density (BMD), architectural measurements and bone mechanics, was determined through a comparison with micro-computed tomography (microCT) and dual energy X-ray absorptiometry (DXA). Forty measurements from 10 cadaver radii with low bone mass were scanned using the three modalities, and image registration was used for 3D data to ensure identical regions were analyzed. The areal BMD of DXA correlated well with volumetric BMD by HR-pQCT despite differences in dimensionality (R(2) = 0.69), and the correlation improved when non-dimensional bone mineral content was assessed (R(2) = 0.80). Morphological parameters measured by HR-pQCT in a standard patient analysis, including bone volume ratio, trabecular number, derived trabecular thickness, derived trabecular separation, and cortical thickness correlated well with muCT measures (R(2) = 0.59-0.96). Additionally, some non-metric parameters such as connectivity density (R(2) = 0.90) performed well. The mechanical stiffness assessed by finite element analysis of HR-pQCT images was generally higher than for microCT data due to resolution differences, and correlated well at the continuum level (R(2) = 0.73). The validation here of HR-pQCT against gold-standards microCT and DXA provides insight into the accuracy of the system, and suggests that in addition to the standard patient protocol, additional indices of bone quality including connectivity density and mechanical stiffness may be appropriate to include as part of a standard patient analysis for clinical monitoring of bone quality.

  16. MRI assessment of bone structure and microarchitecture.

    PubMed

    Chang, Gregory; Boone, Sean; Martel, Dimitri; Rajapakse, Chamith S; Hallyburton, Robert S; Valko, Mitch; Honig, Stephen; Regatte, Ravinder R

    2017-02-06

    Osteoporosis is a disease of weak bone and increased fracture risk caused by low bone mass and microarchitectural deterioration of bone tissue. The standard-of-care test used to diagnose osteoporosis, dual-energy x-ray absorptiometry (DXA) estimation of areal bone mineral density (BMD), has limitations as a tool to identify patients at risk for fracture and as a tool to monitor therapy response. Magnetic resonance imaging (MRI) assessment of bone structure and microarchitecture has been proposed as another method to assess bone quality and fracture risk in vivo. MRI is advantageous because it is noninvasive, does not require ionizing radiation, and can evaluate both cortical and trabecular bone. In this review article, we summarize and discuss research progress on MRI of bone structure and microarchitecture over the last decade, focusing on in vivo translational studies. Single-center, in vivo studies have provided some evidence for the added value of MRI as a biomarker of fracture risk or treatment response. Larger, prospective, multicenter studies are needed in the future to validate the results of these initial translational studies.

  17. Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients

    PubMed Central

    2010-01-01

    Background Bone mineral density (BMD) accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewing's and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA) after completion of neoadjuvant chemotherapy. Methods DXA measurements of the lumbar spine (L2-4), both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years). Mean Z-scores, areal BMD (g/cm2), calculated volumetric BMD (g/cm3) and bone mineral content (BMC, g) were determined. Results Lumbar spine mean Z-score was -0.14 (95% CI: -0.46 to 0.18), areal BMD was 1.016 g/cm2 (95% CI: 0.950 to 1.082) and volumetric BMD was 0.330 g/cm3 (95% CI: 0.314 to 0.347) which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36), the difference between the affected and non-affected femoral neck was 12.1% (95% CI: -16.3 to -7.9) in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7% (95% CI: -29.3 to -14.0) for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80. Conclusions The tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis in later life

  18. Bone mineral density (BMD) and computer tomographic measurements of the equine proximal phalanx in correlation with breaking strength.

    PubMed

    Tóth, P; Horváth, C; Ferencz, V; Tóth, B; Váradi, A; Szenci, O; Bodó, G

    2013-01-01

    Despite the fact that bone mineral density (BMD) is an important fracture risk predictor in human medicine, studies in equine orthopedic research are still lacking. We hypothesized that BMD correlates with bone failure and fatigue fractures of this bone. Thus, the objectives of this study were to measure the structural and mechanical properties of the proximal phalanx with dual energy X-ray absorptiometry (DXA), to correlate the data obtained from DXA and computer tomography (CT) measurements to those obtained by loading pressure examination and to establish representative region of interest (ROI) for in vitro BMD measurements of the equine proximal phalanx for predicting bone failure force. DXA was used to measure the whole bone BMD and additional three ROI sites in 14 equine proximal phalanges. Following evaluation of the bone density, whole bone, cortical width and area in the mid-diaphyseal plane were measured on CT images. Bones were broken using a manually controlled universal bone crusher to measure bone failure force and reevaluated for the site of fractures on follow-up CT images. Compressive load was applied at a constant displacement rate of 2 mm/min until failure, defined as the first clear drop in the load measurement. The lowest BMD was measured at the trabecular region (mean +/- SD: 1.52 +/- 0.12 g/cm2; median: 1.48 g/cm2; range: 1.38-1.83 g/cm2). There was a significant positive linear correlation between trabelcular BMD and the breaking strength (P = 0.023, r = 0.62). The trabecular region of the proximal phalanx appears to be the only significant indicator of failure of strength in vitro. This finding should be reassessed to further reveal the prognostic value of trabecular BMD in an in vivo fracture risk model.

  19. Expanding the Description of Spaceflight Effects beyond Bone Mineral Density [BMD]: Trabecular Bone Score [TBS] in ISS Astronauts

    NASA Technical Reports Server (NTRS)

    Sibonga, J. D.; Spector, E. R.; King, L. J.; Evans, H. J.; Smith, S. A.

    2014-01-01

    Dual-energy x-ray absorptiometry [DXA] is the widely-applied bone densitometry method used to diagnose osteoporosis in a terrestrial population known to be at risk for age-related bone loss. This medical test, which measures areal bone mineral density [aBMD] of clinically-relevant skeletal sites (e.g., hip and spine), helps the clinician to identify which persons, among postmenopausal women and men older than 50 years, are at high risk for low trauma or fragility fractures and might require an intervention. The most recognized osteoporotic fragility fracture is the vertebral compression fracture which can lead to kyphosis or hunched backs typically seen in the elderly. DXA measurement of BMD however is recognized to be insufficient as a sole index for assessing fracture risk. DXA's limitation may be related to its inability to monitor changes in structural parameters, such as trabecular vs. cortical bone volumes, bone geometry or trabecular microarchitecture. Hence, in order to understand risks to human health and performance due to space exposure, NASA needs to expand its measurements of bone to include other contributors to skeletal integrity. To this aim, the Bone and Mineral Lab conducted a pilot study for a novel measurement of bone microarchitecture that can be obtained by retrospective analysis of DXA scans. Trabecular Bone Score (TBS) assesses changes to trabecular microarchitecture by measuring the grey color "texture" information extracted from DXA images of the lumbar spine. An analysis of TBS in 51 ISS astronauts was conducted to assess if TBS could detect 1) an effect of spaceflight and 2) a response to countermeasures independent of DXA BMD. In addition, changes in trunk body lean tissue mass and in trunk body fat tissue mass were also evaluated to explore an association between body composition, as impacted by ARED exercise, and bone microarchitecture. The pilot analysis of 51 astronaut scans of the lumbar spine suggests that, following an ISS

  20. Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

    PubMed Central

    Gallo, Sina; Vanstone, Catherine A.; Weiler, Hope A.

    2012-01-01

    For over 2 decades, dual-energy X-ray absorptiometry (DXA) has been the gold standard for estimating bone mineral density (BMD) and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation), weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada). Whole body (WB) as well as regional sites of the lumbar spine (LS 1–4) and femur was measured using DXA (QDR 4500A, Hologic Inc.) providing bone mineral content (BMC) for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0 ± 14.2 versus 227.0 ± 29.7 g), spine BMC by 130% (2.35 ± 0.42 versus 5.37 ± 1.02 g), and femur BMC by 190% (2.94 ± 0.54 versus 8.50 ± 1.84 g). Spine BMD increased by 14% (0.266 ± 0.044 versus 0.304 ± 0.044 g/cm2) during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals. PMID:23091773

  1. Bone mineral density predicts fractures in chronic kidney disease.

    PubMed

    West, Sarah L; Lok, Charmaine E; Langsetmo, Lisa; Cheung, Angela M; Szabo, Eva; Pearce, Dawn; Fusaro, Maria; Wald, Ron; Weinstein, Jordan; Jamal, Sophie A

    2015-05-01

    Fractures are common in chronic kidney disease (CKD). The optimal methods by which to assess fracture risk are unknown, in part, due to a lack of prospective studies. We determined if bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), and/or high-resolution peripheral quantitative computed tomography (HRpQCT) could predict fractures in men and women ≥18 years old with stages 3 to 5 CKD. BMD was measured by DXA (at the total hip, lumbar spine, ultradistal, and 1/3 radius) and by HRpQCT (at the radius), and subjects were followed for 2 years for incident morphometric spine fractures and low-trauma clinical fractures. The mean age of the subjects was 62 years with equal numbers having stages 3, 4, and 5 CKD. Over 2 years there were 51 fractures in 35 subjects. BMD by DXA at baseline was significantly lower at all sites among those with incident fractures versus those without. For example, the mean BMD at the total hip in those with incident fractures was 0.77 g/cm2 (95% confidence interval [CI], 0.73 to 0.80) and in those without fracture was 0.95 g/cm2 (95% CI, 0.92 to 0.98). Almost all baseline HRpQCT measures were lower in those with incident fracture versus those without. For example, volumetric BMD in those with incident fractures was 232 mg HA/cm3 (95% CI, 213 to 251) and in those without fracture was 317.6 mg HA/cm3 (95% CI, 306 to 329.1). Bone loss occurred in all subjects, but was significantly greater among those with incident fractures. Our data demonstrate that low BMD (by DXA and HRpQCT) and a greater annualized percent decrease in BMD are risk factors for subsequent fracture in men and women with predialysis CKD.

  2. Gonadal steroid–dependent effects on bone turnover and bone mineral density in men

    PubMed Central

    Finkelstein, Joel S.; Lee, Hang; Leder, Benjamin Z.; Goldstein, David W.; Hahn, Christopher W.; Hirsch, Sarah C.; Linker, Alex; Perros, Nicholas; Servais, Andrew B.; Taylor, Alexander P.; Webb, Matthew L.; Youngner, Jonathan M.; Yu, Elaine W.

    2016-01-01

    BACKGROUND. Severe gonadal steroid deficiency induces bone loss in adult men; however, the specific roles of androgen and estrogen deficiency in hypogonadal bone loss are unclear. Additionally, the threshold levels of testosterone and estradiol that initiate bone loss are uncertain. METHODS. One hundred ninety-eight healthy men, ages 20–50, received goserelin acetate, which suppresses endogenous gonadal steroid production, and were randomized to treatment with 0, 1.25, 2.5, 5, or 10 grams of testosterone gel daily for 16 weeks. An additional cohort of 202 men was randomized to receive these treatments plus anastrozole, which suppresses conversion of androgens to estrogens. Thirty-seven men served as controls and received placebos for goserelin and testosterone. Changes in bone turnover markers, bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA), and BMD by quantitative computed tomography (QCT) were assessed in all men. Bone microarchitecture was assessed in 100 men. RESULTS. As testosterone dosage decreased, the percent change in C-telopeptide increased. These increases were considerably greater when aromatization of testosterone to estradiol was also suppressed, suggesting effects of both testosterone and estradiol deficiency. Decreases in DXA BMD were observed when aromatization was suppressed but were modest in most groups. QCT spine BMD fell substantially in all testosterone-dose groups in which aromatization was also suppressed, and this decline was independent of testosterone dose. Estradiol deficiency disrupted cortical microarchitecture at peripheral sites. Estradiol levels above 10 pg/ml and testosterone levels above 200 ng/dl were generally sufficient to prevent increases in bone resorption and decreases in BMD in men. CONCLUSIONS. Estrogens primarily regulate bone homeostasis in adult men, and testosterone and estradiol levels must decline substantially to impact the skeleton. TRIAL REGISTRATION. ClinicalTrials.gov, NCT00114114

  3. [Bone and calcium update; diagnosis and therapy of metabolic bone disease update. Advances in clinical trials for osteoporosis in Japan].

    PubMed

    Nakamura, Toshitaka

    2011-12-01

    Microdensitometry of the metacarpal bone on radiograph was first set up as the endpoint of the treatment in clinical trials in Japan in 1980s. Then, radial bone mineral content obtained by single photon absorptiometry was used. In 1990s, lumbar spine BMD measured by DXA became the major endpoint of the study which was designed as prospective, randomized, double-blind, controlled trial. In 2000s, assessments on the incidences of the vertebral fractures have become mandatory as the primary endpoint of the placebo-controlled trial. The numbers of the subjects required in the study are getting larger and the subtleties in the study including adverse events more important along the progress of evidence-based medicine.

  4. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the ‘Gold Standard’ Tarnished?

    PubMed Central

    Hands, Beth; Pennell, Craig E.; Lye, Stephen J.; Mountain, Jennifer A.

    2016-01-01

    Background and Aims Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. Methods and Results 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Conclusion Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults. PMID:27622523

  5. Seven-site versus three-site method of body composition using BodyMetrix ultrasound compared to dual-energy X-ray absorptiometry.

    PubMed

    Baranauskas, Marissa N; Johnson, Kelly E; Juvancic-Heltzel, Judith A; Kappler, Rachele M; Richardson, Laura; Jamieson, Scott; Otterstetter, Ronald

    2015-10-22

    Obesity is a steadily growing epidemic affecting all segments of the population including college-aged students. The weight gain that is evidenced amid the transitional stage of college years increases the risks associated with cardiovascular and metabolic diseases. The BodyMetrix® BX-2000 (ULTRA) using a seven-site method has been evaluated against dual-energy X-ray absorptiometry (DXA) for estimation of body composition, which has yielded conflicting results. To date, no studies have compared the three-site method Jackson and Pollock three-site method to DXA.

  6. Body composition in young female eating-disorder patients with severe weight loss and controls: evidence from the four-component model and evaluation of DXA

    PubMed Central

    Wells, J C K; Haroun, D; Williams, J E; Nicholls, D; Darch, T; Eaton, S; Fewtrell, M S

    2015-01-01

    Background/Objectives: Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED involving substantial weight loss, relative to healthy controls using the four-component (4C) model, and (2) to explore the validity of DXA body composition assessment in ED patients. Subjects/Methods: Body composition of 13 females with ED and 117 controls, aged 10–18 years, was investigated using the 4C model. Accuracy of DXA for estimation of FFM and fat mass (FM) was tested using the approach of Bland and Altman. Results: Adjusting for age, height and pubertal stage, ED patients had significantly lower whole-body FM, FFM, protein mass (PM) and mineral mass (MM) compared with controls. Trunk and limb FM and limb lean soft tissue were significantly lower in ED patients. However, no significant difference in the hydration of FFM was detected. Compared with the 4C model, DXA overestimated FM by 5±36% and underestimated FFM by 1±9% in ED patients. Conclusion: Our study confirms that ED patients are depleted not only in FM but also in FFM, PM and MM. DXA has limitations for estimating body composition in individual young female ED patients. PMID:26173868

  7. Body composition at 6 months of life: comparison of air displacement plethysmography and dual-energy X-ray absorptiometry.

    PubMed

    Fields, David A; Demerath, Ellen W; Pietrobelli, Angelo; Chandler-Laney, Paula C

    2012-11-01

    Body composition assessment during infancy is important because it is a critical period for obesity risk development, thus valid tools are needed to accurately, precisely, and quickly determine both fat and fat-free mass. The purpose of this study was to compare body composition estimates using dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP) at 6 months old. We assessed the agreement between whole body composition using DXA and ADP in 84 full-term average-for-gestational-age boys and girls using DXA (Lunar iDXA v11-30.062; Infant whole body analysis enCore 2007 software, GE, Fairfield, CT) and ADP (Infant Body Composition System v3.1.0, COSMED USA, Concord, CA). Although the correlations between DXA and ADP for %fat (r = 0.925), absolute fat mass (r = 0.969), and absolute fat-free mass (r = 0.945) were all significant, body composition estimates by DXA were greater for both %fat (31.1 ± 3.6% vs. 26.7 ± 4.7%; P < 0.001) and absolute fat mass (2,284 ± 449 vs. 1,921 ± 492 g; P < 0.001), and lower for fat-free mass (5,022 ± 532 vs. 5,188 ± 508 g; P < 0.001) vs. ADP. Inter-method differences in %fat decreased with increasing adiposity and differences in fat-free mass decreased with increasing infant age. Estimates of body composition determined by DXA and ADP at 6 months of age were highly correlated, but did differ significantly. Additional work is required to identify the technical basis for these rather large inter-method differences in infant body composition.

  8. Changes in bone fatigue resistance due to collagen degradation.

    PubMed

    Wynnyckyj, Chrystia; Willett, Thomas L; Omelon, Sidney; Wang, Jian; Wang, Zhirui; Grynpas, Marc D

    2011-02-01

    Clinical tools for evaluating fracture risk, such as dual energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS), focus on bone mineral and cannot detect changes in the collagen matrix that affect bone mechanical properties. However, the mechanical response tissue analyzer (MRTA) directly measures a whole bone mechanical property. The aims of our study were to investigate the changes in fatigue resistance after collagen degradation and to determine if clinical tools can detect changes in bone mechanical properties due to fatigue. Male and female emu tibiae were endocortically treated with 1 M KOH for 1-14 days and then either fatigued to failure or fatigued to induce stiffness loss without fracture. Partial fatigue testing caused a decrease in modulus measured by mechanical testing even when not treated with KOH, which was detected by MRTA. At high stresses, only KOH-treated samples had a lower fatigue resistance compared to untreated bones for both sexes. No differences were observed in fatigue behavior at low stresses for all groups. KOH treatment is hypothesized to have changed the collagen structure in situ and adversely affected the bone. Cyclic creep may be an important mechanism in the fast deterioration rate of KOH-treated bones, as creep is the major cause of fatigue failure for bones loaded at high stresses. Therefore, collagen degradation caused by KOH treatment may be responsible for the observed altered fatigue behavior at high stresses, since collagen is responsible for the creep behavior in bone.

  9. Errors in dual energy x-ray absorptiometry estimation of body composition induced by hypohydration.

    PubMed

    Rodriguez-Sanchez, Nidia; Galloway, Stuart D R

    2015-02-01

    Dual energy x-ray absorptiometry (DXA) is a popular tool to determine body composition (BC) in athletes, and is used for analysis of fat-free soft tissue mass (FFST) or fat mass (FM) gain/loss in response to exercise or nutritional interventions. The aim of the current study was to assess the effect of exercise-heat stress induced hypohydration (HYP, >2% of body mass (BM) loss) vs. maintenance of euhydration (EUH) on DXA estimates of BC, sum of skinfolds (SF), and impedance (IMP) measurements in athletes. Competitive athletes (23 males and 15 females) recorded morning nude BM for 7 days before the first main trial. Measurements on the first trial day were conducted in a EUH condition, and again after exercise-heat stress induced HYP. On the second trial day, fluid and electrolyte losses were replaced during exercise using a sports drink. A reduction in total BM (1.6 ± 0.4 kg; 2.3 ± 0.4% HYP) and total FFST (1.3 ± 0.4 kg), mainly from trunk (1.1 ± 0.5 kg), was observed using DXA when participants were HYP, reflecting the sweat loss. Estimated fat percent increased (0.3 ± 0.3%), however, total FM did not change (0.1 ± 0.2 kg). SF and IMP declined with HYP (losses of 1.5 ± 2.9% and 1.6 ± 3% respectively) suggesting FM loss. When EUH was maintained there were no significant changes in BM, DXA estimates, or SF values pre to post exercise, but IMP still declined. We conclude that use of DXA for FFST assessment in athletes must ensure a EUH state, particularly when considering changes associated with nutritional or exercise interventions.

  10. Impact of Growth Hormone on Adult Bone Quality in Turner Syndrome: A HR-pQCT Study.

    PubMed

    Nour, Munier A; Burt, Lauren A; Perry, Rebecca J; Stephure, David K; Hanley, David A; Boyd, Steven K

    2016-01-01

    Women with Turner syndrome (TS) are known to be at risk of osteoporosis. While childhood growth hormone (GH) treatment is common in TS, the impact of this therapy on bone health has been poorly understood. The objective of this study was to determine the influence of childhood GH treatment on adult bone quality in women with TS. 28 women aged 17-45 with confirmed TS (12 GH-treated) agreed to participate in this cross-sectional study. Dual X-ray absorptiometry (DXA) of lumbar spine, hip, and radius and high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the radius and tibia were used to determine standard morphological and micro-architectural parameters of bone health. Finite element (FE) analysis and polar moment of inertia (pMOI) were used to estimate bone strength. GH-treated subjects were +7.4 cm taller (95% CI 2.5-12.3 cm, p = 0.005). DXA-determined areal BMD of hip, spine, and radius was similar between treatment groups. Both tibial and radial total bone areas were greater among GH-treated subjects (+20.4 and +21.2% respectively, p < 0.05), while other micro-architectural results were not different between groups. pMOI was significantly greater among GH-treated subjects (radius +35.0%, tibia +34.0%, p < 0.05). Childhood GH treatment compared to no treatment in TS was associated with an increased height, larger bones, and greater pMOI, while no significant difference in DXA-derived BMD, HR-pQCT micro-architectural parameters, or FE-estimated bone strength was detected. The higher pMOI and greater bone size may confer benefit for fracture reduction in these GH-treated patients.

  11. Periprosthetic bone loss after insertion of an uncemented, customized femoral stem and an uncemented anatomical stem

    PubMed Central

    2011-01-01

    Background and purpose Customized femoral stems are designed to have a perfect fit and fill in the femur in order to achieve physiological load transfer and minimize stress shielding. Dual-energy X-ray absorptiometry (DXA) is regarded as an accurate method for detection of small alterations in bone mineral density (BMD) around hip prostheses. We present medium-term DXA results from a randomized study comparing a customized and an anatomical femoral stem. Methods 100 hips were randomized to receive either the anatomical ABG-I stem or the Unique customized femoral stem, both uncemented. DXA measurements were conducted postoperatively and after 3, 6, 12, 24, 36, and 60 months, and BMD was computed for each of the 7 Gruen zones in the proximal femur. Results Results from 87 patients were available for analysis. 78 completed the 5-year follow-up: 35 patients in the ABG group and 43 patients in the Unique group. In both groups, we found the greatest degree of bone loss in the proximal Gruen zones. In zone 1, there was 15% reduction in BMD in the ABG-I group and 14% reduction in the Unique group. In zone 7, the reduction was 28% in the ABG-I group and 27% in the Unique group. The only statistically significant difference between the groups was found in Gruen zone 4, which is distal to the tip of the stem, with 1.6% reduction in BMD in the ABG-I group and 9.7% reduction in the Unique group (p = 0.003). Interpretation 5-year DXA results showed that because of stress-shielding, proximal bone loss could not be avoided—either for the anatomical ABG-I stem or for the customized Unique stem. PMID:21668387

  12. Skeletal health in long-duration astronauts: nature, assessment, and management recommendations from the NASA Bone Summit.

    PubMed

    Orwoll, Eric S; Adler, Robert A; Amin, Shreyasee; Binkley, Neil; Lewiecki, E Michael; Petak, Steven M; Shapses, Sue A; Sinaki, Mehrsheed; Watts, Nelson B; Sibonga, Jean D

    2013-06-01

    Concern about the risk of bone loss in astronauts as a result of prolonged exposure to microgravity prompted the National Aeronautics and Space Administration to convene a Bone Summit with a panel of experts at the Johnson Space Center to review the medical data and research evidence from astronauts who have had prolonged exposure to spaceflight. Data were reviewed from 35 astronauts who had served on spaceflight missions lasting between 120 and 180 days with attention focused on astronauts who (1) were repeat fliers on long-duration missions, (2) were users of an advanced resistive exercise device (ARED), (3) were scanned by quantitative computed tomography (QCT) at the hip, (4) had hip bone strength estimated by finite element modeling, or (5) had lost >10% of areal bone mineral density (aBMD) at the hip or lumbar spine as measured by dual-energy X-ray absorptiometry (DXA). Because of the limitations of DXA in describing the effects of spaceflight on bone strength, the panel recommended that the U.S. space program use QCT and finite element modeling to further study the unique effects of spaceflight (and recovery) on bone health in order to better inform clinical decisions.

  13. Sex- and age-related differences in femoral neck cross-sectional structural changes in mainland Chinese men and women measured using dual-energy X-ray absorptiometry.

    PubMed

    Gong, Jian; Tang, Min; Guo, Bin; Shang, JingJie; Tang, Yongjin; Xu, Hao

    2016-02-01

    We investigated age-related changes in estimated bone strength and cross-sectional structure of the femoral neck (FN) in mainland Chinese men and women (according to age and sex) using dual-energy X-ray absorptiometry (DXA). A total of 3855 healthy adults (2713 women, 1142 men; ages 25-91years) were analyzed by FN bone mineral density (BMD) assessment and hip structural/strength analysis (HSA), including cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), section modulus (Z), periosteal diameter (PD), endocortical diameter (ED), and cortical thickness (CT) using DXA. HSA differences between age and sex groups were adjusted for body weight, height and FN BMD. Trends according to age were estimated by linear regression analysis. There was no inverse correlation between HSA parameters and age in young adults. Some HSA parameters (CSMI, CSA, Z, CT) decreased significantly with age, whereas PD and ED increased significantly. Older adults had less estimated bone strength and CT and higher PD and ED (p<0.05) than young adults. Men had greater increases in PD and ED than women across all ages. FN strength decreases with age in both sexes, caused by FN cross-sectional structural deterioration. Indirect comparison of our data with those from other populations showed less age-related FN periosteal apposition in Chinese than Caucasian men, but similar amounts in women. This may partly explain different male/female hip fracture rates among ethnic groups. Chinese men have more structural disadvantages regarding FN geometry during aging than Caucasian men, possibly conferring added susceptibility to hip fracture.

  14. Age-related decrements in bone mineral density in women over 65

    NASA Technical Reports Server (NTRS)

    Steiger, P.; Cummings, S. R.; Black, D. M.; Spencer, N. E.; Genant, H. K.

    1992-01-01

    Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cm2 was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in all regions except the spine, where the difference between the two age groups was 6%. Ward's triangle and the calcaneus exhibited the largest decrements, with 26 and 21%, respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from -0.82% at the femoral neck and trochanter to -1.30% at Ward's triangle. Correlations between the different regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and calcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.

  15. [DEXA (dual-energy x-ray absorptiometry) and DPA (dual photon absorptiometry) in densitometry of the femoral neck: correlation of the measurements of three commercially available instruments].

    PubMed

    Hübsch, P; Schneider, B; Seidl, G; Kalchhauser, G; Klaushofer, K; Popovic, R

    1991-07-01

    The bone mineral density measurements of three different instruments at the femoral head were compared using 12 cadaver specimens. Two of these instruments were operated by x-rays (dual energy x-ray absorptiometry = DEXA), whereas one system was based on a gadolinium source (dual photon absorptiometry = DPA). Although excellent correlation between the measurements was obtained (r greater than 0,9), the measurements of one of the DEXA-instruments were significantly higher than the measurements of the two other systems. We conclude that a comparison of bone mineral density measurements obtained on different densitometry instruments may pose problems. Follow-up examinations should be done on one single densitometry unit.

  16. Birth weight predicts bone size in young adulthood at cortical sites in men and trabecular sites in women from The Gambia.

    PubMed

    de Bono, Stephanie; Schoenmakers, Inez; Ceesay, Mustapha; Mendy, Michael; Laskey, M Ann; Cole, Tim J; Prentice, Ann

    2010-05-01

    Fracture risk is determined by bone mass, size and architecture. Birth weight (Bwt) is reported to predict adult bone mass and density. Early life environment may therefore be a determinant of bone strength in later life. However such evidence was obtained using dual energy X-ray absorptiometry (DXA), which is known to be dependent on size. We used peripheral quantitative computed tomography (pQCT) and DXA to investigate Bwt as a determinant of bone size and cross section area (CSA), bone mineral content (BMC) and volumetric bone mineral density (vBMD) and areal BMD (aBMD) independent of current weight, height and age. The study population consisted of 68 males and 52 nulliparous females aged 17 to 21years from Keneba, The Gambia. This population has a high prevalence of factors likely to influence skeletal development (poor nutrition, low calcium intake, late puberty and high physical activity). Measures of bone size and CSA, BMC and BMD were obtained using pQCT (Stratec 2000; at 4% and 66% radius; 4% and 50% tibia) and DXA (Lunar DPX; spine, hip, forearm and whole body). Sequential univariable (influence of Bwt on bone variables) and multivariable linear regression analyses (influence of Bwt on bone variables after adjusting for current height, weight and age) were used to investigate the independent effects of Bwt and attained size. Analyses were performed separately by sex. Bwt was a significant positive predictor of CSA at appendicular cortical sites in males and CSA and bone area at appendicular and most axial trabecular sites in females before and after adjustment for current height, weight and age. Bwt was not consistently related to BMC, vBMD or aBMD as measured by pQCT or DXA. Current weight was a positive predictor of aBMD and pQCT- and DXA-derived BMC in males and females. Height predicted aBMD and trabecular vBMD in males. In summary, Bwt significantly predicted attained CSA at cortical sites in males and at trabecular sites in females. Current weight

  17. Abnormalities in Cortical Bone, Trabecular Plates, and Stiffness in Postmenopausal Women Treated With Glucocorticoids

    PubMed Central

    Sutter, Stephanie; Nishiyama, Kyle K.; Kepley, Anna; Zhou, Bin; Wang, Ji; McMahon, Donald J.; Guo, X. Edward

    2014-01-01

    Context: The mechanisms by which glucocorticoids (GCs) increase skeletal fragility are not well understood. Objective: The objective of the study was to evaluate the microarchitecture, trabecular morphology, and biomechanical properties of bone in postmenopausal women treated with GCs. Design: This was a case-control study. Setting: The study was conducted at a university hospital outpatient facility. Patients: Postmenopausal women treated with oral GCs for longer than 3 months (n = 30) and age/race-matched controls (n = 60) participated in the study. Main Outcome Measures: Areal bone mineral density aBMD (BMD) by dual-energy x-ray absorptiometry (DXA) was measured. Trabecular and cortical volumetric BMD (vBMD) and microarchitecture by high-resolution peripheral computed tomography of the distal radius and tibia were also measured. Whole-bone stiffness was estimated by finite element analysis. A novel technique, individual trabecula segmentation, was used to evaluate trabecular type (as plate or rod), orientation, and connectivity. Results: DXA T-scores did not differ significantly at any site. GC subjects had significantly lower total, cortical, and trabecular vBMD and thinner cortices, fewer, thinner, more widely, and irregularly spaced trabeculae. They had fewer trabecular plates, fewer axially aligned trabeculae, and lower trabecular connectivity. Differences ranged from 4% to 65% for these trabecular measures and 5% to 17% for the cortical measures. Whole-bone stiffness was significantly lower (11%–16%) in GC subjects. Markers of bone formation (osteocalcin and amino-terminal propeptide of type I procollagen) and resorption (C-telopeptide) were lower in the GC subjects. Conclusions: Despite similar areal BMD by DXA, GC-treated women had abnormal cortical and trabecular vBMD and microarchitecture at both the radius and tibia, including fewer trabecular plates, a less axially aligned trabecular network, lower trabecular connectivity, thinner cortices, and

  18. Serum Bone Biomarkers and Oral/Systemic Bone Loss in Humans

    PubMed Central

    Payne, J.B.; Stoner, J.A.; Lee, H.-M.; Nummikoski, P.V.; Reinhardt, R.A.; Golub, L.M.

    2011-01-01

    We recently reported that subantimicrobial-dose doxycycline (SDD) significantly reduced serum bone-resorption biomarkers in subgroups of post-menopausal women. We hypothesize that changes in serum bone biomarkers are associated not only with systemic bone mineral density (BMD) changes, but also with alveolar bone changes over time. One hundred twenty-eight eligible post-menopausal women with periodontitis and systemic osteopenia were randomly assigned to receive SDD or placebo tablets twice daily for two years, adjunctive to periodontal maintenance. Sera were analyzed for bone biomarkers. As expected, two-year changes in a serum bone biomarker were significantly associated with systemic BMD loss at the lumbar spine (osteocalcin, bone-turnover biomarker, p = 0.0002) and femoral neck (osteocalcin p = 0.0025). Two-year changes in serum osteocalcin and serum pyridinoline-crosslink fragment of type I collagen (ICTP; bone-resorption biomarker) were also significantly associated with alveolar bone density loss (p < 0.0001) and alveolar bone height loss (p = 0.0008), respectively. Thus, we have shown that serum bone biomarkers are associated with not only systemic BMD loss, but with alveolar bone loss as well. Clinical Trial Registration Information: Protocol registered at ClinicalTrials.gov, NCT00066027. Abbreviations: bone mineral density (BMD), bone-specific alkaline phosphatase (BSAP), computer-assisted densitometric image analysis (CADIA), confidence interval (CI), deoxypyridinoline-containing degradation fragment of the C-terminal telopeptide region of type I collagen (CTX), coefficient of variation (CV), dual-energy x-ray absorptiometry (DXA), pyridinoline-crosslink-containing degradation fragment of the C-terminal telopeptide region of type I collagen (ICTP), and subantimicrobial-dose doxycycline (SDD). PMID:21422479

  19. New reference data on bone mineral density and the prevalence of osteoporosis in Korean adults aged 50 years or older: the Korea National Health and Nutrition Examination Survey 2008-2010.

    PubMed

    Lee, Kyung-Shik; Bae, Su-Hyun; Lee, Seung Hwa; Lee, Jungun; Lee, Dong Ryul

    2014-11-01

    This cross-sectional study was performed to investigate the reference values for bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and the prevalence of osteoporosis in the Korean population by applying domestic reference data. In total, 25,043 Korean adults ≥20 yr of age (11,792 men and 13,251 women) participated in the study. The BMDs of the total hip, femoral neck, and lumbar spine were measured by DXA (Discovery-W, Hologic Inc.), and subjects with a BMD - 2.5 standard deviations or lower than the mean BMD for young adults (20-29 yr old) were considered to have osteoporosis. When applying the new reference values determined in this study from Korean subjects, the overall prevalence of osteoporosis increased in men aged ≥50 yr compared with that provided by the DXA manufacturer from Japanese subjects (12.2% vs. 7.8%, P<0.001) and decreased in postmenopausal women aged ≥50 yr (32.9% vs. 38.7%, P<0.001). According to the findings of this study, use of the reference values provided by the DXA manufacturer has resulted in the underdiagnosis of osteoporosis in Korean men and the overdiagnosis of osteoporosis in Korean women. Our data will serve as valuable reference standards for the diagnosis and management for osteoporosis in the Korean population.

  20. [Bone protection in corticosteroid treated patients].

    PubMed

    Savoldi, Silvana; Giacchino, Franca; Rollino, Cristiana; Manganaro, Marco; Besso, Luca; Izzo, Cristina; Gianoglio, Bruno; Amore, Alessandro; Fenoglio, Roberta; Stratta, Piero

    2015-01-01

    The Piedmont Group of Clinical Nephrology compared the activity of 15 nephrology centers in Piedmont and Aosta Valley as regards bone protection in patients on corticosteroids therapy. Fracture prevalence shows great variability: in 4/15 centers (27%) no fractures were found, in 6/15 centers (40%) fractures were present in 1-4% of cases, in 1 center in 18% of patients. Clinical risk of fracture was based on sex, age and postmenopausal status in 11/14 of the centers (79%), history of fractures and bone disease in 4/14 centers (27%), smoking and alcohol consumption in 3 and 2 centers respectively, glucocorticoid dose and duration in 4, in children bone age and calcium phosphorus status. Dual energy X-ray absorptiometry was performed in 12 centers based on risk factors, in 8 (57%) DXA was performed during the follow-up, in 4 it was performed after 12 months and in 2 after 2-3 years. DXA is not prescribed in children. Only in one center, risk assessment is based on FRAX. Most of the patients are treated with vitamin D supplementation at a dose of steroids of 5 mg/d (80%). Calcium carbonate is used in 9 centers (60%), in two it is used only in the presence of low ionized calcium or bone mineral density. Bisphosphonates are used following AIFA prescription, in particular alendronate in all centers, risedronate in seven and denosumab in one. The analysis shows the great variability of the clinical and therapeutic approach regarding bone protection in patients on corticosteroids therapy, in Piedmont and Aosta Valley.

  1. THE MEASUREMENT OF BONE QUALITY USING GRAY LEVEL CO-OCCURRENCE MATRIX TEXTURAL FEATURES.

    PubMed

    Shirvaikar, Mukul; Huang, Ning; Dong, Xuanliang Neil

    2016-10-01

    In this paper, statistical methods for the estimation of bone quality to predict the risk of fracture are reported. Bone mineral density and bone architecture properties are the main contributors of bone quality. Dual-energy X-ray Absorptiometry (DXA) is the traditional clinical measurement technique for bone mineral density, but does not include architectural information to enhance the prediction of bone fragility. Other modalities are not practical due to cost and access considerations. This study investigates statistical parameters based on the Gray Level Co-occurrence Matrix (GLCM) extracted from two-dimensional projection images and explores links with architectural properties and bone mechanics. Data analysis was conducted on Micro-CT images of 13 trabecular bones (with an in-plane spatial resolution of about 50μm). Ground truth data for bone volume fraction (BV/TV), bone strength and modulus were available based on complex 3D analysis and mechanical tests. Correlation between the statistical parameters and biomechanical test results was studied using regression analysis. The results showed Cluster-Shade was strongly correlated with the microarchitecture of the trabecular bone and related to mechanical properties. Once the principle thesis of utilizing second-order statistics is established, it can be extended to other modalities, providing cost and convenience advantages for patients and doctors.

  2. Comparison of circumference measures and height-weight tables with dual-energy x-ray absorptiometry assessment of body composition in r.o.t.c. Cadets.

    PubMed

    Pritchett, Kelly L; Mitchell, Katherine M; Pritchett, Robert C; Gee, David L

    2017-03-13

    Height-weight tables and circumference measures are used by the U.S. Army to predict body composition because they require little equipment/expertise. However, agreement between the Army's new 2002 circumference equation and an established laboratory technique has not been determined. The purpose of this study was to quantify agreement in body fat percentages between the Army's circumference measures (taping) and dual-energy x-ray absorptiometry (DXA); second to determine categorical agreement between height-weight tables and DXA. Male Reserve Officer Training Corps (R.O.T.C.) cadets (N=23; 20.6 ± 1.6 years, 179.1 ± 6.6 cm; 81.4 ± 10.3 kg) were taped according to Army protocol to predict body fat. % body fat prediction was compared to DXA via a Bland-Altman Plot with ±2-4% body fat established as a zone of agreement (ZOA). 13/23 cadets fell outside the ZOA. No cadet was over the compliance threshold (20-22% fat) using the tape method, however with DXA, 7/23 cadets were non-compliant. Height-weight tables provided a moderate level of categorical agreement with DXA. The results depict poor agreement between taping and DXA, as taping generally underestimated % body fat. Compared to taping, heightweight tables were better able to identify excess fat weight.

  3. Agreement of BMI-Based Equations and DXA in Determining Body-Fat Percentage in Adults With Down Syndrome.

    PubMed

    Esco, Michael R; Nickerson, Brett S; Bicard, Sara C; Russell, Angela R; Bishop, Phillip A

    2016-01-01

    The purpose of this investigation was to evaluate measurements of body-fat percentage (BF%) in 4 body-mass-index- (BMI) -based equations and dual-energy X-ray absorptiometry (DXA) in individuals with Down syndrome (DS). Ten male and 10 female adults with DS volunteered for this study. Four regression equations for estimating BF% based on BMI previously developed by Deurenberg et al. (DE(BMI-BF%)), Gallagher et al. (GA(BMI-BF%)), Womersley & Durnin (WO(BMI-BF%)), and Jackson et al. (JA(BMI-BF%)) were compared with DXA. There was no significant difference (p = .659) in mean BF% values between JA(BMI-BF%) (BF% = 40.80% ± 6.3%) and DXA (39.90% ± 11.1%), while DE(BMI-BF%) (34.40% ± 9.0%), WO(BMI-BF%) (35.10% ± 9.4%), and GA(BMI-BF%) (35.10% ± 9.4%) were significantly (p < .001) lower. The limits of agreement (1.96 SD of the constant error) varied from 9.80% to 16.20%. Therefore, BMI-based BF% equations should not be used in individuals with DS.

  4. Bone mineral density, adiposity, and cognitive functions

    PubMed Central

    Sohrabi, Hamid R.; Bates, Kristyn A.; Weinborn, Michael; Bucks, Romola S.; Rainey-Smith, Stephanie R.; Rodrigues, Mark A.; Bird, Sabine M.; Brown, Belinda M.; Beilby, John; Howard, Matthew; Criddle, Arthur; Wraith, Megan; Taddei, Kevin; Martins, Georgia; Paton, Athena; Shah, Tejal; Dhaliwal, Satvinder S.; Mehta, Pankaj D.; Foster, Jonathan K.; Martins, Ian J.; Lautenschlager, Nicola T.; Mastaglia, Francis; Laws, Simon M.; Martins, Ralph N.

    2015-01-01

    Cognitive decline and dementia due to Alzheimer's disease (AD) have been associated with genetic, lifestyle, and environmental factors. A number of potentially modifiable risk factors should be taken into account when preventive or ameliorative interventions targeting dementia and its preclinical stages are investigated. Bone mineral density (BMD) and body composition are two such potentially modifiable risk factors, and their association with cognitive decline was investigated in this study. 164 participants, aged 34–87 years old (62.78 ± 9.27), were recruited for this longitudinal study and underwent cognitive and clinical examinations at baseline and after 3 years. Blood samples were collected for apolipoprotein E (APOE) genotyping and dual energy x-ray absorptiometry (DXA) was conducted at the same day as cognitive assessment. Using hierarchical regression analysis, we found that BMD and lean body mass, as measured using DXA were significant predictors of episodic memory. Age, gender, APOE status, and premorbid IQ were controlled for. Specifically, the List A learning from California Verbal Learning Test was significantly associated with BMD and lean mass both at baseline and at follow up assessment. Our findings indicate that there is a significant association between BMD and lean body mass and episodic verbal learning. While the involvement of modifiable lifestyle factors in human cognitive function has been examined in different studies, there is a need for further research to understand the potential underlying mechanisms. PMID:25741279

  5. In vivo body composition in autochthonous and conventional pig breeding groups by dual-energy X-ray absorptiometry and magnetic resonance imaging under special consideration of Cerdo Ibérico.

    PubMed

    Kremer, P V; Fernández-Fígares, I; Förster, M; Scholz, A M

    2012-12-01

    The improvement of carcass quality is one of the main breeding goals in pig production. To select appropriate breeding animals, it is of major concern to exactly and reliably analyze the body composition in vivo. Therefore, the objective of the study was to examine whether the combination of dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) offers the opportunity to reliably analyze quantitative and qualitative body composition characteristics of different pig breeding groups in vivo. In this study, a total of 77 pigs were studied by DXA and MRI at an average age of 154 days. The pigs originated from different autochthonous or conventional breeds or crossbreeds and were grouped into six breed types: Cerdo Ibérico (Ib); Duroc × Ib (Du_Ib); White Sow Lines (WSL, including German Landrace and German Large White); Hampshire/Pietrain (Pi_Ha, including Hampshire, Pietrain × Hampshire (PiHa) and Pietrain × PiHa); Pietrain/Duroc (Pi_Du, including Pietrain × Duroc (PiDu) and Pietrain × PiDu); crossbred WSL (PiDu_WSL, including Pietrain × WSL and PiDu × WSL). A whole-body scan was performed by DXA with a GE Lunar DPX-IQ in order to measure the amount and percentage of fat tissue (FM; %FM), lean tissue (LM; %LM) and bone mineral, whereas a Siemens Magnetom Open with a large body coil was used for MRI in the thorax region between 13th and 14th vertebrae in order to measure the area of the loin (LA) and the above back fat area (FA) of both body sides. A GLM procedure using SAS 9.2 was used to analyze the data. As expected, the native breed Ib followed by Du_Ib crossbreeds showed the highest %FM (27.2%, 25.0%) combined with the smallest LA (46.2 cm2, 73.6 cm2), whereas Ib had the lowest BW at an average age of 154 days. Pigs with Pi_Ha origin presented the least %FM (12.4%) and largest LA (99.5 cm2). The WSL and PiDu_WSL showed an intermediate body composition. Therefore, it could be concluded that DXA and MRI and especially their combination

  6. DXA, bioelectrical impedance, ultrasonography and biometry for the estimation of fat and lean mass in cats during weight loss

    PubMed Central

    2012-01-01

    Background Few equations have been developed in veterinary medicine compared to human medicine to predict body composition. The present study was done to evaluate the influence of weight loss on biometry (BIO), bioimpedance analysis (BIA) and ultrasonography (US) in cats, proposing equations to estimate fat (FM) and lean (LM) body mass, as compared to dual energy x-ray absorptiometry (DXA) as the referenced method. For this were used 16 gonadectomized obese cats (8 males and 8 females) in a weight loss program. DXA, BIO, BIA and US were performed in the obese state (T0; obese animals), after 10% of weight loss (T1) and after 20% of weight loss (T2). Stepwise regression was used to analyze the relationship between the dependent variables (FM, LM) determined by DXA and the independent variables obtained by BIO, BIA and US. The better models chosen were evaluated by a simple regression analysis and means predicted vs. determined by DXA were compared to verify the accuracy of the equations. Results The independent variables determined by BIO, BIA and US that best correlated (p < 0.005) with the dependent variables (FM and LM) were BW (body weight), TC (thoracic circumference), PC (pelvic circumference), R (resistance) and SFLT (subcutaneous fat layer thickness). Using Mallows’Cp statistics, p value and r2, 19 equations were selected (12 for FM, 7 for LM); however, only 7 equations accurately predicted FM and one LM of cats. Conclusions The equations with two variables are better to use because they are effective and will be an alternative method to estimate body composition in the clinical routine. For estimated lean mass the equations using body weight associated with biometrics measures can be proposed. For estimated fat mass the equations using body weight associated with bioimpedance analysis can be proposed. PMID:22781317

  7. Total body composition by dual-photon (153Gd) absorptiometry

    SciTech Connect

    Mazess, R.B.; Peppler, W.W.; Gibbons, M.

    1984-10-01

    The lean-fat composition (%FATR) of soft tissue and the mineral mass of the skeleton were determined in vivo using dual-photon (153Gd) absorptiometry (dose under 2 mrem). A rectilinear raster scan was made over the entire body in 18 subjects (14 female, 4 male). Single-photon absorptiometry (125I) measured bone mineral content on the radius. Percentage fat (%FATD) was determined in the same subjects using body density (from underwater weighing with correction for residual lung volume). Lean body mass (LBM) was determined using both %FATR and %FATD. Percentage fat from absorptiometry and from underwater density were correlated (r . 0.87). The deviation of %FATD from %FATR was due to the amount of skeletal mineral as a percentage of the LBM (r . 0.90). Therefore, skeletal variability, even in normal subjects, where mineral ranges only from 4 to 8% of the LBM, essentially precludes use of body density as a composition indicator unless skeletal mass is measured. Anthropometry (fatfolds and weight) predicted %FATR and LBM at least as well as did underwater density. The predictive error of %FATR from fatfolds was 5% while the predictive error in predicting LBM from anthropometry was 2 to 3 kg (3%).

  8. Precision error in dual-photon absorptiometry related to source age

    SciTech Connect

    Ross, P.D.; Wasnich, R.D.; Vogel, J.M.

    1988-02-01

    An average, variable precision error of up to 6% related to source age was observed for dual-photon absorptiometry of the spine in a longitudinal study of bone mineral content involving 393 women. Application of a software correction for source decay compensated for only a portion of this error. The authors conclude that measurement of bone-loss rates using serial dual-photon bone mineral measurements must be interpreted with caution.

  9. High resolution magnetic resonance imaging of the calcaneus: age-related changes in trabecular structure and comparison with dual X-ray absorptiometry measurements

    NASA Technical Reports Server (NTRS)

    Ouyang, X.; Selby, K.; Lang, P.; Engelke, K.; Klifa, C.; Fan, B.; Zucconi, F.; Hottya, G.; Chen, M.; Majumdar, S.; Genant, H. K.

    1997-01-01

    A high-resolution magnetic resonance imaging (MRI) protocol, together with specialized image processing techniques, was applied to the quantitative measurement of age-related changes in calcaneal trabecular structure. The reproducibility of the technique was assessed and the annual rates of change for several trabecular structure parameters were measured. The MR-derived trabecular parameters were compared with calcaneal bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA) in the same subjects. Sagittal MR images were acquired at 1.5 T in 23 healthy women (mean age: 49.3 +/- 16.6 [SD]), using a three-dimensional gradient echo sequence. Image analysis procedures included internal gray-scale calibration, bone and marrow segmentation, and run-length methods. Three trabecular structure parameters, apparent bone volume (ABV/TV), intercept thickness (I.Th), and intercept separation (I.Sp) were calculated from the MR images. The short- and long-term precision errors (mean %CV) of these measured parameters were in the ranges 1-2% and 3-6%, respectively. Linear regression of the trabecular structure parameters vs. age showed significant correlation: ABV/TV (r2 = 33.7%, P < 0.0037), I.Th (r2 = 26.6%, P < 0.0118), I.Sp (r2 = 28.9%, P < 0.0081). These trends with age were also expressed as annual rates of change: ABV/TV (-0.52%/year), I.Th (-0.33%/year), and I.Sp (0.59%/year). Linear regression analysis also showed significant correlation between the MR-derived trabecular structure parameters and calcaneal BMD values. Although a larger group of subjects is needed to better define the age-related changes in trabecular structure parameters and their relation to BMD, these preliminary results demonstrate that high-resolution MRI may potentially be useful for the quantitative assessment of trabecular structure.

  10. Reference data and percentile curves of body composition measured with dual energy X-ray absorptiometry in healthy Chinese children and adolescents.

    PubMed

    Guo, Bin; Xu, Yi; Gong, Jian; Tang, Yongjin; Shang, Jingjie; Xu, Hao

    2015-09-01

    Measurements of body composition by dual-energy X-ray absorptiometry (DXA) have evident value in evaluating skeletal and muscular status in growing children and adolescents. This study aimed to generate age-related trends for body composition in Chinese children and adolescents, and to establish gender-specific reference percentile curves for the assessment of muscle-bone status. A total of 1541 Chinese children and adolescents aged from 5 to 19 years were recruited from southern China. Bone mineral content (BMC), lean mass (LM) and fat mass (FM) were measured for total body and total body less head (TBLH). After 14 years, total body LM was significantly higher in boys than girls (p < 0.001). However, total body FM was significantly higher in girls than boys in age groups 13-19 years (p < 0.01). Both LM and FM were consistent independent predictors of total body and subcranial bone mass in both sexes, even after adjustment for the well-known predictors of BMC. The results of multiple linear regression identified LM as the stronger predictor of total body and subcranial skeleton BMC while the fat mass contributed less. For all the subjects, significant positive correlations were observed between total body LM, height, total body BMC and subcranial BMC (p < 0.01). Subcranial BMC had a better correlation with LM than total body BMC. We have also presented gender-specific percentile curves for LM-for-height and BMC-for-LM which could be used to evaluate and follow various pediatric disorders with skeletal manifestations in this population.

  11. Comparison of the Lunar Prodigy and iDXA Dual-Energy X-ray Absorptiometers for Assessing Total and Regional Body Composition.

    PubMed

    Morrison, Shannon A; Petri, Robert M; Hunter, Heather L; Raju, Dheeraj; Gower, Barbara

    2016-01-01

    The objective of the study was to assess the agreement of the Lunar Prodigy with the newer Lunar iDXA dual-energy X-ray absorptiometer for determining total body and regional (arms, legs, trunk) bone mineral density (BMD), bone mineral content (BMC), fat mass (FM), lean tissue mass (LTM), total body mass, and percent fat. Ninety-two healthy adult males (n = 36) and females (n = 56) were scanned consecutively on the iDXA and the Prodigy dual-energy X-ray absorptiometers. For iDXA, relative to Prodigy, paired t tests indicated significantly lower estimates for total body and regional BMD and BMC (p < 0.001). Measures of total body and trunk FM, LTM, and percent fat did not differ between the instruments. In regional analyses, estimates of FM and percent fat were greater, and that of LTM was lower, in the arms (p < 0.001). In contrast, iDXA estimates of LTM were higher in the legs (p < 0.001). All body composition measures were significantly correlated (p < 0.001). Bland-Altman analyses indicated that significant bias existed between iDXA and Prodigy for total body and regional BMD estimates (p < 0.001) such that iDXA underestimated BMD to a greater extent in persons with higher values. In addition, iDXA overestimation bias existed for FM in total body, arms, and legs, and the overestimation was primarily observed in participants with greater body fat (p < 0.001). When combining or comparing data from iDXA with those from Prodigy, investigators should be aware that certain total body and regional estimates are significantly different. The greatest percent differences were observed for arm BMD, FM, and percent fat.

  12. Detecting meaningful body composition changes in athletes using dual-energy x-ray absorptiometry.

    PubMed

    Colyer, Steffi L; Roberts, Simon P; Robinson, Jonathan B; Thompson, Dylan; Stokes, Keith A; Bilzon, James L J; Salo, Aki I T

    2016-04-01

    Dual-energy x-ray absorptiometry (DXA) imaging is considered to provide a valid and reliable estimation of body composition when stringent scanning protocols are adopted. However, applied practitioners are not always able to achieve this level of control and the subsequent impact on measurement precision is not always taken into account when evaluating longitudinal body composition changes. The primary aim of this study was to establish the reliability of DXA in an applied elite sport setting to investigate whether real body composition changes can be detected. Additionally, the performance implications of these changes during the training year were investigated. Forty-eight well-trained athletes (from four diverse sports) underwent two DXA scans using a 'real-world' approach (with limited pre-scan controls), typically within 48 h, to quantify typical error of measurement (TEM). Twenty-five athletes underwent further scans, before and after specific training and competition blocks. 'True' body composition changes were evaluated using 2  ×  TEM thresholds. Twelve bob skeleton athletes also performed countermovement jump and leg press tests at each time point. Many 'true' body composition changes were detected and coincided with the primary training emphases (e.g. lean mass gains during hypertrophy-based training). Clear relationships (r  ±  90% CI) were observed between performance changes (countermovement jump and leg press) and changes in lean mass (0.53  ±  0.26 and 0.35  ±  0.28, respectively) and fat mass (-0.44  ±  0.27 and  -0.37  ±  0.28, respectively). DXA was able to detect real body composition changes without the use of stringent scanning controls. Associations between changes in body composition and performance demonstrated the potential influence of these changes on strength and power indices.

  13. Muscle and Bone Impairment in Children With Marfan Syndrome: Correlation With Age and FBN1 Genotype.

    PubMed

    Haine, Elsa; Salles, Jean-Pierre; Khau Van Kien, Philippe; Conte-Auriol, Françoise; Gennero, Isabelle; Plancke, Aurélie; Julia, Sophie; Dulac, Yves; Tauber, Maithé; Edouard, Thomas

    2015-08-01

    Marfan syndrome (MFS) is a rare connective tissue disorder caused by mutation in the gene encoding the extracellular matrix protein fibrillin-1 (FBN1), leading to transforming growth factor-beta (TGF-β) signaling dysregulation. Although decreased axial and peripheral bone mineral density (BMD) has been reported in adults with MFS, data about the evolution of bone mass during childhood and adolescence are limited. The aim of the present study was to evaluate bone and muscle characteristics in children, adolescents, and young adults with MFS. The study population included 48 children and young adults (22 girls) with MFS with a median age of 11.9 years (range 5.3 to 25.2 years). The axial skeleton was analyzed at the lumbar spine using dual-energy X-ray absorptiometry (DXA), whereas the appendicular skeleton (hand) was evaluated using the BoneXpert system (with the calculation of the Bone Health Index). Muscle mass was measured by DXA. Compared with healthy age-matched controls, bone mass at the axial and appendicular levels and muscle mass were decreased in children with MFS and worsened from childhood to adulthood. Vitamin D deficiency (<50 nmol/L) was found in about a quarter of patients. Serum vitamin D levels were negatively correlated with age and positively correlated with lumbar spine areal and volumetric BMD. Lean body mass (LBM) Z-scores were positively associated with total body bone mineral content (TB-BMC) Z-scores, and LBM was an independent predictor of TB-BMC values, suggesting that muscle hypoplasia could explain at least in part the bone loss in MFS. Patients with a FBN1 premature termination codon mutation had a more severe musculoskeletal phenotype than patients with an inframe mutation, suggesting the involvement of TGF-β signaling dysregulation in the pathophysiologic mechanisms. In light of these results, we recommend that measurement of bone mineral status should be part of the longitudinal clinical investigation of MFS children.

  14. Assessment of adiposity in psoriatic patients by dual energy X-ray absorptiometry compared to conventional methods*

    PubMed Central

    Diniz, Michelle dos Santos; Bavoso, Nádia Couto; Kakehasi, Adriana Maria; Lauria, Márcio Weissheimer; Soares, Maria Marta Sarquis; Machado-Pinto, Jackson

    2016-01-01

    BACKGROUND Obesity is considered a chronic low-grade inflammatory disease that shares mediators of inflammation with psoriasis, such as TNF-α and IL-6. The relationship between these two conditions involves factors such as predisposition and response to therapy, in addition to an association with cardiovascular disease. OBJECTIVES The aim of the present study was to investigate the prevalence of adiposity as determined by body mass index (BMI), waist circumference (WC), and dual energy X-ray absorptiometry (DXA) evaluation in patients with psoriasis. METHODS BMI, WC and body composition by DXA were measured in 42 psoriatic patients without joint complaints and in 41 control patients using standard procedures. In the comparison between cases and controls, we used Pearson’s Χ2 test or Fisher’s exact test, and the nonparametric Mann-Whitney test. The difference between the diverse classification methods for obesity was evaluated using McNemar’s test. To test the level of agreement between those variables, we used the weighted kappa coefficient. RESULTS There was no difference in the prevalence of obesity among cases and controls. Both BMI and WC had low agreement with measures of body fat evaluated by DXA. With the use of DXA scanning, prevalence of overweight and obesity in patients with psoriasis was 83.3%, which constitutes a strong evidence of the need for intervention on this metabolic parameter. CONCLUSION Dual energy X-ray absorptiometry was more capable of identifying obesity compared with BMI and WC both in psoriatic and control patients. PMID:27192512

  15. Comparative assessment of bone among wild-type, restricted ovulator and out-of-production hens.

    PubMed

    Kim, W K; Ford, B C; Mitchell, A D; Elkin, R G; Leach, R M

    2004-08-01

    1. The aim of this study was to assess bone characteristics in restricted ovulator (RO) hens. These hens generally are unable to ovulate due to a point mutation in the oocyte VLDL receptor gene whose protein product mediates the uptake of yolk precursors. Because these hens do not have the cyclic calcium (Ca) metabolism associated with egg formation, they could be a useful model for studying bone metabolism. 2. RO hens had greater humerus, femur and tibia ash concentrations than wild-type (WT) and out-of-production (OP) hens. Bone mineral content and density obtained with dual-energy X-ray absorptiometry (DXA) were highly correlated with the results of conventional bone assays. 3. Gross and histological examination of the femurs confirmed the presence of extremely dense medullary bone deposition in the RO hens. However, the composition of non-collagenous protein extracts of medullary bone was similar for the two genotypes. 4. Analysis of medullary bone extracts for glycosaminoglycans (GAG) confirmed the presence of large amounts of keratan sulphate (KS) in the matrix of medullary bone. 5. Plasma Ca, total GAG and KS concentrations of RO hens were markedly higher than WT and OP hens. The changes in plasma calcium and keratan sulphate are probably a reflection of elevated Ca-binding yolk precursor molecules and intensive medullary bone formation in response to increased plasma oestrogen observed by others in RO hens.

  16. Arteriovenous Fistula Affects Bone Mineral Density Measurements in End-Stage Renal Failure Patients

    PubMed Central

    Torregrosa, José-Vicente; Fuster, David; Peris, Pilar; Vidal-Sicart, Sergi; Solà, Oriol; Domenech, Beatriz; Martín, Gloria; Casellas, Joan; Pons, Francisca

    2009-01-01

    Background and objectives: Hemodialysis needs an arteriovenous fistula (AVF) that may influence the structure and growth of nearby bone and affect bone mass measurement. The study analyzed the effect of AVF in the assessment of forearm bone mineral density (BMD) measured by dual energy x-ray absorptiometry (DXA) and examined its influence on the final diagnosis of osteoporosis. Design, setting, participants, & measurements: Forty patients (52 ± 18 yr) in hemodialysis program (12 ± 8 yr) with permeable AVF in forearm were included. Patients were divided in two groups (over and under 50 yr). BMD of both forearms (three areas), lumbar spine, and femur was measured by DXA. Forearm measurements in each arm were compared. Patients were diagnosed as normal only if all territories were considered nonpathologic and osteoporosis/osteopenia was determined by the lowest score found. Results: Ten patients were excluded and 30 patients were analyzed. BMD in the forearm with AVF was significantly lower than that observed in the contralateral forearm in both groups of patients and in all forearm areas analyzed. When only lumbar spine and femur measurements were considered, 70% of patients were nonpathologic and 30% were osteoporotic. However, inclusion of AVF forearm classified 63% as osteoporotic and a further 27% as osteopenic, leaving only 10% as nonpathologic. Conclusions: Forearm AVF affects BMD measurements by decreasing their values in patients with end-stage renal failure. This may produce an overdiagnosis of osteoporosis, which should be taken into account when evaluating patients of this type. PMID:19713298

  17. Comparison of bone histomorphometry and μCT for evaluating bone quality in tail-suspended rats

    NASA Astrophysics Data System (ADS)

    Sun, Lian-Wen; Huang, Yun-Fei; Wang, Ying; Luan, Hui-Qin; Fan, Yu-Bo

    2014-10-01

    Astronauts often suffer from microgravity-induced osteoporosis due to their time in space. Bone histomorphometry, the 'gold standard' technique for detecting bone quality, is widely used in the evaluation of osteoporosis. This study investigates whether μCT has the same application value as histomorphometry in the evaluation of weightlessness-induced bone loss. A total of 24 SD rats were distributed into three groups (n = 8, each): tail-suspension (TS), TS plus active exercise (TSA), and control (CON). After 21 days, bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) and μCT, and microstructure was measured by μCT and histomorphometry. BMD was found to have decreased significantly in TS and TSA compared with the CON group. The results of the μCT measurements showed that a change in BMD mainly occurred in the trabecular bone, and the trabecular BMD increased significantly in the TSA compared with the TS group. The comparison of μCT and histomorphometry showed that TS led to a significant decrease in bone volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N), and it led to an increase in trabecular separation (Tb.Sp). However, active exercise can prevent these changes. Significant differences in most parameters between TSA and CON were found by μCT but not by histomorphometry. Additionally, the parameters of these two methods are highly correlated. Therefore, the application value of μCT is as good as histomorphometry and DXA in the diagnosis of weightlessness-induced osteoporosis and is even better in evaluating the efficacy of exercise.

  18. The Lichfield bone study: the skeletal response to exercise in healthy young men

    PubMed Central

    Eleftheriou, Kyriacos I.; Kehoe, Anthony; James, Laurence E.; Payne, John R.; Skipworth, James R.; Puthucheary, Zudin A.; Drenos, Fotios; Pennell, Dudley J.; Loosemore, Mike; World, Michael; Humphries, Steve E.; Haddad, Fares S.; Montgomery, Hugh E.

    2012-01-01

    The skeletal response to short-term exercise training remains poorly described. We thus studied the lower limb skeletal response of 723 Caucasian male army recruits to a 12-wk training regime. Femoral bone volume was assessed using magnetic resonance imaging, bone ultrastructure by quantitative ultrasound (QUS), and bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) of the hip. Left hip BMD increased with training (mean ± SD: 0.85 ± 3.24, 2.93 ± 4.85, and 1.89 ± 2.85% for femoral neck, Ward's area, and total hip, respectively; all P < 0.001). Left calcaneal broadband ultrasound attenuation rose 3.57 ± 0.5% (P < 0.001), and left and right femoral cortical volume by 1.09 ± 4.05 and 0.71 ± 4.05%, respectively (P = 0.0001 and 0.003), largely through the rise in periosteal volume (0.78 ± 3.14 and 0.59 ± 2.58% for right and left, respectively, P < 0.001) with endosteal volumes unchanged. Before training, DXA and QUS measures were independent of limb dominance. However, the dominant femur had higher periosteal (25,991.49 vs. 2,5572 mm3, P < 0.001), endosteal (6,063.33 vs. 5,983.12 mm3, P = 0.001), and cortical volumes (19,928 vs. 19,589.56 mm3, P = 0.001). Changes in DXA, QUS, and magnetic resonance imaging measures were independent of limb dominance. We show, for the first time, that short-term exercise training in young men is associated not only with a rise in human femoral BMD, but also in femoral bone volume, the latter largely through a periosteal response. PMID:22114178

  19. Exposure to urban air pollution and bone health in clinically healthy six-year-old children.

    PubMed

    Calderón-Garcidueñas, Lilian; Mora-Tiscareño, Antonieta; Francolira, Maricela; Torres-Jardón, Ricardo; Peña-Cruz, Bernardo; Palacios-López, Carolina; Zhu, Hongtu; Kong, Linglong; Mendoza-Mendoza, Nicolás; Montesinoscorrea, Hortencia; Romero, Lina; Valencia-Salazar, Gildardo; Kavanaugh, Michael; Frenk, Silvestre

    2013-01-01

    Air pollution induces systemic inflammation, as well as respiratory, myocardial and brain inflammation in children. Peak bone mass is influenced by environmental factors. We tested the hypothesis that six-year-olds with lifetime exposures to urban air pollution will have alterations in inflammatory markers and bone mineral density (BMD) as opposed to low-polluted city residents when matched for BMI, breast feeding history, skin phototype, age, sex and socioeconomic status. This pilot study included 20 children from Mexico City (MC) (6.17 years ± 0.63 years) and 15 controls (6.27 years ± 0.76 years). We performed full paediatric examinations, a history of outdoor exposures, seven-day dietary recalls, serum inflammatory markers and dual-energy X-ray absorptiometry (DXA). Children in MC had significantly higher concentrations of IL-6 (p=0.001), marked reductions in total blood neutrophils (p= 0.0002) and an increase in monocytes (p=0.005). MC children also had an insufficient Vitamin D intake and spent less time outdoors than controls (p<0.001) in an environment characterized by decreased UV light, with ozone and fine particulates concentrations above standard values. There were no significant differences between the cohorts in DXA Z scores. The impact of systemic inflammation, vitamin D insufficiency, air pollution, urban violence and poverty may have long-term bone detrimental outcomes in exposed paediatric populations as they grow older, increasing the risk of low bone mass and osteoporosis. The selection of reference populations for DXA must take into account air pollution exposures.

  20. Bone health in HIV and hepatitis B or C infections

    PubMed Central

    Biver, Emmanuel; Calmy, Alexandra; Rizzoli, René

    2016-01-01

    Chronic infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) add to age-dependent bone loss and may contribute to lower bone strength in the elderly. In this review, we report recent highlights on the epidemiology of bone fragility in chronic viral infections with HIV, HCV and HBV, its physiopathology and discuss the interference of antiviral therapies with bone metabolism. Chronic infections influence bone through the interactions between risk factors for bone fragility and falls (which are highly prevalent in infected patients), virus activity and antiviral drugs. HIV-infected patients are at increased risk of fracture and the risk is higher in cases of co-infection with HIV and untreated chronic viral hepatitis. In HIV patients, the majority of bone loss occurs during virus activity and at initiation of antiretroviral therapy (ART). However, long-term elderly HIV-infected patients on successful ART display bone microstructure alterations only partially captured by dual energy X-ray absorptiometry (DXA). Bone loss is associated with an increase of bone resorption, reflecting the upregulation of the receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) pathways via a crosstalk between virus activity, inflammation and the immune system. The use of some antiviral drugs, such as tenofovir (controlling both HBV and HIV infections) or protease inhibitors, may be associated with higher bone toxicity. The reduction of tenofovir plasma concentrations with the implementation of tenofovir alafenamide (TAF) attenuates bone mineral density (BMD) loss but it remains unknown whether it will contribute to reducing fracture risk in long-term HIV-treated patients. Moreover, to what extent the new direct-acting agents for treatment of HCV, including nucleotide inhibitors and protease inhibitors, may affect bone health similarly as ART in HIV should be investigated. PMID:28101146

  1. Lean mass as a total mediator of the influence of muscular fitness on bone health in schoolchildren: a mediation analysis.

    PubMed

    Torres-Costoso, Ana; Gracia-Marco, Luis; Sánchez-López, Mairena; García-Prieto, Jorge Cañete; García-Hermoso, Antonio; Díez-Fernández, Ana; Martínez-Vizcaíno, Vicente

    2015-01-01

    This report aims to analyse the independent association of lean mass and muscle fitness with bone mineral content (BMC) and bone mineral density (BMD), and to examine whether the relationship between muscle fitness and bone health is mediated by lean mass. Body composition (by dual energy X-ray absorptiometry (DXA)), muscle fitness, physical activity, age and height were measured in 132 schoolchildren (62 boys, aged 8-11 years). Analysis of covariance tested differences in bone-related variables by lean mass and muscle fitness, controlling for different sets of confounders. Linear regression models fitted for mediation analyses examined whether the association between muscle fitness and bone mass was mediated by lean mass. Children with good performance in handgrip and standing long jump had better and worse bone health, respectively. These differences disappeared after controlling for lean mass. Children with high lean mass had higher values in all bone-related variables. In addition, the relationship between muscle fitness and bone mass was fully mediated by lean mass. In conclusion, the relationship between upper-limbs muscle fitness and bone health seems to be dependent on lean mass but not on muscle fitness. Schoolchildren with high lean mass have more BMC and BMD in all regions. Lean mass mediates the association between muscle fitness and bone mass.

  2. Tartrate-Resistant Acid Phosphatase 5b in Young Patients With Sickle Cell Disease and Trait Siblings: Relation to Vasculopathy and Bone Mineral Density.

    PubMed

    Mokhtar, Galila Mohamed; Tantawy, Azza Abdel Gawad; Hamed, Ahmed Al-Saeed; Adly, Amira Abdel Moneam; Ismail, Eman Abdel Rahman; Makkeyah, Sara Mostafa

    2017-01-01

    Bone involvement is a frequent cause of acute morbidity in sickle cell disease (SCD). Tartrate-resistant acid phosphatase 5b (TRACP 5b), a bone resorption marker, is produced specifically by activated osteoclasts. We assessed bone mineral density (BMD) in 30 young patients with SCD and 17 asymptomatic patients with sickle cell trait (SCT) compared with 32 healthy controls and determined TRACP 5b levels in relation to vascular complications. Serum ferritin, alkaline phosphatase (ALP), and TRACP 5b were measured. Echocardiography was performed with assessment of BMD using dual energy X-ray absorptiometry (DXA). The BMD was decreased in patients with SCD compared with SCT and controls (P = .005), with no significant difference between the latter 2 groups. Patients with SCD had higher incidence of bone complications than SCT group and controls (P = .03). The SCD group with abnormal DXA scan had higher ferritin and ALP than normal BMD. Serum TRACP 5b was significantly higher in patients with SCD than SCT and controls (P = .003). The TRACP 5b levels were associated with severe vaso-occlusive crisis (P = .022). Patients treated with hydroxyurea and those on chelation therapy had lower TRACP 5b levels than untreated patients. The TRACP 5b level was positively correlated with lactate dehydrogenase, while there was no relation with ferritin, ALP, or BMD. We suggest that bone complications frequently occur in SCD as reflected by low BMD and high ALP and TRACP 5b. Hemolysis and iron overload may be involved in the occurrence of these complications. The lack of correlation between abnormal DXA scan and high TRACP 5b suggests that bone disease in SCD is multifactorial.

  3. Advanced imaging assessment of bone quality.

    PubMed

    Genant, Harry K; Jiang, Yebin

    2006-04-01

    Noninvasive and/or nondestructive techniques can provide structural information about bone, beyond simple bone densitometry. While the latter provides important information about osteoporotic fracture risk, many studies indicate that bone mineral density (BMD) only partly explains bone strength. Quantitative assessment of macrostructural characteristics, such as geometry, and microstructural features, such as relative trabecular volume, trabecular spacing, and connectivity, may improve our ability to estimate bone strength. Methods for quantitatively assessing macrostructure include (besides conventional radiographs) dual X ray absorptiometry (DXA) and computed tomography (CT), particularly volumetric quantitative computed tomography (vQCT). Methods for assessing microstructure of trabecular bone noninvasively and/or nondestructively include high-resolution computed tomography (hrCT), microcomputed tomography (micro-CT), high-resolution magnetic resonance (hrMR), and micromagnetic resonance (micro-MR). vQCT, hrCT, and hrMR are generally applicable in vivo; micro-CT and micro-MR are principally applicable in vitro. Despite progress, problems remain. The important balances between spatial resolution and sampling size, or between signal-to-noise and radiation dose or acquisition time, need further consideration, as do the complexity and expense of the methods versus their availability and accessibility. Clinically, the challenges for bone imaging include balancing the advantages of simple bone densitometry versus the more complex architectural features of bone, or the deeper research requirements versus the broader clinical needs. The biological differences between the peripheral appendicular skeleton and the central axial skeleton must be further addressed. Finally, the relative merits of these sophisticated imaging techniques must be weighed with respect to their applications as diagnostic procedures, requiring high accuracy or reliability, versus their monitoring

  4. Techniques for undertaking dual-energy X-ray absorptiometry whole-body scans to estimate body composition in tall and/or broad subjects.

    PubMed

    Nana, Alisa; Slater, Gary J; Hopkins, Will G; Burke, Louise M

    2012-10-01

    Dual-energy X-ray absorptiometry (DXA) is becoming a popular tool to measure body composition, owing to its ease of operation and comprehensive analysis. However, some people, especially athletes, are taller and/or broader than the active scanning area of the DXA bed and must be scanned in sections. The aim of this study was to investigate the reliability of DXA measures of whole-body composition summed from 2 or 3 partial scans. Physically active young adults (15 women, 15 men) underwent 1 whole-body and 4 partial DXA scans in a single testing session under standardized conditions. The partial scanning areas were head, whole body from the bottom of the chin down, and right and left sides of the body. Body-composition estimates from whole body were compared with estimates from summed partial scans to simulate different techniques to accommodate tall and/or broad subjects relative to the whole-body scan. Magnitudes of differences in the estimates were assessed by standardization. In simulating tall subjects, summation of partial scans that included the head scan overestimated whole-body composition by ~3 kg of lean mass and ~1 kg of fat mass, with substantial technical error of measurement. In simulating broad subjects, summation of right and left body scans produced no substantial differences in body composition than those of the whole-body scan. Summing partial DXA scans provides accurate body-composition estimates for broad subjects, but other strategies are needed to accommodate tall subjects.

  5. Bioelectrical impedance and dual-energy x-ray absorptiometry assessments of changes in body composition following exercise in patients with type 2 diabetes mellitus.

    PubMed

    Miyatani, Masae; Yang, Pearl; Thomas, Scott; Craven, B Catharine; Oh, Paul

    2012-01-01

    We aimed to compare the level of agreement between leg-to-leg bioelectrical impedance analysis (LBIA) and dual-energy X-ray absorptiometry (DXA) for assessing changes in body composition following exercise intervention among individuals with Type 2 diabetes mellitus (T2DM). Forty-four adults with T2DM, age 53.2 ± 9.1 years; BMI 30.8 ± 5.9 kg/m(2) participated in a 6-month exercise program with pre and post intervention assessments of body composition. Fat free mass (FFM), % body fat (%FM) and fat mass (FM) were measured by LBIA (TBF-300A) and DXA. LBIA assessments of changes in %FM and FM post intervention showed good relative agreements with DXA variables (P < 0.001). However, Bland-Altman plot(s) indicated that there were systematic errors in the assessment of the changes in body composition using LBIA compared to DXA such that, the greater the changes in participant body composition, the greater the disparity in body composition data obtained via LBIA versus DXA data (FFM, P = 0.013; %FM, P < 0.001; FM, P < 0.001). In conclusion, assessment of pre and post intervention body composition implies that LBIA is a good tool for assessment qualitative change in body composition (gain or loss) among people with T2DM but is not sufficiently sensitive to track quantitative changes in an individual's body composition.

  6. Bone mineral density response to long-term bisphosphonate therapy in fibrous dysplasia.

    PubMed

    Parisi, M S; Oliveri, M B; Mautalen, C A

    2001-01-01

    Fibrous dysplasia of bone is a rare disease related to a genetic mutation in which bone formation at osseous sites is altered. In the last few years, bisphosphonates have become one of the choice drugs to treat this disease. A 26-yr-old woman presented after 6 wk of spontaneous right leg pain owing to a fissure fracture of the right femoral neck. She reported precocious puberty at the age of 2, with diagnosis of McCune-Albright syndrome. Radioisotope bone scanning, radiographic, biochemical, and densitometric studies were performed. Treatment with bisphosphonates was started because bone turnover biochemical markers were abnormal. Oral olpadronate followed by iv pamidronate substantially decreased bone resorption. Bone mineral density (BMD) of total skeleton and subareas was assessed by dual X-ray absorptiometry (DXA) throughout the 5 yr of treatment. At the end of this period, BMD of the total skeleton had increased 6.2%. However, BMD of the areas most affected by fibrous dysplasia, the legs and pelvis, had increased 12.7 and 11%, respectively. Region of interest analysis of individual bones of the legs performed with the total skeleton scan revealed that BMD of the areas most affected by fibrous dysplasia was lower than that of the less affected contralateral bones. During the first 3 yr, treatment with bisphosphonates substantially increased BMD of the right femur and tibia (22 and 28%, respectively). After that, values seemed to stabilize. DXA evaluation of the total skeleton and its subareas was useful to evaluate the efficacy of bisphosphonate treatment. Moreover, the plateau observed in BMD values after 3 yr of treatment suggests that treatment could have been discontinued when the densitometric values stabilized.

  7. Bone Tissue Properties Measurement by Reference Point Indentation in Glucocorticoid-Induced Osteoporosis.

    PubMed

    Mellibovsky, Leonardo; Prieto-Alhambra, Daniel; Mellibovsky, Fernando; Güerri-Fernández, Roberto; Nogués, Xavier; Randall, Connor; Hansma, Paul K; Díez-Perez, Adolfo

    2015-09-01

    Glucocorticoids, widely used in inflammatory disorders, rapidly increase bone fragility and, therefore, fracture risk. However, common bone densitometry measurements are not sensitive enough to detect these changes. Moreover, densitometry only partially recognizes treatment-induced fracture reductions in osteoporosis. Here, we tested whether the reference point indentation technique could detect bone tissue property changes early after glucocorticoid treatment initiation. After initial laboratory and bone density measurements, patients were allocated into groups receiving calcium + vitamin D (Ca+D) supplements or anti-osteoporotic drugs (risedronate, denosumab, teriparatide). Reference point indentation was performed on the cortical bone layer of the tibia by a handheld device measuring bone material strength index (BMSi). Bone mineral density was measured by dual-energy X-ray absorptiometry (DXA). Although Ca+D-treated patients exhibited substantial and significant deterioration, risedronate-treated patients exhibited no significant change, and both denosumab- and teriparatide-treated participants exhibited significantly improved BMSi 7 weeks after initial treatment compared with baseline; these trends remained stable for 20 weeks. In contrast, no densitometry changes were observed during this study period. In conclusion, our study is the first to our knowledge to demonstrate that reference point indentation is sensitive enough to reflect changes in cortical bone indentation after treatment with osteoporosis therapies in patients newly exposed to glucocorticoids.

  8. Bones of contention: bone mineral density recovery in celiac disease--a systematic review.

    PubMed

    Grace-Farfaglia, Patricia

    2015-05-07

    Metabolic bone disease is a frequent co-morbidity in newly diagnosed adults with celiac disease (CD), an autoimmune disorder triggered by the ingestion of dietary gluten. This systematic review of studies looked at the efficacy of the gluten-free diet, physical activity, nutrient supplementation, and bisphosphonates for low bone density treatment. Case control and cohort designs were identified from PubMed and other academic databases (from 1996 to 2015) that observed newly diagnosed adults with CD for at least one year after diet treatment using the dual-energy x-ray absorptiometry (DXA) scan. Only 20 out of 207 studies met the inclusion criteria. Methodological quality was assessed using the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement checklist. Gluten-free diet adherence resulted in partial recovery of bone density by one year in all studies, and full recovery by the fifth year. No treatment differences were observed between the gluten-free diet alone and diet plus bisphosphonates in one study. For malnourished patients, supplementation with vitamin D and calcium resulted in significant improvement. Evidence for the impact of physical activity on bone density was limited. Therapeutic strategies aimed at modifying lifestyle factors throughout the lifespan should be studied.

  9. Bones of Contention: Bone Mineral Density Recovery in Celiac Disease—A Systematic Review

    PubMed Central

    Grace-Farfaglia, Patricia

    2015-01-01

    Metabolic bone disease is a frequent co-morbidity in newly diagnosed adults with celiac disease (CD), an autoimmune disorder triggered by the ingestion of dietary gluten. This systematic review of studies looked at the efficacy of the gluten-free diet, physical activity, nutrient supplementation, and bisphosphonates for low bone density treatment. Case control and cohort designs were identified from PubMed and other academic databases (from 1996 to 2015) that observed newly diagnosed adults with CD for at least one year after diet treatment using the dual-energy x-ray absorptiometry (DXA) scan. Only 20 out of 207 studies met the inclusion criteria. Methodological quality was assessed using the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement checklist. Gluten-free diet adherence resulted in partial recovery of bone density by one year in all studies, and full recovery by the fifth year. No treatment differences were observed between the gluten-free diet alone and diet plus bisphosphonates in one study. For malnourished patients, supplementation with vitamin D and calcium resulted in significant improvement. Evidence for the impact of physical activity on bone density was limited. Therapeutic strategies aimed at modifying lifestyle factors throughout the lifespan should be studied. PMID:25961322

  10. A portable real-time ultrasonic bone densitometer.

    PubMed

    Kaufman, Jonathan J; Luo, Gangming; Siffert, Robert S

    2007-09-01

    The objectives of this study were to develop a novel ultrasound device to estimate bone mineral density (BMD) at the calcaneus. The device is entirely self-contained, portable (bone contained in the propagation path, and thus is equivalent to the bone mineral content estimated by dual-energy X-ray absorptiometry (DXA) scanners, and to the (areal) BMD when normalized by transducer area. Computer simulations of ultrasound propagation were used to study the relationship between NTD and BMD. The simulations used micro-computed tomography (micro-CT) images of a set of 10 calcaneal bone cores, which were further processed by morphologic image processing to obtain a set of 30 "samples" with BMDs ranging from 0.25 to 1.83 g/cm2. The NTD and BMD were found to be very highly correlated (r=0.99), demonstrating the high sensitivity of NTD to bone mass. A clinical institutional review board-approved study measured 85 adult women at the heel. BMD was measured at the same time using DXA. A linear regression using NTD produced a linear correlation coefficient of 0.86, which represents a significant improvement over present ultrasound bone densitometers, but not nearly as good as the simulation results. Reasons for this have been identified (viz., errors in distance measurement and lack of coincidence between the DXA and ultrasound regions of interest), and a new device and experimental protocol to deal with these sources of error has been developed and is currently under clinical trials. It is expected that this should improve the correlation

  11. Measurement of spine and total body mineral by dual-photon absorptiometry

    NASA Technical Reports Server (NTRS)

    Mazess, R. B.; Young, D.

    1983-01-01

    The use of Gd-153 dual-photon absorptiometry at 43 and 100 keV to measure individual-bone and total-body bone minerals is discussed in a survey of recent studies on humans, phantoms, and monkeys. Precision errors of as low as 1 percent have been achieved in vivo, suggesting the use of sequential measurements in studies of immobilization and space-flight effects.

  12. Vertebral deformities identified by vertebral fracture assessment: associations with clinical characteristics and bone mineral density.

    PubMed

    Jacobs-Kosmin, Dana; Sandorfi, Nora; Murray, Heather; Abruzzo, John L

    2005-01-01

    Whether vertebral fractures identified on radiographs are painful or not, they are associated with increased morbidity and mortality. Vertebral fractures on X-rays correlate with low bone mineral density (BMD) at the spine and hip in addition to several clinical characteristics. Evidence suggests that vertebral deformities detected by X-ray and by vertebral fracture assessment (VFA) show good agreement. We examined the relationship between VFA-detected vertebral deformities and patient characteristics as well as BMD by analyzing the records of 432 patients who had undergone dual-energy X-ray absorptiometry (DXA) scans with VFA. Patients' demographic data and T-scores were obtained from patient questionnaires and DXA scans. We categorized vertebral deformities by type and severity. Patients with vertebral deformities were significantly older and more likely to report a history of fracture after childhood. Significantly more estrogen use was reported in patients without deformity. Those with deformities had significantly lower T-scores at the femoral neck and total hip but not at the spine. Increased severity and number of deformities correlated with lower T-scores at the total hip and femoral neck but not the spine. In conclusion, vertebral deformities detected by VFA, like those on X-ray, correlate with both clinical characteristics and reduced bone mass at the hip. These relationships, in addition to rapid performance, convenience, and minimal radiation exposure, indicate VFA-detected vertebral deformities are a valuable adjunct in identifying patients in need of additional evaluation and treatment.

  13. Bone density testing: science, the media, and patient care.

    PubMed

    Rothman, Micol S; Miller, Paul D; Lewiecki, E Michael; Bilezikian, John P

    2014-06-01

    Dual-energy X-ray absorptiometry (DXA) is an inexpensive, noninvasive, widely available method for diagnosing osteoporosis, assessing fracture risk, and monitoring the effects of therapy. By diagnosing high-risk patients before a fracture occurs, clinicians can intervene early to reduce fracture risk. Appropriate use of DXA results in money saving for healthcare systems that might otherwise be spent for fracture-related care. Recent reports of studies evaluating DXA screening criteria and intervals for retesting have received considerable media coverage, sometimes suggesting that DXA is expensive, over-utilized, and unnecessary. This may lead to more patients who might benefit from early detection of osteoporosis remaining undiagnosed. We advocate for the use of current clinical practice guidelines with individualization of patient care factors to determine the optimal intervals for DXA testing.

  14. Differential Bone Loss in Mouse Models of Colon Cancer Cachexia

    PubMed Central

    Bonetto, Andrea; Kays, Joshua K.; Parker, Valorie A.; Matthews, Ryan R.; Barreto, Rafael; Puppa, Melissa J.; Kang, Kyung S.; Carson, James A.; Guise, Theresa A.; Mohammad, Khalid S.; Robling, Alexander G.; Couch, Marion E.; Koniaris, Leonidas G.; Zimmers, Teresa A.

    2017-01-01

    Cachexia is a distinctive feature of colorectal cancer associated with body weight loss and progressive muscle wasting. Several mechanisms responsible for muscle and fat wasting have been identified, however it is not known whether the physiologic and molecular crosstalk between muscle and bone tissue may also contribute to the cachectic phenotype in cancer patients. The purpose of this study was to clarify whether tumor growth associates with bone loss using several experimental models of colorectal cancer cachexia, namely C26, HT-29, and ApcMin/+. The effects of cachexia on bone structure and strength were evaluated with dual energy X-ray absorptiometry (DXA), micro computed tomography (μCT), and three-point bending test. We found that all models showed tumor growth consistent with severe cachexia. While muscle wasting in C26 hosts was accompanied by moderate bone depletion, no loss of bone strength was observed. However, HT-29 tumor bearing mice showed bone abnormalities including significant reductions in whole-body bone mineral density (BMD), bone mineral content (BMC), femoral trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th), but no declines in strength. Similarly, cachexia in the ApcMin/+ mice was associated with significant decreases in BMD, BMC, BV/TV, Tb.N, and Tb.Th as well as decreased strength. Our data suggest that colorectal cancer is associated with muscle wasting and may be accompanied by bone loss dependent upon tumor type, burden, stage and duration of the disease. It is clear that preserving muscle mass promotes survival in cancer cachexia. Future studies will determine whether strategies aimed at preventing bone loss can also improve outcomes and survival in colorectal cancer cachexia. PMID:28123369

  15. Differential Bone Loss in Mouse Models of Colon Cancer Cachexia.

    PubMed

    Bonetto, Andrea; Kays, Joshua K; Parker, Valorie A; Matthews, Ryan R; Barreto, Rafael; Puppa, Melissa J; Kang, Kyung S; Carson, James A; Guise, Theresa A; Mohammad, Khalid S; Robling, Alexander G; Couch, Marion E; Koniaris, Leonidas G; Zimmers, Teresa A

    2016-01-01

    Cachexia is a distinctive feature of colorectal cancer associated with body weight loss and progressive muscle wasting. Several mechanisms responsible for muscle and fat wasting have been identified, however it is not known whether the physiologic and molecular crosstalk between muscle and bone tissue may also contribute to the cachectic phenotype in cancer patients. The purpose of this study was to clarify whether tumor growth associates with bone loss using several experimental models of colorectal cancer cachexia, namely C26, HT-29, and Apc(Min/+). The effects of cachexia on bone structure and strength were evaluated with dual energy X-ray absorptiometry (DXA), micro computed tomography (μCT), and three-point bending test. We found that all models showed tumor growth consistent with severe cachexia. While muscle wasting in C26 hosts was accompanied by moderate bone depletion, no loss of bone strength was observed. However, HT-29 tumor bearing mice showed bone abnormalities including significant reductions in whole-body bone mineral density (BMD), bone mineral content (BMC), femoral trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th), but no declines in strength. Similarly, cachexia in the Apc(Min/+) mice was associated with significant decreases in BMD, BMC, BV/TV, Tb.N, and Tb.Th as well as decreased strength. Our data suggest that colorectal cancer is associated with muscle wasting and may be accompanied by bone loss dependent upon tumor type, burden, stage and duration of the disease. It is clear that preserving muscle mass promotes survival in cancer cachexia. Future studies will determine whether strategies aimed at preventing bone loss can also improve outcomes and survival in colorectal cancer cachexia.

  16. Prediction of fat-free body mass from bioelectrical impedance and anthropometry among 3-year-old children using DXA.

    PubMed

    Ejlerskov, Katrine T; Jensen, Signe M; Christensen, Line B; Ritz, Christian; Michaelsen, Kim F; Mølgaard, Christian

    2014-01-27

    For 3-year-old children suitable methods to estimate body composition are sparse. We aimed to develop predictive equations for estimating fat-free mass (FFM) from bioelectrical impedance (BIA) and anthropometry using dual-energy X-ray absorptiometry (DXA) as reference method using data from 99 healthy 3-year-old Danish children. Predictive equations were derived from two multiple linear regression models, a comprehensive model (height(2)/resistance (RI), six anthropometric measurements) and a simple model (RI, height, weight). Their uncertainty was quantified by means of 10-fold cross-validation approach. Prediction error of FFM was 3.0% for both equations (root mean square error: 360 and 356 g, respectively). The derived equations produced BIA-based prediction of FFM and FM near DXA scan results. We suggest that the predictive equations can be applied in similar population samples aged 2-4 years. The derived equations may prove useful for studies linking body composition to early risk factors and early onset of obesity.

  17. Bone geometry and strength adaptations to physical constraints inherent in different sports: comparison between elite female soccer players and swimmers.

    PubMed

    Ferry, Beatrice; Duclos, Martine; Burt, Lauren; Therre, Perrine; Le Gall, Franck; Jaffré, Christelle; Courteix, Daniel

    2011-05-01

    Sports training characterized by impacts or weight-bearing activity is well known to induce osteogenic effects on the skeleton. Less is known about the potential effects on bone strength and geometry, especially in female adolescent athletes. The aim of this study was to investigate hip geometry in adolescent soccer players and swimmers compared to normal values that stemmed from a control group. This study included 26 swimmers (SWIM; 15.9 ± 2 years) and 32 soccer players (SOC; 16.2 ± 0.7 years), matched in body height and weight. A group of 15 age-matched controls served for the calculation of hip parameter Z-scores. Body composition and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry (DXA). DXA scans were analyzed at the femoral neck by the hip structure analysis (HSA) program to calculate the cross-sectional area (CSA), cortical dimensions (inner endocortical diameter, ED; outer width and thickness, ACT), the centroid (CMP), cross-sectional moment of inertia (CSMI), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and femoral shaft (FS) sites. Specific BMDs were significantly higher in soccer players compared with swimmers. At all bone sites, every parameter reflecting strength (CSMI, Z, BR) favored soccer players. In contrast, swimmers had hip structural analysis (HSA) Z-scores below the normal values of the controls, thus denoting weaker bone in swimmers. In conclusion, this study suggests an influence of training practice not only on BMD values but also on bone geometry parameters. Sports with high impacts are likely to improve bone strength and bone geometry. Moreover, this study does not support the argument that female swimmers can be considered sedentary subjects regarding bone characteristics.

  18. Comparisons of a Multi-Frequency Bioelectrical Impedance Analysis to the Dual-Energy X-Ray Absorptiometry Scan in Healthy Young Adults Depending on their Physical Activity Level

    PubMed Central

    Verney, Julien; Schwartz, Chloé; Amiche, Saliha; Pereira, Bruno; Thivel, David

    2015-01-01

    This study aimed at comparing BIA and DXA results in assessing body composition in young adults depending on their physical activity level. Eighty healthy 19–30 years old subjects were enrolled and their body composition (Fat Mass and Fat-Free Mass) was assessed by dual-energy X-ray absorptiometry (DXA) and by a newly developed Bioelectrical Impedance Analyzer (BIA - Tanita MC780). A seven-day physical activity level was assessed using a 3-axial accelerometer. DXA-FM% and BIA-FM% were correlated (p<0.001; r= 0.852; ICC [IC95%]: 0.84 [0.75 – 0.90]; concordance coefficient: 0.844). DXA-FFM and BIA FFM were correlated (p<0.001; r=0.976; ICC [IC95%]: 0.95 [0.93 – 0.97], concordance coefficient: 0.955). DXA and BIA measurements of FM% and FFM were highly correlated in both boys and girls regardless of the physical activity level. Compared with DXA scans, newly developed bioelectrical impedance analyzers provide satisfactory fat mass and lean mass measures in healthy young women and men, despite their physical activity level. PMID:26557191

  19. Comparisons of a Multi-Frequency Bioelectrical Impedance Analysis to the Dual-Energy X-Ray Absorptiometry Scan in Healthy Young Adults Depending on their Physical Activity Level.

    PubMed

    Verney, Julien; Schwartz, Chloé; Amiche, Saliha; Pereira, Bruno; Thivel, David

    2015-09-29

    This study aimed at comparing BIA and DXA results in assessing body composition in young adults depending on their physical activity level. Eighty healthy 19-30 years old subjects were enrolled and their body composition (Fat Mass and Fat-Free Mass) was assessed by dual-energy X-ray absorptiometry (DXA) and by a newly developed Bioelectrical Impedance Analyzer (BIA - Tanita MC780). A seven-day physical activity level was assessed using a 3-axial accelerometer. DXA-FM% and BIA-FM% were correlated (p<0.001; r= 0.852; ICC [IC95%]: 0.84 [0.75 - 0.90]; concordance coefficient: 0.844). DXA-FFM and BIA FFM were correlated (p<0.001; r=0.976; ICC [IC95%]: 0.95 [0.93 - 0.97], concordance coefficient: 0.955). DXA and BIA measurements of FM% and FFM were highly correlated in both boys and girls regardless of the physical activity level. Compared with DXA scans, newly developed bioelectrical impedance analyzers provide satisfactory fat mass and lean mass measures in healthy young women and men, despite their physical activity level.

  20. High Resolution Peripheral Quantitative Computed Tomography for Assessment of Bone Quality

    NASA Astrophysics Data System (ADS)

    Kazakia, Galateia

    2014-03-01

    The study of bone quality is motivated by the high morbidity, mortality, and societal cost of skeletal fractures. Over 10 million people are diagnosed with osteoporosis in the US alone, suffering 1.5 million osteoporotic fractures and costing the health care system over 17 billion annually. Accurate assessment of fracture risk is necessary to ensure that pharmacological and other interventions are appropriately administered. Currently, areal bone mineral density (aBMD) based on 2D dual-energy X-ray absorptiometry (DXA) is used to determine osteoporotic status and predict fracture risk. Though aBMD is a significant predictor of fracture risk, it does not completely explain bone strength or fracture incidence. The major limitation of aBMD is the lack of 3D information, which is necessary to distinguish between cortical and trabecular bone and to quantify bone geometry and microarchitecture. High resolution peripheral quantitative computed tomography (HR-pQCT) enables in vivo assessment of volumetric BMD within specific bone compartments as well as quantification of geometric and microarchitectural measures of bone quality. HR-pQCT studies have documented that trabecular bone microstructure alterations are associated with fracture risk independent of aBMD.... Cortical bone microstructure - specifically porosity - is a major determinant of strength, stiffness, and fracture toughness of cortical tissue and may further explain the aBMD-independent effect of age on bone fragility and fracture risk. The application of finite element analysis (FEA) to HR-pQCT data permits estimation of patient-specific bone strength, shown to be associated with fracture incidence independent of aBMD. This talk will describe the HR-pQCT scanner, established metrics of bone quality derived from HR-pQCT data, and novel analyses of bone quality currently in development. Cross-sectional and longitudinal HR-pQCT studies investigating the impact of aging, disease, injury, gender, race, and

  1. Measuring body composition in dogs using multifrequency bioelectrical impedance analysis and dual energy X-ray absorptiometry.

    PubMed

    Rae, L S; Vankan, D M; Rand, J S; Flickinger, E A; Ward, L C

    2016-06-01

    Thirty-five healthy, neutered, mixed breed dogs were used to determine the ability of multifrequency bioelectrical impedance analysis (MFBIA) to predict accurately fat-free mass (FFM) in dogs using dual energy X-ray absorptiometry (DXA)-measured FFM as reference. A second aim was to compare MFBIA predictions with morphometric predictions. MFBIA-based predictors provided an accurate measure of FFM, within 1.5% when compared to DXA-derived FFM, in normal weight dogs. FFM estimates were most highly correlated with DXA-measured FFM when the prediction equation included resistance quotient, bodyweight, and body condition score. At the population level, the inclusion of impedance as a predictor variable did not add substantially to the predictive power achieved with morphometric variables alone; in individual dogs, impedance predictors were more valuable than morphometric predictors. These results indicate that, following further validation, MFBIA could provide a useful tool in clinical practice to objectively measure FFM in canine patients and help improve compliance with prevention and treatment programs for obesity in dogs.

  2. Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review☆

    PubMed Central

    Krahenbühl, Tathyane; Gonçalves, Ezequiel Moreira; Costa, Eduardo Tavares; Barros, Antonio de Azevedo

    2014-01-01

    Objective: To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges. Data source: A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound. Data synthesis: 21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies. Conclusions: QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA. PMID:25479860

  3. Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study

    PubMed Central

    2017-01-01

    A recently developed diagnostic tool, trabecular bone score (TBS), can provide quality of trabecular microarchitecture based on images obtained from dual-energy X-ray absorptiometry (DXA). Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. In this pre-post study of female patients, TBS and fracture risk assessment tool (FRAX) adjusted with TBS (T-FRAX) were evaluated along with bone mineral density (BMD) and FRAX. Medical records of patients with (n = 30) and without (n = 16) glucocorticoid treatment were retrospectively reviewed. All patients had undergone DXA twice within a 12- to 24-month interval. Analysis of covariance was conducted to compare the outcomes between the two groups of patients, adjusting for age and baseline values. Results showed that a significant lower adjusted mean of TBS (p = 0.035) and a significant higher adjusted mean of T-FRAX for major osteoporotic fracture (p = 0.006) were observed in the glucocorticoid group. Conversely, no significant differences were observed in the adjusted means for BMD and FRAX. These findings suggested that TBS and T-FRAX could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy. PMID:28127556

  4. Cluster Analysis of Bone Microarchitecture from High Resolution Peripheral Quantitative Computed Tomography Demonstrates two Separate Phenotypes Associated with High Fracture Risk in Men and Women

    PubMed Central

    Edwards, MH; Robinson, DE; Ward, KA; Javaid, MK; Walker-Bone, K; Cooper, C; Dennison, EM

    2016-01-01

    Osteoporosis is a major healthcare problem which is conventionally assessed by dual energy x-ray absorptiometry (DXA). New technologies such as high resolution peripheral quantitative computed tomography (HRpQCT) also predict fracture risk. HRpQCT measures a number of bone characteristics that may inform specific patterns of bone deficits. We used cluster analysis to define different bone phenotypes and their relationships to fracture prevalence and areal bone mineral density (BMD). 177 men and 159 women, in whom fracture history was determined by self-report and vertebral fracture assessment, underwent HRpQCT of the distal radius and femoral neck DXA. Five clusters were derived with two clusters associated with elevated fracture risk. “Cluster 1” contained 26 women (50.0% fractured) and 30 men (50.0% fractured) with a lower mean cortical thickness and cortical volumetric BMD, and in men only, a mean total and trabecular area more than the sex-specific cohort mean. “Cluster 2” contained 20 women (50.0% fractured) and 14 men (35.7% fractured) with a lower mean trabecular density and trabecular number than the sex-specific cohort mean. Logistic regression showed fracture rates in these clusters to be significantly higher than the lowest fracture risk cluster (5) (p<0.05). Mean femoral neck areal BMD was significantly lower than cluster 5 in women in cluster 1 and 2 (p<0.001 for both), and in men, in cluster 2 (p<0.001) but not 1 (p=0.220). In conclusion, this study demonstrates two distinct high risk clusters in both men and women which may differ in etiology and response to treatment. As cluster 1 in men does not have low areal BMD, these men may not be identified as high risk by conventional DXA alone. PMID:27130873

  5. Cluster analysis of bone microarchitecture from high resolution peripheral quantitative computed tomography demonstrates two separate phenotypes associated with high fracture risk in men and women.

    PubMed

    Edwards, M H; Robinson, D E; Ward, K A; Javaid, M K; Walker-Bone, K; Cooper, C; Dennison, E M

    2016-07-01

    Osteoporosis is a major healthcare problem which is conventionally assessed by dual energy X-ray absorptiometry (DXA). New technologies such as high resolution peripheral quantitative computed tomography (HRpQCT) also predict fracture risk. HRpQCT measures a number of bone characteristics that may inform specific patterns of bone deficits. We used cluster analysis to define different bone phenotypes and their relationships to fracture prevalence and areal bone mineral density (BMD). 177 men and 159 women, in whom fracture history was determined by self-report and vertebral fracture assessment, underwent HRpQCT of the distal radius and femoral neck DXA. Five clusters were derived with two clusters associated with elevated fracture risk. "Cluster 1" contained 26 women (50.0% fractured) and 30 men (50.0% fractured) with a lower mean cortical thickness and cortical volumetric BMD, and in men only, a mean total and trabecular area more than the sex-specific cohort mean. "Cluster 2" contained 20 women (50.0% fractured) and 14 men (35.7% fractured) with a lower mean trabecular density and trabecular number than the sex-specific cohort mean. Logistic regression showed fracture rates in these clusters to be significantly higher than the lowest fracture risk cluster [5] (p<0.05). Mean femoral neck areal BMD was significantly lower than cluster 5 in women in cluster 1 and 2 (p<0.001 for both), and in men, in cluster 2 (p<0.001) but not 1 (p=0.220). In conclusion, this study demonstrates two distinct high risk clusters in both men and women which may differ in etiology and response to treatment. As cluster 1 in men does not have low areal BMD, these men may not be identified as high risk by conventional DXA alone.

  6. The Official Positions of the International Society for Clinical Densitometry: acquisition of dual-energy X-ray absorptiometry body composition and considerations regarding analysis and repeatability of measures.

    PubMed

    Hangartner, Thomas N; Warner, Sarah; Braillon, Pierre; Jankowski, Larry; Shepherd, John

    2013-01-01

    In preparation for the International Society for Clinical Densitometry Position Development Conference of 2013 in Tampa, Florida, Task Force 2 was created as 1 of 3 task forces in the area of body composition assessment by dual-energy X-ray absorptiometry (DXA). The assignment was to review the literature, summarize the relevant findings, and formulate positions covering (1) accuracy and precision assessment, (2) acquisition of DXA body composition measures in patients, and (3) considerations regarding analysis and repeatability of measures. There were 6 primary questions proposed to the task force by the International Society for Clinical Densitometry board and expert panel. Based on a series of systematic reviews, 14 new positions were developed, which are intended to augment and define good clinical practice in quantitative assessment of body composition by DXA.

  7. Air displacement plethysmography, dual-energy X-ray absorptiometry, and total body water to evaluate body composition in preschool-age children.

    PubMed

    Crook, Tina A; Armbya, Narain; Cleves, Mario A; Badger, Thomas M; Andres, Aline

    2012-12-01

    Anthropometrics and body mass index are only proxies in the evaluation of adiposity in the pediatric population. Air displacement plethysmography technology was not available for children aged 6 months to 9 years until recently. Our study was designed to test the precision of air displacement plethysmography (ADP) in measuring body fat mass in children at ages 3 to 5 years compared with a criterion method, deuterium oxide dilution (D(2)O), which estimates total body water and a commonly used methodology, dual-energy x-ray absorptiometry (DXA). A prospective, cross-sectional cohort of 66 healthy children (35 girls) was recruited in the central Arkansas region between 2007 and 2009. Weight and height were obtained using standardized procedures. Fat mass (%) was measured using ADP, DXA, and D(2)O. Concordance correlation coefficient and Bland-Altman plots were used to investigate the precision of the ADP techniques against D(2)O and DXA in children at ages 3 to 5 years. ADP concordance correlation coefficient for fat mass was weak (0.179) when compared with D(2)O. Bland-Altman plots revealed a low accuracy and large scatter of ADP fat mass (%) results (mean=-2.5, 95% CI -20.3 to 15.4) compared with D(2)O. DXA fat mass (%) results were more consistent although DXA systematically overestimated fat mass by 4% to 5% compared with D(2)O. Compared with D(2)O, ADP does not accurately assess percent fat mass in children aged 3 to 5 years. Thus, D(2)O, DXA, or quantitative nuclear magnetic resonance may be considered better options for assessing fat mass in young children.

  8. Imaging-Based Methods for Non-invasive Assessment of Bone Properties Influenced by Mechanical Loading.

    PubMed

    Macintyre, Norma J; Lorbergs, Amanda L

    2012-01-01

    Purpose: To describe the most common in vivo imaging-based research tools used to assess bone properties that are influenced by mechanical loading associated with exercise, habitual physical activity, or disease states. Bone is a complex metabolically active tissue that adapts to changes in mechanical loading by altering the amount and spatial organization of mineral. Method: Using a narrative review design, the authors provide an overview of bone biology and biomechanics to emphasize the importance of bone size scale, porosity, and degree of mineralization when interpreting measures acquired using quantitative ultrasound (QUS), dual-energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and finite element analysis (FEA). For each imaging modality, basic imaging principles, typical outcome measures associated with changes in mechanical loading, and salient features for physiotherapists are described. Main Results: While each imaging modality has strengths and limitations, currently CT-based methods are best suited for determining the effects of mechanical loading on bone properties—particularly in the peripheral skeleton. Conclusions: Regardless of the imaging technology used, the physiotherapist must carefully consider the assumptions of the imaging-based method, the clinical context, the nature of the change in mechanical loading, and the expected time course for change in bone properties.

  9. Bone Disorders in Chronic Kidney Disease: An Update in Diagnosis and Management.

    PubMed

    Babayev, Revekka; Nickolas, Thomas L

    2015-01-01

    Renal osteodystrophy (ROD) is a bone disorder that occurs in chronic kidney disease (CKD) patients and is associated with 2- to 14-fold increased fracture risk compared to the general population. Risk of fractures is also increased in kidney transplant recipients especially within the first 5 years after transplantation. Fractures in CKD patients are associated with increased morbidity and mortality; thus, proper screening and management of CKD bone complications is critical to improving clinical outcomes. Tetracycline double-labeled transiliac crest bone biopsy with histomorphometry is the gold standard for the diagnosis and classification of ROD. However, bone biopsy is not practical to obtain in all patients. Thus, there is great interest in noninvasive approaches that can be used in the clinic to assess ROD. Here, we discuss the role of surrogate measures of bone health in CKD patients, such as dual energy X-ray absorptiometry (DXA) and novel high-resolution imaging, in conjunction with biochemical biomarkers of bone turnover. Recommended guidelines for diagnosis and management of CKD-MBD are discussed.

  10. Protection of trabecular bone in ovariectomized rats by turmeric (Curcuma longa L.) is dependent on extract composition.

    PubMed

    Wright, Laura E; Frye, Jennifer B; Timmermann, Barbara N; Funk, Janet L

    2010-09-08

    Extracts prepared from turmeric (Curcuma longa L., [Zingiberaceae]) containing bioactive phenolic curcuminoids were evaluated for bone-protective effects in a hypogonadal rat model of postmenopausal osteoporosis. Three-month female Sprague-Dawley rats were ovariectomized (OVX) and treated with a chemically complex turmeric fraction (41% curcuminoids by weight) or a curcuminoid-enriched turmeric fraction (94% curcuminoids by weight), both dosed at 60 mg/kg 3x per week, or vehicle alone. Effects of two months of treatment on OVX-induced bone loss were followed prospectively by serial assessment of bone mineral density (BMD) of the distal femur using dual-energy X-ray absorptiometry (DXA), while treatment effects on trabecular bone microarchitecture were assessed at two months by microcomputerized tomography (microCT). Chemically complex turmeric did not prevent bone loss, however, the curcuminoid-enriched turmeric prevented up to 50% of OVX-induced loss of trabecular bone and also preserved the number and connectedness of the strut-like trabeculae. These results suggest that turmeric may have bone-protective effects but that extract composition is a critical factor.

  11. Protection of Trabecular Bone in Ovariectomized Rats by Turmeric (Curcuma longa L.) is Dependent on Extract Composition

    PubMed Central

    Wright, Laura E.; Frye, Jennifer B.; Timmermann, Barbara N.; Funk, Janet L.

    2010-01-01

    Extracts prepared from turmeric (Curcuma longa L., [Zingiberaceae]) containing bioactive phenolic curcuminoids were evaluated for bone-protective effects in a hypogonadal rat model of postmenopausal osteoporosis. Three-month female Sprague Dawley rats were ovariectomized (OVX) and treated with a chemically complex turmeric fraction (41% curcuminoids by weight) or a curcuminoid-enriched turmeric fraction (94% curcuminoids by weight), both dosed at 60mg/kg 3x per week, or vehicle alone. Effects of two months of treatment on OVX-induced bone loss were followed prospectively by serial assessment of bone mineral density (BMD) of the distal femur using dual-energy x-ray absorptiometry (DXA), while treatment effects on trabecular bone microarchitecture were assessed at two months by micro-computerized tomography (μCT). Chemically complex turmeric did not prevent bone loss, however, the curcuminoid-enriched turmeric prevented up to 50% of OVX-induced loss of trabecular bone and also preserved the number and connectedness of the strut-like trabeculae. These results suggest that turmeric may have bone-protective effects but that extract composition is a critical factor. PMID:20695490

  12. Fractal analysis of bone architecture at distal radius.

    PubMed

    Tomomitsu, Tatsushi; Mimura, Hiroaki; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

    2005-12-20

    Bone strength depends on bone quality (architecture, turnover, damage accumulation, and mineralization) as well as bone mass. In this study, human bone architecture was analyzed using fractal image analysis, and the clinical relevance of this method was evaluated. The subjects were 12 healthy female controls and 16 female patients suspected of having osteoporosis (age range, 22-70 years; mean age, 49.1 years). High-resolution CT images of the distal radius were acquired and analyzed using a peripheral quantitative computed tomography (pQCT) system. On the same day, bone mineral densities of the lumbar spine (L-BMD), proximal femur (F-BMD), and distal radius (R-BMD) were measured by dual-energy X-ray absorptiometry (DXA). We examined the correlation between the fractal dimension and six bone mass indices. Subjects diagnosed with osteopenia or osteoporosis were divided into two groups (with and without vertebral fracture), and we compared measured values between these two groups. The fractal dimension correlated most closely with L-BMD (r=0.744). The coefficient of correlation between the fractal dimension and L-BMD was very similar to the coefficient of correlation between L-BMD and F-BMD (r=0.783) and the coefficient of correlation between L-BMD and R-BMD (r=0.742). The fractal dimension was the only measured value that differed significantly between both the osteopenic and the osteoporotic subjects with and without vertebral fracture. The present results suggest that the fractal dimension of the distal radius can be reliably used as a bone strength index that reflects bone architecture as well as bone mass.

  13. Effects of an 8-Month Ashtanga-Based Yoga Intervention on Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Study

    PubMed Central

    Kim, SoJung; Bemben, Michael G.; Knehans, Allen W.; Bemben, Debra A.

    2015-01-01

    Although Yoga has the potential to be an alternative physical activity to enhance bone health, there is a lack of high quality evidence for this type of intervention. The purpose of this randomized controlled trial was to examine the effects of a progressive 8-month Ashtanga-based Yoga program on bone turnover markers (BTM), areal bone mineral density (aBMD) and volumetric bone characteristics in premenopausal women. Thirty-four premenopausal women (35-50 years) were randomly assigned either to a Yoga group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga-based Yoga series 2 times/week with one day between sessions for 8 months, and the session intensity was progressively increased by adding the number of sun salutations (SS). Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone specific physical activity questionnaire (BPAQ) at 2 month intervals for 8 months. Body composition was measured by dual energy x-ray absorptiometry (DXA). Bone formation (bone alkaline phosphatase, Bone ALP) and bone resorption (Tartrate-Resistant Acid Phosphatase-5b, TRAP5b) markers were assessed at baseline and after 8 months. aBMD of total body, lumbar spine and dual proximal femur and tibia bone characteristics were measured using DXA and peripheral Quantitative Computed Tomography (pQCT), respectively. We found that the serum Bone ALP concentrations were maintained in YE, but significantly (p = 0.005) decreased in CON after the 8 month intervention, and there were significant (p = 0.002) group differences in Bone ALP percent changes (YE 9.1 ± 4.0% vs. CON -7.1 ± 2.3%). No changes in TRAP5b were found in either group. The 8-month Yoga program did not increase aBMD or tibia bone strength variables. Body composition results showed no changes in weight, fat mass, or % fat, but small significant increases in bone free lean body mass occurred in both groups. The findings of this study

  14. Comparison of Bioimpedance and Dual-Energy X-Ray Absorptiometry for Measurement of Fat Mass in Hemodialysis Patients

    PubMed Central

    Molfino, Alessio; Don, Burl R.; Kaysen, George A.

    2014-01-01

    Background Fat mass (FM) is measured with dual-energy X-ray absorptiometry (DXA), but is expensive and not portable. Multifrequency bioimpedance spectroscopy (BIS) measures total body water (TBW) and intracellular and extracellular water (ICW, ECW). Fat mass (FM) is calculated subtracting Fat Free Mass (FFM) from weight assuming fractional hydration of FFM of 0.73. Hemodialysis patients (HD), however, have non physiologic expansion of ECW. Our aim was to apply a model to estimate FM in HD and controls. Methods We estimated the hydration of FFM in healthy subjects (C) and HD with BIS (Impedimed multifrequency) assuming hydration of 0.73 or using a formula allowing ECW and ICW to vary, deriving a value for FM accounting for variances in ECW and ICW. FM was measured by DXA (Hologic Discovery W) in 25 C and in 11 HD. We measured TBW, ECW and ICW with BIS and calculated FM using either Weight - TBW/.73 or with a formula accounting for variations in ECW/ICW to estimate FM. Results ECW/ICW was greater in HD than in C (0.83±0.08 vs 0.76± 0.04; p=0.001). FM (Kg) measured by DXA, or estimated from TBW using constant hydration or accounting for variations in ECW/ICW were not significantly different in C or in HD. Values obtained by all methods correlated (p<0.001) and none of the Bland-Altman plots regressed (r2=0.00). FM measured by DXA and by BIS in both C and HD combined correlated (r2=0.871). Conclusion Expansion of ECW in HD is statistically significant, however the effect on hydration of FFM is insufficient to cause significant deviation from values derived using a hydration value of 0.73 within the range of expansion of ECW in the HD population studied here. PMID:23689544

  15. Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture

    PubMed Central

    Yang, Lang; Peel, Nicola; Clowes, Jackie A; McCloskey, Eugene V; Eastell, Richard

    2011-01-01

    Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic’s software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly >1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures. PMID:18767924

  16. Method and apparatus for multiple-projection, dual-energy x-ray absorptiometry scanning

    NASA Technical Reports Server (NTRS)

    Charles, Jr., Harry K. (Inventor); Beck, Thomas J. (Inventor); Feldmesser, Howard S. (Inventor); Magee, Thomas C. (Inventor)

    2007-01-01

    Methods and apparatuses for advanced, multiple-projection, dual-energy X-ray absorptiometry scanning systems include combinations of a conical collimator; a high-resolution two-dimensional detector; a portable, power-capped, variable-exposure-time power supply; an exposure-time control element; calibration monitoring; a three-dimensional anti-scatter-grid; and a gantry-gantry base assembly that permits up to seven projection angles for overlapping beams. Such systems are capable of high precision bone structure measurements that can support three dimensional bone modeling and derivations of bone strength, risk of injury, and efficacy of countermeasures among other properties.

  17. Reloading partly recovers bone mineral density and mechanical properties in hind limb unloaded rats

    NASA Astrophysics Data System (ADS)

    Zhao, Fan; Li, Dijie; Arfat, Yasir; Chen, Zhihao; Liu, Zonglin; Lin, Yu; Ding, Chong; Sun, Yulong; Hu, Lifang; Shang, Peng; Qian, Airong

    2014-12-01

    Skeletal unloading results in decreased bone formation and bone mass. During long-term space flight, the decreased bone mass is impossible to fully recover. Therefore, it is necessary to develop the effective countermeasures to prevent spaceflight-induced bone loss. Hindlimb Unloading (HLU) simulates effects of weightlessness and is utilized extensively to examine the response of musculoskeletal systems to certain aspects of space flight. The purpose of this study is to investigate the effects of a 4-week HLU in rats and subsequent reloading on the bone mineral density (BMD) and mechanical properties of load-bearing bones. After HLU for 4 weeks, the rats were then subjected to reloading for 1 week, 2 weeks and 3 weeks, and then the BMD of the femur, tibia and lumbar spine in rats were assessed by dual energy X-ray absorptiometry (DXA) every week. The mechanical properties of the femur were determined by three-point bending test. Dry bone and bone ash of femur were obtained through Oven-Drying method and were weighed respectively. Serum alkaline phosphatase (ALP) and serum calcium were examined through ELISA and Atomic Absorption Spectrometry. The results showed that 4 weeks of HLU significantly decreased body weight of rats and reloading for 1 week, 2 weeks or 3 weeks did not recover the weight loss induced by HLU. However, after 2 weeks of reloading, BMD of femur and tibia of HLU rats partly recovered (+10.4%, +2.3%). After 3 weeks of reloading, the reduction of BMD, energy absorption, bone mass and mechanical properties of bone induced by HLU recovered to some extent. The changes in serum ALP and serum calcium induced by HLU were also recovered after reloading. Our results indicate that a short period of reloading could not completely recover bone after a period of unloading, thus some interventions such as mechanical vibration or pharmaceuticals are necessary to help bone recovery.

  18. The Effects of Hypergravity and Adrenalectomy on Bone Mineral Content, Urine Calcium and Body Mass in Rats

    NASA Technical Reports Server (NTRS)

    Lau, A.; Ramirez, J.; Melson, E.; Moran, M.; Baer, L.; Arnaud, S.; Wade, C.; Girten, B.; Dalton, Bonnie (Technical Monitor)

    2001-01-01

    The effects of 14 days of increased gravitational load, and the absence of adrenal stress hormones on total body bone mineral content (BMC) were examined in male Sprague-Dawley rats. Centrifugation at 2 Gs (2G) was used to increase the gravitational load, and bilateral adrenalectomy (ADX) was used to eliminate the production of adrenal stress hormones. Stationary groups at 1 G (1G) and sham operated (SHAM) animals served as controls. Thirty rats (n=6 or 8) made up the four experimental groups (1G SHAM, 1G ADX, 2G SHAM and 2G ADX). BMC was assessed by dual energy x-ray absorptiometry (DXA) which was performed to determine the total body bone mineral content, and also through bone ashing of the left femur and the left humerus. Activity was determined through biotelemetry, also body mass and food intake were measured. Multi-factorial analysis of variance (MANCOVA) and Newman Keuls post hoc tests were used to analyze significant effects (p is less than 0.05) for the primary variables. Results from both DXA and the ashed femur indicated that BMC decreased significantly with increased G for both the SHAM and ADX groups. The BMC determined by DXA for the 1G ADX group was also significantly lower than the 1G SHAM group, however the 2G SHAM and 2G ADX groups were not significantly different. However, the bone ashing results showed the femur differed significantly only between the rates of centrifugation and not between the ADX and SHAM. The humerus showed no significant difference between any of the groups. There was a significant decrease in body mass with increased G and there was no ADX effect on body mass. When DXA BMC was normalized for body mass changes, there were no significant group differences. However, with bone ashing, the femur BMC/BW still showed significant difference between rates of centrifugation, with the 2G group being lower. Activity level decreased with body mass, and food intake data showed there was significant hypophagia during the first few days of

  19. Densitometer-Specific Differences in the Correlation Between Body Mass Index and Lumbar Spine Trabecular Bone Score.

    PubMed

    Mazzetti, Gillian; Berger, Claudie; Leslie, William D; Hans, Didier; Langsetmo, Lisa; Hanley, David A; Kovacs, Christopher S; Prior, Jerrilyn C; Kaiser, Stephanie M; Davison, K Shawn; Josse, Robert; Papaioannou, Alexandra; Adachi, Jonathan R; Goltzman, David; Morin, Suzanne N

    2016-12-26

    Trabecular bone score (TBS) is a gray-level texture measure derived from lumbar spine dual-energy X-ray absorptiometry (DXA) images that predicts fractures independent of bone mineral density (BMD). Increased abdominal soft tissue in individuals with elevated body mass index (BMI) absorbs more X-rays during image acquisition for BMD measurement and must be accommodated by the TBS algorithm. We aimed to determine if the relationship between BMI and TBS varied between 2 major manufacturers' densitometers, because different densitometers accommodate soft tissues differently. We identified 1919 women and 811 men, participants of the Canadian Multicentre Osteoporosis Study, aged ≥40 yr with lumbar spine DXA scans acquired on GE Lunar (4 centers) or Hologic (3 centers) densitometers at year 10 of follow-up. TBS was calculated for L1-L4 (TBS iNsight® software, version 2.1). A significant negative correlation between TBS and BMI was observed when TBS measurements were performed on Hologic densitometers in men (Pearson r = -0.36, p <0.0001) and in women (Pearson r = -0.33, p <0.0001); significant correlations were not seen when TBS was measured on GE Lunar densitometers (Pearson r = 0.00 in men, Pearson r = -0.02 in women). Age-adjusted linear regression models confirmed significant interactions between BMI and densitometer manufacturer for both men and women (p < 0.0001). In contrast, comparable positive correlations were observed between BMD and BMI on both Hologic and GE Lunar densitometers in men and women. In conclusion, BMI significantly affects TBS values in men and women when measured on Hologic but not GE Lunar densitometers. This finding has implications for clinical and research applications of TBS, especially when TBS is measured sequentially on DXA densitometers from different manufacturers or when results from different machines are pooled for analysis.

  20. Calcium supplementation does not rescue the programmed adult bone deficits associated with perinatal growth restriction.

    PubMed

    Romano, Tania; Wark, John D; Wlodek, Mary E

    2010-12-01

    Low birth weight and poor childhood growth program a variety of adult diseases including bone disorders such as osteoporosis. We have previously reported that offspring born small, as a result of uteroplacental insufficiency, have shorter femurs, lower bone mineral content and a bone strength deficit as adults. The aim of this study was to determine the effects of calcium supplementation from adolescence on growth restricted male and female offspring which have a programmed bone deficit. Bilateral uterine vessel ligation (Restricted) or sham surgery (Control) was performed on gestational day 18 in WKY rats to induce uteroplacental insufficiency and growth restriction. At 2 months pups were allocated to one of four diet groups: diet 1-constant normal calcium diet, diet 2-variable normal calcium diet, diet 3-constant high calcium diet, diet 4-variable high calcium diet. Diet groups 1 and 3 were fed their respective diets constantly for the duration of the study. In groups 2 and 4, rats were fed one diet for 5 days, followed by a switch to a low calcium diet for the next 5 days. At 6 months Dual Energy Xray Absorptiometry (DXA) and Peripheral Quantitative Computed Tomography (pQCT) were performed on the right femur. Bone turnover markers were measured at 4 months. Male and female Restricted offspring were born 14% lighter compared to Controls (p<0.05). At 6 months both male and female Restricted offspring remained smaller and had shorter femurs compared to Controls (p<0.05). Restricted males and females had reduced trabecular and cortical content compared to Controls, regardless of diet (p<0.05). Trabecular bone density was lower in Restricted females only (p<0.05). A constant high calcium diet increased cortical BMD in Restricted male and both female groups (p<0.05). Measures of bone geometry indicated that Restricted offspring have narrower bones with preservation of absolute cortical thickness (p<0.05). Importantly, the stress strain index of bone bending strength

  1. The effects of swimming training on bone tissue in adolescence.

    PubMed

    Gómez-Bruton, A; González-Agüero, A; Gómez-Cabello, A; Matute-Llorente, A; Casajús, J A; Vicente-Rodríguez, G

    2015-12-01

    The aim was to analyze bone mineral content (BMC) and density (BMD) in regular swimming trained adolescents and the interaction that weigh-bearing sports may have on these values. Bone mass was evaluated by dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS) in 77 swimmers (34 females/43 males) and 52 normoactive controls (CG; 23 females/29 males) from 11 to 18 years. Swimmers who had performed or were performing other sports (OSP; 11 females/20 males) were compared with pure swimmers (PSW; 23 females/23 males). Both groups were compared with CG. Bone values were compared using analyses of covariance adjusting for height, calcium intake, subtotal lean (whole body lean minus head), and pubertal status. Male PSW showed lower BMD and BMC at several sites than male CG. However, for male OSP, only lumbar spine BMC was lower in OSP than male CG. Male PSW showed lower BMD and BMC when compared with male OSP. Female PSW showed higher arm BMD and lower leg BMC than female CG, while female OSP only presented lower leg BMC than female CG. Contrary to males, female-PSW presented higher BMD and BMC than female OSP. No differences in QUS values were found between swimmers and CG. To summarize, although more information is needed for females, it seems that for males, swimming is associated with lower BMC and BMD.

  2. Techniques for deriving tissue structure from multiple projection dual-energy x-ray absorptiometry

    NASA Technical Reports Server (NTRS)

    Charles, Jr., Harry K. (Inventor); Beck, Thomas J. (Inventor); Feldmesser, Howard S. (Inventor); Magee, Thomas C. (Inventor)

    2004-01-01

    Techniques for deriving bone properties from images generated by a dual-energy x-ray absorptiometry apparatus include receiving first image data having pixels indicating bone mineral density projected at a first angle of a plurality of projection angles. Second image data and third image data are also received. The second image data indicates bone mineral density projected at a different second angle. The third image data indicates bone mineral density projected at a third angle. The third angle is different from the first angle and the second angle. Principal moments of inertia for a bone in the subject are computed based on the first image data, the second image data and the third image data. The techniques allow high-precision, high-resolution dual-energy x-ray attenuation images to be used for computing principal moments of inertia and strength moduli of individual bones, plus risk of injury and changes in risk of injury to a patient.

  3. Body composition in older community-dwelling adults with hip fracture: portable field methods validated by dual-energy X-ray absorptiometry.

    PubMed

    Villani, Anthony M; Miller, Michelle; Cameron, Ian D; Kurrle, Susan; Whitehead, Craig; Crotty, Maria

    2013-04-14

    Ageing is associated with weight loss and subsequently poor health outcomes. The present study assessed agreement between two field methods, bioelectrical impedance spectroscopy (BIS) and corrected arm muscle area (CAMA) for assessment of body composition against dual-energy X-ray absorptiometry (DXA), the reference technique. Agreement between two predictive equations estimating skeletal muscle mass (SMM) from BIS against SMM from DXA was also determined. Assessments occurred at baseline < 14 d post-surgery (n 79), and at 6 months (6M; n 75) and 12 months (12M; n 63) in community-living older adults after surgical treatment for hip fracture. The 95 % limits of agreement (LOA) between BIS and DXA, CAMA and DXA and the equations and DXA were assessed using Bland-Altman analyses. Mean bias and LOA for fat-free mass (FFM) between BIS and DXA were: baseline, 0.7 (-10.9, 12.4) kg; 6M, - 0.5 (-20.7, 19.8) kg; 12M, 0.1 (-8.7, 8.9) kg and for SMM between CAMA and DXA were: baseline, 0.3 (-11.7, 12.3) kg; 6M, 1.3 (-4.5, 7.1) kg; 12M, 0.9 (-5.4, 7.2) kg. Equivalent data for predictive equations against DXA were: equation 1: baseline, 15.1 (-9.5, 20.6) kg; 6M, 17.1 (-12.0, 22.2) kg; 12M, 17.5 (-13.0, 22.0) kg; equation 2: baseline, 12.6 (-7.3, 19.9) kg; 6M, 14.4 (-9.7, 19.1) kg; 12M, 14.8 (-10.7, 18.9) kg. Proportional bias (BIS: β = -0.337, P< 0.001; CAMA: β = -0.294, P< 0.001) was present at baseline but not at 6M or 12 M. Clinicians should be cautious in using these field methods to predict FFM and SMM, particularly in the acute care setting. New predictive equations would be beneficial.

  4. Assessment of bone mineral density in the jaws and its relationship to radiomorphometric indices

    PubMed Central

    Gulsahi, A; Paksoy, CS; Ozden, S; Kucuk, NO; Cebeci, ARI; Genc, Y

    2010-01-01

    Objectives The aim of this study was to evaluate maxillary, mandibular and femoral neck bone mineral density using dual energy X-ray absorptiometry (DXA) and to determine any correlation between the bone mineral density of the jaws and panoramic radiomorphometric indices. Methods 49 edentulous patients (18 males and 31 females) aged between 41 and 78 years (mean age 60.2 ± 11.04) were examined by panoramic radiography. Bone mineral density (BMD) of the jaws and femoral neck was measured with a DXA; bone mineral density was calculated at the anterior, premolar and molar regions of the maxilla and mandible. Results The mean maxillary molar BMD (0.45 g cm−2) was significantly greater than the maxillary anterior and premolar BMD (0.31 g cm−2, P < 0.05). Furthermore, the mean mandibular anterior and premolar BMD (1.39 g cm−2 and 1.28 g cm−2, respectively) was significantly greater than the mean mandibular molar BMD (1.09 g cm−2, P < 0.01). Although BMD in the maxillary anterior and premolar regions were correlated, BMD in all the mandibular regions were highly correlated. Maxillary and mandibular BMD were not correlated with femoral BMD. In addition, mandibular cortical index (MCI) classification, mental index (MI) or panoramic mandibular index (PMI) values were not significantly correlated with the maxillary and mandibular BMDs (P > 0.05). Conclusions The BMD in this study was highest in the mandibular anterior region and lowest in the maxillary anterior and premolar regions. The BMD of the jaws was not correlated with either femoral BMD or panoramic radiomorphometric indices. PMID:20587652

  5. Comparison of dual-energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance analysis for the assessment of body composition in severely obese Caucasian children and adolescents.

    PubMed

    Lazzer, Stefano; Bedogni, Giorgio; Agosti, Fiorenza; De Col, Alessandra; Mornati, Daniela; Sartorio, Alessandro

    2008-10-01

    The objectives of the present study were to compare body composition assessed by dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP) and bioelectrical impedance analysis (BIA) in severely obese Caucasian children and adolescents and to develop and validate new equations for predicting body composition from BIA using DXA as the reference method. Body composition was assessed in fifty-eight obese children and adolescents (BMI 34.4 (SD 4.9) kg/m(2)) aged 10-17 years by DXA, ADP and BIA. ADP body fat content was estimated from body density using equations devised by Siri (ADP(Siri)) and Lohman (ADP(Lohman)). In the whole sample, the Bland-Altman test showed that ADP(Siri) and ADP(Lohman) underestimated percentage fat mass (%FM) by 2.1 (SD 3.4) and by 3.8 (SD 3.3) percent units (P<0.001), respectively, compared to DXA. In addition, compared to DXA, BIA underestimated %FM by 5.8 (SD 4.6) percent units in the whole group (P<0.001). A new prediction equation (FFM (kg) = 0.87 x (stature(2)/body impedance) + 3.1) was developed on the pooled sample and cross-validated on an external group of sixty-one obese children and adolescents. The difference between predicted and measured FFM in the external group was -1.6 (SD 2.9) kg (P<0.001) and FFM was predicted accurately (error < 5%) in 75% of subjects. In conclusion, DXA, ADP and the BIA are not interchangeable for the assessment of %FM in severely obese children and adolescents. The new prediction equation offers an alternative approach to DXA for the estimation of body composition in severely obese children and adolescents.

  6. The Sp1 binding site polymorphism in the collagen type I alpha 1 (COLIA1) gene is not associated with bone mineral density in healthy children, adolescents, and young adults.

    PubMed

    Berg, J P; Lehmann, E H; Stakkestad, J A; Haug, E; Halse, J

    2000-08-01

    Up to 85% of the variance in bone mineral density (BMD) is genetically determined. A putative candidate gene involved in the regulation of bone mass is the COLIA1 gene encoding type I collagen, which is the major protein of bone. We examined possible allelic influences of a G to T COLIA1 gene polymorphism in a recognition site for the transcription factor Sp1 on: (i) gain of forearm BMD using single photon absorptiometry (SPA); and (ii), BMD of the forearm, spine, hip, and whole body with dual X-ray absorptiometry (DXA). At baseline, 269 healthy boys and girls aged 8.2-16.5 years were eligible for the study. Forearm BMD measurements obtained at baseline and after 3.8+/-0.1 years (+/-s.d.) were used to calculate the annual percentage change in BMD. Calcium intake and physical activity were determined by a detailed questionnaire at baseline and after 1 year. Essentially no significant differences in forearm BMD gain or in BMD assessed at the forearm, spine, and whole body were observed among the three COLIA1 genotypes. In conclusion, the data indicate that the polymorphism at the Sp1 site in the COLIA1 gene is not associated with BMD or gain of forearm BMD in healthy boys and girls.

  7. Relationship between Bone Mineral Density and Body Composition Estimated by Dual-Energy X-ray Absorptiometry: Comparison between Groups Aged 20-39 and 40-59 Years.

    PubMed

    Hayashida, Keiichi; Takeda, Yoshihiro; Yatake, Hidetoshi; Yamaguchi, Motoi; Yamamoto, Kenyu; Kuwano, Tadao; Katsuda, Toshizo

    2015-12-18

    Bone mineral density (BMD) is affected by lean body mass and body weight to various degrees in the course of aging. The attempt of this study is to determine the optimal time to begin prevention of osteoporosis. In this study, female hospital employees aged 20-59 years were divided into 2 age groups, 20-39 years and 40-59 years based on age at peak BMD, and the relations of total BMD, subtotal BMD and lumbar spine BMD to lean body mass and body weight were examined in both groups. Subtotal BMD was calculated by subtracting head BMD from total BMD along with whole body measurement. While persistent positive correlations were found among all factors in the 20-39-year-old group, subtotal BMD and lumbar spine BMD were positively correlated to lean body mass in the 40-59-year-old group. Thus, lean body mass and body weight appeared to exert a profound influence on subtotal BMD in those aged 20-39 years, but lean body mass in those aged 40-59 years. Lean body mass appears to provide the best prediction of subsequent development of osteoporosis.

  8. Normative data of body fat mass and its distribution as assessed by DXA in Indian adult population.

    PubMed

    Marwaha, Raman K; Tandon, Nikhil; Garg, M K; Narang, Archna; Mehan, Neena; Bhadra, Kuntal

    2014-01-01

    Dual-energy X-ray absorptiometry (DXA) assessment of body fat mass is precise and highly correlated with under water weighing. In view of ethnic differences, we undertook this study to prepare normative data for body fat mass in apparently healthy adult Indians and correlate it with body mass index (BMI). This cross-sectional population-based study included 2347 subjects (male: 924; female: 1423) aged >20 yr who participated in a general health examination. They were evaluated for anthropometry and body fat mass by DXA. All subjects were categorized as overweight and obese based on standard BMI criteria. Mean age and BMI were 49.1 ± 18.2yr and 25.0 ± 4.7kg/m(2), respectively. Mean percent total and regional fat (trunk, arm, and leg) reached maximum in the age group of 30-40yr in males and 50-60yr in females. Females had significantly higher total and regional fat mass compared with males. Fat mass was positively correlated with age (r = 0.224; p < 0.00001) and BMI (r = 0.668; p < 0.00001). Prevalence of overweight and obesity was seen in 2119 (46.1%) and 536 (13.8%), respectively, according to World Health Organization definition and 64.0% and 31.1%, respectively, as per Indian guidelines. Percent total body fat mass (PTBFM) of 25% in males and 30% in females corresponds to BMI of 22.0kg/m(2) with sensitivity of >80% and specificity of >70% in receiver operating characteristic curve analysis. Body fat mass in Indians is higher than that in Western populations for a given age and BMI. PTBFM of 25% in males and 30% in females corresponds to BMI of 22kg/m(2) in Indians.

  9. Obstacles in the optimization of bone health outcomes in the female athlete triad.

    PubMed

    Ducher, Gaele; Turner, Anne I; Kukuljan, Sonja; Pantano, Kathleen J; Carlson, Jennifer L; Williams, Nancy I; De Souza, Mary Jane

    2011-07-01

    Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the 'female athlete triad'. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture. This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging. Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.

  10. Zoledronic acid prevents loss of trabecular bone after focal irradiation in mice.

    PubMed

    Keenawinna, Lihini; Oest, Megan E; Mann, Kenneth A; Spadaro, Joseph; Damron, Timothy A

    2013-07-01

    Radiation therapy for soft tissue sarcomas and metastatic disease can adversely affect bone, leading to late-onset fragility fractures. Adjunct administration of bisphosphonates has been postulated as means of minimizing these adverse effects. Using a murine model of focal hindlimb irradiation, we examined the potential for zoledronic acid treatment to minimize the deleterious effects of localized radiotherapy (RTx) on bone. Mice received a single, unilateral hindlimb exposure of 20 Gy. Beginning 4 days prior to irradiation, and at 1, 2 and 3 weeks post-irradiation, animals were treated with zoledronic acid or saline/vehicle injections. Areal bone mineral density was assessed at 4 days, and 2, 4 and 12 weeks post-irradiation by dual-energy X-ray absorptiometry (DXA). Micro-computed tomography and axial compression testing were used to quantify changes in morphological and mechanical properties of femurs at 4 and 12 weeks post-irradiation. Radiation had differential effects on cortical and trabecular bone, increasing cortical bone mineral content (BMC), cortical bone volume (BV) and trabecular separation (Tb.Sp) while decreasing trabecular number (Tb.N) by 12 weeks after localized radiotherapy. Administration of zoledronic acid increased hindlimb areal bone mineral density in both the presence and absence of radiotherapy, increased cortical bone mineral content and bone volume, increased trabecular bone volume (BV/TV), increased trabecular number, increased trabecular thickness (Tb.Th), and decreased trabecular separation compared to irradiated and vehicle control femurs. Despite these improvements in morphology with zoledronic acid, no biomechanical advantage was observed. Further work is needed to define the role of bisphosphonates in prevention of post-irradiation fragility fractures.

  11. Motor Competence in Early Childhood Is Positively Associated With Bone Strength in Late Adolescence

    PubMed Central

    Sayers, Adrian; Deere, Kevin C; Emond, Alan; Tobias, Jon H

    2016-01-01

    ABSTRACT The onset of walking in early childhood results in exposure of the lower limb to substantial forces from weight bearing activity that ultimately contribute to adult bone strength. Relationships between gross motor score (GMS), at 18 months and bone outcomes measured at age 17 years were examined in 2327 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Higher GMS indicated greater motor competence in weight‐bearing activities. Total hip bone mineral density (BMD) and hip cross‐sectional moment of inertia (CSMI) were assessed from dual‐energy X‐ray absorptiometry (DXA). Bone measures including cortical bone mineral content (BMC), periosteal circumference (PC), cortical thickness (CT), cortical bone area (CBA), cortical BMD (BMDC) and cross‐sectional moment of inertia (CSMI) were assessed by peripheral quantitative computed tomography (pQCT) at 50% distal‐proximal length. Before adjustment, GMS was associated with hip BMD, CSMI, and tibia BMC, PC, CT, CBA and CSMI (all p < 0.001) but not BMDC (p > 0.25). Strongest associations (standardized regression coefficients with 95% CI) were between GMS and hip BMD (0.086; 95% CI, 0.067 to 0.105) and tibia BMC (0.105; 95% CI, 0.089 to 0.121). With the exception of hip BMD, larger regression coefficients were observed in males (gender interactions all p < 0.05). Adjustment for lean mass resulted in substantial attenuation of regression coefficients, suggesting associations between impaired motor competence and subsequent bone development are partly mediated by alterations in body composition. In conclusion, impaired motor competence in childhood is associated with lower adolescent bone strength, and may represent a risk factor for subsequent osteoporosis. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR). PMID:26713753

  12. Greater access to fast food outlets is associated with poorer bone health in young children

    PubMed Central

    Vogel, Christina; Parsons, Camille; Godfrey, Keith; Robinson, Sian; Harvey, Nicholas C; Inskip, Hazel; Cooper, Cyrus; Baird, Janis

    2016-01-01

    Purpose Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. Methods 1107 children participating in the Southampton Women’s Survey, United Kingdom, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and four and/or six years by Dual-energy X-ray Absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant’s neighbourhood were used to derive three measures of the food environment: the counts of fast food outlets, healthy speciality stores and supermarkets. Results Neighbourhood exposure to fast food outlets was associated with lower BMD in infancy (β=−0.23(z-score): 95% CI −0.38, −0.08), and lower BMC after adjustment for bone area and confounding variables (β=−0.17(z-score): 95% CI −0.32, −0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at four and six years (β=0.16(z-score): 95% CI 0.00, 0.32 and β=0.13(z-score): 95% CI −0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at four years but not at six years. Conclusions The neighbourhood food environment pregnant mothers and young children are exposed to may effect bone development during early childhood. If confirmed in future studies, action to reduce access to fast food outlets could have benefits for childhood development and long term bone health. PMID:26458387

  13. Bone loss at the distal femur and proximal tibia in persons with spinal cord injury: imaging approaches, risk of fracture, and potential treatment options.

    PubMed

    Cirnigliaro, C M; Myslinski, M J; La Fountaine, M F; Kirshblum, S C; Forrest, G F; Bauman, W A

    2017-03-01

    Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force. To quantify bone mineral density (BMD) at the knee, dual energy x-ray absorptiometry (DXA) and/or computed tomography (CT) bone densitometry are routinely employed in the clinical and research settings. A detailed review of imaging methods to acquire and quantify BMD at the distal femur and proximal tibia has not been performed to date but, if available, would serve as a reference for clinicians and researchers. This article will discuss the risk of fracture at the knee in persons with SCI, imaging methods to acquire and quantify BMD at the distal femur and proximal tibia, and treatment options available for prophylaxis against or reversal of osteoporosis in individuals with SCI.

  14. Anthropometric indices as measures of body fat assessed by DXA in relation to cardiovascular risk factors in children and adolescents: NHANES 1999-2004

    PubMed Central

    Cui, Zhaohui; Truesdale, Kimberly P; Cai, Jianwen; Koontz, Michaela B; Stevens, June

    2015-01-01

    Objective Anthropometrics are commonly used indices of total and central adiposity. No study has compared anthropometric measurements to dual-energy X-ray absorptiometry (DXA) measurements as correlates of cardiovascular risks in a nationally representative sample of youth. We aimed to evaluate the validity of anthropometrics compared to DXA-assessed adiposity in relation to cardiovascular risks in youth aged 8-19 years. Methods Data were from the National Health and Nutrition Examination Survey 1999-2004 (n=7013). We examined the correlations between anthropometric and DXA measures of adiposity (i.e., body mass index (BMI) versus percent fat mass (%FM) and fat mass index, and waist circumference (WC) and waist-to-height ratio (WHtR) versus percent trunk fat mass (%TFM)) with nine cardiovascular risks, stratified by sex and age, or race-ethnicity. Results Anthropometric and DXA adiposity measures were significantly correlated with insulin (r: 0.48 to 0.66), C-reactive protein (r: 0.47 to 0.58), triglycerides (r: 0.15 to 0.41), high-density lipoprotein cholesterol (HDL-C, r: −0.44 to −0.22), systolic blood pressure (SBP, r: 0.10 to 0.31), low-density lipoprotein cholesterol (r: 0.09 to 0.30), total cholesterol (TC, r: 0.01 to 0.29) and glucose (r: 0.05 to 0.20). Only in all youth, BMI was more strongly correlated with SBP (0.22 vs. 0.12, P<0.0001) and HDL-C (−0.34 vs. −0.25, P<0.0001) than %FM; WC but not WHtR was more strongly correlated with HDL-C (−0.37 vs. −0.30, P<0.0001) but less strongly associated with TC (0.12 vs. 0.21, P<0.0001) than %TFM. Conclusions DXA adiposity measures do not produce stronger associations with cardiovascular risk factors in youth than BMI or WC. PMID:26405434

  15. The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

    PubMed Central

    Czekuc-Kryskiewicz, Edyta; Pludowski, Pawel; Zaniuk, Katarzyna; Jaworski, Maciej; Łuba, Anna; Grzybowska, Karolina; Piłat, Krystyna; Dobrzanska, Anna

    2016-01-01

    Background Metabolic bone disease of prematurity still occurs in preterm infants, although a significant improvement in neonatal care has been observed in recent decades. Dual-energy X-ray absorptiometry (DXA) is the precise technique for assessing bone mineral content (BMC) in preterm infants, but is not widely available. Aim To investigate the clinical and biochemical parameters, including bone metabolism markers as potential predictors of BMC, in preterm infants up to 3 months corrected age (CA). Materials and Methods Ca-P homeostasis, iPTH, 25-hydroxyvitamin D, osteocalcin, N-terminal propeptide, cross-linked C-telopeptide and amino-terminal pro C-type natriuretic peptide and the DXA scans were prospectively performed in 184 preterm infants (≤ 34 weeks’ gestation) between term age and 3 mo CA. Lower bone mass was defined as BMC below or equal to respective median value for the whole study group, rounded to the nearest whole number. Results The appropriate quality DXA scans were available for 160 infants (87%) examined at term and for 130 (71%) tested at 3 mo CA. Higher iPTH level was the only independent predictor of lower BMC at term, whereas lower BMC at 3 mo CA was associated both with lower urinary phosphate excretion and higher serum osteocalcin level. ROC analysis showed that iPTH >43.6 pg/mL provided 40% sensitivity and 88% specificity in identification of preterm infants with lower BMC at term. In turn, urinary phosphate excretion (TRP>97% or UP/Cr ≤0.74 mg/mg) and serum osteocalcin >172 ng/mL provided 40% sensitivity and 93% specificity in identification of infants with decreased BMC at 3 mo CA. Conclusion Serum iPTH might to be a simple predictor of reduced BMC in preterm infants at term age, but urinary phosphate excretion and serum osteocalcin might predict reduced BMC at 3 mo CA. These results represent a promising diagnostic tool based on simple, widely available biochemical measurements for bone mass assessment in preterm infants. PMID

  16. Development, validation and characterization of a novel mouse model of Adynamic Bone Disease (ABD).

    PubMed

    Ng, Adeline H; Willett, Thomas L; Alman, Benjamin A; Grynpas, Marc D

    2014-11-01

    The etiology of Adynamic Bone Disease (ABD) is poorly understood but the hallmark of ABD is a lack of bone turnover. ABD occurs in renal osteodystrophy (ROD) and is suspected to occur in elderly patients on long-term anti-resorptive therapy. A major clinical concern of ABD is diminished bone quality and an increased fracture risk. To our knowledge, experimental animal models for ABD other than ROD-ABD have not been developed or studied. The objectives of this study were to develop a mouse model of ABD without the complications of renal ablation, and to characterize changes in bone quality in ABD relative to controls. To re-create the adynamic bone condition, 4-month old female Col2.3Δtk mice were treated with ganciclovir to specifically ablate osteoblasts, and pamidronate was used to inhibit osteoclastic resorption. Four groups of animals were used to characterize bone quality in ABD: Normal bone controls, No Formation controls, No Resorption controls, and an Adynamic group. After a 6-week treatment period, the animals were sacrificed and the bones were harvested for analyses. Bone quality assessments were conducted using established techniques including bone histology, quantitative backscattered electron imaging (qBEI), dual energy X-ray absorptiometry (DXA), microcomputed tomography (microCT), and biomechanical testing. Histomorphometry confirmed osteoblast-related hallmarks of ABD in our mouse model. Bone formation was near complete suppression in the No Formation and Adynamic specimens. Inhibition of bone resorption in the Adynamic group was confirmed by tartrate-resistant acid phosphatase (TRAP) stain. Normal bone mineral density and architecture were maintained in the Adynamic group, whereas the No Formation group showed a reduction in bone mineral content and trabecular thickness relative to the Adynamic group. As expected, the No Formation group had a more hypomineralized profile and the Adynamic group had a higher mean mineralization profile that is

  17. Periprosthetic tibial bone mineral density changes after total knee arthroplasty

    PubMed Central

    Jaroma, Antti; Soininvaara, Tarja; Kröger, Heikki

    2016-01-01

    Background and purpose Total knee arthroplasty (TKA) may cause postoperative periprosthetic bone loss due to stress shielding. Bone also adapts to mechanical alterations such as correction of malalignment. We investigated medium-term changes in bone mineral density (BMD) in tibial periprosthetic bone after TKA. Patients and methods 86 TKA patients were prospectively measured with dual-energy X-ray absorptiometry (DXA), the baseline measurement being within 1 week after TKA and the follow-up measurements being at 3 and 6 months, and at 1, 2, 4, and 7 years postoperatively. Long standing radiographs were taken and clinical evaluation was done with the American Knee Society (AKS) score. Results The baseline BMD of the medial tibial metaphyseal region of interest (ROI) was higher in the varus aligned knees (25%; p < 0.001). Medial metaphyseal BMD decreased in subjects with preoperatively varus aligned knees (13%, p < 0.001) and in those with preoperatively valgus aligned knees (12%, p = 0.02) between the baseline and 7-year measurements. No statistically significant changes in BMD were detected in lateral metaphyseal ROIs. No implant failures or revision surgery due to tibial problems occurred. Interpretation Tibial metaphyseal periprosthetic bone is remodeled after TKA due to mechanical axis correction, resulting in more balanced bone stock below the tibial tray. The diaphyseal BMD remains unchanged after the initial drop, within 3–6 months. This remodeling process was related to good component survival, as there were no implant failures or revision operations due to tibial problems in this medium-term follow-up. PMID:27120266

  18. Correlation between serum leptin and bone mineral density in hemodialysis patients

    PubMed Central

    Ghorban-Sabbagh, Mahin; Nazemian, Fatemeh; Naghibi, Massih; Shakeri, Mohammad-Taghi; Ahmadi-Simab, Saeedeh; Javidi-Dasht-Bayaz, Reza

    2016-01-01

    Introduction: For diagnosing of specific types of bone lesions in hemodialysis (HD) patients, it is necessary to conduct a bone biopsy as the gold standard method. However, it is an invasive procedure. While different markers have been suggested as alternative methods, none of them has been selected. The frequency of hip fractures is 80 fold in HD patients who have two-fold mortality as compared with general population. Objectives: Recently, serum leptin has been suggested as a bone density marker. This study tries to confirm this proposal. Patients and Methods: In this study about 104 HD patients (53.8% male and 46.2% female) were enrolled. The average age was 38.28±7.89 years. Serum leptin, bone alkaline phosphatase, intact parathyroid hormone (iPTH), 25(OH)D, calcium, phosphorus and bone mineral density (BMD) (at the femoral neck and lumbar spine, as measured by dual-energy x-ray absorptiometry [DXA]) were assessed. Results: Analysis by polynomial regression revealed no correlation between BMD Z-score at two points and serum leptin level. According to the thresholds of 25 ng/mL and 18-24 ng/mL in some studies, we detected 25 ng/mL as the threshold in our patients. Under this threshold, the leptin effect on bone mass was negative, and above the threshold of 25 ng/mL, we found leptin had positive effect on bone mass. Conclusion: In this investigation, we found, leptin has a bimodal effect on bone mass. Cortical bones assessment may be a better option for assessment. PMID:27689105

  19. Measurement of the subcutaneous fat in the distal forearm by single photon absorptiometry

    SciTech Connect

    Hassager, C.; Borg, J.; Christiansen, C.

    1989-02-01

    The influence of subcutaneous fat on single photon (/sup 125/I) absorptiometry (SPA) measurement of bone mineral content of the distal forearm was investigated. A fat correction model was tested by measurements on eight lean subjects with different amounts of porcine fat around their forearm, and further validated from measurements on 128 females. In addition, it is shown that the fat content in the distal forearm can be measured by SPA with a short-term precision at 1.9% in an obese subject and that it correlates well with total body fat (r2 = .7) measured by dual photon absorptiometry, skinfold thickness (r2 = .5), and body mass index (r2 = .6). By using this method in a double-blind placebo-controlled trial, hormonal substitutional therapy significantly decreased the forearm fat content without affecting the body weight in postmenopausal osteoporotic women.

  20. Bone Strength and Arterial Stiffness Impact on Cardiovascular Mortality in a General Population

    PubMed Central

    Avramovska, Maja; Sikole, Aleksandar

    2016-01-01

    Osteoporosis and increased arterial stiffness independently have been found to be associated with higher cardiovascular events rates in the general population (GP). We examined 558 patients from GP by dual-energy X-ray absorptiometry (DXA) and pulse wave velocity (PWV) measurements at baseline, with 36-month follow-up period. DXA assessed bone mineral density of femoral neck (BMD FN) and lumbar spine (BMD LS). Carotid-femoral PWV was assessed by pulsed-Doppler. The aim of our study is to find correlation between bone strength and arterial stiffness and their impact on cardiovascular mortality in GP. The mean ± SD of BMD FN, BMD LS, and PWV was 0.852 ± 0.1432 g/cm2, 0.934 ± 0.1546 g/cm2, and 9.209 ± 1.9815 m/s. In multiple regression analysis we found BMD FN (βst = −6.0094, p < 0.0001), hypertension (βst = 1.7340, p < 0.0091), and diabetes (βst = 0.4595, p < 0.0046). With Cox-regression analysis, after 17 cardiovascular events, the significant covariates retained by the backward model were BMD FN (b = −2.4129, p = 0.015) and PWV (b = 0.2606, p = 0.0318). The cut-off values were PWV = 9.4 m/s, BMD FN = 0.783 g/cm2, and BMD LS = 0.992 g/cm2. The results for BMD FN and PWV hazard ratio risk were 1.116 and 1.297, respectively. BMD FN as a measure of bone strength and PWV as a measure of arterial stiffness are strong independent predictors of cardiovascular mortality in GP. PMID:27047700

  1. Cortical thickness and medullary canal dimensions of the bone phalanx are predicted by quantitative ultrasound parameters.

    PubMed

    Guglielmi, Giuseppe; de Terlizzi, Francesca; Scalzo, Giacomo; Battista, Claudia; Scillitani, Alfredo

    2010-01-01

    The aim of the study was to investigate the relationship between quantitative ultrasound (QUS) parameters extracted from the analysis of the ultrasound (US) signal and the geometric properties of the bones. One hundred and one subjects in the age range of 20-7 4yr (mean: 52+/-12 yr) have been measured by QUS at the phalanges for the evaluation of amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), US peak amplitude (UPA), signal dynamic (SDY), slope, energy, and fast wave amplitude (FWA). Hand radiograph, lumbar spine dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT), and femoral neck DXA forearm peripheral QCT were performed on all patients. BTT is related to cortical thickness (CTh) (r=0.62, p<0.0001), and FWA is related to medullary canal thickness (r=-0.64, p<0.0001). Other parameters are related to both medullary canal thickness (AD-SoS: r=-0.21; UPA: r=-0.53; SDY: r=-0.56; slope: r=-0.64; energy: r=-0.44, p<0.05) and CTh (AD-SoS: r=0.54, p<0.0001; UPA: r=0.51; SDY: r=0.38; slope: r=0.32; energy: r=0.56, p<0.001). Linear multivariate models indicate that BTT, UPA, and energy measured at the phalanges carry independent information on CTh of the bone, whereas FWA, SDY, and slope are related only to medullary canal thickness.

  2. Determinants of bone mineral density in Chinese men.

    PubMed

    Cheung, E Y N; Ho, A Y Y; Lam, K F; Tam, S; Kung, A W C

    2005-12-01

    Osteoporotic fractures are increasing among Asian populations in both genders, but the risk factors for low bone mineral density (BMD) in Asian men is unclear. To determine the hormonal and lifestyle risk factors for low BMD in Asian men, we studied 407 community-dwelling southern Chinese men aged 50 years and above. Medical history and lifestyle habits were obtained with a structured questionnaire. Dietary calcium and phytoestrogen intake were assessed by a semi-quantitative questionnaire. BMD at the spine and hip were measured by dual-energy X-ray absorptiometry (DXA). Fasting blood was analyzed for 25(OH)D, parathyroid hormone (PTH), total and bioavailable estradiol (bio-E) and testosterone (bio-T). The mean age of the cohort was 68.42+/-10.4 (50-96) years. In the linear regression model, weight, age, body mass index (BMI), bio-E, PTH, cigarette smoking and weight-bearing exercise were significant determinants of total hip BMD. Together they explained 55% of the total variance of hip BMD, with body weight being the most important determining factor. With age and weight adjustment, height, bio-T and flavonoid intake were identified as additional determinants of total hip BMD. Strategies to prevent bone loss and osteoporosis in Asian men should include lifestyle modification and maintenance of hormonal sufficiency.

  3. Assessment of body composition in Indian adults: comparison between dual-energy X-ray absorptiometry and isotope dilution technique.

    PubMed

    Kulkarni, Bharati; Kuper, Hannah; Taylor, Amy; Wells, Jonathan C; Radhakrishna, K V; Kinra, Sanjay; Ben-Shlomo, Yoav; Smith, George Davey; Ebrahim, Shah; Kurpad, A V; Byrne, Nuala M; Hills, Andrew P

    2014-10-14

    Dual-energy X-ray absorptiometry (DXA) and isotope dilution technique have been used as reference methods to validate the estimates of body composition by simple field techniques; however, very few studies have compared these two methods. We compared the estimates of body composition by DXA and isotope dilution (18O) technique in apparently healthy Indian men and women (aged 19-70 years, n 152, 48 % men) with a wide range of BMI (14-40 kg/m2). Isotopic enrichment was assessed by isotope ratio mass spectroscopy. The agreement between the estimates of body composition measured by the two techniques was assessed by the Bland-Altman method. The mean age and BMI were 37 (sd 15) years and 23·3 (sd 5·1) kg/m2, respectively, for men and 37 (sd 14) years and 24·1 (sd 5·8) kg/m2, respectively, for women. The estimates of fat-free mass were higher by about 7 (95 % CI 6, 9) %, those of fat mass were lower by about 21 (95 % CI - 18, - 23) %, and those of body fat percentage (BF%) were lower by about 7·4 (95 % CI - 8·2, - 6·6) % as obtained by DXA compared with the isotope dilution technique. The Bland-Altman analysis showed wide limits of agreement that indicated poor agreement between the methods. The bias in the estimates of BF% was higher at the lower values of BF%. Thus, the two commonly used reference methods showed substantial differences in the estimates of body composition with wide limits of agreement. As the estimates of body composition are method-dependent, the two methods cannot be used interchangeably.

  4. Bone density, strength, and formation in adult cathepsin K (-/-) mice.

    PubMed

    Pennypacker, B; Shea, M; Liu, Q; Masarachia, P; Saftig, P; Rodan, S; Rodan, G; Kimmel, D

    2009-02-01

    Cathepsin K (CatK) is a cysteine protease expressed predominantly in osteoclasts, that plays a prominent role in degrading Type I collagen. Growing CatK null mice have osteopetrosis associated with a reduced ability to degrade bone matrix. Bone strength and histomorphometric endpoints in young adult CatK null mice aged more than 10 weeks have not been studied. The purpose of this paper is to describe bone mass, strength, resorption, and formation in young adult CatK null mice. In male and female wild-type (WT), heterozygous, and homozygous CatK null mice (total N=50) aged 19 weeks, in-life double fluorochrome labeling was performed. Right femurs and lumbar vertebral bodies 1-3 (LV) were evaluated by dual-energy X-ray absorptiometry (DXA) for bone mineral content (BMC) and bone mineral density (BMD). The trabecular region of the femur and the cortical region of the tibia were evaluated by histomorphometry. The left femur and sixth lumbar vertebral body were tested biomechanically. CatK (-/-) mice show higher BMD at the central and distal femur. Central femur ultimate load was positively influenced by genotype, and was positively correlated with both cortical area and BMC. Lumbar vertebral body ultimate load was also positively correlated to BMC. Genotype did not influence the relationship of ultimate load to BMC in either the central femur or vertebral body. CatK (-/-) mice had less lamellar cortical bone than WT mice. Higher bone volume, trabecular thickness, and trabecular number were observed at the distal femur in CatK (-/-) mice. Smaller marrow cavities were also present at the central femur of CatK (-/-) mice. CatK (-/-) mice exhibited greater trabecular mineralizing surface, associated with normal volume-based formation of trabecular bone. Adult CatK (-/-) mice have higher bone mass in both cortical and cancellous regions than WT mice. Though no direct measures of bone resorption rate were made, the higher cortical bone quantity is associated with a smaller

  5. Differences in geriatric anthropometric data between DXA-based subject-specific estimates and non-age-specific traditional regression models.

    PubMed

    Chambers, April J; Sukits, Alison L; McCrory, Jean L; Cham, Rakie

    2011-08-01

    Age, obesity, and gender can have a significant impact on the anthropometrics of adults aged 65 and older. The aim of this study was to investigate differences in body segment parameters derived using two methods: (1) a dual-energy x-ray absorptiometry (DXA) subject-specific method (Chambers et al., 2010) and (2) traditional regression models (de Leva, 1996). The impact of aging, gender, and obesity on the potential differences between these methods was examined. Eighty-three healthy older adults were recruited for participation. Participants underwent a whole-body DXA scan (Hologic QDR 1000/W). Mass, length, center of mass, and radius of gyration were determined for each segment. In addition, traditional regressions were used to estimate these parameters (de Leva, 1996). A mixed linear regression model was performed (α = 0.05). Method type was significant in every variable of interest except forearm segment mass. The obesity and gender differences that we observed translate into differences associated with using traditional regressions to predict anthropometric variables in an aging population. Our data point to a need to consider age, obesity, and gender when utilizing anthropometric data sets and to develop regression models that accurately predict body segment parameters in the geriatric population, considering gender and obesity.

  6. Dual-energy X-ray absorptiometry measured regional body composition least significant change: effect of region of interest and gender in athletes.

    PubMed

    Buehring, Bjoern; Krueger, Diane; Libber, Jessie; Heiderscheit, Bryan; Sanfilippo, Jennifer; Johnson, Brian; Haller, Irina; Binkley, Neil

    2014-01-01

    Dual-energy X-ray absorptiometry (DXA) is widely used to evaluate body composition in athletes. Knowledge of measurement precision is essential for monitoring body composition changes over time. This study begins characterizing DXA body composition precision in 60 (30 males and 30 females) Division 1 athletes focusing on gender, regional, and tissue type differences. Two total body scans with repositioning between were performed on the same day. Least significant change (LSC) for the root-mean-square deviation (LSCRMSD) and the percent coefficient of variation (LSC%CV) for total, lean, and fat mass was calculated for 6 regions of interest. The effect of gender, region, tissue type, and mass on the standard deviation (SD) and percent coefficient of variation (%CV) between the 2 scans was evaluated using repeated measures regression analysis. Statistically significant effects of gender, region, tissue type, and mass on SD and %CV were noted. To generalize, a nonlinear positive relationship between LSCRMSD and mass and a nonlinear negative relationship between LSC%CV and mass were observed. In conclusion, DXA body composition LSC varies among genders, regions, tissues, and mass. As such, when evaluating serial body composition in athletes, especially if assessing regional change, knowledge of precision in individuals of similar body size and gender to the population of interest is needed.

  7. Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet

    PubMed Central

    Larussa, Tiziana; Suraci, Evelina; Imeneo, Maria; Marasco, Raffaella; Luzza, Francesco

    2017-01-01

    Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2–33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03–1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03–1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6–192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling. PMID:28146115

  8. 42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the use of a dual energy x-ray absorptiometry system (axial skeleton). (3) Medicare covers a medically... bone mass measurement is performed by a dual energy x-ray absorptiometry system (axial skeleton) and the initial measurement was not performed by a dual energy x-ray absorptiometry system (axial...

  9. 42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the use of a dual energy x-ray absorptiometry system (axial skeleton). (3) Medicare covers a medically... bone mass measurement is performed by a dual energy x-ray absorptiometry system (axial skeleton) and the initial measurement was not performed by a dual energy x-ray absorptiometry system (axial...

  10. 42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the use of a dual energy x-ray absorptiometry system (axial skeleton). (3) Medicare covers a medically... bone mass measurement is performed by a dual energy x-ray absorptiometry system (axial skeleton) and the initial measurement was not performed by a dual energy x-ray absorptiometry system (axial...

  11. [High resolution peripheral quantitative computed tomography for the assessment of morphological and mechanical bone parameters].

    PubMed

    Fuller, Henrique; Fuller, Ricardo; Pereira, Rosa Maria R

    2015-01-01

    High resolution peripheral quantitative computed tomography (HR-pQCT) is a new technology commercially available for less than 10 years that allows performing in vivo assessment of bone parameters. HR-pQCT assesses the trabecular thickness, trabecular separation, trabecular number and connectivity density and, in addition, cortical bone density and thickness and total bone volume and density in high-definition mode, which additionally allows obtaining digital constructs of bone microarchitecture. The application of mathematics to captured data, a method called finite element analysis (FEA), allows the estimation of the physical properties of the tissue, simulating supported loads in a non-invasive way. Thus, HR-pQCT simultaneously acquires data previously provided separately by dual energy x-ray absorptiometry (DXA), magnetic resonance imaging and histomorphometry, aggregating biomechanical estimates previously only possible in extracted tissues. This method has a satisfactory reproducibility, with coefficients of variation rarely exceeding 3%. Regarding accuracy, the method shows a fair to good agreement (r(2) = 0.37-0.97). The main clinical application of this method is in the quantification and monitoring of metabolic bone disorders, more fully evaluating bone strength and fracture risk. In rheumatoid arthritis patients, this allows gauging the number and size of erosions and cysts, in addition to joint space. In osteoarthritis, it is possible to characterize the bone marrow edema-like areas that show a correlation with cartilage breakdown. Given its high cost, HR-pQCT is still a research tool, but the high resolution and efficiency of this method reveal advantages over the methods currently used for bone assessment, with a potential to become an important tool in clinical practice.

  12. Influence of Body Composition, Oral Contraceptive Use, and Physical Activity on Bone Mineral Density in Premenopausal Women.

    PubMed

    Sherk, Vanessa D; Howard, Clint D; Bemben, Michael G; Bemben, Debra A

    In premenopausal women, low bone density may reflect attainment of a lower peak bone mass which can increase risk of osteoporosis after menopause. The purpose of this study was to examine the relationship between total body, lumbar spine, and proximal femur bone mineral density (BMD) and body composition and oral contraceptive (OC) use in 18-30 year old women. Sixty-five healthy women, split into groups of oral contraceptive users (OC, n = 36) and non oral contraceptive users (Non-OC, n = 29), completed Baecke physical activity, calcium intake, and menstrual history questionnaires. Total body, AP lumbar spine, and dual proximal femur scans were performed using Dual Energy X-Ray Absorptiometry (DXA). Body composition measures were obtained from the total body scan analysis. No significant differences were found for BMD in OC users and non-users. Bone free lean body mass (BFLBM) and weight were positively correlated to all BMD sites, and fat mass was related to total body and L1-L4 spine BMD (p < 0.05). Stepwise regression analyses determined that weight was a significant predictor for all BMD sites (p < 0.05). When separating the two components of body weight, BFLBM was a significant predictor for all BMD sites, and fat mass only predicted total body BMD. In conclusion, this study indicates that weight and BFLBM are significant contributors to BMD in young healthy premenopausal women, and OC use did not influence the relationship between BMD and BFLBM.

  13. Preliminary study report: topological texture features extracted from standard radiographs of the heel bone are correlated with femoral bone mineral density

    NASA Astrophysics Data System (ADS)

    Boehm, H. F.; Lutz, J.; Koerner, M.; Notohamiprodjo, M.; Reiser, M.

    2009-02-01

    With the growing number of eldery patients in industrialized nations the incidence of geriatric, i.e. osteoporotic fractures is steadily on the rise. It is of great importance to understand the characteristics of hip fractures and to provide diagnostic tests for the assessment of an individual's fracture-risk that allow to take preventive action and give therapeutic advice. At present, bone-mineral-density (BMD) obtained from DXA (dual-energy x-ray-absorptiometry) is the clinical standard of reference for diagnosis and follow-up of osteoporosis. Since availability of DXA - other than that of clinical X-ray imaging - is usually restricted to specialized medical centers it is worth trying to implement alternative methods to estimate an individual's BMD. Radiographs of the peripheral skeleton, e.g. the ankle, range among the most ordered diagnostic procedures in surgery for exclusion or confirmation of fracture. It would be highly beneficial if - as a by-product of conventional imaging - one could obtain a quantitative parameter that is closely correlated with femoral BMD in addition to the original diagnostic information, e.g. fracture status at the peripheral site. Previous studies could demonstrate a correlation between calcaneal BMD and osteoporosis. The objective of our study was to test the hypothesis that topological analysis of calcaneal bone texture depicted by a lateral x-ray projection of the ankle allows to estimate femoral BMD. Our analysis on 34 post-menopausal patients indicate that texture properties based on graylevel topology in calcaneal x-ray-films are closely correlated with BMD at the hip and may qualify as a substitute indicator of femoral fracture risk.

  14. What Happens to bone health during and after spaceflight?

    NASA Technical Reports Server (NTRS)

    Sibonga, Jean D.; Evans, Harlan J.; Spector, Elisabeth R.; Maddocks, Mary J.; Smith, Scott A.; Shackelford, Linda C.; LeBlanc, Adrian D.

    2006-01-01

    Weightless conditions of space flight accelerate bone loss. There are no reports to date that address whether the bone that is lost during spaceflight could ever be recovered. Spaceinduced bone loss in astronauts is evaluated at the Johnson Space Center (JSC) by measurement of bone mineral density (BMD) by Dual-energy x-ray absorptiometry (DXA) scans. Astronauts are routinely scanned preflight and at various time points postflight (greater than or equal to Return+2 days). Two sets of BMD data were used to model spaceflight-induced loss and skeletal recovery in crewmembers following long-duration spaceflight missions (4-6 months). Group I was from astronauts (n=7) who were systematically scanned at multiple time points during the postflight period as part of a research protocol to investigate skeletal recovery. Group II came from a total of 49 sets of preflight and postflight data obtained by different protocols. These data were from 39 different crewmembers some of whom served on multiple flights. Changes in BMD (between pre- and postflight BMD) were plotted as a function of time (days-after-landing); plotted data were fitted to an exponential equation which enabled estimations of i) BMD change at day 0 after landing and ii) the number of days by which 50% of the lost bone is recovered (half-life). These fits were performed for BMD of the lumbar spine, trochanter, pelvis, femoral neck and calcaneus. There was consistency between the models for BMD recovery. Based upon the exponential model of BMD restoration, recovery following long-duration missions appears to be substantially complete in crewmembers within 36 months following return to Earth.

  15. Recovery of Spaceflight-induced Bone Loss: Bone Mineral Density after Long-Duration Missions as Fitted with an Exponential Function

    NASA Technical Reports Server (NTRS)

    Sibonga, J. D.; Evans, H. J.; Sung, H. G.; Spector, E. R.; Lang, T. F.; Oganov, V. S.; Bakulin, A. V.; Shackelford, L. C.; LeBlanc, A. D.

    2007-01-01

    The loss of bone mineral in NASA astronauts during spaceflight has been investigated throughout the more than 40 years of space travel. Consequently, it is a medical requirement at NASA Johnson Space Center (JSC) that changes in bone mass be monitored in crew members by measuring bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA) before and after flight on astronauts who serve on long-duration missions (4-6 months). We evaluated this repository of medical data to track whether there is recovery of bone mineral that was lost during spaceflight. Our analysis was supplemented by BMD data from cosmonauts ( by convention, a space traveler formally employed by the Russia Aviation and Space Agency or by the previous Soviet Union) who had also flown on long-duration missions. Data from a total of 45 individual crew members -- a small number of whom flew on more than one mission -- were used in this analysis. Changes in BMD (between 56 different sets of pre- and postflight measurements) were plotted as a function of time (days after landing). Plotted BMD changes were fitted to an exponential mathematical function that estimated: i) BMD change on landing day (day 0) and ii) the number of days after landing when 50% of the lost bone would be recovered ("50% recovery time") in the lumbar spine, trochanter, pelvis, femoral neck and calcaneus. In sum, averaged losses of bone mineral after long-duration spaceflight ranged between 2-9% across all sites with our recovery model predicting a 50% restoration of bone loss for all sites to be within 9 months.

  16. Aging Versus Postmenopausal Osteoporosis: Bone Composition and Maturation Kinetics at Actively-Forming Trabecular Surfaces of Female Subjects Aged 1 to 84 Years.

    PubMed

    Paschalis, Eleftherios P; Fratzl, Peter; Gamsjaeger, Sonja; Hassler, Norbert; Brozek, Wolfgang; Eriksen, Erik F; Rauch, Frank; Glorieux, Francis H; Shane, Elizabeth; Dempster, David; Cohen, Adi; Recker, Robert; Klaushofer, Klaus

    2016-02-01

    Bone strength depends on the amount of bone, typically expressed as bone mineral density (BMD), determined by dual-energy X-ray absorptiometry (DXA), and on bone quality. Bone quality is a multifactorial entity including bone structural and material compositional properties. The purpose of the present study was to examine whether bone material composition properties at actively-forming trabecular bone surfaces in health are dependent on subject age, and to contrast them with postmenopausal osteoporosis patients. To achieve this, we analyzed by Raman microspectroscopy iliac crest biopsy samples from healthy subjects aged 1.5 to 45.7 years, paired biopsy samples from females before and immediately after menopause aged 46.7 to 53.6 years, and biopsy samples from placebo-treated postmenopausal osteoporotic patients aged 66 to 84 years. The monitored parameters were as follows: the mineral/matrix ratio; the mineral maturity/crystallinity (MMC); nanoporosity; the glycosaminoglycan (GAG) content; the lipid content; and the pyridinoline (Pyd) content. The results indicate that these bone quality parameters in healthy, actively-forming trabecular bone surfaces are dependent on subject age at constant tissue age, suggesting that with advancing age the kinetics of maturation (either accumulation, or posttranslational modifications, or both) change. For most parameters, the extrapolation of models fitted to the individual age dependence of bone in healthy individuals was in rough agreement with their values in postmenopausal osteoporotic patients, except for MMC, lipid, and Pyd content. Among these three, Pyd content showed the greatest deviation between healthy aging and disease, highlighting its potential to be used as a discriminating factor.

  17. Relation between bone mineral density and IL-17 serum levels in Serbian patients with early Rheumatoid arthritis

    PubMed Central

    Dimic, Aleksandar; Milenkovic, Sasa; Krtinic, Dane; Aleksic, Ivana

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation and destruction of joint cartilage and bone. Different cytokines play important role in the processes that cause articular destruction and extra-articular manifestations in RA. The contribution of cytokines representing the Th1 (INF-γ), Th2 (IL-4) and IL-17A to the pathogenesis of early RA and bone mineral density (BMD) loss in still poorly understood. Serum samples of 38 early RA patients were evaluated for erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide antibodies (anti-CCP) and for the tested cytokines (IL-17A, IL-4 and INF-γ). BMD was evaluated by dualenergy X-ray absorptiometry (DXA). Disease activity score (DAS28) calculation was assessed for all patients. Control serum samples were obtained from 34 healthy volunteers. The levels of tested cytokines were significantly higher (IL-17A, p<0.001; INF-γ, P<0.001; IL-4, P<0.01) in patients with early RA, compared to the healthy controls. In early RA patients, strong correlation of serum IL-17A was found with DAS28, ESR and CRP. Also, a significant negative correlation was found between serum INF-γ levels and the DAS28 score. Significantly positive correlation of BMD values and CRP, DAS28 IL-17A were also demonstrated. DXA analysis revealed that the most common site for osteoporosis was the lumbar spine followed by the femoral neck. BMD values significantly correlated with CRP, DAS28 score and IL-17A serum levels. The mean serum IL-17A levels, in patients with early RA, corresponded with disease activity, severity and BMD loss, indicating the potential usefulness of serum IL-17A in defining the disease activity and bone remodeling. PMID:28352685

  18. Bone Related Health Status in Adolescent Cyclists

    PubMed Central

    Olmedillas, Hugo; González-Agüero, Alejandro; Moreno, Luís A.; Casajús, José A.; Vicente-Rodríguez, Germán

    2011-01-01

    Purpose To describe bone status and analyse bone mass in adolescent cyclists. Methods Male road cyclists (n = 22) who had been training for a minimum of 2 years and a maximum of 7 years with a volume of 10 h/w, were compared to age-matched controls (n = 22) involved in recreational sports activities. Subjects were divided in 2 groups based on age: adolescents under 17 yrs (cyclists, n = 11; controls, n = 13) and over 17 yrs (cyclists, n = 11; controls, n = 9). Peak oxygen uptake (VO2max) was measured on a cycloergometer. Whole body, lumbar spine, and hip bone mineral content (BMC), density (BMD) and bone area were assessed using dual x-ray absorptiometry (DXA). Volumetric BMD (vBMD) and bone mineral apparent density (BMAD) were also estimated. Results The BMC of cyclists was lower for the whole body, pelvis, femoral neck and legs; BMD for the pelvis, hip, legs and whole body and legs bone area was lower but higher in the hip area (all, P≤0.05) after adjusting by lean mass and height. The BMC of young cyclists was 10% lower in the leg and 8% higher in the hip area than young controls (P≤0.05). The BMC of cyclists over 17 yrs was 26.5%, 15.8% and 14.4% lower BMC at the pelvis, femoral neck and legs respectively while the BMD was 8.9% to 24.5% lower for the whole body, pelvis, total hip, trochanter, intertrochanter, femoral neck and legs and 17.1% lower the vBMD at the femoral neck (all P≤0.05). Grouped by age interaction was found in both pelvis and hip BMC and BMD and in femoral neck vBMD (all P≤0.05). Conclusion Cycling performed throughout adolescence may negatively affect bone health, then compromising the acquisition of peak bone mass. PMID:21980360

  19. Comparing non contrast computerized tomography criteria versus dual X-ray absorptiometry as predictors of radio-opaque upper urinary tract stone fragmentation after electromagnetic shockwave lithotripsy.

    PubMed

    Hameed, Diaa A; Elgammal, Mohammed A; ElGanainy, Ehab O; Hageb, Adel; Mohammed, Khaled; El-Taher, Ahmed Mohamed; Mostafa, Mostafa Mohamed; Ahmed, Abdelfatah Ibrahim

    2013-11-01

    The objective of this study was to assess the value of dual X-ray absorptiometry (DXA) in comparison to non contrast computed tomography (NCCT) density as possible predictors of upper urinary tract stone disintegration by shock wave lithotripsy (SWL). This study included 100 consecutive patients, with solitary renal stone 0.5-2 cm or upper ureteral stone up to 1 cm. DXA to calculate stone mineral density (SMD) and stone mineral content (SMC) was done. NCCT was performed to measure Hounsfield units (HU). SWL was performed with an electromagnetic lithotripsy, plain X-ray documented disintegration after SWL. Successful treatment was defined as stone free or complete fragmentation after 1 or 2 sessions of SWL. The impact of patients age, sex, body mass index, stone laterality, location, volume, length, mean SMC and SMD, HU and Hounsfield density (HD), skin to stone distance (SSD) and number of shock waves were evaluated by univariate and multivariate analysis. Only 76 patients were available for follow-up. Success of disintegration was observed in 50 out of 76 patients (65.8 %). On multivariate analysis, SMC and number of shock wave were the significant independent factors affecting SWL outcome (p = 0.04 and p = 0.000, respectively). SMC as detected by DXA is a significant predictor of success of stone disintegration by SWL. SMC measured by DXA is more accurate than HU measured by CT. Patients with high stone mineral content (SMC greater than 0.65 g) should be directly offered another treatment option.

  20. Comparison of two bioelectrical impedance analysis devices with dual energy X-ray absorptiometry and magnetic resonance imaging in the estimation of body composition.

    PubMed

    Wang, Ji-Guang; Zhang, Yi; Chen, Han-E; Li, Yan; Cheng, Xiao-Guang; Xu, Li; Guo, Zhe; Zhao, Xing-Shan; Sato, Tetsuya; Cao, Qi-Yun; Chen, Ke-Min; Li, Biao

    2013-01-01

    We compared a 4-limb bioelectrical impedance analysis (BIA) system, HBF 359 (Omron), and a 2-limb foot-to-foot device, BC 532 (Tanita), with the standard dual energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) methods for the measurement of body fat percentage (BF), skeletal muscle mass percentage (SMM, or fat-free mass [FFM] for BC 532), and visceral fat level (VF). Body composition was measured in 200 healthy volunteers (100 men and 100 women, mean age 48 years) by HBF 359 and BC 532 and by DXA and MRI. The agreement was assessed by correlation analysis and paired t-test. The correlation coefficients between BIA and DXA or MRI ranged from 0.71 to 0.89 for BF, SMM, and VF by HBF 359 and from 0.77 to 0.90 for BF, FFM, and VF by BC 532 in all subjects and in men and women separately (p < 0.001 for all). Compared with DXA, HBF 359 significantly (p < 0.001) underestimated BF by -5.8% in men and -9.6% in women. Compared with MRI, the corresponding underestimatons (negative) or overestimations (positive) by HBF 359 in men and women were, respectively, +1.9% (p = 0.02) and +1.7% (p = 0.10) for SMM, and +13.3% (p < 0.001) and -8.5% (p = 0.006), for VF. The corresponding values by BC 532 in men and women were -10.7 and -6.2% for BF, -1.4 and -2.5% for FFM, and +20.4 and -18.0% for VF. The BIA devices are accurate in the estimation of body composition, especially skeletal muscle mass or FFM.

  1. Case Study: The Effect of 32 Weeks of Figure-Contest Preparation on a Self-Proclaimed Drug-free Female's Lean Body and Bone Mass.

    PubMed

    Petrizzo, John; DiMenna, Frederick J; Martins, Kimberly; Wygand, John; Otto, Robert M

    2017-03-02

    To achieve the criterion appearance prior to competing in a physique competition, athletes undergo preparatory regimens involving high-volume intense resistance and aerobic exercise with hypocaloric energy intake. As the popularity of "drug-free" competition increases, more athletes are facing this challenge without the recuperative advantage provided by performance-enhancing drugs. Consequently, the likelihood of loss of lean body and/or bone mass is increased. The purpose of this investigation was to monitor changes in body composition for a 29-year-old self-proclaimed drug-free female figure competitor during a 32-week preparatory regimen comprising high-volume resistance and aerobic exercise with hypocaloric energy intake. We used dual-energy x-ray absorptiometry (DXA) to evaluate regional fat and bone mineral density. During the initial 22 weeks, the subject reduced energy intake and engaged in resistance (4-5 sessions/week) and aerobic (3 sessions/week) training. During the final 10 weeks, the subject increased exercise frequency to 6 (resistance) and 4 (aerobic) sessions/week while ingesting 1130-1380 kcal/day. During this 10-week period, she consumed a high quantity of protein (~55% of energy intake) and nutritional supplements. During the 32 weeks, body mass and fat mass decreased by 12% and 55%, respectively. Conversely, lean body mass increased by 1.5%, an amount that exceeded the coefficient of variation associated with DXA-derived measurement. Total bone mineral density was unchanged throughout. In summary, in preparation for a figure competition, a self-proclaimed drug-free female achieved the low body-fat percentage required for success in competition without losing lean mass or bone density by following a 32-week preparatory exercise and nutritional regimen.

  2. Use of MR-based trabecular bone microstructure analysis at the distal radius for osteoporosis diagnostics: a study in post-menopausal women with breast cancer and treated with aromatase inhibitor

    PubMed Central

    Baum, Thomas; Karampinos, Dimitrios C.; Seifert-Klauss, Vanadin; Pencheva, Tsvetelina D.; Jungmann, Pia M.; Rummeny, Ernst J.; Müller, Dirk; Bauer, Jan S.

    2016-01-01

    Summary Purpose Treatment with aromatase inhibitor (AI) is recommended for post-menopausal women with hormone-receptor positive breast cancer. However, AI therapy is known to induce bone loss leading to osteoporosis with an increased risk for fragility fractures. The purpose of this study was to investigate whether changes of magnetic resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarker can already be detected in subjects with AI intake but still without evidence for osteoporosis according to dual energy X-ray absorptiometry (DXA)-based bone mineral density (BMD) measurements as current clinical gold standard. Methods Twenty-one postmenopausal women (62±6 years of age) with hormone-receptor positive breast cancer, ongoing treatment with aromatase inhibitor for 23±15 months, and no evidence for osteoporosis (current DXA T-score greater than −2.5) were recruited for this study. Eight young, healthy women (24±2 years of age) were included as controls. All subjects underwent 3 Tesla magnetic resonance imaging (MRI) of the distal radius to assess the trabecular bone microstructure. Results Trabecular bone microstructure parameters were not significantly (p>0.05) different between subjects with AI intake and controls, including apparent bone fraction (0.42±0.03 vs. 0.42±0.05), trabecular number (1.95±0.10 mm−1 vs 1.89±0.15 mm−1), trabecular separation (0.30±0.03 mm vs 0.31±0.06 mm), trabecular thickness (0.21±0.01 mm vs 0.22±0.02 mm), and fractal dimension (1.70±0.02 vs. 1.70±0.03). Conclusion These findings suggest that the initial deterioration of trabecular bone microstructure as measured by MRI and BMD loss as measured by DXA occur not sequentially but rather simultaneously. Thus, the use of MR-based trabecular bone microstructure assessment is limited as early diagnostic biomarker in this clinical setting. PMID:27252740

  3. Placental Size Is Associated Differentially With Postnatal Bone Size and Density

    PubMed Central

    Holroyd, Christopher R; Osmond, Clive; Barker, David JP; Ring, Sue M; Lawlor, Debbie A; Tobias, Jon H; Smith, George Davey; Harvey, Nicholas C

    2016-01-01

    ABSTRACT We investigated relationships between placental size and offspring adolescent bone indices using a population‐based, mother–offspring cohort. The Avon Longitudinal Study of Parents and Children (ALSPAC) recruited pregnant women from the southwest of England between 1991 and 1993. There were 12,942 singleton babies born at term who survived at least the first 12 months. From these, 8933 placentas were preserved in formaldehyde, with maternal permission for their use in research studies. At the approximate age of 15.5 years, the children underwent a dual‐energy X‐ray absorptiometry (DXA) scan (measurements taken of the whole body minus head bone area [BA], bone mineral content [BMC], and areal bone mineral density [aBMD]). A peripheral quantitative computed tomography (pQCT) scan (Stratec XCT2000L; Stratec, Pforzheim, Germany) at the 50% tibial site was performed at this visit and at approximately age 17.7 years. In 2010 a sample of 1680 placentas were measured and photographed. To enable comparison of effect size across different variables, predictor and outcome variables were standardized to Z‐scores and therefore results may be interpreted as partial correlation coefficients. Complete placental, DXA, and pQCT data were available for 518 children at age 15.5 years. After adjustment for gender, gestational age at birth, and age at time of pQCT, the placental area was positively associated with endosteal circumference (β [95% CI]: 0.21 [0.13, 0.30], p < 0.001), periosteal circumference (β [95% CI]: 0.19 [0.10, 0.27], p < 0.001), and cortical area (β [95% CI]: 0.10 [0.01, 0.18], p = 0.03), and was negatively associated with cortical density (β [95% CI]: –0.11 [–0.20, –0.03], p = 0.01) at age 15.5 years. Similar relationships were observed for placental volume, and after adjustment for additional maternal and offspring covariates. These results suggest that previously observed associations between placental size and

  4. Association between Obesity and Bone Mineral Density by Gender and Menopausal Status

    PubMed Central

    Salamat, Mohammad Reza; Salamat, Amir Hossein

    2016-01-01

    Background We investigated whether there were gender differences in the effect of obesity on bone mineral density (BMD) based on menopausal status. Methods We assessed 5,892 consecutive patients 20 to 91 years old who were referred for dual-energy X-ray absorptiometry (DXA) scans. All subjects underwent a standard BMD scan of the hip (total hip and femoral neck) and lumbar spine (L1 to L4) using a DXA scan and body size assessment. Body mass index was used to categorize the subjects as normal weight, overweight, and obese. Results BMD was higher in obese and overweight versus normal weight men, premenopausal women, and postmenopausal women. Compared to men ≥50 years and postmenopausal women with normal weight, the age-adjusted odds ratio of osteopenia was 0.19 (95% confidence interval [CI], 0.07 to 0.56) and 0.38 (95% CI, 0.29 to 0.51) for obese men ≥50 years and postmenopausal women. Corresponding summaries for osteoporosis were 0.26 (95% CI, 0.11 to 0.64) and 0.15 (95% CI, 0.11 to 0.20), respectively. Compared to men <50 years and premenopausal women with normal weight, the age-adjusted odds ratio of low bone mass was 0.22 (95% CI, 0.11 to 0.45) and 0.16 (95% CI, 0.10 to 0.26) for obese men <50 years and premenopausal women, respectively. Conclusion Obesity is associated with BMD of the hip and lumbar spine and overweight and obese individuals have similar degrees of osteoporosis. This result was not significantly different based on gender and menopausal status, which could be an important issue for further investigation. PMID:27834082

  5. Bone Health and Osteoporosis.

    PubMed

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  6. Does a childhood fracture predict low bone mass in young adulthood? A 27-year prospective controlled study.

    PubMed

    Buttazzoni, Christian; Rosengren, Bjorn E; Tveit, Magnus; Landin, Lennart; Nilsson, Jan-Åke; Karlsson, Magnus K

    2013-02-01

    A fracture in childhood is associated with low bone mineral density (BMD), but it is debated whether a fracture at growth also predicts low BMD in young adulthood. The purpose of this work was to gender-specifically evaluate whether children with a fracture are at increased risk of low BMD in young adulthood. Distal forearm BMD (g/cm2) was measured with single-photon absorptiometry (SPA) in 47 boys and 26 girls (mean age 10 years, range 3-16 years) with an index fracture and in 41 boys and 43 girls (mean age 10 years, range 4-16 years) with no fracture. BMD was re-measured mean 27 years later with the same SPA apparatus and with dual-energy absorptiometry (DXA), quantitative ultrasound (QUS), and peripheral computed tomography (pQCT). Individual Z-scores were calculated using the control cohort as reference population. Data are presented as means with 95% confidence intervals (95% CI) within brackets and correlation with Pearson's correlation coefficient. Boys with an index fracture had at fracture event a distal forearm BMD Z-score of -0.4 (95% CI, -0.7 to -0.1) and at follow-up -0.4 (95% CI, -0.7 to -0.1). Corresponding values in girls were -0.2 (95% CI, -0.5 to 0.1) and -0.3 (95% CI, -0.7 to 0.1). The deficit in absolute bone mass was driven by men with index fractures in childhood due to low energy rather than moderate or high energy. There were no changes in BMD Z-score during the follow-up period. The BMD deficit at follow-up was in boys with an index fracture verified with all advocated techniques. A childhood fracture in men was associated with low BMD and smaller bone size in young adulthood whereas the deficit in women did not reach statistical significance.

  7. Later Age at Onset of Independent Walking Is Associated with Lower Bone Strength at Fracture-Prone Sites in Older Men.

    PubMed

    Ireland, Alex; Muthuri, Stella; Rittweger, Joern; Adams, Judith E; Ward, Kate A; Kuh, Diana; Cooper, Rachel

    2017-02-09

    Later age at onset of independent walking is associated with lower leg bone strength in childhood and adolescence. However it is unknown whether these associations persist into older age, or whether they are evident at axial (central) or upper limb sites. Therefore we examined walking age obtained at 2y and bone outcomes obtained by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans at 60-64y in a nationally-representative cohort study of British people, the MRC National Survey of Health and Development. It was hypothesised that later walking age would be associated with lower bone strength at all sites. Later independent walking age was associated with lower height-adjusted hip (standardised regression coefficients with 95%CI) [-0.179(-0.251,-0.107)], spine [-0.157(-0.232,-0.082)] and distal radius [-0.159(-0.245,-0.073)] bone mineral content (BMC, indicating bone compressive strength) in men (all P < 0.001). Adjustment for covariates partially attenuated these associations, primarily due to lower lean mass and adolescent sporting ability in later walkers. These associations were also evident for a number of hip geometric parameters (including cross-sectional moment of inertia (CSMI), indicating bone bending/torsional strength) assessed by Hip Structural Analysis (HSA) from DXA scans. Similar height-adjusted associations were also observed in women for several hip, spine and upper limb outcomes, although adjustment for fat or lean mass led to complete attenuation for most outcomes, with the exception of femoral shaft CSMI and spine bone area (BA). In conclusion, later independent walking age appears to have a lifelong association with bone strength across multiple skeletal sites in men. These effects may result from direct effects of early life loading on bone growth, and mediation by adult body composition. Results suggest that late walking age may represent a novel risk factor for subsequent low bone strength

  8. The Relationship Between Lower Limb Bone and Muscle in Military Recruits, Response to Physical Training, and Influence of Smoking Status

    PubMed Central

    Puthucheary, Zudin; Kordi, Mehdi; Rawal, Jai; Eleftheriou, Kyriacos I.; Payne, John; Montgomery, Hugh E.

    2015-01-01

    The relationship between bone and skeletal muscle mass may be affected by physical training. No studies have prospectively examined the bone and skeletal muscle responses to a short controlled exercise-training programme. We hypothesised that a short exercise-training period would affect muscle and bone mass together. Methods: Femoral bone and Rectus femoris Volumes (RFVOL) were determined by magnetic resonance imaging in 215 healthy army recruits, and bone mineral density (BMD) by Dual X-Ray Absorptiometry (DXA) and repeated after 12 weeks of regulated physical training. Results: Pre-training, RFVOL was smaller in smokers than non-smokers (100.9 ± 20.2 vs. 108.7 ± 24.5, p = 0.018; 96.2 ± 16.9 vs. 104.8 ± 21.3, p = 0.002 for dominant/non-dominant limbs), although increases in RFVOL with training (of 14.2 ± 14.5% and 13.2 ± 15.6%] respectively, p < 0.001) were independent of prior smoking status. Pre-training RFVOL was related to bone cortical volume (r2 = 0.21 and 0.30, p < 0.001 for dominant and non-dominant legs), and specifically to periosteal (r2 = 0.21 and 0.23, p < 0.001) volume. Pre-training dominant RFVOL was independently associated with Total Hip BMD (p < 0.001). Training-related increases in RFVOL and bone volumes were related. Whilst smokers demonstrated lower muscle mass than non-smokers, differences were abolished with training. Training-related increases in muscle mass were related to increases in periosteal bone volume in both dominant and non-dominant legs. PMID:25792356

  9. Bone geometry, volumetric density, microarchitecture, and estimated bone strength assessed by HR-pQCT in Klinefelter syndrome.

    PubMed

    Shanbhogue, Vikram V; Hansen, Stinus; Jørgensen, Niklas Rye; Brixen, Kim; Gravholt, Claus H

    2014-11-01

    Although the expected skeletal manifestations of testosterone deficiency in Klinefelter's syndrome (KS) are osteopenia and osteoporosis, the structural basis for this is unclear. The aim of this study was to assess bone geometry, volumetric bone mineral density (vBMD), microarchitecture, and estimated bone strength using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with KS. Thirty-one patients with KS confirmed by lymphocyte chromosome karyotyping aged 35.8 ± 8.2 years were recruited consecutively from a KS outpatient clinic and matched with respect to age and height with 31 healthy subjects aged 35.9 ± 8.2 years. Dual-energy X-ray absorptiometry (DXA) and HR-pQCT were performed in all participants, and blood samples were analyzed for hormonal status and bone biomarkers in KS patients. Twenty-one KS patients were on long-term testosterone-replacement therapy. In weight-adjusted models, HR-pQCT revealed a significantly lower cortical area (p < 0.01), total and trabecular vBMD (p = 0.02 and p = 0.04), trabecular bone volume fraction (p = 0.04), trabecular number (p = 0.05), and estimates of bone strength, whereas trabecular spacing was higher (p = 0.03) at the tibia in KS patients. In addition, cortical thickness was significantly reduced, both at the radius and tibia (both p < 0.01). There were no significant differences in indices of bone structure, estimated bone strength, or bone biomarkers in KS patients with and without testosterone therapy. This study showed that KS patients had lower total vBMD and a compromised trabecular compartment with a reduced trabecular density and bone volume fraction at the tibia. The compromised trabecular network integrity attributable to a lower trabecular number with relative preservation of trabecular thickness is similar to the picture found in women with aging. KS patients also displayed a reduced cortical area and thickness at the tibia, which in

  10. Prognostic Value of Bone Mineral Density on Curve Progression: A Longitudinal Cohort Study of 513 Girls with Adolescent Idiopathic Scoliosis

    PubMed Central

    YIP, Benjamin Hon Kei; YU, Fiona Wai Ping; WANG, Zhiwei; HUNG, Vivian Wing Yin; LAM, Tsz Ping; NG, Bobby Kin Wah; ZHU, Feng; CHENG, Jack Chun Yiu

    2016-01-01

    Osteopenia has been found to occur in about 30% of Adolescent Idiopathic Scoliosis (AIS) patients. This study aimed to investigate its prognostic value on the risk of curve progression to surgical threshold. Newly diagnosed AIS girls (N = 513) with Cobb angle 10°–40° were recruited with follow-up till maturity. Bilateral hips were assessed with dual-energy x-ray absorptiometry (DXA). Distal radius of a subgroup of 90 subjects was further assessed with high-resolution peripheral quantitative computed tomography (HR-pQCT). 55 patients progressed to surgical threshold or underwent spine surgery at the end of follow-up. Cox model with osteopenia status performed significantly better than the model without (p = 0.010). Osteopenic patients had significantly higher risk of surgery (HR2.25, p = 0.011), even after adjustment for menarche status, age and initial Cobb angle. The incremental predictive value of osteopenia was, however, not statistically significant. In the subgroup analysis, cortical bone density was identified as a better marker to improve the sensitivity of the prediction, but requires further larger study to validate this finding. These consistent results of bone density measured at different sites suggest a systemic effect, rather than local effect to the deformed spine, and support to the link of abnormal bone density to the etiopathogenesis in AIS patients. PMID:27991528

  11. Breast tumors induced by N-methyl-N-nitrosourea are damaging to bone strength, structure, and mineralization in the absence of metastasis in rats.

    PubMed

    Thorpe, Matthew P; Valentine, Rudy J; Moulton, Christopher J; Wagoner Johnson, Amy J; Evans, Ellen M; Layman, Donald K

    2011-04-01

    Current theory on the influence of breast cancer on bone describes metastasis of tumor cells to bone tissue, followed by induction of osteoclasts and bone degradation. Tumor influences on bone health in pre- or nonmetastatic models are unknown. Female rats (n = 48, 52 days old) were injected with N-methyl-N-nitrosourea (MNU) to induce breast cancer. Animals were euthanized 10 weeks later, and tumors were weighed and classified histologically. Right femurs were extracted for testing of bone mineral density (BMD) by dual X-ray absorptiometry (DXA), bone mechanical strength by three-point bending and femoral neck bending tests, and structure by micro-computed tomography (µCT). Of 48 rats, 22 developed one or more tumors in response to MNU injection by 10 weeks. Presence of any tumor predicted significantly poorer bone health in 17 of 28 measures. In tumored versus nontumored animals, BMD was adversely affected by 3%, force at failure of the femoral midshaft by 4%, force at failure of the femoral neck by 12%, and various trabecular structural parameters by 6% to 27% (all p < .05). Similarly, greater tumor burden, represented by total tumor weight, adversely correlated with bone outcomes: r = -0.51 for BMD, -0.42 and -0.35 for femur midshaft force and work at failure, and between 0.36 and 0.59 (absolute values) for trabecular architecture (all p < .05). Presence of MNU-induced tumors and total tumor burden showed a negative association with bone health of the femur in rats in the absence of metastasis. Further study is required to elucidate mechanisms for this association.

  12. Postmenopausal women with colles' fracture have lower values of bone mineral density than controls as measured by quantitative ultrasound and densitometry.

    PubMed

    Sosa, Manuel; Saavedra, P; del Pino-Montes, J; Alegre, J; Pérez-Cano, R; Guerra, G Martínez Díaz; Díaz-Curiel, M; Valero, C; Muñoz-Torres, M; Torrijos, A; Mosquera, J; Gómez-Alonso, C

    2005-01-01

    Measurement of ultrasonographic parameters provides information concerning not only bone density but also bone architecture. We investigated the usefulness of ultrasonographic parameters and bone mineral density (BMD) to evaluate the probability of Colles' fracture. Two-hundred eighty-nine postmenopausal women (62.3 +/- 8.7 yr) with (n = 76) and without (n = 213) Colles' fracture were studied. BMD of lumbar spine and proximal femur was evaluated in all women by dual-energy X-ray absorptiometry (DXA) and speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness in the calcaneus were measured by a Sahara ultrasonometer (Hologic). Patients suffering from Colles' fracture had lower values of BMD adjusted by height at the lumbar spine, L2-L4 (0.797 g/cm2 vs 0.860 g/cm2), femoral neck (0.685 g/cm2 vs 0.712 g/cm2 ), SOS (1518 m/sg vs 1525 m/sg), and stiffness (74.6 vs 77.7) (p < 0.05). Nevertheless, BUA values were similar in both groups. After stepwise logistic regression analysis, the area found under receiver operating characteristic (ROC) curves was 0.60 for L2L4 and 0.63 for a formula combining L2L4 and height. Our data suggest that patients suffering from Colles' fracture have lower values of BMD by DXA, SOS, and stiffness. However, the ability of these techniques to discriminate is low because the values for the area under ROC curve are 0.60 for L2-L4 and 0.63 for a formula derived of the combination of L2-L4 and height.

  13. The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys

    PubMed Central

    Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung

    2016-01-01

    Purpose Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. Methods A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008–2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. Results After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43–0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Conclusions Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association. PMID:26816211

  14. [MINERAL BONE DENSITY AND BODY COMPOSITION IN PARTICIPANTS IN EXPERIMENT MARS-500].

    PubMed

    Novikov, V E; Oganov, V S; Kabitskaya, O E; Murashko, L M; Naidina, V P; Chernikhova, E A

    2016-01-01

    Investigations of the bone system and body composition in Mars-500 test-subjects (prior to and on completion of the experiment) involved dual-energy X-ray absorptiometry (DXA) using the HOLOGIC Delphy densitometer and the protocol performed to examine cosmonauts. Bone density of lumber vertebrae and femoral proximal epiphysis, and body composition were measured. Reliable changes in vertebral density found in 3 test-subjects displayed different trends from +2.6 to -2.4%. At the same time, the experiment decreased significantly mineral density of the femoral proximal epiphysis, including the neck, in all test-subjects. Four test-subjects had cranial mineralization increased by 5-9%, same as in some cosmonauts after space flight. All tests-subjects incurred adipose loss from 2 to 7 kg; one test-subject lost 20 kg, i.e. his adipose mass became three times less. Changes in lean mass (1-3 kg) typically were negative; as for changes in lean mass of extremities, they could be linked with adherence to one or another type of physical activity. Therefore, extended exposure to confinement may affect mineralization of some parts of the skeleton. Unlike real space missions and long-term bedrest studies conducted at the Institute of Biomedical Problems in the past, Mars-500 did not cause clinically significant mineral losses (osteoporosis, osteopenia), probably because of the absence of effects of microgravity.

  15. Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice.

    PubMed

    Harvey, N C; Glüer, C C; Binkley, N; McCloskey, E V; Brandi, M-L; Cooper, C; Kendler, D; Lamy, O; Laslop, A; Camargos, B M; Reginster, J-Y; Rizzoli, R; Kanis, J A

    2015-09-01

    Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. In order for TBS to usefully add to bone mineral density (BMD) and clinical risk factors in osteoporosis risk stratification, it must be independently associated with fracture risk, readily obtainable, and ideally, present a risk which is amenable to osteoporosis treatment. This paper summarizes a review of the scientific literature performed by a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. Low TBS is consistently associated with an increase in both prevalent and incident fractures that is partly independent of both clinical risk factors and areal BMD (aBMD) at the lumbar spine and proximal femur. More recently, TBS has been shown to have predictive value for fracture independent of fracture probabilities using the FRAX® algorithm. Although TBS changes with osteoporosis treatment, the magnitude is less than that of aBMD of the spine, and it is not clear how change in TBS relates to fracture risk reduction. TBS may also have a role in the assessment of fracture risk in some causes of secondary osteoporosis (e.g., diabetes, hyperparathyroidism and glucocorticoid-induced osteoporosis). In conclusion, there is a role for TBS in fracture risk assessment in combination with both aBMD and FRAX.

  16. Impact of dietary intake, education, and physical activity on bone mineral density among North Indian women.

    PubMed

    Kumar, Ashok; Mittal, Soniya; Orito, Seiya; Ishitani, Ken; Ohta, Hiroaki

    2010-03-01

    The aim of the study was to determine the relationship of dietary nutrients and bone mineral density (BMD) in North Indian women. This cross-sectional study was conducted from April 2006 to March 2008. Subjects included 255 healthy women, aged 20-69 years, who were relatives of patients being admitted in the hospital. Various demographic characteristics including socioeconomic status and serum parameters in relationship to BMD were evaluated. In addition, the daily dietary intake of energy, protein, fat, and calcium and the amount of physical activity were assessed. BMD at the lumbar spine, femoral neck, and Ward's triangle was measured by dual-energy X-ray absorptiometry (DXA). Body mass index (BMI), physical activity, and educational level were positively correlated with BMD. The daily intakes of energy (1563.4 +/- 267.2 kcal) and protein (48.7 +/- 8.7 g) were below the recommended dietary allowance. Daily dietary energy, protein, and calcium intakes were correlated with BMD at the lumbar spine. Stepwise multiple linear regression analyses showed that age, BMI, and physical activity were significant predictors for BMD at all sites. In addition, energy intake was also a predictor for BMD at the lumbar spine. The protein intake was associated with BMD at the spine (P = 0.02 and beta = 0.163) even after making adjustments for energy intake. Thus, dietary pattern coupled with higher education levels and greater physical activity favored bone health.

  17. Associations of Polyunsaturated Fatty Acid Intake with Bone Mineral Density in Postmenopausal Women

    PubMed Central

    Harris, Margaret; Farrell, Vanessa; Houtkooper, Linda; Going, Scott; Lohman, Timothy

    2015-01-01

    A secondary analysis of cross-sectional data was analyzed from 6 cohorts (Fall 1995–Fall 1997) of postmenopausal women (n = 266; 56.6 ± 4.7 years) participating in the Bone Estrogen Strength Training (BEST) study (a 12-month, block-randomized, clinical trial). Bone mineral density (BMD) was measured at femur neck and trochanter, lumbar spine (L2–L4), and total body BMD using dual-energy X-ray absorptiometry (DXA). Mean dietary polyunsaturated fatty acids (PUFAs) intakes were assessed using 8 days of diet records. Multiple linear regression was used to examine associations between dietary PUFAs and BMD. Covariates included in the models were total energy intake, body weight at year 1, years after menopause, exercise, use of hormone therapy (HT), total calcium, and total iron intakes. In the total sample, lumbar spine and total body BMD had significant negative associations with dietary PUFA intake at P < 0.05. In the non-HT group, no significant associations between dietary PUFA intake and BMD were seen. In the HT group, significant inverse associations with dietary PUFA intake were seen in the spine, total body, and Ward's triangle BMD, suggesting that HT may influence PUFA associations with BMD. This study is registered with clinicaltrials.gov, identifier: NCT00000399. PMID:25785226

  18. Difference in Bone Mineral Density Change at the Lateral Femoral Cortices according to Administration of Different Bisphosphonate Agents

    PubMed Central

    Kim, Sungjun; Bang, Hyun Hee; Yoo, Hanna; Lim, Hyunsun; Jung, Woo Seok

    2016-01-01

    Background To retrospectively assess whether the response of subtrochanteric lateral cortex (STLC) is different according to the bisphosphonate agents in terms of bone mineral density (BMD) change. Methods A total of 149 subjects, who had 2- to 4-year interval follow-up of BMD using dual energy X-ray absorptiometry (DXA), were included in this retrospective study divided into following 3 groups: control group (no consumption of any anti-osteoporotic drugs, n=38), alendronate group (naïve alendronate users, n=48), risedronate group (naïve risedronate users, n=63). BMD was measured at the STLC and subtrochanteric medial cortex (STMC) in each patient by drawing rectangular ROIs at the bone cortices. The percent change of BMD at the STLC were compared between the aforementioned 3 groups by using analysis of covariance model to control five independent variables of age, body mass index, percent change of STMC, hip axis length, time interval between DXA examinations. Results The least square mean values±standard deviation of the percent change of BMD in the control, alendronate, and risedronate groups were 1.46±1.50, 2.23±1.26, and 6.96±1.11, respectively. The risedronate group showed significantly higher change of BMD percentage compared with the control (adjusted P=0.012) or alendronate (adjusted P=0.016) groups. Conclusions The percent change of BMD at the STLC in the risedronate user group was greater than the alendronate and control groups. The implication of these changes needs to be further verified. PMID:27294080

  19. Data Mining Activity for Bone Discipline: Calculating a Factor of Risk for Hip Fracture in Long-Duration Astronauts

    NASA Technical Reports Server (NTRS)

    Ellman, R.; Sibonga, J. D.; Bouxsein, M. L.

    2010-01-01

    The factor-of-risk (Phi), defined as the ratio of applied load to bone strength, is a biomechanical approach to hip fracture risk assessment that may be used to identify subjects who are at increased risk for fracture. The purpose of this project was to calculate the factor of risk in long duration astronauts after return from a mission on the International Space Station (ISS), which is typically 6 months in duration. The load applied to the hip was calculated for a sideways fall from standing height based on the individual height and weight of the astronauts. The soft tissue thickness overlying the greater trochanter was measured from the DXA whole body scans and used to estimate attenuation of the impact force provided by soft tissues overlying the hip. Femoral strength was estimated from femoral areal bone mineral density (aBMD) measurements by dual-energy x-ray absorptiometry (DXA), which were performed between 5-32 days of landing. All long-duration NASA astronauts from Expedition 1 to 18 were included in this study, where repeat flyers were treated as separate subjects. Male astronauts (n=20) had a significantly higher factor of risk for hip fracture Phi than females (n=5), with preflight values of 0.83+/-0.11 and 0.36+/-0.07, respectively, but there was no significant difference between preflight and postflight Phi (Figure 1). Femoral aBMD measurements were not found to be significantly different between men and women. Three men and no women exceeded the theoretical fracture threshold of Phi=1 immediately postflight, indicating that they would likely suffer a hip fracture if they were to experience a sideways fall with impact to the greater trochanter. These data suggest that male astronauts may be at greater risk for hip fracture than women following spaceflight, primarily due to relatively less soft tissue thickness and subsequently greater impact force.

  20. Bone mineral density reduction in adolescents with systemic erythematosus lupus: association with lack of vitamin D supplementation.

    PubMed

    Caetano, M; Terreri, M T; Ortiz, T; Pinheiro, M; Souza, F; Sarni, R

    2015-12-01

    The aim of this study is to evaluate body composition and the bone mineral density in female adolescents with juvenile systemic lupus erythematosus. Body composition (BC) and bone mineral density (BMD) were evaluated in an observational cohort study with 35 postmenarcheal adolescent females. The variables studied were as follows: current and cumulative corticosteroid dose, intake of supplements containing calcium and vitamin D, 24-h proteinuria, body mass index (BMI), and height for age (Z-score). BC was assessed using dual-energy X-ray absorptiometry (DXA) at two time points (median interval of 1.2 years). The fat mass index (FMI = fat mass in kilograms divided by the height in meters squared) and lean mass index (LMI = lean mass in kilograms divided by the height in meters squared) were calculated based on the DXA results. BMD was classified according to the International Society of Clinical Densitometry (low BMD for chronological age < -2.0 standard deviations). .The mean age of the subjects was 15.4 ± 1.8 years. Of patients, 54.3 % were normal weight, 22.8 % were overweight, 22.8 % were obese, and 8.6 % had short stature. Low BMD for chronological age was observed in 42.8 % of patients, and 60 % were not taking vitamin D. There was no significant difference between the two time points with respect to FMI, LMI, or body mass index Z-score (ZBMI); however, BMD has decreased significantly (p = 0.011). There was an association between not taking a vitamin D supplement and decreased BMD (p = 0.027). Almost half of the patients had altered nutritional status. The BMD decrease in adolescents with juvenile systemic lupus erythematosus (JSLE) was associated with the lack of vitamin D supplementation, highlighting the importance of well-defined vitamin D supplementation protocols.

  1. Associations of genetic lactase non-persistence and sex with bone loss in young adulthood.

    PubMed

    Laaksonen, Marika M L; Impivaara, Olli; Sievänen, Harri; Viikari, Jorma S A; Lehtimäki, Terho J; Lamberg-Allardt, Christel J E; Kärkkäinen, Merja U M; Välimäki, Matti; Heikkinen, Jorma; Kröger, Liisa M; Kröger, Heikki P J; Jurvelin, Jukka S; Kähönen, Mika A P; Raitakari, Olli T

    2009-05-01

    Some studies have reported that after attainment of peak bone mass (PBM), slow bone loss may occur in both men and women; however, findings are inconsistent. Genetic factors play a significant role in bone loss, but the available evidence is conflicting. Genetic lactase non-persistence (lactase C/C(-13910) genotype) is suggested to increase risk for inadequate calcium intake predisposing to poorer bone health. We investigated whether this genotype is associated with PBM and bone loss in young Finnish adults. Subjects belong to the Cardiovascular Risk in Young Finns Study that is an ongoing multi-centre follow-up of atherosclerosis risk factors. From the original cohort, randomly selected subjects aged 20-29 participated in baseline bone mineral density (BMD) measurements (n=358), and in follow-up measurements 12 years later (n=157). Bone mineral content (BMC) and BMD at lumbar spine (LS) and femoral neck (FN) were measured at baseline and follow-up with dual energy X-ray absorptiometry (DXA). Lactase C/T(-13910) polymorphism was determined by PCR and allele-specific fluorogenic probes. Information on lifestyle was elicited with questionnaires. During the follow-up, bone loss at both bone sites was greater in males (LS BMD: -1.1%, FN BMD: -5.2%) than in females (LS BMD: +2.1%, FN BMD: -0.7%) (both bone sites p=0.001). Younger age predicted greater loss of FN BMC and BMD in females (p=0.013 and p=0.001, respectively). Increased calcium intake predicted FN BMD gain in both sexes (in females B=0.007 g/cm(2)/mg, p=0.002; in males B=0.006, p=0.045), and increased physical activity LS BMD gain in females (B=0.091 g/cm(2)/physical activity point, p=0.023). PBM did not differ between the lactase genotypes, but males with the CC(-13910) genotype seemed to be prone to greater bone loss during the follow-up (LS BMD: C/C vs. T/T p=0.081). In conclusion, bone loss in young adulthood was more common in males than in females and seemed to occur mainly at the femoral neck. Young

  2. Mechanistic investigations on the etiology of Risperdal(®) Consta(®)-induced bone changes in female Wistar Hannover rats.

    PubMed

    de Waal, Eric J; Roosen, Wendy; Vinken, Petra; Vandenberghe, John; Sterkens, Patrick; Lammens, Lieve

    2012-09-28

    RISPERDAL(®) CONSTA(®) is a long-acting, intramuscular formulation of risperidone microspheres for the biweekly treatment of schizophrenia and other psychiatric disorders. In a 24-month carcinogenicity study male and female Wistar Hannover rats received RISPERDAL(®) CONSTA(®) by intramuscular injection at dosages of 5 or 40 mg/kg once every 2 weeks. Bone changes described as "osteodystrophy" were observed by routine microscopic examination at 40 mg/kg in the sternum of female rats after 12 months, and in the sternum and stifle joint of both male and female rats after 24 months of treatment, respectively. To investigate the etiology of these bone changes, a 12-month mechanistic study was conducted in female Wistar Hannover rats at dosages of 5, 20 and 40 mg/kg once every 2 weeks. In addition to routine parameters, this study included bone markers, hormone measurements, and peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) bone density measurements. It revealed a treatment-related reduction in metaphyseal trabecular bone density of the femur and tibia at 20 and 40 mg/kg, which was evident in the tibia from Week 13 of treatment onwards. There was no convincing evidence for any of the modes of action known to underlie trabecular bone loss in rats including renal, nutritional, or hepatic osteodystrophy, estrogen deficiency, hyperthyroidism or glucocorticoid excess. It is hypothetized that prolonged hyperprolactinemia accompanied by an increase in parathyroid hormone-related protein (PTHrP) levels and a slight hypoestrogenic state could have caused the reduced trabecular bone density in RISPERDAL(®) CONSTA(®)-treated rats. The relevance of this finding in terms of human risk is unknown.

  3. [Dual X-ray absorptiometry (DEXA) in children with chronic diseases].

    PubMed

    Feber, J; Janda, J; Krasnićanova, H

    2000-04-01

    Dual energy X-ray absorptiometry (DEXA) can be used for the measurement of bone density at the level of lumbar spine, whole body scan, and also for the measurement of bone mass content (BMC), lean body mass (LBM), and fat body mass (FBM). Although this method has been originally developed for the diagnosis and monitoring of osteoporosis in adults, it is used in children with chronic diseases like chronic renal failure, chronic gastrointestinal and rheumatological diseases. However, children with chronic disease often demonstrate statural growth disturbances and decreased growth velocity. Therefore, their actual height does not correspond to the actual chronological age. Normal values of DEXA for a given age are based on data from children with normal height. Interpretation of DEXA regardless of the actual height, which is usually stunted, may lead to false conclusions and wrong therapeutic attitudes. Thus, when interpreting results obtained in such patients a few transformations and calculations should be done.

  4. [Dual energy X-ray absorptiometry in Ilizarov lower extremity lengthening: preliminary study].

    PubMed

    Wroński, S; Wojciechowski, P; Wójcik, K; Kusz, D

    1999-01-01

    Ilizarov method for lower extremity lengthening has been employed in 107 patients. Some 25% of numerous complications are bony union disturbances. Dual energy X-ray absorptiometry (DEXA) for assessment of new bone formation was introduced to reduce these problems. Detailed densitometry methodology developed on the ground of 93 measurements in 11 patients is presented. Pre-operative measurement was followed by subsequent evaluations done every 3 weeks after the onset of distraction. DEXA was capable of showing the callus 3-4 weeks earlier than conventional radiography. DEXA allows for adjusting the pace of lengthening to the extent of new bone mineralization, evaluation of lengthening achieved, determining the timing for safe removal of the apparatus. The need for temporary rearranging of the apparatus and troublesome image analysis are among the drawbacks of the method.

  5. Correlation of a feline muscle mass score with body composition determined by dual-energy X-ray absorptiometry.

    PubMed

    Michel, Kathryn E; Anderson, Wendy; Cupp, Carolyn; Laflamme, Dorothy P

    2011-10-01

    Body condition scoring (BCS) systems primarily assess body fat. Both overweight and underweight animals may have loss of lean tissue that may not be noted using standard BCS systems. Catabolism of lean tissue can occur rapidly, may account for a disproportionate amount of body mass loss in sick cats and can have deleterious consequences for outcome. Therefore, along with evaluation of body fat, patients should undergo evaluation of muscle mass. The aims of the present study were first to evaluate the repeatability and reproducibility of a 4-point feline muscle mass scoring (MMS) system and second to assess the convergent validity of MMS by dual-energy X-ray absorptiometry (DXA). MMS was as follows: 3, normal muscle mass; 2, slight wasting; 1, moderate wasting; 0, severe wasting. For the first aim, forty-four cats were selected for evaluation based on age and BCS, and for the second aim, thirty-three cats were selected based on age, BCS and MMS. Cats were scored by ten different evaluators on three separate occasions. Body composition was determined by DXA. Inter- and intra-rater agreement were assessed using kappa analysis. Correlation between MMS and BCS, age, percentage lean body mass and lean body mass (LBM) was determined using Spearman's rank-order correlation. The MMS showed moderate inter-rater agreement in cats that scored normal or severely wasted (κ = 0.48-0.53). Intra-rater agreement was substantial (κ = 0.71-0.73). The MMS was significantly correlated with BCS (r 0.76, P < 0.0001), age (r - 0.75, P < 0.0001), LBM (g) (r 0.62, P < 0.0001) and percentage LBM (r - 0.49, P < 0.0035). Additional investigation is needed to determine whether the MMS can be refined and to assess its clinical applicability.

  6. Bone mineral density in MPS IV A (Morquio syndrome type A)

    PubMed Central

    Kecskemethy, Heidi H.; Kubaski, Francyne; Harcke, H.T.; Tomatsu, Shunji

    2015-01-01

    Mucopolysaccharidosis IV A (MPS IV A), Morquio A, is caused by deficiency in lysosomal enzyme N-acetylgalactosamine-6-sulfate sulfatase (GALNS), which is responsible for the catabolism of the glycosaminoglycans (GAGs) keratan sulfate (KS) and chondroitin 6-sulfate (C6S). Accumulation of GAGs results in disrupted cartilage formation and skeletal dysplasia. In this prospective cross-sectional study, bone mineral density (BMD) of the whole body (WB), lumbar spine (LS), and lateral distal femur (LDF) was acquired by dual-energy X-ray absorptiometry (DXA) on patients with MPS IV A. Functional abilities, medical history, Tanner score, and laboratory results were reviewed. Age and sex-matched norms were used to calculate Z-scores. Participants included 18 patients (13 females; 16 were unrelated) with a mean age of 21.4 years (3.3 to 40.8 years). While every patient was able to bear weight, 9 were full-time ambulators. Whole-body DXA could be obtained on only 6 patients (5 full-time ambulators) because of respiratory compromise caused by the position, presence of hardware, or positioning difficulties. Mean WB Z-score was −2.0 (range − 0.3 to −4.1). Technical issues invalidating LS DXA in 8 patients included kyphosis at the thoracolumbar junction resulting in overlap of vertebrae in the posterior-anterior view. Mean LS BMD Z-score in full-time ambulators was −3.4 (range − 1.6 to −5.0) and in the non-/partial ambulator was −4.0 (−3.7 to −4.2). Lateral distal femur BMD was acquired on every patient, and average Z-scores were −2 or less at all sites; full-time ambulators exhibited higher BMD. In conclusion, the LDF proved to be the most feasible site to measure in patients with MPS IV A. The higher LDF values in ambulators suggest this should be a consideration in promoting bone health for this group. PMID:26670863

  7. Prevalence and factors associated with low bone mineral density in Saudi women: a community based survey

    PubMed Central

    2014-01-01

    Background Low bone mineral density (BMD) is a public health issue in Saudi Arabia. This study measured the prevalence and factors associated with low BMD in Saudi women in Riyadh, Saudi Arabia. Methods A cross sectional study using two stage cluster sampling technique was conducted in Riyadh, 2009. Thirty clusters, each comprising of 300 houses were randomly chosen and from each cluster 38–40 households were selected to identify 1150 women of >40 years. Women were invited to primary health care center for filling of self-administered questionnaire (n = 1069) comprising of sociodemographic, health, diet and physical activity variables. 1008 women underwent screening for low BMD using the quantitative ultrasound technique. 535 (53%) women with positive screening test were referred to King Khalid Hospital for Dual X-ray Energy absorptiometry (DXA). Results 362 women underwent DXA and 212 (39.6%) were screened low BMD either at lumbar spine or femur neck. Mean age of women was 55.26(±8.84) years. Multivariate logistic analysis found; being aged 61 to 70 years (OR 2.75, 95% CI: 1.32-1.48), no literacy (OR 2.97, 95% CI:1.44 - 6.12) or primary education (OR 4.12, 95% CI:2.05-8.29), history of fractures (OR 2.20, 95% CI:1.03- 4.69) and not drinking laban(diluted yogurt) (OR 2.81, 95% CI:1.47- 5.37) significantly associated with low BMD. Conclusions Women with low level of education, who do not drink laban and had history of fractures were at high risk of low BMD. PMID:24400907

  8. Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density.

    PubMed

    Walsh, Marianne C; Hunter, Gary R; Livingstone, Margaret Barbara

    2006-01-01

    Sarcopenia, the decline of muscle mass with age, causes impaired gait, disability and falls. It may therefore increase the risk of fracture for osteoporotic women. The aims of this study were to determine the prevalence of sarcopenia in osteopenic and osteoporotic women, and to determine if hormone replacement therapy (HRT), diet, or physical activity (PA) has a role in the prevention of sarcopenia. One hundred and thirty-one premenopausal and 82 postmenopausal (54 taking HRT) healthy women (17-77 years) volunteered for the study. Body composition was measured by dual X-ray absorptiometry (DXA). Sarcopenia was defined as a relative skeletal muscle index (RSMI) (appendicular skeletal muscle mass divided by height) below 5.45 kg/m2. Osteopenia was defined by a densitometric t-score for bone mineral density (BMD) (g/cm2) below -1.0 and osteoporosis by a t-score below -2.5. Nutrient intake was assessed using 3-day food records and physical activity (PA) was measured using the Baecke Physical Activity Questionnaire. Pearson chi-squared, independent t-tests, simple correlation and multiple regression were used to analyze the data. In premenopausal osteopenic women the prevalence of sarcopenia was 12.5%. In postmenopausal women it was 25% for those with osteopenia, and 50% for those with osteoporosis. PA was independently related to RSMI (beta=0.222, p=0.0001), but diet and HRT were not. After adjusting for PA, RSMI was not significantly related to BMD. These data suggest that the relationship between RSMI, BMD and risk of osteoporosis may largely be mediated through participation in PA. Sarcopenia screening simultaneous to BMD examinations by DXA, may be of value in identifying osteoporotic women with sarcopenia, a group that may be most in need of exercise interventions to increase muscle and BMD.

  9. Value of clinical factors in selecting postmenopausal women with rheumatoid arthritis for bone densitometry

    PubMed Central

    Nolla, J; Fiter, J; Gomez-Vaquero, C; Alegre, J; Valverde, J; Roig-Escofet, D

    2001-01-01

    OBJECTIVE—Criteria to decide which patients with rheumatoid arthritis (RA) should be examined by dual energy x ray absorptiometry (DXA) are currently not available. The rheumatologists from Amsterdam have proposed preliminary criteria based on clinical risk factors (age, disease activity, and functional status). These criteria are preliminary and not widely accepted but might be helpful in practice. The value of the proposal in a group of Spanish postmenopausal women with RA is analysed.
METHODS—DXA (lumbar spine and femoral neck) was performed in 128 patients recruited from a clinical setting, and the proposed criteria were applied. T and Z scores were established for a Spanish reference population.
RESULTS—The mean (SD) age of the patients was 61.3 (10.7) and mean duration of the postmenopausal period 14.5 (10.1) years. Mean duration of RA was 13.7 (7.7) years. Mean C reactive protein was 22 (21) mg/l; mean erythrocyte sedimentation rate 26 (18) mm/1st h; and mean Health Assessment Questionnaire score 1.25 (0.79). Ninety (70%) patients fulfilled the proposed criteria. Their sensitivity for the diagnosis of osteoporosis (T score ⩽−2.5 SD) was 86% and their specificity, 43%. Positive predictive value was 54% and negative predictive value, 79%.
CONCLUSIONS—The proposed criteria seem a good screening method for the selection of those patients with RA whose bone mineral density should be assessed as the sensitivity and negative predictive value are acceptable.

 PMID:11454646

  10. Bone

    NASA Astrophysics Data System (ADS)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  11. A comparison of dual energy X-ray absorptiometry and bioelectrical impedance analysis to measure total and segmental body composition in healthy young adults.

    PubMed

    Leahy, Siobhan; O'Neill, Cian; Sohun, Rhoda; Jakeman, Philip

    2012-02-01

    The aim of this study was to investigate the accuracy of BIA in the measurement of total body composition and regional fat and the fat free mass in the healthy young adults. Four hundred and three healthy young adults (167 women and 236 men) aged 18-29 years were recruited from the Mid-West region of Ireland. Multi frequency, eight-polar bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) were used to measure the total body and segmental (arm, leg and trunk) fat mass and the fat free mass. BIA was found to underestimate the percentage total body fat in men and women (p < 0.001). This underestimate increased in men with >24.6% body fat and women with >32% body fat (p < 0.001). Fat tissue mass in the trunk segment was overestimated by 2.1 kg (p < 0.001) in men and underestimated by 0.4 kg (p < 0.001) in women. BIA was also found to underestimate the fat free mass in the appendages by 1.0 kg (p < 0.001) in men and 0.9 kg (p < 0.001) in women. Compared to dual energy X-ray absorptiometry, bioelectrical impedance analysis underestimates the total body fat mass and overestimates fat free mass in healthy young adults. BIA should, therefore, be used with caution in the measurement of total body composition in women and men with >25% total body fat. Though statistically significant, the small difference (~ 4%) between the methods indicates that the BIA may be used interchangeably with DXA in the measurement of appendicular fat free mass in healthy young adults.

  12. Head, Neck, Trunk and Pelvis Tissue Mass Predictions for Young Adults using Anthropometric Measures and DXA.

    PubMed

    Gyemi, Danielle L; Kahelin, Charles; George, Nicole C; Andrews, David M

    2017-03-24

    Accurate prediction of wobbling mass (WM), fat mass (FM), lean mass (LM) and bone mineral content (BMC) of living people using regression equations developed from anthropometric measures (lengths, circumferences, breadths, skinfolds) has previously been reported, but only for the extremities. Multiple linear stepwise regression was used to generate comparable equations for the head, neck, trunk and pelvis of young adults (38 males, 38 females). Equations were validated using actual tissue masses from an independent sample of 13 males and 13 females by manually segmenting full body Dual-energy X-ray Absorptiometry scans. Prediction equations exhibited adjusted R(2) values ranging from .249 to .940, with more explained variance for LM and WM than BMC and FM, especially for the head and neck. Mean relative errors between predicted and actual tissue masses ranged from -11.07% (trunk FM) to 7.61% (neck FM). Actual and predicted tissue masses from all equations were significantly correlated (R(2) = .329 to .937), except head BMC (R(2) = .046). These results show promise for obtaining in-vivo head, neck, trunk and pelvis tissue mass estimates in young adults. Further research is needed to improve head and neck FM and BMC predictions and develop tissue mass prediction equations for older populations.

  13. Ultrasound parameters and markers of bone turnover in hyperthyroidism: a longitudinal study.

    PubMed

    Acotto, C Gómez; Niepomniszcze, H; Vega, E; Mautalen, C A

    2004-01-01

    Hyperthyroid patients are characterized by accelerated bone turnover leading to bone mass loss. The aim of this study was to assess changes in quantitative ultrasound [QUS] parameters, bone mineral density (BMD), and biochemical markers of bone turnover in patients prior to and after the onset of hyperthyroid treatment. A 2-yr longitudinal study was performed on 10 women recently diagnosed with Grave's disease after starting antithyroid therapy. Six patients were postmenopausal. All patients showed evidence of thyrotoxicosis as indicated by suppressed serum TSH and high levels of total serum thyroxine. They received antithyroid therapy (methimazole and/or 131I radiodine). QUS parameters were measured using an Achilles ultrasound unit and BMD was assessed by dual-energy X-ray absorptiometry (DXA). Thyroid hormones and markers of bone turnover were determined at baseline and 6, 12, and 24 mo after the onset of treatment.Stiffness, broadband ultrasound attenuation (BUA), and speed of sound (SOS) were low at baseline compared to normal values for the same age range and increased after 2 yr of treatment. A significant increase in BMD of the lumbar spine, total skeleton, and skeletal regions (legs) was also observed after treatment. Recovery of stiffness was almost complete at 12 mo. No significant elevation was observed between 12 and 24 mo. Stiffness increased 7.6%, 10.4%, and 10.4% after 6 mo (p < 0.02), after 1 yr (p < 0.02), and after 2 yr, respectively. No significant increase in SOS and BUA was observed between 12 and 24 mo. Furthermore, recovery of total skeleton and lumbar spine BMD continued throughout the study. Successful antithyroid therapy produced a rapid increase in QUS parameters (Stiffness) and spine BMD and femoral neck during the first year of treatment and a slower increment in total skeleton (up to 24 mo). Overall, ad integrum restitution was not observed in QUS or BMD.

  14. Dental malocclusion is associated with reduced systemic bone mineral density in adolescents.

    PubMed

    Konstantynowicz, Jerzy; Sierpinska, Teresa; Kaczmarski, Maciej; Piotrowska-Jastrzebska, Janina; Golebiewska, Maria

    2007-01-01

    There is no published data about associations between the state of dentition and bone mass in adolescents. The objective of this study was to investigate whether the prevalence of caries and dental malocclusion is associated with bone mass during growth. In 123 healthy Caucasian subjects (72 males, 51 females) aged 14-18 yr, DMFT figures (decayed teeth, missing teeth, filled teeth) and presence of malocclusion, according to Angle classification, were determined. Participants completed a questionnaire regarding dental hygiene, physical activity level, and consumption of sweets. Anthropometry and pubertal stages were examined. Bone mineral density (BMD) was examined using dual energy X-ray absorptiometry (DXA) in the total body, head, and lumbar spine. No association was found between DMFT (mean+/-SD: 8.33+/-3.9) and BMD or Z-scores for BMD. Malocclusion was found in 49 subjects (39.8%) and was more prevalent in females than males. Malocclusion was associated with lower total BMD independently of body size (p=0.001; Z-scores: -0.21+/-0.27 vs +0.33+/-0.17; p=0.1) in males (but not females), producing odds ratio 1.6 (95% confidence interval: 1.09-2.34%; p=0.02). Head BMD was also lower in the males with malocclusion than in those without (p=0.004). Neither caries nor the tooth loss appear to be associated with BMD during growth. Boys with malocclusion are at higher risk of reduced BMD. This suggests that inadequate bone mass accrual in males coexists with impaired growth of the masticatory system in childhood and adolescence, however, the causal pathway is unknown. Factors that produce malocclusion may also affect bone mass or size but further prospective studies are needed to evaluate the relationship.

  15. The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development.

    PubMed

    Lappe, Joan M; Watson, Patrice; Gilsanz, Vicente; Hangartner, Thomas; Kalkwarf, Heidi J; Oberfield, Sharon; Shepherd, John; Winer, Karen K; Zemel, Babette

    2015-01-01

    Childhood and adolescence are critical periods of bone mineral content (BMC) accrual that may have long-term consequences for osteoporosis in adulthood. Adequate dietary calcium intake and weight-bearing physical activity are important for maximizing BMC accrual. However, the relative effects of physical activity and dietary calcium on BMC accrual throughout the continuum of pubertal development in childhood remains unclear. The purpose of this study was to determine the effects of self-reported dietary calcium intake and weight-bearing physical activity on bone mass accrual across the five stages of pubertal development in a large, diverse cohort of US children and adolescents. The Bone Mineral Density in Childhood study was a mixed longitudinal study with 7393 observations on 1743 subjects. Annually, we measured BMC by dual-energy X-ray absorptiometry (DXA), physical activity and calcium intake by questionnaire, and pubertal development (Tanner stage) by examination for up to 7 years. Mixed-effects regression models were used to assess physical activity and calcium intake effects on BMC accrual at each Tanner stage. We found that self-reported weight-bearing physical activity contributed to significantly greater BMC accrual in both sexes and racial subgroups (black and nonblack). In nonblack males, the magnitude of the activity effect on total body BMC accrual varied among Tanner stages after adjustment for calcium intake; the greatest difference between high- and low-activity boys was in Tanner stage 3. Calcium intake had a significant effect on bone accrual only in nonblack girls. This effect was not significantly different among Tanner stages. Our findings do not support differential effects of physical activity or calcium intake on bone mass accrual according to maturational stage. The study demonstrated significant longitudinal effects of weight-bearing physical activity on bone mass accrual through all stages of pubertal development.

  16. Combined intervention of soy isoflavone and moderate exercise prevents body fat elevation and bone loss in ovariectomized mice.

    PubMed

    Wu, Jian; Wang, Xinxiang; Chiba, Hiroshige; Higuchi, Mitsuru; Nakatani, Teruyo; Ezaki, Osamu; Cui, Hongbin; Yamada, Kazuhiko; Ishimi, Yoshiko

    2004-07-01

    Body fat accumulation and bone loss are both often associated with estrogen deficiency following menopause. In this study, we examined whether soy isoflavone, one of the phytoestrogens, and moderate exercise interventions exhibit cooperative effects on body composition and bone mass in ovariectomized (OVX) mice. Eight-week-old female mice were assigned to 6 groups: (1) sham-operated (sham); (2) OVX; (3) OVX with received a soy isoflavone diet (OVX+ISO); (4) OVX with exercised on a treadmill (OVX+EX); (5) OVX with given both isoflavone and exercise (OVX+ISO&EX ); and (6) OVX with treated with 17 beta-estradiol subcutaneously (OVX+E2). Body composition and bone mineral density (BMD) were estimated by dual-energy x-ray absorptiometry (DXA). After the 6-week intervention, whole body fat (%) in the OVX group showed significantly higher than that in the sham group. Intervention of exercise and isoflavone alone partially inhibited OVX-induced body fat gain, and the combined intervention as well as E2 treatment completely restored fat mass to the sham level. Lean body mass in the whole body was not different in OVX group compared with that in OVX+ISO, OVX+EX, and OVX+E2 groups, but it was significantly higher in OVX+ISO&EX than in other groups. BMD of the whole body, lumbar spine, or femur showed significantly reduced by OVX, and the bone loss was partially inhibited by intervention of exercise or isoflavone alone. However, the combined intervention completely restored the bone mass to the level of sham, as did E2. Serum total cholesterol was significantly increased by OVX, which was normalized by the combined intervention or E2 treatment. These results demonstrate that combined intervention of soybean isoflavone and exercise prevented body fat accumulation in the whole body with an increase in lean body mass and restoration of bone mass, and reduced high serum cholesterol in OVX mice.

  17. Diminished bone strength is observed in adult women and men who sustained a mild trauma distal forearm fracture during childhood.

    PubMed

    Farr, Joshua N; Khosla, Sundeep; Achenbach, Sara J; Atkinson, Elizabeth J; Kirmani, Salman; McCready, Louise K; Melton, L Joseph; Amin, Shreyasee

    2014-10-01

    Children and adolescents who sustain a distal forearm fracture (DFF) owing to mild, but not moderate, trauma have reduced bone strength and cortical thinning at the distal radius and tibia. Whether these skeletal deficits track into adulthood is unknown. Therefore, we studied 75 women and 75 men (age range, 20 to 40 years) with a childhood (age < 18 years) DFF and 150 sex-matched controls with no history of fracture using high-resolution peripheral quantitative computed tomography (HRpQCT) to examine bone strength (ie, failure load) by micro-finite element (µFE) analysis, as well as cortical and trabecular bone parameters at the distal radius and tibia. Level of trauma (mild versus moderate) was assigned using a validated classification scheme, blind to imaging results. When compared to sex-matched, nonfracture controls, women and men with a mild trauma childhood DFF (eg, fall from standing height) had significant reductions in failure load (p < 0.05) of the distal radius, whereas women and men with a moderate trauma childhood DFF (eg, fall while riding a bicycle) had values similar to controls. Consistent findings were observed at the distal tibia. Furthermore, women and men with a mild trauma childhood DFF had significant deficits in distal radius cortical area (p < 0.05), and significantly lower dual-energy X-ray absorptiometry (DXA)-derived bone density at the radius, hip, and total body regions compared to controls (all p < 0.05). By contrast, women and men with a moderate trauma childhood DFF had bone density, structure, and strength that did not differ significantly from controls. These findings in young adults are consistent with our observations in children/adolescents with DFF, and they suggest that a mild trauma childhood DFF may presage suboptimal peak bone density, structure, and strength in young adulthood. Children and adolescents who suffer mild trauma DFFs may need to be targeted for lifestyle interventions to help achieve improved skeletal health.

  18. Diminished Bone Strength Is Observed in Adult Women and Men Who Sustained a Mild Trauma Distal Forearm Fracture During Childhood

    PubMed Central

    Farr, Joshua N; Khosla, Sundeep; Achenbach, Sara J; Atkinson, Elizabeth J; Kirmani, Salman; McCready, Louise K; Melton, L Joseph; Amin, Shreyasee

    2015-01-01

    Children and adolescents who sustain a distal forearm fracture (DFF) owing to mild, but not moderate, trauma have reduced bone strength and cortical thinning at the distal radius and tibia. Whether these skeletal deficits track into adulthood is unknown. Therefore, we studied 75 women and 75 men (age range, 20 to 40 years) with a childhood (age <18 years) DFF and 150 sex-matched controls with no history of fracture using high-resolution peripheral quantitative computed tomography (HRpQCT) to examine bone strength (ie, failure load) by micro–finite element (µFE) analysis, as well as cortical and trabecular bone parameters at the distal radius and tibia. Level of trauma (mild versus moderate) was assigned using a validated classification scheme, blind to imaging results. When compared to sex-matched, nonfracture controls, women and men with a mild trauma childhood DFF (eg, fall from standing height) had significant reductions in failure load (p < 0.05) of the distal radius, whereas women and men with a moderate trauma childhood DFF (eg, fall while riding a bicycle) had values similar to controls. Consistent findings were observed at the distal tibia. Furthermore, women and men with a mild trauma childhood DFF had significant deficits in distal radius cortical area (p < 0.05), and significantly lower dual-energy X-ray absorptiometry (DXA)-derived bone density at the radius, hip, and total body regions compared to controls (all p < 0.05). By contrast, women and men with a moderate trauma childhood DFF had bone density, structure, and strength that did not differ significantly from controls. These findings in young adults are consistent with our observations in children/adolescents with DFF, and they suggest that a mild trauma childhood DFF may presage suboptimal peak bone density, structure, and strength in young adulthood. Children and adolescents who suffer mild trauma DFFs may need to be targeted for lifestyle interventions to help achieve improved skeletal

  19. Increased trabecular bone and improved biomechanics in an osteocalcin-null rat model created by CRISPR/Cas9 technology

    PubMed Central

    Lambert, Laura J.; Challa, Anil K.; Niu, Aidi; Zhou, Lihua; Tucholski, Janusz; Johnson, Maria S.; Nagy, Tim R.; Eberhardt, Alan W.; Estep, Patrick N.; Kesterson, Robert A.

    2016-01-01

    ABSTRACT Osteocalcin, also known as bone γ-carboxyglutamate protein (Bglap), is expressed by osteoblasts and is commonly used as a clinical marker of bone turnover. A mouse model of osteocalcin deficiency has implicated osteocalcin as a mediator of changes to the skeleton, endocrine system, reproductive organs and central nervous system. However, differences between mouse and human osteocalcin at both the genome and protein levels have challenged the validity of extrapolating findings from the osteocalcin-deficient mouse model to human disease. The rat osteocalcin (Bglap) gene locus shares greater synteny with that of humans. To further examine the role of osteocalcin in disease, we created a rat model with complete loss of osteocalcin using the CRISPR/Cas9 system. Rat osteocalcin was modified by injection of CRISPR/Cas9 mRNA into the pronuclei of fertilized single cell Sprague-Dawley embryos, and animals were bred to homozygosity and compound heterozygosity for the mutant alleles. Dual-energy X-ray absorptiometry (DXA), glucose tolerance testing (GTT), insulin tolerance testing (ITT), microcomputed tomography (µCT), and a three-point break biomechanical assay were performed on the excised femurs at 5 months of age. Complete loss of osteocalcin resulted in bones with significantly increased trabecular thickness, density and volume. Cortical bone volume and density were not increased in null animals. The bones had improved functional quality as evidenced by an increase in failure load during the biomechanical stress assay. Differences in glucose homeostasis were observed between groups, but there were no differences in body weight or composition. This rat model of complete loss of osteocalcin provides a platform for further understanding the role of osteocalcin in disease, and it is a novel model of increased bone formation with potential utility in osteoporosis and osteoarthritis research. PMID:27483347

  20. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry

    PubMed Central

    Ido, Ayumi; Nakayama, Yuki; Ishii, Kojiro; Iemitsu, Motoyuki; Sato, Koji; Fujimoto, Masahiro; Kurihara, Toshiyuki; Hamaoka, Takafumi; Satoh-Asahara, Noriko; Sanada, Kiyoshi

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40–82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle thickness (MTH) was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO) and sarcopenic obesity (SO) groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI) measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA. PMID:26700167

  1. Comparison of resting and total energy expenditure in peritoneal dialysis patients and body composition measured by dual-energy X-ray absorptiometry.

    PubMed

    El-Kateb, S; Sridharan, S; Farrington, K; Davenport, A

    2016-11-01

    Under basal resting conditions muscle metabolism is reduced, whereas metabolism increases with physical activity. We wished to determine whether there was an association between resting energy expenditure (REE) and total energy expenditure (TEE) in peritoneal dialysis (PD) patients and lean body mass (LBM). We determined REE and TEE by recently validated equations, using doubly labelled isotopic water, and LBM by dual-energy X-ray absorptiometry (DXA) scanning. We studied 87 patients, 50 male (57.4%), 25 diabetic (28.7%), mean age 60.3±17.6 years, with a median PD treatment of 11.4 (4.7-29.5) months. The mean weight was 70.1±17.7 kg with a REE of 1509±245 kcal/day and TEE 1947±378 kcal/day. REE was associated with body size (weight r=0.78 and body mass index (BMI) r=0.72) and body composition (LBM r=0.77, lean body mass index (LBMI) r=0.76, r=0.62), all P<0.001). For TEE, there was an association with weight r=0.58, BMI r=0.49 and body composition (LBM r=0.64, LBMI (r=0.54), all P<0.001). We compared LBMI measured by DXA and that estimated by the Boer equation using anthropomorphic measurements, which overestimated and underestimated LBM for smaller patients and heavier patients, respectively. Muscle metabolism is reduced at rest and increases with physical activity. Whereas previous reports based on REE did not show any association with LBM, we found an association between both REE and TEE, using a recently validated equation derived from dialysis patients, and LBM measured by DXA scanning. Estimation of muscle mass from anthropomorphic measurements systematically overestimated LBM for small patients and conversely underestimated for heavier patients.

  2. Dual-Energy X-Ray Absorptiometry, Skinfold Thickness, and Waist Circumference for Assessing Body Composition in Ambulant and Non-Ambulant Wheelchair Games Players.

    PubMed

    Willems, Annika; Paulson, Thomas A W; Keil, Mhairi; Brooke-Wavell, Katherine; Goosey-Tolfrey, Victoria L

    2015-01-01

    Field-based assessments provide a cost-effective and accessible alternative to dual-energy X-ray absorptiometry (DXA) for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n = 7) or relied on a wheelchair for sports participation only (walkers; n = 7). Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan and Weir, Durnin and Womersley, Lean et al, Gallagher et al, and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thickness and sum of 8 skinfold thickness. Results showed that non-walkers had significantly lower total lean tissue mass (46.2 ± 6.6 kg vs. 59.4 ± 8.2 kg, P = 0.006) and total body mass (65.8 ± 4.2 kg vs. 79.4 ± 14.9 kg; P = 0.05) than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to 14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thickness had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes.

  3. Bone Mineral Density Is Positively Related to Carotid Intima‐Media Thickness: Findings From a Population‐Based Study in Adolescents and Premenopausal Women

    PubMed Central

    Deere, Kevin; Lawlor, Debbie A; Benfield, Li; Tobias, Jon H; Gregson, Celia L

    2016-01-01

    ABSTRACT Osteoporosis and cardiovascular disease (CVD) are both common causes of morbidity and mortality. Previous studies, mainly of people older than 60 years, suggest a relationship between these conditions. Our aim was to determine the association between bone characteristics and CVD markers in younger and middle‐aged individuals. Women (n = 3366) and their adolescent offspring (n = 4368) from the UK population‐based cohort study, Avon Longitudinal Study of Parents and Children (ALSPAC), were investigated. We measured total body (TB) and hip bone mineral density (BMD), TB bone area (BA) and bone mineral content (BMC) by dual‐energy X‐ray absorptiometry (DXA), and carotid intima‐media thickness (cIMT) by high‐resolution ultrasound. Arterial distensibility was calculated as the difference between systolic and diastolic arterial diameters. Linear regression determined associations between bone exposures and cIMT (in adolescents) and both cIMT and arterial distensibility (in women), generating partial correlation coefficients. Mean (SD) age of women was 48 (4.2) years, body mass index (BMI) was 26.2 (5.0) kg/m2, and 71% were premenopausal. In confounder‐adjusted analyses (age, height, lean mass, fat mass, menopause, smoking, estrogen replacement, calcium/vitamin D supplementation, and education) TB and hip BMD were both positively associated with cIMT (0.071 [0.030, 0.112], p = 0.001; 0.063 [0.025, 0.101], p = 0.001, respectively). Femoral neck BMD and TB BMD, BMC, and BA were positively associated with arterial distensibility. Mean (SD) age of adolescents was 17 (0.4) years, BMI was 23 (4.1) kg/m2, and 44.5% were male. Total hip and TB measurements were positively associated with cIMT, with similar magnitudes of association to those found in their mothers. In contrast to most published findings, we identified weak positive associations between BMD and cIMT in predominantly premenopausal women and their adolescent offspring. We found

  4. t10c12-CLA maintains higher bone mineral density during aging by modulating osteoclastogenesis and bone marrow adiposity.

    PubMed

    Rahman, Md M; Halade, Ganesh V; Williams, Paul J; Fernandes, Gabriel

    2011-09-01

    Conjugated linoleic acid (CLA) has been shown to positively influence calcium and bone metabolism. Earlier, we showed that CLA (equal mixture of c9t11-CLA and t10c12-CLA) could protect age-associated bone loss by modulating inflammatory markers and osteoclastogenesis. Since, c9t11-CLA and t10c12-CLA isomers differentially regulate functional parameters and gene expression in different cell types, we examined the efficacy of individual CLA isomers against age-associated bone loss using 12 months old C57BL/6 female mice fed for 6 months with 10% corn oil (CO), 9.5% CO + 0.5% c9t11-CLA, 9.5% CO + 0.5% t10c12-CLA or 9.5% CO + 0.25% c9t11-CLA + 0.25% t10c12-CLA. Mice fed a t10c12-CLA diet maintained a significantly higher bone mineral density (BMD) in femoral, tibial and lumbar regions than those fed CO and c9t11-CLA diets as measured by dual-energy-X-ray absorptiometry (DXA). The increased BMD was accompanied by a decreased production of osteoclastogenic factors, that is, RANKL, TRAP5b, TNF-alpha and IL-6 in serum. Moreover, a significant reduction of high fat diet-induced bone marrow adiposity was observed in t10c12-CLA fed mice as compared to that of CO and c9t11-CLA fed mice, as measured by Oil-Red-O staining of bone marrow sections. In addition, a significant reduction of osteoclast differentiation and bone resorbing pit formation was observed in t10c12-CLA treated RAW 264.7 cell culture stimulated with RANKL as compared to that of c9t11-CLA and linoleic acid treated cultures. In conclusion, these findings suggest that t10c12-CLA is the most potent CLA isomer and it exerts its anti-osteoporotic effect by modulating osteoclastogenesis and bone marrow adiposity.

  5. Body Composition and Bone Mineral Density of Division 1 Collegiate Football Players, a Consortium of College Athlete Research (C-CAR) Study.

    PubMed

    Bosch, Tyler A; Carbuhn, Aaron; Stanforth, Philip R; Oliver, Jonathan M; Keller, Kathryn A; Dengel, Donald R

    2017-03-08

    The purpose of the present study was to generate normative data for total and regional body composition in Division 1 collegiate football players using dual-energy X-ray absorptiometry (DXA) and examine positional differences in total and regional measurements. Data was used from the Consortium of College Athlete Research (C-CAR) group. Four hundred-sixty-seven players were included in this study. Height, weight, total and regional fat mass, lean mass and bone mineral density were measured in each athlete in the preseason (June-August). Players were categorized by their offensive or defensive position for comparisons. Linemen tended to have the higher fat and lean mass measures (p<0.05 for all) compared to other positions. Positions that mirror each other (ex. Linemen) had similar body composition and body ratios. All positions were classified as overweight or obese based on BMI (>25 kg/m), yet other than offensive and defensive linemen, all positions had healthy percent body fat (13-20%) and low visceral fat mass (<500 g). The data presented here provide normative positional data for total and regional fat mass, lean mass, and bone density in Division 1 collegiate football players. Player position had a significant effect on body composition measures and is likely associated with on-field positional requirements. From a player health perspective, even though all positions had relatively high BMI values, the majority of positions had relatively low body fat and visceral fat, which is important for the health of players during and after their playing career. The increased accuracy and reliability of DXA provides greater information regarding positional differences in college football players compared to other methods.

  6. Bone density, microstructure and strength in obese and normal weight men and women in younger and older adulthood.

    PubMed

    Evans, Amy L; Paggiosi, Margaret A; Eastell, Richard; Walsh, Jennifer S

    2015-05-01

    Obesity is associated with greater areal BMD (aBMD) and is considered protective against hip and vertebral fracture. Despite this, there is a higher prevalence of lower leg and proximal humerus fracture in obesity. We aimed to determine if there are site-specific differences in BMD, bone structure, or bone strength between obese and normal-weight adults. We studied 100 individually-matched pairs of normal (body mass index [BMI] 18.5 to 24.9 kg/m2) and obese (BMI >30 kg/m2) men and women, aged 25 to 40 years or 55 to 75 years. We assessed aBMD at the whole body (WB), hip (TH), and lumbar spine (LS) with dual-energy X-ray absorptiometry (DXA), LS trabecular volumetric BMD (Tb.vBMD) by quantitative computed tomography (QCT), and vBMD and microarchitecture and strength at the distal radius and tibia with high-resolution peripheral QCT (HR-pQCT) and micro-finite element analysis. Serum type 1 procollagen N-terminal peptide (P1NP) and collagen type 1 C-telopeptide (CTX) were measured by automated electrochemiluminescent immunoassay (ECLIA). Obese adults had greater WB, LS, and TH aBMD than normal adults. The effect of obesity on LS and WB aBMD was greater in older than younger adults (p < 0.01). Obese adults had greater vBMD than normal adults at the tibia (p < 0.001 both ages) and radius (p < 0.001 older group), thicker cortices, higher cortical BMD and tissue mineral density, lower cortical porosity, higher trabecular BMD, and higher trabecular number than normal adults. There was no difference in bone size between obese and normal adults. Obese adults had greater estimated failure load at the radius (p < 0.05) and tibia (p < 0.01). Differences in HR-pQCT measurements between obese and normal adults were seen more consistently in the older than the younger group. Bone turnover markers were lower in obese than in normal adults. Greater BMD in obesity is not an artifact of DXA measurement. Obese adults have higher BMD, thicker and denser cortices, and higher

  7. Impaired bone health and asymptomatic vertebral compressions in fracture-prone children: a case-control study.

    PubMed

    Mäyränpää, Mervi K; Viljakainen, Heli T; Toiviainen-Salo, Sanna; Kallio, Pentti E; Mäkitie, Outi

    2012-06-01

    Frequent fractures in children may be a sign of impaired bone health, but it remains unestablished when and how fracture-prone children should be assessed. This prospective study elucidated skeletal characteristics and predisposing factors in children with recurrent fractures. Findings were used to establish guidelines for screening. During a 12-month period we recorded fracture history for all children (n = 1412) treated for an acute fracture at a large university hospital. All apparently healthy children over 4 years of age, who had sustained: (1) at least one vertebral fracture; (2) two long-bone fractures before age 10 years; or (3) three long-bone fractures before age 16 years, were recruited. They underwent dual-energy X-ray absorptiometry (DXA), laboratory tests, and spinal radiography. Information regarding family history and lifestyle factors were collected. Findings were compared with healthy controls. Sixty-six fracture-prone children (44 males, mean age 10.7 years; 5% of all children with fractures) were identified. Altogether, they had sustained 183 long-bone fractures (median 3, range 0–7); 11 children had sustained vertebral fracture(s). Patients had significantly lower bone mineral density (BMD) at lumbar spine (p < 0.001), hip (p = 0.007), and whole body (p < 0.001) than the controls; only 5 children (8%) had a BMD Z-score < −2.0. Asymptomatic vertebral compressions were prevalent, especially in those under 10 years of age. Hypercalciuria (11%) and hyperphosphaturia (22%) were significantly more prevalent than in controls. Serum concentration of 25-hydroxyvitamin D (S-25OHD) was below 50 nmol/L in 55%; low levels were associated with low BMD and vertebral compressions. The fracture-prone children had lower calcium intake, less physical activity, and more often had siblings with fractures than the controls. The findings suggest that a thorough pediatric evaluation, including DXA and spinal radiography, is often indicated

  8. CZT detector for dual-energy x-ray absorptiometry (DEXA)

    NASA Astrophysics Data System (ADS)

    Wear, James; Buchholz, Michael; Payne, Randall K.; Gorsuch, Darrell; Bisek, Joseph; Ergun, David L.; Grosholz, Joe; Falk, Ron

    2000-12-01

    A cadmium-zinc-telluride (CZT) detector has been developed for a bone densitometer that uses dual-energy x-ray absorptiometry (DEXA) to determine bone mineral density in vivo. A linear array of 16 discrete CZT detectors is used with a narrow fan-shaped x-ray beam to scan the patient. Each detector is 3 mm thick and 7 mm by 3 mm in area and has simple planar contacts. The x-ray beam has two broad energy lobes with effective energies of approximately 38 keV and approximately 65 keV. The energy sensitivity of the CZT detectors allows discrimination between low and high energy x-rays. Using DEXA, the relative difference in these two count rates permits a quantitative measurement of the real densities of bone mineral and soft tissue. The detectors demonstrate good performance characteristics and stable operation in a clinical environment. This paper discusses the suitability of CZT for use in DEXA applications and describes its successful implementation and performance in this bone densitometer.

  9. Childhood Forearm Breaks Resulting from Mild Trauma May Indicate Bone Deficits

    MedlinePlus

    ... a powerful new technology called high-resolution peripheral quantitative computed tomography (HRpQCT), which, unlike DXA, can assess ... persist throughout life. The investigators concluded that additional research is needed to determine if childhood bone weakness ...

  10. Breast Density Assessment by Dual Energy X-ray Absorptiometry in Women and Girls

    DTIC Science & Technology

    2009-07-01

    of this project among adult women and adolescent girls, who will be recruited as mothers and daughters, will be to 1. Correlate breast density...girls. Our hypotheses are as follows: 1. DXA imaging can provide a valid assessment of breast density in adult women and in young girls. 2. DXA...among adult women and adolescent girls, who will be recruited as mothers and daughters, are to: 1. Correlate breast density measured by DXA with

  11. Bone Mineral Density Is Positively Related to Carotid Intima-Media Thickness: Findings From a Population-Based Study in Adolescents and Premenopausal Women.

    PubMed

    Frysz, Monika; Deere, Kevin; Lawlor, Debbie A; Benfield, Li; Tobias, Jon H; Gregson, Celia L

    2016-12-01

    Osteoporosis and cardiovascular disease (CVD) are both common causes of morbidity and mortality. Previous studies, mainly of people older than 60 years, suggest a relationship between these conditions. Our aim was to determine the association between bone characteristics and CVD markers in younger and middle-aged individuals. Women (n = 3366) and their adolescent offspring (n = 4368) from the UK population-based cohort study, Avon Longitudinal Study of Parents and Children (ALSPAC), were investigated. We measured total body (TB) and hip bone mineral density (BMD), TB bone area (BA) and bone mineral content (BMC) by dual-energy X-ray absorptiometry (DXA), and carotid intima-media thickness (cIMT) by high-resolution ultrasound. Arterial distensibility was calculated as the difference between systolic and diastolic arterial diameters. Linear regression determined associations between bone exposures and cIMT (in adolescents) and both cIMT and arterial distensibility (in women), generating partial correlation coefficients. Mean (SD) age of women was 48 (4.2) years, body mass index (BMI) was 26.2 (5.0) kg/m(2) , and 71% were premenopausal. In confounder-adjusted analyses (age, height, lean mass, fat mass, menopause, smoking, estrogen replacement, calcium/vitamin D supplementation, and education) TB and hip BMD were both positively associated with cIMT (0.071 [0.030, 0.112], p = 0.001; 0.063 [0.025, 0.101], p = 0.001, respectively). Femoral neck BMD and TB BMD, BMC, and BA were positively associated with arterial distensibility. Mean (SD) age of adolescents was 17 (0.4) years, BMI was 23 (4.1) kg/m(2) , and 44.5% were male. Total hip and TB measurements were positively associated with cIMT, with similar magnitudes of association to those found in their mothers. In contrast to most published findings, we identified weak positive associations between BMD and cIMT in predominantly premenopausal women and their adolescent offspring. We found greater femoral

  12. High-Dose Vitamin D and Calcium Attenuates Bone Loss with Antiretroviral Therapy Initiation

    PubMed Central

    Overton, Edgar Turner; Chan, Ellen S.; Brown, Todd T.; Tebas, Pablo; McComsey, Grace A.; Melbourne, Kathleen M.; Napoli, Andrew; Hardin, William Royce; Ribaudo, Heather J.; Yin, Michael T.

    2015-01-01

    Background Antiretroviral therapy (ART) initiation for HIV-1 infection is associated with 2-6% loss in bone mineral density (BMD). Objective To evaluate vitamin D3 (4000 IU daily) plus calcium (1000 mg calcium carbonate daily) supplementation on bone loss associated with ART initiation. Design 48-week prospective, randomized, double-blind, placebo-controlled study. Setting Thirty nine AIDS Clinical Trials Network research units. Participants ART-naïve HIV-infected adults. Measurements BMD by dual-energy X-ray absorptiometry (DXA); 25-hydroxy vitamin D (25(OH)D) levels, parathyroid hormone (PTH), phosphate metabolism, markers of bone turnover and systemic inflammation. Results 165 eligible subjects were randomized (79 Vitamin D/calcium (VitD/Cal); 86 placebo); 142 subjects with evaluable DXA data were included in the primary analysis. The study arms were well-balanced at baseline: median age 33 years; 90% male; 33% non-Hispanic black; median CD4 count 341 cells/mm3; and median 25(OH)D 23 ng/mL (57 nmol/L). At 48 weeks, subjects receiving placebo had greater decline in total hip BMD than VitD/Cal: −3.19% median change (1st-3rd quartile (Q1, Q3) −5.12%, −1.02%) vs. (−1.46% −3.16%,−0.40%). respectively (p=0.001). Lumbar spine BMD loss for the two groups was similar: −2.91% (−4.84%, −1.06%) vs. −1.41% (−3.78%, 0.00%), (p=0.085). At week 48, 90% of participants achieved HIV-1 RNA <50 copies/mL. Levels of 25(OH)D3 increased in the VitD/Cal but not the placebo group: median change of 24.5 (14.6, 37.8) vs. 0.7 (−5.3, 4.3) ng/mL, respectively (p<0.001). Additionally, increases in markers of bone turnover were blunted in the VitD/Cal group. Limitations No international sites were included; only 48 weeks of follow up Conclusion Vitamin D/calcium supplementation mitigates the loss of BMD seen with initiation of efavirenz/emtricitabine/tenofovir, particularly at the total hip, which is the site of greatest concern for fragility fracture. Primary Funding

  13. Like Mother, Like Daughter? Dietary and Non-Dietary Bone Fracture Risk Factors in Mothers and Their Daughters

    PubMed Central

    SOBAS, Kamila; WADOLOWSKA, Lidia; SLOWINSKA, Malgorzata Anna; CZLAPKA-MATYASIK, Magdalena; WUENSTEL, Justyna; NIEDZWIEDZKA, Ewa

    2015-01-01

    Background: The aim of this study was to demonstrate similarities and differences between mothers and daughters regarding dietary and non-dietary risk factors for bone fractures and osteoporosis. Methods: The study was carried out in 2007–2010 on 712 mothers (29–59 years) and daughters (12–21 years) family pairs. In the sub-sample (170 family pairs) bone mineral density (BMD) was measured for the forearm by dual-energy x-ray absorptiometry (DXA). The consumption of dairy products was determined with a semi-quantitative food frequency questionnaire (ADOS-Ca) and calcium intake from the daily diet was calculated. Results: The presence of risk factors for bone fractures in mothers and daughters was significantly correlated. The Spearman rank coefficient for dietary factors of fracture risk was 0.87 (P<0.05) in whole sub-sample, 0.94 (P<0.05) in bottom tercile of BMD, 0.82 (P<0.05) in middle tercile of BMD, 0.54 (P>0.05) in upper tercile of BMD and for non-dietary factors of fracture risk was 0.83 (P<0.05) in whole sub-sample, 0.86 (P<0.05) in bottom tercile of BMD, 0.93 (P<0.05) in middle tercile of BMD, 0.65 (P<0.05) in upper tercile of BMD. Conclusions: Our results confirm the role of the family environment for bone health and document the stronger effect of negative factors of the family environment as compared to other positive factors on bone fracture risk. PMID:26576372

  14. Muscle strength is a determinant of bone mineral content in the hemiparetic upper extremity: implications for stroke rehabilitation.

    PubMed

    Pang, Marco Y C; Eng, Janice J

    2005-07-01

    Individuals with stroke have a high incidence of bone fractures and approximately 30% of these fractures occur in the upper extremity. The high risk of falls and the decline in bone and muscle health make the chronic stroke population particularly prone to upper extremity fractures. This was the first study to investigate the bone mineral content (BMC), bone mineral density (BMD), and soft tissue composition of the upper extremities and their relationship to stroke-related impairments in ambulatory individuals with chronic stroke (onset >1 year). Dual-energy X-ray absorptiometry (DXA) was used to acquire total body scans on 56 (22 women) community-dwelling individuals (>or=50 years of age) with chronic stroke. BMC (g) and BMD (g/cm2), lean mass (g), and fat mass (g) for each arm were derived from the total body scans. The paretic upper extremity was evaluated for muscle strength (hand-held dynamometry), impairment of motor function (Fugl-Meyer motor assessment), spasticity (Modified Ashworth Scale), and amount of use of the paretic arm in daily activities (Motor Activity Log). Results showed that the paretic arm had significantly lower BMC (13.8%, P<0.001), BMD (4.5%, P<0.001), and lean mass (9.0%, P<0.001) but higher fat mass (6.3%, P=0.028) than the non-paretic arm. Multiple regression analysis showed that lean mass in the paretic arm, height, and muscle strength were significant predictors (R2=0.810, P<0.001) of the paretic arm BMC. Height, muscle strength, and gender were significant predictors (R2=0.822, P<0.001) of lean mass in the paretic arm. These results highlight the potential of muscle strengthening to promote bone health of the paretic arm in individuals with chronic stroke.

  15. Muscle strength is a determinant of bone mineral content in the hemiparetic upper extremity: Implications for stroke rehabilitation

    PubMed Central

    Pang, Marco YC; Eng, Janice J

    2011-01-01

    Individuals with stroke have a high incidence of bone fractures and approximately 30% of these fractures occur in the upper extremity. The high risk of falls and the decline in bone and muscle health make the chronic stroke population particularly prone to upper extremity fractures. This was the first study to investigate the bone mineral content (BMC), bone mineral density (BMD) and soft tissue composition of the upper extremities and their relationship to stroke-related impairments in ambulatory individuals with chronic stroke (onset >1 year). Dual-energy X-ray absorptiometry (DXA) was used to acquire total body scans on 56 (22 women) community-dwelling individuals (≥50 years of age) with chronic stroke. BMC (g) and BMD (g/cm2), lean mass (g) and fat mass (g) for each arm were derived from the total body scans. The paretic upper extremity was evaluated for muscle strength (hand-held dynamometry), spasticity (Modified Ashworth Scale), impairment of motor function (Fugl-Meyer Motor Assessment) and amount of use of the paretic arm in daily activities (Motor Activity Log). Results showed that the paretic arm had significantly lower BMC (13.8%, p<0.001), BMD (4.5%, p<0.001) and lean mass (9.0%, p<0.001) but higher fat mass (6.3%, p=0.028) than the non-paretic arm. Multiple regression analysis showed that lean mass in the paretic arm, height and muscle strength were significant predictors (R2=0.810, p<0.001) of the paretic arm BMC. Height, muscle strength and gender were significant predictors (R2=0.822, p<0.001) of lean mass in the paretic arm. These results highlight the potential of muscle strengthening to promote bone health of the paretic arm in individuals with chronic stroke. PMID:15869927

  16. Differential Effects of Dietary Fat Content and Protein Source on Bone Phenotype and Fatty Acid Oxidation in Female C57Bl/6 Mice

    PubMed Central

    Sawin, Emily A.; Stroup, Bridget M.; Murali, Sangita G.; O’Neill, Lucas M.; Ntambi, James M.

    2016-01-01

    Background Glycomacropeptide (GMP) is a 64-amino acid glycophosphopeptide released from κ-casein during cheesemaking that promotes satiety, reduces body fat, increases bone mass and infers prebiotic and anti-inflammatory effects. The impact of adiposity and gender on bone health is unclear. Objective To determine how feeding female mice diets providing 60% Fat Kcal (high-fat) or 13% Fat Kcal (control) with either GMP or casein as the protein source impacts: body composition, ex vivo fatty acid oxidation, bone (femoral) biomechanical performance, and the relationship between body composition and bone. Methods Weanling female C57Bl/6 mice were fed high-fat (60% Fat Kcal) or control diets (13% Fat Kcal) with GMP or casein from 3 to 32 weeks of age with assessment of body weight and food intake. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Fatty acid oxidation was measured in liver, muscle, and fat tissues using 14C-palmitate. Plasma concentrations of hormones and cytokines were determined. Bone biomechanical performance was assessed by the 3-point bending test. Results Female mice fed high-fat diets showed increased fatty acid oxidation capacity in both gastrocnemius muscle and brown adipose tissue compared to mice fed the control diets with a lower fat content. Despite increased fat mass in mice fed the high-fat diets, there was little evidence of glucose impairment or inflammation. Mice fed the high-fat diets had significantly greater total body bone mineral density (BMD), femoral BMD, and femoral cross-sectional area than mice fed the control diets. Femora of mice fed the high-fat diets had increased yield load and maximum load before fracture, consistent with greater bone strength, but reduced post-yield displacement or ductility, consistent with bone brittleness. Female mice fed a high-fat GMP diet displayed increased fat oxidation capacity in subcutaneous fat relative to mice fed the high-fat casein diet. Regardless of dietary fat

  17. Body Segment Inertial Parameters of elite swimmers Using DXA and indirect Methods.

    PubMed

    Rossi, Marcel; Lyttle, Andrew; El-Sallam, Amar; Benjanuvatra, Nat; Blanksby, Brian

    2013-01-01

    As accurate body segment inertial parameters (BSIPs) are difficult to obtain in motion analysis, this study computed individual BSIPs from DXA scan images. Therefore, by co-registering areal density data with DXA grayscale image, the relationship between pixel color gradient and the mass within the pixel area could be established. Thus, one can calculate BSIPs, including segment mass, center of mass (COM) and moment of inertia about the sagittal axis (Ixx). This technique calculated whole body mass very accurately (%RMSE of < 1.5%) relatively to results of the generic DXA scanner software. The BSIPs of elite male and female swimmers, and young adult Caucasian males (n = 28), were computed using this DXA method and 5 other common indirect estimation methods. A 3D surface scan of each subject enabled mapping of key anthropometric variables required for the 5 indirect estimation methods. Mass, COM and Ixx were calculated for seven body segments (head, trunk, head + trunk, upper arm, forearm, thigh and shank). Between-group comparisons of BSIPs revealed that elite female swimmers had the lowest segment masses of the three groups (p < 0.05). Elite male swimmers recorded the greatest inertial parameters of the trunk and upper arms (p < 0.05). Using the DXA method as the criterion, the five indirect methods produced errors greater than 10% for at least one BSIP in all three populations. Therefore, caution is required when computing BSIPs for elite swimmers via these indirect methods, DXA accurately estimated BSIPs in the frontal plane. Key PointsElite swimmers have significantly different body segment inertial parameters than young adult Caucasian males.The errors computed from indirect BSIP estimation methods are large regardless whether applied to elite swimmers or young adult Caucasian males.No indirect estimation method consistently performed best.

  18. Trabecular volumetric bone mineral density is associated with previous fracture during childhood and adolescence in males: the GOOD study.

    PubMed

    Darelid, Anna; Ohlsson, Claes; Rudäng, Robert; Kindblom, Jenny M; Mellström, Dan; Lorentzon, Mattias

    2010-03-01

    Areal bone mineral density (aBMD) measured with dual-energy X-ray absorptiometry (DXA) has been associated with fracture risk in children and adolescents, but it remains unclear whether this association is due to volumetric BMD (vBMD) of the cortical and/or trabecular bone compartments or bone size. The aim of this study was to determine whether vBMD or bone size was associated with X-ray-verified fractures in men during growth. In total, 1068 men (aged 18.9 +/- 0.6 years) were included in the population-based Gothenburg Osteoporosis and Obesity Determinants (GOOD) Study. Areal BMD was measured by DXA, whereas cortical and trabecular vBMD and bone size were measured by peripheral quantitative computerized tomography (pQCT). X-ray records were searched for fractures. Self-reported fractures in 77 men could not be confirmed in these records. These men were excluded, resulting in 991 included men, of which 304 men had an X-ray-verified fracture and 687 were nonfracture subjects. Growth charts were used to establish the age of peak height velocity (PHV, n = 600). Men with prevalent fractures had lower aBMD (lumbar spine 2.3%, p = .005; total femur 2.6%, p = .004, radius 2.1%, p < .001) at all measured sites than men without fracture. Using pQCT measurements, we found that men with a prevalent fracture had markedly lower trabecular vBMD (radius 6.6%, p = 7.5 x 10(-8); tibia 4.5%, p = 1.7 x 10(-7)) as well as a slightly lower cortical vBMD (radius 0.4%, p = .0012; tibia 0.3%, p = .015) but not reduced cortical cross-sectional area than men without fracture. Every SD decrease in trabecular vBMD of the radius and tibia was associated with 1.46 [radius 95% confidence interval (CI) 1.26-1.69; tibia 95% CI 1.26-1.68] times increased fracture prevalence. The peak fracture incidence coincided with the timing of PHV (+/-1 year). In conclusion, trabecular vBMD but not aBMD was independently associated with prevalent X-ray-verified fractures in young men. Further studies are

  19. Complex regional pain syndrome in a competitive athlete and regional osteoporosis assessed by dual-energy X-ray absorptiometry: a case report

    PubMed Central

    2014-01-01

    Introduction Dual-energy X-ray absorptiometry is rarely utilized in the clinical care of patients with complex regional pain syndrome, but may be useful for the non-invasive determination of regional bone fragility and fracture risk, as well as muscular atrophy and regional body composition. This is the first report in the literature of complex regional pain syndrome and musculoskeletal co-morbidities in an athlete, and is the first to focus on dual-energy X-ray absorptiometry for the clinical assessment of complex regional pain syndrome. Case presentation In this report, we describe the case of a 29-year-old Caucasian man with type 1 complex regional pain syndrome. His body mass index was 29.4kg/m2 at the time of presentation. Despite severe complex regional pain syndrome in the left limb and long term use of a wheelchair, the patient participated in high-performance powerlifting. Dual-energy X-ray absorptiometry revealed marked unilateral differences in bone strength and lean mass between the affected regions and the contralateral regions. Low bone mineral density for age was found in the left hip, with Z-scores ranging from −2.2 to −3.0, and the patient had previously suffered two fractures. Bone density Z-scores in the right hip and legs were normal. Conclusions Dual-energy X-ray absorptiometry is a valuable tool for the clinical investigation of musculoskeletal health in patients with complex regional pain syndrome. Regional osteoporosis in complex regional pain syndrome patients is complicated and should be investigated and monitored. Physical activity is possible for some complex regional pain syndrome patients, depending on the type of exercise and the region affected, and it may protect bone density and strength at non affected skeletal sites. PMID:24885227

  20. Predicting Trabecular Bone Stiffness from Clinical Cone-Beam CT and HR-pQCT Data; an In Vitro Study Using Finite Element Analysis

    PubMed Central

    Moreno, Rodrigo; Brismar, Torkel B.; Pahr, Dieter H.; Smedby, Örjan

    2016-01-01

    Stiffness and shear moduli of human trabecular bone may be analyzed in vivo by finite element (FE) analysis from image data obtained by clinical imaging equipment such as high resolution peripheral quantitative computed tomography (HR-pQCT). In clinical practice today, this is done in the peripheral skeleton like the wrist and heel. In this cadaveric bone study, fourteen bone specimens from the wrist were imaged by two dental cone beam computed tomography (CBCT) devices and one HR-pQCT device as well as by dual energy X-ray absorptiometry (DXA). Histomorphometric measurements from micro-CT data were used as gold standard. The image processing was done with an in-house developed code based on the automated region growing (ARG) algorithm. Evaluation of how well stiffness (Young’s modulus E3) and minimum shear modulus from the 12, 13, or 23 could be predicted from the CBCT and HR-pQCT imaging data was studied and compared to FE analysis from the micro-CT imaging data. Strong correlations were found between the clinical machines and micro-CT regarding trabecular bone structure parameters, such as bone volume over total volume, trabecular thickness, trabecular number and trabecular nodes (varying from 0.79 to 0.96). The two CBCT devices as well as the HR-pQCT showed the ability to predict stiffness and shear, with adjusted R2-values between 0.78 and 0.92, based on data derived through our in-house developed code based on the ARG algorithm. These findings indicate that clinically used CBCT may be a feasible method for clinical studies of bone structure and mechanical properties in future osteoporosis research. PMID:27513664

  1. Bone Geometry, Volumetric Density, Microarchitecture, and Estimated Bone Strength Assessed by HR-pQCT in Adult Patients With Type 1 Diabetes Mellitus.

    PubMed

    Shanbhogue, Vikram V; Hansen, Stinus; Frost, Morten; Jørgensen, Niklas Rye; Hermann, Anne Pernille; Henriksen, Jan Erik; Brixen, Kim

    2015-12-01

    The primary goal of this cross-sectional in vivo study was to assess peripheral bone microarchitecture, bone strength, and bone remodeling in adult type 1 diabetes (T1D) patients with and without diabetic microvascular disease (MVD+ and MVD-, respectively) and to compare them with age-, gender-, and height-matched healthy control subjects (CoMVD+ and CoMVD-, respectively). The secondary goal was to assess differences in MVD- and MVD+ patients. Fifty-five patients with T1DM (MVD+ group: n = 29) were recruited from the Funen Diabetes Database. Dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT) of the ultradistal radius and tibia, and biochemical markers of bone turnover were performed in all participants. There were no significant differences in HR-pQCT parameters between MVD- and CoMVD- subjects. In contrast, MVD+ patients had larger total and trabecular bone areas (p = 0.04 and p = 0.02, respectively), lower total, trabecular, and cortical volumetric bone mineral density (vBMD) (p < 0.01, p < 0.04, and p < 0.02, respectively), and thinner cortex (p = 0.03) at the radius, and lower total and trabecular vBMD (p = 0.01 and p = 0.02, respectively) at the tibia in comparison to CoMVD+. MVD+ patients also exhibited lower total and trabecular vBMD (radius p = 0.01, tibia p < 0.01), trabecular thickness (radius p = 0.01), estimated bone strength, and greater trabecular separation (radius p = 0.01, tibia p < 0.01) and network inhomogeneity (radius p = 0.01, tibia p < 0.01) in comparison to MVD- patients. These differences remained significant after adjustment for age, body mass index, gender, disease duration, and glycemic control (average glycated hemoglobin over the previous 3 years). Although biochemical markers of bone turnover were significantly lower in MVD+ and MVD- groups in comparison to controls, they were similar between the MVD+ and MVD

  2. Pediatric data for dual X-ray absorptiometric measures of normal lumbar bone mineral density in children under 5 years of age using the lunar prodigy densitometer

    PubMed Central

    Manousaki, D.; Rauch, F.; Chabot, G.; Dubois, J.; Fiscaletti, M.; Alos, N.

    2016-01-01

    Objectives: Knowledge of physiological variations of bone mineral density (BMD) in newborns and infants is necessary to evaluate pathological changes associated with fractures. Limited reference data for children under 5 years old are available. This study provides normative data of lumbar BMD for the Lunar Prodigy in young children under 5 years old. Subjects and methods: We assessed cross-sectionally 155 healthy children (77 boys, 80% Caucasian), ranging in age from newborn to the age of 5 years. Lumbar bone mineral content (BMC) and areal BMD were measured by dual-energy X-ray absorptiometry using a Lunar Prodigy absorptiometer. Volumetric BMD was calculated using the Kroeger and Carter methods. Results: BMC and areal BMD increased from birth to 5 years (p<0.001). Volumetric BMD did not change with age. BMD and BMC correlated with age, weight and height (R2≥0.85 for all), with a maximum gain between the ages of 1 and 4 years, which did not follow the same pattern as height velocity. We did not find significant sex difference for any of the three measured parameters. Conclusion: This study provides normative data for lumbar spine densitometry of infants and young children using the Lunar Prodigy DXA system. PMID:27609039

  3. Sustained Modeling-Based Bone Formation During Adulthood in Cynomolgus Monkeys May Contribute to Continuous BMD Gains With Denosumab.

    PubMed

    Ominsky, Michael S; Libanati, Cesar; Niu, Qing-Tian; Boyce, Rogely W; Kostenuik, Paul J; Wagman, Rachel B; Baron, Roland; Dempster, David W

    2015-07-01

    Denosumab (DMAb) administration to postmenopausal women with osteoporosis is associated with continued bone mineral density (BMD) increases and low fracture incidence through 8 years, despite persistently reduced bone turnover markers and limited fluorochrome labeling in iliac crest bone biopsies. BMD increases were hypothesized to result from additional accrual of bone matrix via modeling-based bone formation-a hypothesis that was tested by examining fluorochrome labeling patterns in sections from ovariectomized (OVX) cynomolgus monkeys (cynos) treated with DMAb for 16 months. Mature OVX or Sham cynos were treated monthly with vehicle for 16 months, whereas other OVX cynos received monthly 25 or 50 mg/kg DMAb. DMAb groups exhibited very low serum bone resorption and formation biomarkers and near-absent fluorochrome labeling in proximal femur cancellous bone. Despite these reductions, femoral neck dual-energy X-ray absorptiometry (DXA) BMD continued to rise in DMAb-treated cynos, from a 4.6% increase at month 6 to 9.8% above baseline at month 16. Further examination of cortical bone in the proximal femur demonstrated consistent and prominent labeling on the superior endocortex and the inferior periosteal surface, typically containing multiple superimposed labels from month 6 to 16 over smooth cement lines, consistent with continuous modeling-based bone formation. These findings were evident in all groups. Quantitative analysis at another modeling site, the ninth rib, demonstrated that DMAb did not alter the surface extent of modeling-based labels, or the cortical area bound by them, relative to OVX controls, while significantly reducing remodeling-based bone formation and eroded surface. This conservation of modeling-based formation occurred concomitantly with increased femoral neck strength and, when coupled with a reduction in remodeling-based bone loss, is likely to contribute to increases in bone mass with DMAb treatment. Thus, this study provides preclinical

  4. Appropriate use of bone densitometry

    SciTech Connect

    Genant, H.K.; Block, J.E.; Steiger, P.; Glueer, C.C.; Ettinger, B.; Harris, S.T.

    1989-03-01

    The authors discuss current capabilities of three common bone densitometry techniques--single photon absorptiometry, dual photon absorptiometry, and quantitative computed tomography--and potential capabilities of new innovations of each of these techniques. They believe that use of bone densitometry is valid in the following four clinical applications and recommend its usage to (a) assess patients with metabolic diseases known to affect the skeleton, (b) assess perimenopausal women for initiation of estrogen replacement therapy, (c) establish a diagnosis of osteoporosis or assess its severity in the context of general clinical care, and (d) monitor the efficacy of treatment interventions or the natural course of disease.

  5. The Relationship Between Greater Prepubertal Adiposity, Subsequent Age of Maturation, and Bone Strength During Adolescence.

    PubMed

    Glass, Natalie A; Torner, James C; Letuchy, Elena M; Burns, Trudy L; Janz, Kathleen F; Eichenberger Gilmore, Julie M; Schlechte, Janet A; Levy, Steven M

    2016-07-01

    This longitudinal study investigated whether greater prepubertal adiposity was associated with subsequent timing of maturation and bone strength during adolescence in 135 girls and 123 boys participating in the Iowa Bone Development Study. Greater adiposity was defined using body mass index (BMI) data at age 8 years to classify participants as overweight (OW, ≥85th percentile for age and sex) or healthy weight (HW). Maturation was defined as the estimated age of peak height velocity (PHV) based on a series of cross-sectional estimates. Measurements were taken at ages 11, 13, 15, and 17 years for estimates of body composition by dual-energy X-ray absorptiometry (DXA), bone compression (bone strength index), and torsion strength (polar strength-strain index) at the radius and tibia by pQCT, and femoral neck bending strength (section modulus) by hip structural analysis. Bone strength in OW versus HW were evaluated by fitting sex-specific linear mixed models that included centered age (visit age - grand mean age of cohort) as the time variable and adjusted for change in fat mass, and limb length in model 1. Analyses were repeated using biological age (visit age - age PHV) as the time variable for model 1 with additional adjustment for lean mass in model 2. BMI was negatively associated with age of maturation (p < 0.05). OW versus HW girls had significantly greater bone strength (p < 0.001) in model 1, whereas OW versus HW boys had significantly greater bone strength (p < 0.001) at the tibia and femoral neck but not radius (p > 0.05). Analyses were repeated using biological age, which yielded reduced parameter estimates for girls but similar results for boys (model 1.) Differences were no longer present after adjustment for lean mass (model 2) in girls (p > 0.05) whereas differences at the tibia were sustained in boys (p < 0.05). These findings demonstrate sex- and site-specific differences in the associations between adiposity, maturation, and

  6. Wrist bone mineral density utility in diagnosing hip osteoporosis in postmenopausal women

    PubMed Central

    Eftekhar-Sadat, Bina; Ghavami, Mostafa; Toopchizadeh, Vahideh; Ghahvechi Akbari, Masood

    2016-01-01

    Background: Osteoporosis is a common bone disease that increases with age. Wrist bone mineral density (BMD) has significant correlation with other skeletal sites and it could be used as a diagnostic method for osteoporosis. The purpose of this study was to evaluate the role of wrist BMD in diagnosing osteoporosis in postmenopausal women. Methods: In this cross-sectional study, 99 postmenopausal women with mean age of 57 ± 6.9 (range 50–76) years were evaluated. BMD of nondominant wrist, lumbar spine (L2–L4) and femur bone using a dual-energy X-ray absorptiometry (DXA) device as well as lateral lumbosacral X-ray for degenerative joint disease (DJD) evaluation were measured. Mean T-score of wrist was lower than hip and lumbar area. Results: Osteopenia and osteoporosis were observed in 40.4% and 59.6% in the wrist, 38.4% and 24.2% in the hip and 36.4% and 49.5% in lumbar-spine BMD measurements, respectively. There was positive correlation between wrist BMD with hip BMD (r = 0.468,p < 0.001) and lumbar BMD (r = 0.322, p = 0.001). DJD due to lumbosacral X-ray was reported in 84 cases (84.8%) including mild DJD in 45 (53.5%), moderate DJD in 33 (39.3%) and severe DJD in 6 (7.2%). Conclusions: Our results showed that wrist BMD has better accuracy than lumbar BMD in diagnosing osteoporosis in postmenopausal women. PMID:28203357

  7. Meconium Tenofovir Concentrations and Growth and Bone Outcomes in Prenatally Tenofovir Exposed HIV-Uninfected Children

    PubMed Central

    Himes, Sarah K.; Wu, Julia W.; Jacobson, Denise L.; Tassiopoulos, Katherine; Hazra, Rohan; Kacanek, Deborah; Van Dyke, Russell B.; Rich, Kenneth C.; Siberry, George K.; Huestis, Marilyn A.

    2015-01-01

    Background Maternal tenofovir disoproxil fumarate (TDF) treatment among HIV-infected pregnant women results in fetal tenofovir (TFV) exposure. Fetal TFV toxicity was demonstrated in animals, but most clinical investigations have not observed toxicity in humans. Methods We evaluated HIV-exposed, uninfected infants in the SMARTT cohort of the Pediatric HIV/AIDS Cohort Study whose mothers were prescribed TDF for ≥8 third trimester weeks. Infant dual-energy X-ray absorptiometry (DXA) scans were obtained at 0–4 weeks to measure whole body bone mineral content (BMC). Meconium TFV concentrations were quantified by liquid chromatography-tandem mass spectrometry. Results Fifty-eight TFV-exposed infants had meconium TFV quantified. Detectable concentrations were 11–48,100 ng/g; 3 infants had undetectable concentrations. Maternal TDF prescription duration ranged from 8–41 gestational weeks; infant gestational ages were 36–41 weeks. Meconium TFV concentrations were not correlated with TFV exposure duration or timing and did not vary by concomitant prescription of protease inhibitors. Increased meconium TFV concentrations were associated with greater gestational ages (ρ=0.29, P=0.03) and lower maternal plasma HIV RNA before delivery (ρ=−0.29, P=0.04). Meconium TFV concentrations were not associated with infant weight, length (n=58), or BMC (n=49). Conclusions For the first time, we explored associations between meconium TFV concentrations and infant growth and bone measurements; we did not observe a meconium concentration-dependent relationship for these infant outcomes. These findings support other clinical research failing to show dose-response relationships for growth and bone outcomes among intrauterine TFV-exposed infants. High meconium TFV concentrations correlated with low maternal viral load, suggesting maternal TDF adherence significantly contributes to meconium TFV concentrations. PMID:25961889

  8. Regional bone density changes in anterior cruciate ligament deficient knees: a DEXA study.

    PubMed

    Bayar, Ahmet; Sarikaya, Selda; Keser, Selçuk; Ozdolap, Senay; Tuncay, Ibrahim; Ege, Ahmet

    2008-10-01

    Bone mineral density (BMD) loss is one of the secondary problems occurring in knee joint after injury of anterior cruciate ligament (ACL). The effect of this injury on BMDs of specific regions is not clear. The aim of this study was to investigate BMD changes in unreconstructed ACL-deficient knees with subregion analysis of dual energy X-ray absorptiometry (DEXA). Precision and reliability studies of DEXA revealed that two region of interests (ROI) in medial condyle, two ROIs in lateral femoral condyle (LFC) and one ROI in medial tibial plateau (MTP) in anteroposterior (AP) DXA view and one ROI for each of distal femur, proximal tibia and patella in lateral view had high reproducibility and reliability. Thirty-two patients with complete ACL ruptures were collected for the study and uninjured sides served as the control. All the patients were male with a mean age of 30 years. Mean duration of ACL rupture was 24 months. There were significant BMD losses in both ROIs of LFC and ROI of MTP in AP view and all three ROIs of lateral view. Greatest BMD losses in AP and lateral views were at MTP and patella respectively. There was a significant association between patellar BMD loss and duration after trauma. Bone bruises in lateral condyle might be the cause of selective involvement of LFC. Periarticular bone mineral loss in ACL-deficient knees has a predilection for the specified region of interest rather than uniform periarticular loss. This may be important for graft fixation or a factor in tunnel enlargement.

  9. Rapid small-animal dual-energy X-ray absorptiometry using digital radiography.

    PubMed

    Holdsworth, D W; Thornton, M M; Drost, D; Watson, P H; Fraher, L J; Hodsman, A B

    2000-12-01

    Although dual-energy X-ray absorptiometry (DEXA) is an established technique for clinical assessment of areal bone mineral density (BMD), the spatial resolution, signal-to-noise ratio, scan time, and availability of clinical DEXA systems may be limiting factors for small-animal investigations using a large number of specimens. To avoid these limitations, we have implemented a clinical digital radiography system to perform rapid area DEXA analysis on in vitro rat bone specimens. A crossed step-wedge (comprised of epoxy-based materials that mimic the radiographic properties of tissue and bone) was used to calibrate the system. Digital radiographs of bone specimens (pelvis, spine, femur, and tibia from sham-ovariectomized [SHAM] and ovariectomized [OVX] rats) were obtained at 40 kilovolt peak (kVp) and 125 kVp, and the resulting areal BMD values were compared with those obtained with a clinical fan-beam DEXA system (Hologics QDR 4500). Our investigation indicates that the cross-wedge calibrated (CWC) DEXA technique provides high-precision measurements of bone mineral content (BMC; CV = 0.6%) and BMD (CV = 0.8%) within a short acquisition time (<30 s). Areal BMD measurements reported by the CWC-DEXA system are within 8.5% of those reported by a clinical fan-beam scanner, and BMC values are within 5% of the known value of test specimens. In an in vivo application, the CWC-DEXA system is capable of reporting significant differences between study groups (SHAM and OVX) that are not reported by a clinical fan-beam DEXA system, because of the reduced variance and improved object segmentation provided by the CWC-DEXA system.

  10. Maternal gestational vitamin D supplementation and offspring bone health: a multicentre randomised, double-blind, placebo-controlled trial (MAVIDOS)

    PubMed Central

    Cooper, Cyrus; Harvey, Nicholas C; Bishop, Nicholas J; Kennedy, Stephen; Papageorghiou, Aris T; Schoenmakers, Inez; Fraser, Robert; Gandhi, Saurabh V; Carr, Andrew; D’Angelo, Stefania; Crozier, Sarah R; Moon, Rebecca J; Arden, Nigel K; Dennison, Elaine M; Godfrey, Keith M; Inskip, Hazel M; Prentice, Ann; Mughal, M. Zulf; Eastell, Richard; Reid, David M; Javaid, M Kassim

    2016-01-01

    Background Maternal vitamin D status has been associated with lower bone mass of the offspring in many, but not all, observational studies. However, proof that maternal vitamin D repletion during pregnancy improves offspring bone mass is lacking. Methods Between 06/10/2008 and 11/02/2014, we randomly assigned pregnant women with a serum 25-hydroxyvitamin D [25(OH)D] 25-100nmol/l at 12 weeks’ gestation to either 1000IU/day cholecalciferol or matched placebo from 14 weeks’ gestation until delivery. Serum 25(OH)D was measured at 14 and 34 weeks’ gestation. Neonatal whole body bone mineral, assessed within 2 weeks after birth (n=665) by dual-energy X-ray absorptiometry (DXA), was the primary outcome. Secondary pre-specified analyses explored interactions with study centre, maternal ethnicity, parity, compliance, protocol completion, baseline BMI, baseline 25(OH)D and change in 25(OH)D from 14 to 34 weeks; and offspring sex and season of birth. Findings We found no difference in neonatal whole body bone mineral content (BMC) of infants born to mothers randomised to 1000IU/day cholecalciferol compared with infants born to mothers randomised to placebo [61.6g (95%CI: 60.3, 62.8g) vs 60.5g (95%CI: 59.3, 61.7g) respectively, p=0.21]. Interpretation Supplementation of mothers with 1000IU/day cholecalciferol during pregnancy did not lead to increased offspring whole body BMC compared with placebo. PMID:26944421

  11. Relevance of 2D radiographic texture analysis for the assessment of 3D bone micro-architecture

    SciTech Connect

    Apostol, Lian; Boudousq, Vincent; Basset, Oliver; Odet, Christophe; Yot, Sophie; Tabary, Joachim; Dinten, Jean-Marc; Boller, Elodie; Kotzki, Pierre-Olivier; Peyrin, Francoise

    2006-09-15

    Although the diagnosis of osteoporosis is mainly based on dual x-ray absorptiometry, it has been shown that trabecular bone micro-architecture is also an important factor in regard to fracture risk. In vivo, techniques based on high-resolution x-ray radiography associated to texture analysis have been proposed to investigate bone micro-architecture, but their relevance for giving pertinent 3D information is unclear. Thirty-three calcaneus and femoral neck bone samples including the cortical shells (diameter: 14 mm, height: 30-40 mm) were imaged using 3D-synchrotron x-ray micro-CT at the ESRF. The 3D reconstructed images with a cubic voxel size of 15 {mu}m were further used for two purposes: (1) quantification of three-dimensional trabecular bone micro-architecture (2) simulation of realistic x-ray radiographs under different acquisition conditions. The simulated x-ray radiographs were then analyzed using a large variety of texture analysis methods (co-occurrence, spectral density, fractal, morphology, etc.). The range of micro-architecture parameters was in agreement with previous studies and rather large, suggesting that the population was representative. More than 350 texture parameters were tested. A small number of them were selected based on their correlation to micro-architectural morphometric parameters. Using this subset of texture parameters, multiple regression allowed one to predict up to 93% of the variance of micro-architecture parameters using three texture features. 2D texture features predicting 3D micro-architecture parameters other than BV/TV were identified. The methodology proposed for evaluating the relationships between 3D micro-architecture and 2D texture parameters may also be used for optimizing the conditions for radiographic imaging. Further work will include the application of the method to physical radiographs. In the future, this approach could be used in combination with DXA to refine osteoporosis diagnosis.

  12. The effect of menarche age, parity and lactation on bone mineral density in premenopausal ambulatory multiple sclerosis patients.

    PubMed

    Sioka, Chrissa; Fotopoulos, Andreas; Papakonstantinou, Stilianos; Georgiou, Athanasia; Pelidou, Sygliti-Henrietta; Kyritsis, Athanasios P; Kalef-Ezra, John A

    2015-07-01

    Although pregnancy and breast-feeding do not have any deleterious effect on disease activity in female multiple sclerosis (MS) patients, their role on bone mineral density (BMD) and osteoporosis risk is unknown. We investigated the role of age at menarche, parity and lactation on BMD expressed as percentage of the mean BMD (%BMD) in 46 pre-menopausal ambulatory female MS patients using dual-energy X-ray absorptiometry (DXA) scans in lumbar spine (LS) and hip. MS female patients with age at menarche ≥13 years old had reduced %BMD compared to those with menarche age <13 years (95.2±10.7 vs 102.1±13.3, p=0.05 in LS; 90.5±12.6 vs 99.8±12.6, p=0.02 in hip). Parity did not result in any statistically significant changes in either LS or hip. Patients that breastfed their offspring compared to those that did not had significantly lower BMD in both LS (93.9±9.3 vs 110.7±15.6, p=0.004) and hip (91.6±10.7 vs 105.6±15.3, p=0.02). MS female patients with menarche at age≥13 years and those who breastfed their offspring may have reduced BMD. Larger studies are needed to verify these findings and establish a definite role of menarche age and breast feeding with BMD.

  13. Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: the osteoporotic fractures in men (MrOS) study.

    PubMed

    Sheu, Yahtyng; Zmuda, Joseph M; Boudreau, Robert M; Petit, Moira A; Ensrud, Kristine E; Bauer, Douglas C; Gordon, Christopher L; Orwoll, Eric S; Cauley, Jane A

    2011-01-01

    Many fractures occur in individuals without osteoporosis defined by areal bone mineral density (aBMD). Inclusion of other aspects of skeletal strength may be useful in identifying at-risk subjects. We used surrogate measures of bone strength at the radius and tibia measured by peripheral quantitative computed tomography (pQCT) to evaluate their relationships with nonvertebral fracture risk. Femoral neck (FN) aBMD, measured by dual-energy X-ray absorptiometry (DXA), also was included. The study population consisted of 1143 white men aged 69+ years with pQCT measures at the radius and tibia from the Minneapolis and Pittsburgh centers of the Osteoporotic Fractures in Men (MrOS) study. Principal-components analysis and Cox proportional-hazards modeling were used to identify 21 of 58 pQCT variables with a major contribution to nonvertebral incident fractures. After a mean 2.9 years of follow-up, 39 fractures occurred. Men without incident fractures had significantly greater bone mineral content, cross-sectional area, and indices of bone strength than those with fractures by pQCT. Every SD decrease in the 18 of 21 pQCT parameters was significantly associated with increased fracture risk (hazard ration ranged from 1.4 to 2.2) independent of age, study site, body mass index (BMI), and FN aBMD. Using area under the receiver operation characteristics curve (AUC), the combination of FN aBMD and three radius strength parameters individually increased fracture prediction over FN aBMD alone (AUC increased from 0.73 to 0.80). Peripheral bone strength measures are associated with fracture risk and may improve our ability to identify older men at high risk of fracture.

  14. Effects of eight-month treatment with ONO-5334, a cathepsin K inhibitor, on bone metabolism, strength and microstructure in ovariectomized cynomolgus monkeys.

    PubMed

    Ochi, Yasuo; Yamada, Hiroyuki; Mori, Hiroshi; Nakanishi, Yasutomo; Nishikawa, Satoshi; Kayasuga, Ryoji; Kawada, Naoki; Kunishige, Akiko; Hashimoto, Yasuaki; Tanaka, Makoto; Sugitani, Masafumi; Kawabata, Kazuhito

    2014-08-01

    This study examined the effect of ONO-5334, a cathepsin K inhibitor, on bone turnover, mineral density (BMD), mechanical strength and microstructure in ovariectomized (OVX) cynomolgus monkeys. Vehicle, ONO-5334 (3, 10 or 30 mg/kg) or alendronate (0.5 mg/kg) was orally administered for eight months to sham- and OVX-operated monkeys. ONO-5334 dose-dependently suppressed OVX-induced increase in bone turnover markers (urinary C-terminal cross-linking telopeptide of type I collagen (CTX) and serum osteocalcin). At the dose of 30 mg/kg, ONO-5334 maintained urinary CTX at nearly zero level and kept serum osteocalcin around the level of the sham animals. Marker levels in the alendronate-treated animals were similar to those in the sham animals throughout the study. ONO-5334 dose-dependently reversed the effect of OVX on vertebral BMD as measured by dual-energy X-ray absorptiometry (DXA) with improvement of bone mechanical strength. Both ONO-5334 and alendronate suppressed OVX-induced changes in vertebral microstructure and turnover state. In the femoral neck, peripheral quantitative computed tomography (pQCT) analysis showed that ONO-5334 increased total and cortical BMD. In particular, ONO-5334 significantly increased cortical BMD with improvement of bone mechanical strength. In microstructural analysis, alendronate suppressed OVX-induced increase in femoral mid-shaft osteonal bone formation rate (BFR) to a level below that recorded in the sham group, whereas ONO-5334 at 30 mg/kg did not suppress periosteal, osteonal and endocortical BFR. This finding supports the significant effect of ONO-5334 on cortical BMD and mechanical strength in the femoral neck. The results of this study suggest that ONO-5334 has good therapeutic potential for the treatment of osteoporosis.

  15. Bone fragility and imaging techniques

    PubMed Central

    D’Elia, Giovanni; Caracchini, Giuseppe; Cavalli, Loredana; Innocenti, Paolo

    2009-01-01

    Bone fragility is a silent condition that increases bone fracture risk, enhanced by low bone mass and microarchitecture deterioration of bone tissue that lead to osteoporosis. Fragility fractures are the major clinical manifestation of osteoporosis. A large body of epidemiological data indicates that the current standard for predicting fragility fracture risk is an areal BMD (aBMD) measurement by DXA. Although mineral density measurements assess the quantity of bone, the quality of the tissue is an important predictor of fragility. Thus, bone strength is explained not only by BMD but also by macrostructural and microstructural characteristics of bone tissue. Imaging diagnostics, through the use of X-rays, DXA, Ultrasonography, CT and MR, provides methods for diagnosis and characterization of fractures, and semi- and quantitative methods for assessment of bone consistency and strength, that become precious for bone fragility clinical management if they are integrated by clinical risk factors. The last employment of sophisticated non-invasively imaging techniques in clinical research as high-resolution CT (hrCT), microCT (μ-CT), high-resolution MR (hrMR) and, microRM (μRM), combined with finite element analysis methods, open to new challenges in a better bone strength assessment to enhance the comprehension of biomechanical parameters and the prediction of fragility fractures. PMID:22461252

  16. Bone densitometry in infants

    SciTech Connect

    Barden, H.S.; Mazess, R.B.

    1988-07-01

    Bone mineral mass and density can be measured noninvasively by various absorptiometric procedures. Two methods, dual-photon absorptiometry (DPA) and quantitative computed tomography, have widespread application in adults but only limited use in children. One method, single-photon absorptiometry (SPA), has been used extensively in adults and children and has been modified for use in infants. The radius shaft has been used for most research on infants. However, the difficulty of using older SPA methods on this small bone (4 to 7 mm width) has led a few investigators to measure the shaft of the humerus. The typical precision of measurement in a newborn is about 5% with the use of computerized rectilinear scanners for the radius; older linear scanners have a precision error of 5% to 10% on the humerus. Linear scanners cannot measure precisely the radius in individual neonates. The SPA scans typically take about 5 minutes. The DPA technique using /sup 153/Gd has been modified for use on smaller animals (5 to 10 kg monkeys and dogs), but it has not been used on infants because DPA scans take 20 minutes. New methods using x-ray absorptiometry allow rapid (1 minute), precise (1%) measurements in the perinate. The need for a soft tissue bolus is eliminated, and both the axial and peripheral skeletons can be measured with dual-energy x-ray absorptiometry. Ultrasonic measurements do not yet offer adequate precision in the neonate, given the limited biologic range of values. 83 references.

  17. Hydrolyzed collagen improves bone metabolism and biomechanical parameters in ovariectomized mice: an in vitro and in vivo study.

    PubMed

    Guillerminet, Fanny; Beaupied, Hélène; Fabien-Soulé, Véronique; Tomé, Daniel; Benhamou, Claude-Laurent; Roux, Christian; Blais, Anne

    2010-03-01

    Collagen has an important structural function in several organs of the body, especially in bone and cartilage. The aim of this study was to investigate the effect of hydrolyzed collagen on bone metabolism, especially in the perspective of osteoporosis treatment and understanding of its mechanism of action. An in vivo study was carried out in 12-week-old female C3H/HeN mice. These were either ovariectomized (OVX) or sham-operated (SHAM) and fed for 12 weeks with a diet containing 10 or 25 g/kg of hydrolyzed collagen. We measured bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). C-terminal telopeptide of type I collagen (CTX), marker of bone resorption, and alkaline phosphatase (ALP), marker of bone formation, were assayed after 4 and 12 weeks. Femur biomechanical properties were studied by a 3-point bending test and bone architecture by microtomography. The BMD for OVX mice fed the diet including 25 g/kg of hydrolyzed collagen was significantly higher as compared to OVX mice. The blood CTX level significantly decreased when mice were fed with either of the diets containing hydrolyzed collagen. Finally, we have shown a significant increase in bone strength correlated to geometrical changes for the OVX mice fed the 25 g/kg hydrolyzed collagen diet. Primary cultures of murine bone cells were established from the tibia and femur marrow of BALB/c mice. The growth and differentiation of osteoclasts and osteoblasts cultured with different concentrations (from 0.2 to 1.0 mg/mL) of bovine, porcine or fish hydrolyzed collagens (2 or 5 kDa) were measured. Hydrolyzed collagens (2 or 5 kDa) in the tissue culture medium did not have any significant effects on cell growth as compared to controls. However, there was a significant and dose-dependent increase in ALP activity, a well-known marker of osteogenesis, and a decrease in octeoclast activity in primary culture of bone cells cultured with hydrolyzed collagens (2 kDa only) as compared to the control. It

  18. Determinants of bone mineral density in immobilization: a study on hemiplegic patients.

    PubMed

    del Puente, A; Pappone, N; Mandes, M G; Mantova, D; Scarpa, R; Oriente, P

    1996-01-01

    Osteoporosis that develops during immobilization is a severe condition that confers increased risk of fractures with their burden of mortality and disability. The aim of this study was to investigate the determinants of immobilization osteoporosis. As a model of this condition we studied hemiplegic subjects, measuring bone mineral density in the paralyzed lower limb as compared with the non-paralyzed one. In spite of the limits related to the loss of nervous stimulation, this model offers the advantage of a proper control for the complex genetic and environmental cofactors involved. We examined 48 hemiplegic subjects (31 men, 17 women in menopause) admitted consecutively over a 9-month period. Mean length immobilization was 10.9 months for men (range 1-48 months) and 7.8 months for women (range 1-40 months). The average time since menopause was 14.9 years (range 1.7-23.9 years). For each subject the following were performed: questionnaire, medical examination, anthropometric measurements, evaluation of the scores for spasticity and for lower limb motor capacity in order to account for the different degrees of disability among patients. Bone mineral density was measured using dual-energy X-ray absorptiometry (DXA) at both femoral necks. For each patient we defined a percentage difference in bone loss between the paralyzed and non-paralyzed limb. Regression coefficient were calculated by multiple logistic regression. There was significant bone loss in the paralyzed limb in both sexes, accounting for up to 6.3% in women. Multiple regression analysis showed that the degree of bone loss depends significantly and directly on the length of immobilization, even when controlling for age and sex in the regression model (R = 0.193, p = 0.034). However, when time since menopause was included in the regression model, with length of immobility as a covariate, it was the only significant determinant of bone loss (R = 0.312, p = 0.039). No additional factors were observed among

  19. Optimal management of cancer treatment-induced bone loss: considerations for elderly patients.

    PubMed

    Tipples, Karen; Robinson, Anne

    2011-11-01

    Hormone manipulation, commonly used in breast and prostate cancer, can result in significant bone loss. In multiple myeloma (MM), corticosteroids play an important role in therapy but increase the risk of fracture over that expected for any given bone mineral density. These adverse effects on the skeletal system are particularly relevant in the elderly population, in whom osteoporosis can significantly affect not only quality of life but also survival. The associated health and social care costs are becoming increasingly important. Screening with dual energy x-ray absorptiometry (DXA) scans and lifestyle advice on smoking, alcohol and dietary intake are essential parts of the management of patients with cancer treatment-induced bone loss. The value of exercise also cannot be underestimated. A careful drug review should be carried out to eliminate agents that may potentially exacerbate bone toxicity. Therapies to address bone toxicities include bisphosphonates, which have been shown to play an increasingly important role in preventing declines in bone health. The issues of compliance when oral agents are used should not be underestimated. Renal toxicity and osteonecrosis of the jaw are relevant toxicities, especially in the elderly. Cardiac toxicity has not been proven, but there is evidence to suggest that the suppression of bone turnover seen with some, although not all, bisphosphonates is not reversed following cessation of treatment. The implications of this finding need to be borne in mind when treating elderly patients. The possibility of atypical fractures in patients taking bisphosphonates also needs to be given consideration, although this remains a rare complication. Recently, the receptor activator of nuclear factor-κB ligand (RANKL) ligand antibody denosumab has been shown to be of value in fracture prevention, and its subcutaneous route of administration offers a potential advantage. Oncologists should also remember that tamoxifen, which has little

  20. Pubertal timing and bone phenotype in early old age: findings from a British birth cohort study

    PubMed Central

    Kuh, Diana; Muthuri, Stella G; Moore, Adam; Cole, Tim J; Adams, Judith E; Cooper, Cyrus; Hardy, Rebecca; Ward, Kate A

    2016-01-01

    Objectives To investigate the effect of pubertal timing, assessed in adolescence, on bone size, strength and density in men and women in early old age Design A British birth cohort study with prospective indicators of pubertal timing based on age at menarche, clinical assessment of pubertal stage, and growth tempo from serial height measures, and bone measures derived from peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) at 60-64 years on 866 women and 792 men. Methods A first set of regression models investigated the relationships between pubertal timing and bone size, strength and density, adjusting for current height and weight, smoking and adult socioeconomic position. To make an equivalent comparison between men and women, the percentage difference in bone outcomes was calculated for a five-year difference in age at menarche, and in men a comparison between those who were fully mature or pre-adolescent at 14.5 years. A second set of models investigated the percentage difference in bone outcomes for a 5-year difference in timing of peak height velocity (height tempo) derived from longitudinal growth modelling (SITAR). Results After adjustment for current height and weight, a 5-year increase in age at menarche was associated with an 8% (95% CI -17%, 0.5%, p=0.07) lower trabecular volumetric bone mineral density (vBMD); men who were pre-adolescent at 14.5 years had a 9%, (95%CI -14%,-4%; p=.001) lower trabecular vBMD compared with those who had been fully mature. Other confounders did not attenuate these estimates further. Patterns of association were similar but somewhat weaker for lumbar spine and total hip areal BMD. Age at peak height velocity was associated with even larger differences in BMD in men and women, and was negatively associated with bone size and strength. Conclusions The association between later puberty and lower BMD persists into early old age. The 9-10% lower trabecular vBMD in later compared with

  1. Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group.

    PubMed

    Reid, David M; Doughty, Julie; Eastell, Richard; Heys, Steven D; Howell, Anthony; McCloskey, Eugene V; Powles, Trevor; Selby, Peter; Coleman, Robert E

    2008-01-01

    In postmenopausal women, the use of aromatase inhibitors increases bone turnover and induces bone loss at sites rich in trabecular bone at an average rate of 1-3% per year leading to an increase in fracture incidence compared to that seen during tamoxifen use. The bone loss is much more marked in young women with treatment-induced ovarian suppression followed by aromatase inhibitor therapy (average 7-8% per annum). Pre-treatment with tamoxifen for 2-5 years may reduce the clinical significance of the adverse bone effects associated with aromatase inhibitors, particularly if this leads to a shortening in the duration of exposure to an aromatase inhibitor. However, skeletal status should still be assessed at the commencement of aromatase inhibitor therapy. The rate of bone loss in women who experience a premature menopause before the age of 45 or are receiving ovarian suppression therapy is accelerated by the concomitant use of aromatase inhibitors. These patients are considered to be at high risk of clinically important bone loss and should have a baseline dual energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD). Randomised clinical trials in postmenopausal women indicate that bisphosphonates prevent the bone loss and accelerated bone turnover associated with aromatase inhibitor therapy and are a promising strategy for the prevention and treatment of osteoporosis in this setting. Treatment initiation recommendations are based on a combination of risk factors for osteoporotic fracture and BMD levels. Bisphosphonates, along with a healthy lifestyle and adequate intake of calcium and vitamin D are the treatments of choice to prevent bone loss. Due to the rate of bone loss associated with breast cancer treatments, and uncertainties about the interaction between aromatase inhibitor use and BMD for fracture risk, the threshold for intervention has been set at a higher level than that generally recommended for postmenopausal osteoporosis. Management

  2. A two-year program of aerobics and weight training enhances bone mineral density of young women

    NASA Technical Reports Server (NTRS)

    Friedlander, A. L.; Genant, H. K.; Sadowsky, S.; Byl, N. N.; Gluer, C. C.

    1995-01-01

    Previous research suggests that physical activity may have a beneficial effect on bone mineral density (BMD) in women. This relationship was explored in a 2-year, randomized, intervention trial investigating the efficacy of exercise and calcium supplementation on increasing peak bone mass in young women. One hundred and twenty-seven subjects (ages of 20-35 years) were randomly assigned either to an exercise program that contained both aerobics and weight training components or to a stretching program. Calcium supplementation (up to 1500 mg/day including dietary intake) or placebo was given in a double-blinded design to all subjects. Spinal trabecular BMD was determined using quantitative computed tomography (QCT). Spinal integral, femoral neck, and trochanteric BMD were measured by dual X-ray absorptiometry (DXA) and calcaneal BMD by single photon absorptiometry (SPA). Fitness variables included maximal aerobic capacity (VO2max), and isokinetic muscle performance of the trunk and thigh. Measurements were made at baseline, 1 year, and 2 years. Sixty-three subjects (32 exercise, 31 stretching) completed the study, and all the measured bone parameters indicated a positive influence of the exercise intervention. There were significant positive differences in BMD between the exercise and stretching groups for spinal trabecular (2.5%), femoral neck (2.4%), femoral trochanteric (2.3%), and calcaneal (6.4%) measurements. The exercise group demonstrated a significant gain in BMD for spinal integral (1.3 +/- 2.8%, p < 0.02), femoral trochanteric (2.6 +/- 6.1%, p < 0.05), and calcaneal (5.6 +/- 5.1, p < 0.01) measurements. In contrast to exercise, the calcium intervention had no positive effect on any of the bone parameters. In regard to fitness parameters, the exercise group completed the study with significant gains in VO2max and isokinetic (peak torque) values for the knee flexion and extension and trunk extension. This study indicates that over a 2-year period, a combined

  3. 42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the use of a dual energy x-ray absorptiometry system (axial skeleton). (3) Medicare covers a medically... bone mass measurement is performed bya dual energy x-ray absorptiometry system (axial skeleton) and theinitial measurement was not performed by a dual energy x-rayabsorptiometry system (axial skeleton)....

  4. Reference Values of Total Lean Mass, Appendicular Lean Mass, and Fat Mass Measured with Dual-Energy X-ray Absorptiometry in a Healthy Mexican Population.

    PubMed

    Clark, Patricia; Denova-Gutiérrez, Edgar; Ambrosi, Regina; Szulc, Pawel; Rivas-Ruiz, Rodolfo; Salmerón, Jorge

    2016-11-01

    The aim of this study was to develop age- and gender-specific reference values of total lean body mass (LBM), appendicular lean body mass (ALBM), and fat mass (FM) by dual-energy X-ray absorptiometry (DXA) data in a healthy Mexican population. A cross-sectional analysis was conducted on 9518 healthy subjects 7-89 years of age participating in the baseline measurement of the Health Workers Cohort Study. Using DXA, LBM, ALBM, and FM were measured. Using these data, LBM index (LBMI), ALBM index (ALBMI), and fat mass index (FMI) were calculated. LMI, ALMI, and FMI were calculated as the LBM, ALBM, and FM kg divided by the height in meters squared. Males and females were analyzed separately; sex-specific means and standard deviations for LBM, ALBM, FM, LBMI, ALBMI, and FMI were calculated. A total of 2829 males and 6694 females were included in the final analysis. Strong sex gaps were observed after 12 years in LBM, ALBM, LBMI, and ALBMI (P < 0.01). LBM and ALBM values continue to increase for males up to age 20; females plateaued approximately after age 15. Significant sex differences were also observed for FM and FMI. Significant sex- and age-related differences exist in LBM, ALBM, and FM in the Mexican population. In addition, given the null data available in this area, these reference values may be useful in the evaluation of a variety of childhood and adult abnormalities involving lean body mass deficits, mainly in the assessment of muscle wasting, with important medical and epidemiological uses.

  5. The Performance of Five Bioelectrical Impedance Analysis Prediction Equations against Dual X-ray Absorptiometry in Estimating Appendicular Skeletal Muscle Mass in an Adult Australian Population

    PubMed Central

    Yu, Solomon C. Y.; Powell, Alice; Khow, Kareeann S. F.; Visvanathan, Renuka

    2016-01-01

    Appendicular skeletal muscle mass (ASM) is a diagnostic criterion for sarcopenia. Bioelectrical impedance analysis (BIA) offers a bedside approach to measure ASM but the performance of BIA prediction equations (PE) varies with ethnicities and body composition. We aim to validate the performance of five PEs in estimating ASM against estimation by dual-energy X-ray absorptiometry (DXA). We recruited 195 healthy adult Australians and ASM was measured using single-frequency BIA. Bland-Altman analysis was used to assess the predictive accuracy of ASM as determined by BIA against DXA. Precision (root mean square error (RMSE)) and bias (mean error (ME)) were calculated according to the method of Sheiner and Beal. Four PEs (except that by Kim) showed ASM values that correlated strongly with ASMDXA (r ranging from 0.96 to 0.97, p < 0.001). The Sergi equation performed the best with the lowest ME of −1.09 kg (CI: −0.84–−1.34, p < 0.001) and the RMSE was 2.09 kg (CI: 1.72–2.47). In men, the Kyle equation performed better with the lowest ME (−0.32 kg (CI: −0.66–0.02) and RMSE (1.54 kg (CI: 1.14–1.93)). The Sergi equation is applicable in adult Australians (Caucasian) whereas the Kyle equation can be considered in males. The need remains to validate PEs in other ethnicities and to develop equations suitable for multi-frequency BIA. PMID:27043617

  6. Impact of parathyroid status and Ca and vitamin-D supplementation on bone mass and muscle-bone relationships in 208 Belarussian children after thyroidectomy because of thyroid carcinoma.

    PubMed

    Schneider, P; Biko, J; Reiners, Chr; Demidchik, Y E; Drozd, V M; Capozza, R F; Cointry, G R; Ferretti, J L

    2004-09-01

    This observational study analyzes Ca-P metabolism and its impact on bone mass accrual and density and the muscle-bone mass/mass relationships in male and female children and adolescents who were parathyroidectomized because of thyroid carcinoma. Two hundred and eight children and adolescents (119 girls and 89 boys) from Gomel city (Belarus) and its rural surroundings were referred to our institution after having undergone total thyroidectomy for the treatment of advanced papillary thyroid cancer. A subgroup of children with demonstrated primary hypoparathyroidism received dihydrotachysterol (AT-10) and/or Ca supplementation. Among routine procedures over a maximum follow-up period of 5 years (average 3.7 years, maximum 8 visits), whole-body scans were taken using dual energy X-ray absorptiometry (DXA) at each visit in order to determine whole-body bone mineral content (TBMC), projected "areal" bone mineral density (TBMD), total lean mass (TLM) and total fat mass (TFM). The average serum Ca, P and AP concentrations over the whole observation period were significantly different between the groups; however, TBMC z-scores for all studied children were statistically similar in all visits. In girls, no between-group differences in height- and weight-controlled TBMC and TBMD or the TBMC/TLM ratio were observed (ANCOVA) and supplementation exerted no effect on these data, suggesting that the total bone mass accrual was not impaired by PTH deficiency in the studied conditions. However, non-supplemented boys showed lower values of the TBMC/TLM ratio than girls, and supplementation normalized these values in direct correlation with the induced improvement in serum P availability to bone. Results indicate that the primary impairment in parathyroid function and bone metabolism indicators in the thyroidectomized children was unrelated to any measurable change in crude bone mass values. However, in boys this condition impaired the TBMC/TLM ratio in such a way that the

  7. Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: Evidence from biochemistry and densitometry.

    PubMed

    Smith, Scott M; Heer, Martina A; Shackelford, Linda C; Sibonga, Jean D; Ploutz-Snyder, Lori; Zwart, Sara R

    2012-09-01

    Exercise has shown little success in mitigating bone loss from long-duration spaceflight. The first crews of the International Space Station (ISS) used the "interim resistive exercise device" (iRED), which allowed loads of up to 297 lb(f) (or 1337 N) but provided little protection of bone or no greater protection than aerobic exercise. In 2008, the Advanced Resistive Exercise Device (ARED), which allowed absolute loads of up to 600 lb(f) (1675 N), was launched to the ISS. We report dietary intake, bone densitometry, and biochemical markers in 13 crewmembers on ISS missions from 2006 to 2009. Of these 13, 8 had access to the iRED and 5 had access to the ARED. In both groups, bone-specific alkaline phosphatase tended to increase during flight toward the end of the mission (p = 0.06) and increased 30 days after landing (p < 0.001). Most markers of bone resorption were also increased in both groups during flight and 30 days after landing (p < 0.05). Bone densitometry revealed significant interactions (time and exercise device) for pelvis bone mineral density (BMD) and bone mineral content (p < 0.01), hip femoral neck BMD (p < 0.05), trochanter BMD (p < 0.05), and total hip BMD (p < 0.05). These variables were unchanged from preflight only for ARED crewmembers, who also returned from flight with higher percent lean mass and lower percent fat mass. Body mass was unchanged after flight in both groups. All crewmembers had nominal vitamin D status (75 ± 17 nmol/L) before and during flight. These data document that resistance exercise, coupled with adequate energy intake (shown by maintenance of body mass determined by dual-energy X-ray absorptiometry [DXA]) and vitamin D, can maintain bone in most regions during 4- to 6-month missions in microgravity. This is the first evidence that improving nutrition and resistance exercise during spaceflight can attenuate the expected BMD deficits previously observed after prolonged missions.

  8. Pediatric in vivo cross-calibration between the GE Lunar Prodigy and DPX-L bone densitometers.

    PubMed

    Crabtree, Nicola J; Shaw, N J; Boivin, C M; Oldroyd, B; Truscott, J G

    2005-12-01

    Dual energy x-ray absorptiometry (DXA) machine cross-calibration is an important consideration when upgrading from old to new technology. In a recent cross-calibration study using adult subjects, close agreement between GE Lunar DPX-L and GE Lunar Prodigy scanners was reported. The aim of this work was to cross-calibrate the two machines for bone and body composition parameters for pediatrics from age 5 years onwards. One-hundred ten healthy volunteers aged 5-20 years had total body and lumbar spine densitometry performed on DPX-L and Prodigy densitometers. Cross-calibration was achieved using linear regression and Bland-Altman analysis. There was close agreement between the machines, with r2 ranging from 0.85 to 0.99 for bone and body composition parameters. Paired t-tests demonstrated significant differences between machines that were dependent on scan acquisition mode, with the greatest differences reported for the smallest children. At the lumbar spine, Prodigy bone mineral density (BMD) values were on average 1.6% higher compared with DPX-L. For the total body, there were no significant differences in BMD; however, there were significant differences in bone mineral content (BMC) and bone area. For small children, the Prodigy measured lower BMC (9.4%) and bone area (5.8%), whereas for larger children the Prodigy measured both higher BMC (3.1%) and bone area (3.0%). A similar contrasting pattern was also observed for the body composition parameters. Prodigy values for lean body mass were higher (3.0%) for small children and lower (0.5%) for larger children, while fat body mass was lower (16.4%) for small children and higher (2.0%) for large children. Cross-calibration coefficients ranged from 0.84 to 1.12 and were significantly different from 1 (p<0.0001) for BMC and bone area. Bland-Altman plots showed that within the same scan acquisition modes, the magnitude of the difference increased with body weight. The results from this study suggest that the differences

  9. Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: a 12-month study in pre/peri- and postmenarcheal tennis players.

    PubMed

    Ducher, Gaele; Bass, Shona L; Saxon, Leanne; Daly, Robin M

    2011-06-01

    Pre- and early puberty may be the most opportune time to strengthen the female skeleton, but there are few longitudinal data to support this claim. Competitive female premenarcheal (pre/peri, n = 13) and postmenarcheal (post, n = 32) tennis players aged 10 to 17 years were followed over 12 months. The osteogenic response to loading was studied by comparing the playing and nonplaying humeri for dual-energy X-ray absorptiometry (DXA) bone mineral content (BMC) and magnetic resonance imaging (MRI) total bone area (ToA), medullary area (MedA), cortical area (CoA), and muscle area (MCSA) at the humerus. Over 12 months, growth-induced gains (nonplaying arm) in BMC, ToA, and CoA were greater in pre/peri (10% to 19%, p < .001) than in post (3% to 5%, p < .05 to .001) players. At baseline, BMC, ToA, CoA, and MCSA were 8% to 18% greater in the playing versus nonplaying arms in pre/peri and post players (all p < .001); MedA was smaller in the playing versus nonplaying arms in post only players (p < .05). When comparing the annual gains in the playing arm relative to changes in the nonplaying arm, the increases in ToA and CoA were greater in pre/peri than post players (all p < .05). The smaller the side-to-side differences in BMC and CoA at baseline, the larger the exercise benefits at 12 months (r = -0.39 to -0.48, p < .01). The exercise-induced change in MCSA was predictive of the exercise benefits in BMC in pre/peri players only (p < .05). In conclusion, both pre/peri- and postmenarcheal tennis players showed significant exercise-induced skeletal benefits within a year, with greater benefits in cortical bone geometry in pre/perimenarcheal girls.

  10. The effect of thyroid stimulating hormone suppressive therapy on bone geometry in the hip area of patients with differentiated thyroid carcinoma.

    PubMed

    Moon, Jae Hoon; Jung, Kyong Yeun; Kim, Kyoung Min; Choi, Sung Hee; Lim, Soo; Park, Young Joo; Park, Do Joon; Jang, Hak Chul

    2016-02-01

    Subclinical hyperthyroidism has been reported to increase the fracture risk. However, the effect of thyroid stimulating hormone (TSH) suppressive therapy on bone geometry in the hip area of patients with differentiated thyroid carcinoma (DTC) is still unclear. The aim of this study was to investigate the effect of TSH suppression on bone geometry in the hip area of pre- and postmenopausal women with DTC. We conducted a retrospective cohort study including 99 women with DTC (25 pre- and 74 postmenopausal) who had received TSH suppressive therapy for at least 3years and 297 control subjects (75 and 222, respectively) matched for sex and age. Bone mineral density (BMD) in the spine and hip area and bone geometry at the femoral neck measured by dual energy X-ray absorptiometry (DXA) were compared between patients and controls. The association between thyroid hormone and bone parameters was investigated. All analyses of bone parameters were adjusted for age, body mass index, and serum calcium levels. In premenopausal subjects, TSH suppressive therapy was not associated with poor bone parameters. In postmenopausal subjects, patients with DTC undergoing TSH suppression showed lower cross-sectional moment of inertia (CSMI), cross-sectional area, and section modulus and thinner cortical thickness at the femoral neck than those of control subjects, whereas their femoral neck BMD was comparable with controls. Total hip BMD was lower in postmenopausal patients than in controls. CSMI and section modulus at the femoral neck were independently associated with serum free T4 levels in postmenopausal patients. The difference in femoral neck bone geometry between patients and controls was only apparent in postmenopausal DTC patients with free T4 >1.79ng/dL (23.04pmol/l), and not in those with free T4 levels ≤1.79ng/dL (23.04pmol/l). TSH suppression in postmenopausal DTC patients was associated with decreased bone strength by altering bone geometry rather than BMD in the hip area

  11. Resulting Shifts in Percentile and Standard Placements after Comparison of the BOD POD and DXA

    PubMed Central

    HEDEN, TIMOTHY; SHEPARD, STEVE; SMITH, JOHN; COVINGTON, KAY; LECHEMINANT, JAMES

    2008-01-01

    The purpose of this study was to determine the validity of the BOD POD® when compared to the DXA and if placement on a percentile chart and standard table is affected by any differences between the two measures. A total of 244 (27.7 ± 10.8 yrs, 77.3 ± 16.1 kg, 171.4 ± 10.1 cm, 26.31 ± 5.42 BMI) males and females between the ages of 18 and 52 were recruited to participate in this study. The participant’s body fat percentage (%BF) was tested in random order on the BOD POD® and DXA during a 30-minute session following manufacturer’s guidelines and procedures. Dependent t-test indicated the %BF measured by the BOD POD® (23.4% ± 12.8) was significantly lower when compared to the DXA (29.5% ± 12.1), p = .001. The Pearson’s Product moment correlation was 0.95 (p = .001), indicating a very strong relationship between the two instruments. Using estimates of %BF from the BOD POD® also resulted in more favorable shifts on a percentile chart and standard table. Since a high correlation was evident between the two, the BOD POD® can be used as an instrument to track %BF changes over time during a diet and/or exercise intervention. However, caution should be made when classifying %BF with percentile charts or standard tables using the BOD POD® %BF estimates. PMID:27182302

  12. Vitamin D deficiency and reduced bone mineral density in multiple sclerosis: effect of ambulatory status and functional capacity.

    PubMed

    Ozgocmen, Salih; Bulut, Serpil; Ilhan, Nevin; Gulkesen, Arif; Ardicoglu, Ozge; Ozkan, Yusuf

    2005-01-01

    Multiple sclerosis (MS) is a chronic disease and a major cause of disability in young adults. The aims of this study were to assess bone mass in patients with MS in comparison to healthy age- and sex-matched controls, and to evaluate factors influencing bone mineral density (BMD), and the relationship of the pain threshold at peripheral and axial sites with BMD in MS. Thirty-one patients with MS and 30 matched healthy controls participated in the study. The Kurtzke expanded disability status scale (EDSS) and the functional independence measure (FIM) were used to scale disability, mobility, and functional status. Serum 25(OH) vitamin D levels were measured. BMD was measured using dual X-ray absorptiometry (DXA). MS patients had significantly lower BMD at the lumbar spine (L2-L4) and femur trochanter compared to the matched controls. BMD of the lumbar spine was nearly 1 SD lower in MS patients compared with the healthy reference population (Z scores). MS patients had significantly lower vitamin D levels (17.3 ng/ml vs 43.1 ng/ml; P < 0.001) compared to controls, and 19 patients (61%) had a serum level of vitamin D that was less than 20 ng/ml. EDSS scores in the patients were inversely correlated with proximal femur BMD but not with spinal BMD. There was a negative correlation with the cumulative steroid dose and BMD only for femur trochanter BMD. Total myalgia scores for paravertebral muscles correlated significantly with spinal BMD. In conclusion, BMD is significantly lower in MS patients than in healthy controls, vitamin D deficiency is prevalent in MS, and ambulatory status is a determinative factor for osteoporosis in MS. Patients should be encouraged to have adequate sunlight exposure and to increase their mobility. Specific strengthening exercises for hip and back muscles in MS patients would have a substantial impact on bone density, osteoporosis, fracture risk, and mobility.

  13. In vivo application of 3D-line skeleton graph analysis (LSGA) technique with high-resolution magnetic resonance imaging of trabecular bone structure.

    PubMed

    Pothuaud, Laurent; Newitt, David C; Lu, Ying; MacDonald, Brian; Majumdar, Sharmila

    2004-05-01

    Over the last several years magnetic resonance (MR) imaging has emerged as a means of measuring in vivo 3D trabecular bone structure. In particular, MR based diagnosis could be used to complement standard bone mineral density (BMD) methods for assessing osteoporosis and evaluating longitudinal changes. The aim of this study was to demonstrate the feasibility of using the 3D-LSGA technique for the evaluation of trabecular bone structure of high-resolution MR images, particularly for assessing longitudinal changes, in vivo. First, the reproducibility of topological 3D-LSGA based measurements was evaluated in a set of seven volunteers, and coefficients of variations ranged from 3.5% to 6%. Second, high-resolution MR images of the radius in 30 postmenopausal women from a placebo controlled drug study (Idoxifene), divided into placebo ( n=9) and treated ( n=21) groups, were obtained at baseline (BL) and after 1 year of treatment (follow-up, FU). In addition, dual X-ray absorptiometry (DXA) measures of BMD were obtained in the distal radius. Standard morphological measurements based on the mean intercept length (MIL) technique as well as 3D-LSGA based measurements were applied to the 3D MR images. Significant changes from BL to FU were detected, in the treated group, using the topological 3D-LSGA based measurements, morphological measures of volume of connected trabeculae and App Tb.N from MIL analysis. The duration of the study was short, and the number of patients remaining in the study was small, hence these results cannot be interpreted with regard to a true therapeutic response. Furthermore, the site (wrist) and the drug (idoxifene) are not optimal for follow-up study. However, this paper demonstrated the feasibility of using 3D-LSGA based evaluation coupled with in vivo high-resolution MR imaging as a complementary approach for the monitoring of trabecular bone changes in individual subjects.

  14. Lean mass and fat mass have differing associations with bone microarchitecture assessed by high resolution peripheral quantitative computed tomography in men and women from the Hertfordshire Cohort Study.

    PubMed

    Edwards, Mark H; Ward, Kate A; Ntani, Georgia; Parsons, Camille; Thompson, Jennifer; Sayer, Avan A; Dennison, Elaine M; Cooper, Cyrus

    2015-12-01

    Understanding the effects of muscle and fat on bone is increasingly important in the optimisation of bone health. We explored relationships between bone microarchitecture and body composition in older men and women from the Hertfordshire Cohort Study. 175 men and 167 women aged 72-81 years were studied. High resolution peripheral quantitative computed tomography (HRpQCT) images (voxel size 82 μm) were acquired from the non-dominant distal radius and tibia with a Scanco XtremeCT scanner. Standard morphological analysis was performed for assessment of macrostructure, densitometry, cortical porosity and trabecular microarchitecture. Body composition was assessed using dual energy X-ray absorptiometry (DXA) (Lunar Prodigy Advanced). Lean mass index (LMI) was calculated as lean mass divided by height squared and fat mass index (FMI) as fat mass divided by height squared. The mean (standard deviation) age in men and women was 76 (3) years. In univariate analyses, tibial cortical area (p<0.01), cortical thickness (p<0.05) and trabecular number (p<0.01) were positively associated with LMI and FMI in both men and women. After mutual adjustment, relationships between cortical area and thickness were only maintained with LMI [tibial cortical area, β (95% confidence interval (CI)): men 6.99 (3.97,10.01), women 3.59 (1.81,5.38)] whereas trabecular number and density were associated with FMI. Interactions by sex were found, including for the relationships of LMI with cortical area and FMI with trabecular area in both the radius and tibia (p<0.05). In conclusion, LMI and FMI appeared to show independent relationships with bone microarchitecture. Further studies are required to confirm the direction of causality and explore the mechanisms underlying these tissue-specific associations.

  15. Body composition assessment of English Premier League soccer players: a comparative DXA analysis of first team, U21 and U18 squads.

    PubMed

    Milsom, Jordan; Naughton, Robert; O'Boyle, Andy; Iqbal, Zafar; Morgans, Ryland; Drust, Barry; Morton, James P

    2015-01-01

    Professional soccer players from the first team (1st team, n = 27), under twenty-one (U21, n = 21) and under eighteen (U18, n = 35) squads of an English Premier League soccer team were assessed for whole body and regional estimates of body composition using dual-energy X-ray absorptiometry (DXA). Per cent body fat was lower in 1st team (10.0 ± 1.6) compared with both U21 (11.6 ± 2.5, P = 0.02) and U18 (11.4 ± 2.6, P = 0.01) players. However, this difference was not due to variations (P = 0.23) in fat mass between squads (7.8 ± 1.6 v. 8.8 ± 2.1 v. 8.2 ± 2.4 kg, respectively) but rather the presence of more lean mass in 1st team (66.9 ± 7.1 kg, P < 0.01) and U21 (64.6 ± 6.5 kg, P = 0.02) compared with U18 (60.6 ± 6.3 kg) players. Accordingly, fat mass index was not different (P = 0.138) between squads, whereas lean mass index was greater (P < 0.01) in 1st team players (20.0 ± 1.1 kg · m(-2)) compared with U18 players (18.8 ± 1.4 kg · m(-2)). Differences in lean mass were also reflective of higher lean tissue mass in all regions, for example, upper limbs/lower limbs and trunk. Data suggest that training and nutritional interventions for younger players should therefore be targeted to lean mass growth as opposed to body fat loss.

  16. Bone Disease in HIV: Recommendations for Screening and Management in the Older Patient.

    PubMed

    Hoy, Jennifer

    2015-07-01

    Availability of potent antiretroviral therapy (ART) has resulted in markedly improved survival for people with human immunodeficiency virus (HIV) infection, as well as an aging HIV population. Increasing morbidity from age-related conditions has resulted in the need to understand the complex roles HIV and its treatment play in the pathogenesis of these conditions. Bone disease and fragility fractures are conditions that occur more frequently in HIV. It is therefore recommended that risk assessment for fragility fracture using the Fracture Risk Assessment Tool (FRAX(®)) algorithm, and low bone mass by dual energy X-ray absorptiometry (DXA) scan, be performed in all patients with HIV infection over the age of 50 years and in those with a history of fragility fracture, and should be repeated every 2-3 years. Because many HIV experts believe that HIV infection and its treatment is a secondary cause of osteoporosis, it should be included as such in the FRAX(®) assessment tool. Management of osteoporosis in HIV infection should follow the same guidelines as that in the general population. Attention to lifestyle factors, including vitamin D replacement, should be emphasized. Whether cessation of tenofovir- or protease inhibitor-based ART regimens should be considered prior to bisphosphonate treatment is currently unknown and should only occur in patients with active alternative ART regimens. The use of bisphosphonates has been shown to be safe and effective in HIV patients, and while there is limited data on second-line osteoporosis regimens, there is no reason to suggest they would not be effective in people with HIV.

  17. Long-term prophylaxis in severe haemophilia seems to preserve bone mineral density.

    PubMed

    Khawaji, M; Akesson, K; Berntorp, E

    2009-01-01

    It has been previously shown that patients with severe haemophilia and not receiving any prophylactic treatment render a high risk of reduced bone mineral density. The purpose of this study was to evaluate bone mineral density (BMD) in patients with haemophilia of different severity types and treatment. The study group consisted of 26 patients with severe haemophilia (aged 33.6 +/- 2.1) and 16 patients with mild haemophilia (aged 40.2 +/- 3.3). The BMD (g cm(-2)) was measured by dual-energy X-ray absorptiometry (DXA). Physical activity was assessed by a self-report questionnaire. Physical activity was scored as duration (h week(-)) and as metabolic physical activity score by weighing the intensity (MET-h week(-1)). Joints were evaluated according to a physical examination score. There was no significant difference in BMD at lumbar spine L1-L4 (mild, 1.214 vs. severe, 1.175; P = 0.329), total hip (1.085 vs. 1.001, P = 0.114), femoral neck (1.036 vs. 0.977, P = 0.265), trochanter (0.896 vs. 0.820, P = 0.131) and whole body (1.215 vs. 1.183, P = 0.325) between those with mild and severe haemophilia. Based on Z-score, both groups had normal BMD (Z score >-1). In patients with severe haemophilia, there was a significant correlation between joint evaluation score and BMD at total hip (P < 0.0001), femoral neck (P = 0.0003) and trochanter (P = 0.003). Physical activity did not correlate to disease severity. We did not observe a correlation between BMD and severity of haemophilia. The results indicate that the use of factor prophylaxis since early childhood may preserve normal BMD in severe haemophilia.

  18. Fracture Risk and Areal Bone Mineral Density in Adolescent Females with Anorexia Nervosa

    PubMed Central

    Faje, Alexander T.; Fazeli, Pouneh K.; Miller, Karen K.; Katzman, Debra K.; Ebrahimi, Seda; Lee, Hang; Mendes, Nara; Snelgrove, Deirdre; Meenaghan, Erinne; Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Objective To (i) compare fracture prevalence in adolescent females with anorexia nervosa (AN) vs. normal-weight controls and (ii) examine whether reductions in areal bone mineral density (aBMD) predict fracture risk in females with AN. Methods 418 females (310 with active AN and 108 normal-weight controls) 12–22 years old were studied cross-sectionally. Lifetime fracture history was recorded by a physician during participant interviews. Body composition and aBMD measurements of the whole body, whole body less head, lumbar spine, and hip were assessed by dual-energy x-ray absorptiometry (DXA), and bone mineral apparent density (BMAD) was calculated for the lumbar spine. Results Participants with AN and normal-weight controls did not differ for chronological age, sexual maturity, or height. The lifetime prevalence of prior fracture was 59.8% higher in those with AN compared to controls (31.0 % versus 19.4 %, p = 0.02), and the fracture incidence rate peaked in our cohort after the diagnosis of AN. Lower aBMD and lumbar BMAD were not associated with a higher prevalence of fracture in the AN or control group on univariate or multivariate analyses. Compared to controls, fracture prevalence was significantly higher in the subgroup of girls with AN who had normal aBMD or only modest reductions of aBMD (Z-scores > −1 or −1.5). Discussion This is the first study to show that the risk of fracture during childhood and adolescence is significantly higher in patients with AN than in normal-weight controls. Fracture prevalence is increased in this cohort of subjects with AN even without significant reductions in aBMD. PMID:24430890

  19. Cross-mode bioelectrical impedance analysis in a standing position for estimating fat-free mass validated against dual-energy x-ray absorptiometry.

    PubMed

    Huang, Ai-Chun; Chen, Yu-Yawn; Chuang, Chih-Lin; Chiang, Li-Ming; Lu, Hsueh-Kuan; Lin, Hung-Chi; Chen, Kuen-Tsann; Hsiao, An-Chi; Hsieh, Kuen-Chang

    2015-11-01

    Bioelectrical impedance analysis (BIA) is commonly used to assess body composition. Cross-mode (left hand to right foot, Z(CR)) BIA presumably uses the longest current path in the human body, which may generate better results when estimating fat-free mass (FFM). We compared the cross-mode with the hand-to-foot mode (right hand to right foot, Z(HF)) using dual-energy x-ray absorptiometry (DXA) as the reference. We hypothesized that when comparing anthropometric parameters using stepwise regression analysis, the impedance value from the cross-mode analysis would have better prediction accuracy than that from the hand-to-foot mode analysis. We studied 264 men and 232 women (mean ages, 32.19 ± 14.95 and 34.51 ± 14.96 years, respectively; mean body mass indexes, 24.54 ± 3.74 and 23.44 ± 4.61 kg/m2, respectively). The DXA-measured FFMs in men and women were 58.85 ± 8.15 and 40.48 ± 5.64 kg, respectively. Multiple stepwise linear regression analyses were performed to construct sex-specific FFM equations. The correlations of FFM measured by DXA vs. FFM from hand-to-foot mode and estimated FFM by cross-mode were 0.85 and 0.86 in women, with standard errors of estimate of 2.96 and 2.92 kg, respectively. In men, they were 0.91 and 0.91, with standard errors of the estimates of 3.34 and 3.48 kg, respectively. Bland-Altman plots showed limits of agreement of -6.78 to 6.78 kg for FFM from hand-to-foot mode and -7.06 to 7.06 kg for estimated FFM by cross-mode for men, and -5.91 to 5.91 and -5.84 to 5.84 kg, respectively, for women. Paired t tests showed no significant differences between the 2 modes (P > .05). Hence, cross-mode BIA appears to represent a reasonable and practical application for assessing FFM in Chinese populations.

  20. Adiposity assessed by anthropometric measures has a similar or greater predictive ability than dual-energy X-ray absorptiometry measures for abdominal aortic calcification in community-dwelling older adults.

    PubMed

    Shang, Xianwen; Scott, David; Hodge, Allison; Khan, Belal; Khan, Nayab; English, Dallas R; Giles, Graham G; Ebeling, Peter R; Sanders, Kerrie M

    2016-09-01

    To determine whether adiposity assessed by dual-energy X-ray absorptiometry (DXA) compared to simple anthropometric assessments, are more predictive of abdominal aortic calcification (AAC), a risk factor for atherosclerosis. A cross-sectional study of 312 participants (60.3 % female) aged 70.6 ± 5.6 years was conducted in 2010-2011. AAC was assessed by radiography. Adiposity was estimated for whole body, trunk, android, gynoid and visceral regions using DXA in addition to body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR). WHR [tertile 1 as reference, OR (95 % CI) for tertile 3: 3.62 (1.35-9.72)] and android to gynoid fat ratio [tertile 3: 2.87 (1.03-8.01)] were independent predictors of AAC severity among men. Positive associations with AAC severity were observed for WC [tertile 1 as reference, OR for tertile 3: 2.46 (1.12-5.41)], % trunk fat mass [tertile 2: 3.26 (1.52-7.03)], % android fat mass [tertile 2: 2.42 (1.13-5.18), tertile 3: 2.20 (1.02-4.73)] and visceral fat area [tertile 2: 2.28 (1.06-4.87), tertile 3: 2.32 (1.01-5.34)] among women. Indices of total body composition, BMI and % body fat mass were not associated with AAC severity in either men or women. Simple anthropometric measures, WHR and WC were the best predictors of AAC severity in men and women respectively, although higher android to gynoid fat ratio and central fat, assessed by DXA, were also predictive of higher risks of AAC severity in men and women respectively. Our findings add to existing evidence that relatively inexpensive and easily obtained anthropometric measures can be clinically useful indicators of atherosclerosis risk.

  1. Effects of physical exercise on bone mass, balance skill and aerobic capacity in women and men with low bone mineral density, after one year of training--a prospective study.

    PubMed

    Kronhed, A C; Möller, M

    1998-10-01

    Vadstena is a small community in the county of Ostergötland, Sweden, where a project began in 1989 to prevent osteoporosis and to lower the expected incidence of osteoporotic fractures. Persons aged 40-70 years who had a low bone mineral density (BMD) value at screening of the distal radius by single-photon absorptiometry (SPA) were invited to participate in a training study during one year. The definition of low BMD was a densitometry value below -1 SD (standard deviation) from a sex- and age-specific reference value (z-score). Fifteen persons wanted to exercise in a group and 15 persons wanted to become a control group. All participants answered a questionnaire about lifestyle, occupation, diseases, medication and heredity. Clinical tests were made regarding mobility of the joints and muscles, balance and physical fitness. BMD for the hip and the lumbar spine were assessed by dual-energy X-ray absorptiometry (DXA) before and after the investigation period. The training programme was carried out for 60 min twice a week during one year and had the intention to improve bone mass, muscle strength and flexibility, balance skill and aerobic capacity. After the training period there was a significant increase in BMD at the greater trochanter (P < 0.01), in balance skill (standing on one leg with closed eyes and "ski step"-test) (P < 0.05) and in oxygen uptake capacity (P < 0.05) in the exercise group. In the control group, there was a significant increase in BMD at the lumbar spine (P < 0.05). However, these results should be judged with caution because several participants were over the age of 60, and at that age degenerative changes in the lumbar spine may increase to a greater or lesser extent. Regular weight-bearing exercises during one year seem to influence BMD at the greater trochanter in a training group comprising both women and men. However, our study was small in number and further training studies are needed to assess the effect of weight-bearing training

  2. Single- and dual-photon absorptiometry in osteoporosis and osteomalacia

    SciTech Connect

    Wahner, H.W.

    1987-10-01

    Single- and dual-photon absorptiometric methods have been used in the past to identify populations at risk for bone loss, to define the osteoporotic syndrome in terms of bone mass, and to evaluate treatment regimens to prevent bone loss. Technical improvements have made these procedures available for the nontraumatic measurement of bone mineral in the management of the individual patient suspected of having osteoporosis or other bone loss. This requires a different approach to data interpretation because decisions have to be made on the basis of a single measurement. Osteoporosis and osteomalacia cannot be distinguished by bone mineral measurements because both are characterized by a decrease in content of bone mineral. Bone mineral measurements can be used to assess the risk of fracture and, with it, the severity of bone loss. This allows treatment decisions to be made. Repeated measurements made under well-defined conditions allow estimation of long-term rate of bone loss and monitoring of treatment effect. 38 references.

  3. Body fat from body density: Underwater weighing vs. dual-photon absorptiometry

    SciTech Connect

    Wang, J.; Heymsfield, S.B.; Aulet, M.; Thornton, J.C.; Pierson, R.N. Jr.

    1989-06-01

    We measured fat in 286 healthy volunteers by underwater weighing (FUWW) and dual-photon absorptiometry (FDPA) to develop a translation table for the differing results from these entirely different techniques and to study the sources of these differences. In 99 males and 187 females aged 19-94 yr, fatness was 7-47%. Prediction equations are presented for FUWW-FDPA (delta F), density of lean body mass (DLBM), and FDPA. FUWW and FDPA were significantly different from each other (P less than 0.01). Calculated DLBM is less than the assumed constant of 1.10 (P less than 0.01), ranging widely from 1.05 to 1.13 and being highly correlated with the ratio of total body bone mineral to lean body mass (TBBM/LBM). delta F, the differences between FUWW and FDPA measurements in individual subjects, varied widely (-7 to +11% in males and -18 to +13% in females). The difference was positively correlated with the DLBM. FUWW was no better than anthropometrics in equations for predicting FDPA. The FDPA predicted from anthropometrics showed smaller standard errors than when FUWW was used. Neither anthropometrics nor FUWW equations are clearly superior to those previously available.

  4. Combining 3D optical imaging and dual energy absorptiometry to measure three compositional components.

    PubMed

    Malkov, Serghei; Shepherd, John

    2014-02-17

    We report on the design of the technique combining 3D optical imaging and dual-energy absorptiometry body scanning to estimate local body area compositions of three compartments. Dual-energy attenuation and body shape measures are used together to solve for the three compositional tissue thicknesses: water, lipid, and protein. We designed phantoms with tissue-like properties as our reference standards for calibration purposes. The calibration was created by fitting phantom values using non-linear regression of quadratic and truncated polynomials. Dual-energy measurements were performed on tissue-mimicking phantoms using a bone densitometer unit. The phantoms were made of materials shown to have similar x-ray attenuation properties of the biological compositional compartments. The components for the solid phantom were tested and their high energy/low energy attenuation ratios are in good correspondent to water, lipid, and protein for the densitometer x-ray region. The three-dimensional body shape was reconstructed from the depth maps generated by Microsoft Kinect for Windows. We used open-source Point Cloud Library and freeware software to produce dense point clouds. Accuracy and precision of compositional and thickness measures were calculated. The error contributions due to two modalities were estimated. The preliminary phantom composition and shape measurements are found to demonstrate the feasibility of the method proposed.

  5. Combining 3D optical imaging and dual energy absorptiometry to measure three compositional components

    PubMed Central

    Malkov, Serghei; Shepherd, John

    2014-01-01

    We report on the design of the technique combining 3D optical imaging and dual-energy absorptiometry body scanning to estimate local body area compositions of three compartments. Dual-energy attenuation and body shape measures are used together to solve for the three compositional tissue thicknesses: water, lipid, and protein. We designed phantoms with tissue-like properties as our reference standards for calibration purposes. The calibration was created by fitting phantom values using non-linear regression of quadratic and truncated polynomials. Dual-energy measurements were performed on tissue-mimicking phantoms using a bone densitometer unit. The phantoms were made of materials shown to have similar x-ray attenuation properties of the biological compositional compartments. The components for the solid phantom were tested and their high energy/low energy attenuation ratios are in good correspondent to water, lipid, and protein for the densitometer x-ray region. The three-dimensional body shape was reconstructed from the depth maps generated by Microsoft Kinect for Windows. We used open-source Point Cloud Library and freeware software to produce dense point clouds. Accuracy and precision of compositional and thickness measures were calculated. The error contributions due to two modalities were estimated. The preliminary phantom composition and shape measurements are found to demonstrate the feasibility of the method proposed. PMID:25083118

  6. Combining 3D optical imaging and dual energy absorptiometry to measure three compositional components

    NASA Astrophysics Data System (ADS)

    Malkov, Serghei; Shepherd, John

    2014-02-01

    We report on the design of the technique combining 3D optical imaging and dual-energy absorptiometry body scanning to estimate local body area compositions of three compartments. Dual-energy attenuation and body shape measures are used together to solve for the three compositional tissue thicknesses: water, lipid, and protein. We designed phantoms with tissue-like properties as our reference standards for calibration purposes. The calibration was created by fitting phantom values using non-linear regression of quadratic and truncated polynomials. Dual-energy measurements were performed on tissue-mimicking phantoms using a bone densitometer unit. The phantoms were made of materials shown to have similar x-ray attenuation properties of the biological compositional compartments. The components for the solid phantom were tested and their high energy/low energy attenuation ratios are in good correspondent to water, lipid, and protein for the densitometer x-ray region. The three-dimensional body shape was reconstructed from the depth maps generated by Microsoft Kinect for Windows. We used open-source Point Cloud Library and freeware software to produce dense point clouds. Accuracy and precision of compositional and thickness measures were calculated. The error contributions due to two modalities were estimated. The preliminary phantom composition and shape measurements are found to demonstrate the feasibility of the method proposed.

  7. Comparison of Standing Posture Bioelectrical Impedance Analysis with DXA for Body Composition in a Large, Healthy Chinese Population

    PubMed Central

    Chen, Kuen-Tsann; Chen, Yu-Yawn; Wang, Chia-Wei; Chuang, Chih-Lin; Chiang, Li-Ming; Lai, Chung-Liang; Lu, Hsueh-Kuan; Dwyer, Gregory B.; Chao, Shu-Ping; Shih, Ming-Kuei; Hsieh, Kuen-Chang

    2016-01-01

    Bioelectrical impedance analysis (BIA) is a common method for assessing body composition in research and clinical trials. BIA is convenient but when compared with other reference methods, the results have been inconclusive. The level of obesity degree in subjects is considered to be an important factor affecting the accuracy of the measurements. A total of 711 participants were recruited in Taiwan and were sub-grouped by gender and levels of adiposity. Regression analysis and Bland-Altman analysis were used to evaluate the agreement of the measured body fat percentage (BF%) between BIA and DXA. The BF% measured by the DXA and BIA methods (Tanita BC-418) were expressed as BF%DXA and BF%BIA8, respectively. A one-way ANOVA was used to test the differences in BF% measurements by gender and levels of adiposity. The estimated BF%BIA8 and BF%DXA in the all subjects, male and female groups were all highly correlated (r = 0.934, 0.901, 0.916, all P< 0.001). The average estimated BF%BIA8 (22.54 ± 9.48%) was significantly lower than the average BF%DXA (26.26 ± 11.18%). The BF%BIA8 was overestimated in the male subgroup (BF%DXA< 15%), compared to BF%DXA by 0.45%, respectively. In the other subgroups, the BF%BIA8 values were all underestimated. Standing BIA estimating body fat percentage in Chinese participants have a high correlation, but underestimated on normal and high obesity degree in both male and female subjects. PMID:27467065

  8. Correspondence between theoretical models and dual energy x-ray absorptiometry measurements of femoral cross-sectional growth during adolescence

    NASA Technical Reports Server (NTRS)

    van der Meulen, M. C.; Marcus, R.; Bachrach, L. K.; Carter, D. R.

    1997-01-01

    We have developed an analytical model of long bone cross-sectional ontogeny in which appositional growth of the diaphysis is primarily driven by mechanical stimuli associated with increasing body mass during growth and development. In this study, our goal was to compare theoretical predictions of femoral diaphyseal structure from this model with measurements of femoral bone mineral and geometry by dual energy x-ray absorptiometry. Measurements of mid-diaphyseal femoral geometry and structure were made previously in 101 Caucasian adolescents and young adults 9-26 years of age. The data on measured bone mineral content and calculated section modulus were compared with the results of our analytical model of cross-sectional development of the human femur over the same age range. Both bone mineral content and section modulus showed good correspondence with experimental measurements when the relationships with age and body mass were examined. Strong linear relationships were evident for both parameters when examined as a function of body mass.

  9. Lower periprosthetic bone loss and good fixation of an ultra-short stem compared to a conventional stem in uncemented total hip arthroplasty

    PubMed Central

    Salemyr, Mats; Muren, Olle; Ahl, Torbjörn; Bodén, Henrik; Eisler, Thomas; Stark, André; Sköldenberg, Olof

    2015-01-01

    Background and purpose — We hypothesized that an ultra-short stem would load the proximal femur in a more physiological way and could therefore reduce the adaptive periprosthetic bone loss known as stress shielding. Patients and methods — 51 patients with primary hip osteoarthritis were randomized to total hip arthroplasty (THA) with either an ultra-short stem or a conventional tapered stem. The primary endpoint was change in periprosthetic bone mineral density (BMD), measured with dual-energy x-ray absorptiometry (DXA), in Gruen zones 1 and 7, two years after surgery. Secondary endpoints were change in periprosthetic BMD in the entire periprosthetic region, i.e. Gruen zones 1 through 7, stem migration measured with radiostereometric analysis (RSA), and function measured with self-administered functional scores. Results — The periprosthetic decrease in BMD was statistically significantly lower with the ultra-short stem. In Gruen zone 1, the mean difference was 18% (95% CI: −27% to −10%). In zone 7, the difference was 5% (CI: −12% to −3%) and for Gruen zones 1–7 the difference was also 5% (CI: −9% to −2%). During the first 6 weeks postoperatively, the ultra-short stems migrated 0.77 mm more on average than the conventional stems. 3 months after surgery, no further migration was seen. The functional scores improved during the study and were similar in the 2 groups. Interpretation — Up to 2 years after total hip arthroplasty, compared to the conventional tapered stem the ultra-short uncemented anatomical stem induced lower periprosthetic bone loss and had equally excellent stem fixation and clinical outcome. PMID:26134386

  10. Maternal Vitamin D Status and Offspring Bone Fractures: Prospective Study over Two Decades in Aarhus City, Denmark

    PubMed Central

    Petersen, Sesilje Bondo; Olsen, Sjurdur Frodi; Mølgaard, Christian; Granström, Charlotta; Cohen, Arieh; Vestergaard, Peter; Strøm, Marin

    2014-01-01

    Background Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results. Purpose We used occurrence of bone fractures up to the age of 18 as a measure reflecting offspring bone mass and related that to maternal vitamin D status. Methods The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988–89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration of 25-hydroxyvitamin D (25(OH)D) by the liquid chromatography coupled with a tandem mass spectrometric method (LC-MS/MS). Outcome was diagnosis of first time bone fractures extracted from the Danish National Patient Register. Results Vitamin D status was available for 850 women. The median (5th–95th percentile) 25(OH)D was 76.2 (23.0–152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone fractures. However, there was a significantly increased hazard ratio (HR) during childhood for those who had maternal blood drawn in Dec/Jan/Feb compared with Jun/Jul/Aug (HR: 1.75, 95%CI: 1.11–2.74). Adjustment for vitamin D status strengthened this association (1.82, 1.12–2.97), which indicated a potential seasonal impact on offspring fractures independent of maternal vitamin D status. In a sensitivity analysis we found a borderline significant inverse association between continuous concentrations of 25(OH)D and offspring forearm fractures (P = 0.054). Conclusion Overall, our results did not substantiate an association between maternal vitamin D status and offspring bone fractures. Further studies on this subject are needed, but the study populations must be large enough

  11. Bone status of Indian women from a low-income group and its relationship to the nutritional status.

    PubMed

    Shatrugna, Veena; Kulkarni, Bharati; Kumar, P Ajay; Rani, K Usha; Balakrishna, N

    2005-12-01

    Indian women from low-income groups consume diets that have inadequate calcium coupled with too few calories, proteins and micronutrients. Hospital-based data suggest that these women have osteoporotic hip fractures at a much earlier age than Western women. Studies reporting bone parameters of the Indian population involving large sample sizes are not available. This study was therefore carried out with 289 women in the 30-60-year age group to estimate the prevalence of osteoporosis and measure the bone parameters by dual energy X-ray absorptiometry (DXA). Their mean (+/- SD) age was 41.0+/-8.60 years. Their mean (+/- SD) height, weight and body mass index (BMI) were 149.1+/-5.49 cm, 49.2+/-9.85 kg and 22.1+/-3.99, respectively. Dietary intake of calcium was estimated to be 270+/-57 mg/day. The prevalence of osteoporosis at the femoral neck was around 29%. Bone mineral density (BMD) and T scores at all the skeletal sites were much lower than the values reported from the developed countries and were indicative of a high prevalence of osteopenia and osteoporosis. BMD showed a decline after the age of 35 years in cases of the lumbar spine and femoral neck. This was largely due to a decrease of bone mineral content (BMC). The nutritional status of women appears to be an important determinant of bone parameters. BMD and BMC at all the skeletal sites and whole body increased significantly with increasing body weight and BMI of women (P<0.05). However, bone area (BA) did not change with an increase in BMI. In the multiple regression analysis, apart from body weight, age, menopause and calcium intake were the other important determinants of BMD (P<0.05). In addition to these, height was also an important determinant of WB-BMC. This study highlights the urgent need for measures to improve the nutritional status, dietary calcium intake and thus the bone health of this population.

  12. The effect of nutrient intake on bone mineral status in young adults: the Northern Ireland young hearts project.

    PubMed

    Neville, C E; Robson, P J; Murray, L J; Strain, J J; Twisk, J; Gallagher, A M; McGuinness, M; Cran, G W; Ralston, S H; Boreham, C A G

    2002-02-01

    Optimizing peak bone mass in early life may reduce osteoporosis risk in later life. Such optimization may be partly dependent upon diet. In the present study, nutrient intakes and selected lifestyle parameters were assessed in adolescent subjects (238 males, 205 females; aged 15 y) and again, in the same subjects, on one occasion in young adulthood (aged between 20 and 25 y). The extent of the relationships between these parameters and bone mineral density (BMD), dual energy X-ray absorptiometry (DXA), lumbar spine (L2-L4), and femoral neck measured concurrently with diet in young adulthood only, was assessed. Adjusted linear regression models were constructed. Variables included a measure of pubertal status (at age 15 y), age (at young adulthood), height, weight, physical activity, smoking, and mean daily intakes of energy, calcium, protein, vitamin D, phosphorus, total fat, and alcohol. In both sexes, body weight at adolescence and young adulthood was the only factor consistently positively associated with BMD at both measurement sites. Effects of nutrient intake on BMD were inconsistent. Vitamin D and calcium intakes reported by female adolescents showed significant positive relationships with BMD measured in young adulthood (vitamin D measured at the lumbar spine; calcium measured at the femoral neck). The positive relationship between vitamin D and BMD remained significant at young adulthood, but at the femoral neck rather than at the lumbar spine. Also in females, intakes of phosphorus and the calcium:phosphorus ratio (Ca:P) at adolescence were strongly negatively related to femoral neck BMD measured at young adulthood. In males, however, Ca:P reported at young adulthood had a significant positive relationship with lumbar spine BMD, whereas Ca:protein was negatively associated with BMD at the lumbar spine. Intakes of Ca reported by adolescent males also had a strong negative effect on lumbar spine BMD measured at young adulthood.

  13. Longitudinal evaluation of mouse hind limb bone loss after spinal cord injury using novel, in vivo, methodology.

    PubMed

    McManus, Madonna M; Grill, Raymond J

    2011-12-07

    femur was not detectable until 40 days post injury (7% decrease, p < 0.05). SCI-dependent loss of mouse femur density was confirmed post-mortem through the use of Dual-energy X-ray Absorptiometry (DXA), the current "gold standard" for bone density measurements. We detect a 12% loss of BMC in the femurs of mice at 40 days post-SCI using the IVIS Lumina XR. This compares favorably with a previously reported BMC loss of 13.5% by Picard and colleagues who used DXA analysis on mouse femurs post-mortem 30 days post-SCI (9). Our results suggest that the IVIS Lumina XR provides a novel, high-resolution/high-magnification method for performing long-term, longitudinal measurements of hind limb bone density in the mouse following SCI.

  14. Effect of walking exercise on bone metabolism in postmenopausal women with osteopenia/osteoporosis.

    PubMed

    Yamazaki, Satoshi; Ichimura, Shoichi; Iwamoto, Jun; Takeda, Tsuyoshi; Toyama, Yoshiaki

    2004-01-01

    The purpose of this prospective study was to determine whether moderate walking exercise in postmenopausal women with osteopenia/osteoporosis would affect bone metabolism. Fifty postmenopausal women, aged 49-75 years, with osteopenia/osteoporosis were recruited: 32 women entered the exercise program (the exercise group) and 18 served as controls (the control group). The exercise consisted of daily outdoor walking, the intensity of which was 50% of maximum oxygen consumption, with a duration of at least 1 h with more than 8000 steps, at a frequency of 4 days a week, over a 12-month period. Lumbar (L2-L4) bone mineral density (BMD) was measured at the baseline and every 6 months with dual-energy X-ray absorptiometry (DXA) in both groups. Serum bone-specific alkaline phosphatase (BAP) and urinary cross-linked N-terminal telopeptides of type I collagen (NTX) levels were measured at baseline and at months 1, 3, 6, 9, and 12 by EIA and ELISA, respectively, in the exercise group, and urinary NTX level was measured at the baseline and every 6 months in the control group. There were no significant differences in baseline characteristics including age, height, body weight, bone mass index, years since menopause, lumbar BMD, and urinary NTX level between the two groups. Although no significant changes were observed in lumbar BMD and the urinary NTX level in the control group, lumbar BMD in the exercise group was increased as compared with the control group, but was sustained from the baseline. In the exercise group, the urinary NTX level rapidly responded to walking exercise from month 3, and this reduction was sustained until month 12, followed by reduction in the serum BAP level. A moderately negative correlation was found between the percent change in the urinary NTX level at month 3 and that in lumbar BMD at month 12 in the exercise group. This study clearly demonstrates that the mechanism for the positive response of lumbar BMD to moderate walking exercise in

  15. Evaluation of tibial cortical bone by ultrasound velocity in oriental females.

    PubMed

    Wang, S F; Chang, C Y; Shih, C; Teng, M M

    1997-11-01

    In order to evaluate the feasibility of detecting bone status by measuring cortical ultrasound velocity, ultrasonic transmission velocity of the anterior cortex of shin was measured on 175 normal Chinese females aged 31-75 years (mean 52.3 +/- SD 9.1 years). The data were compared with bone mineral density (BMD) of the lumbar spine and/or hip measured by dual energy X-ray absorptiometry (DXA), which was performed on the same day as speed of sound (SOS) examination. Comparison was made with SOS of Caucasian women previously reported in the literature. SOS of three volunteers measured by two different operators were also enrolled in our study for precision testing. The mean value of SOS of the 175 females was 3850.7 +/- 119.3 m s-1 (range: 3411.7-4220.5 m s-1), the peak value being in the fourth decade. The rate of decrease of transmission velocity per decade from fourth decade to fifth decade was 1.7%, while that of fifth decade to sixth decade was 2.2% and that of sixth decade to seventh decade was 4.0%. The interoperative and intraoperative coefficient variance with and without reposition were under 0.32%. SOS moderately correlated with BMD at different sites, the best correlation being with the lumbar spine anteroposterior projection (r = 0.509; p < 0.0001, Pearson's test). There were significant differences in SOS between pre- and post-menopausal groups (p = 0.01, ANOVA test), and between peri- and post-menopausal groups (p = 0.02), but there was no correlation of body weight and height with SOS. SOS also inversely correlated with age and post-menopausal duration. The mean value of SOS in our study was similar to that of Caucasians, but the rate of decrease over 50 years of age was faster. The rate of decline of tibial cortical SOS was similar to that of trabecular bone as previously reported in the literature. As there is a significant decrease of SOS in older females, and older Oriental females suffer from an accelerated cortical bone loss, it is concluded

  16. Elemental quantification using multiple-energy x-ray absorptiometry

    NASA Astrophysics Data System (ADS)

    Kozul, N.; Davis, G. R.; Anderson, P.; Elliott, J. C.

    1999-03-01

    A novel implementation of multiple-energy x-ray absorptiometry (MEXA) for elemental quantification has been developed. Species are resolved on the basis of their differential attenuation spectra across a wide energy range, ideally including absorption edges. By measuring the incident and exiting x-ray spectra and using known values of mass attenuation coefficients over selected energy bands, the density line integral of the species along the x-ray path can be calculated from all the selected energy channels simultaneously by non-linear least squares methods. Effects of `escape' peak phenomena are modelled and corrections for them are included in the MEXA software. The applications of MEXA are illustrated by single measurements on aluminium and zirconium foils, quantitation of aqueous KI diffusing into a porous solid, simultaneous measurement of acidic diffusant 0957-0233/10/3/023/img1 and porous solid with which it reacts and which it dissolves and microtomographic reconstructions of liquid and solid specimens containing caesium and/or iodine.

  17. Changes in bone mineral density 10 years after marked reduction of cadmium exposure in a Chinese population

    SciTech Connect

    Chen, Xiao; Zhu, Guoying; Jin, Taiyi; Akesson, Agneta; Bergdahl, Ingvar A.; Lei, Lijian; Weng, Shifang; Liang, Yihuai

    2009-10-15

    The main focus of this study was to evaluate the long-term effects of Cd on forearm bone mineral density after the cessation of the ingestion of Cd-polluted rice. A total of 458 persons (294 women, 164 men) from three Cd exposure areas (low, moderately, and heavy) participated in this study. Those living in the moderate and heavy exposure areas ceased ingesting Cd-polluted rice (0.51 and 3.7 mg/kg, respectively) in 1996 (10 years prior to present analysis). The participants completed a questionnaire and bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) at the proximal radius and ulna. The changes and change percentage in forearm bone density and the prevalence of osteoporosis between 1998 and 2006 were used as markers of bone recovery. The Cd concentrations in urine (UCd) and blood (BCd) in 1998 were used as Cd exposure markers. The values of the BMD change and change percentage of groups in which UCd was above 5 {mu}g/g creatinine ({mu}g/g crea) and BCd was above 10 {mu}g/L were significantly higher than those of the low-exposure groups (in women, p<0.001; in men, p>0.05). The BMD change and change percentage correlated positively with the UCd and BCd (in women, p<0.01; in men, p>0.05). Analysis of the Z-score revealed that the prevalence of osteoporosis in 2006 was higher than that in 1998 and increased along with the level of UCd and BCd in both women and men, especially for those subjects with the higher BCd [BCd>5 {mu}g/L, OR=3.45 (0.95-13.6); BCd>10 {mu}g/L, OR=4.51(1.57-13.54)] and UCd [UCd>10 {mu}g/g crea, OR=4.74 (1.82-12.81)] in women. It is concluded that decreasing dietary cadmium exposure at the population level is not associated with bone recovery at the individual level, and the adverse bone effects of Cd exposure persisted after the main source of Cd exposure had been blocked, especially in women.

  18. Relationship between Bone Density and Biochemical Markers of Bone among Two Groups Taking Carbamazepine and Sodium Valproate for Epilepsy in Comparison with Healthy Individuals in Yazd

    PubMed Central

    Rahimdel, Abolghasem; Dehghan, Ali; Moghadam, Mahboubeh Abolhassani; Ardekani, Ali Mellat

    2016-01-01

    Introduction Chronic antiepileptic therapy has been associated with metabolic bone diseases including osteomalacia and osteoporosis. The aim of this study was to determine frequency of changes in biochemical and bone mineral density (BMD) in adults receiving valproaic acid (VPA) & carbamazepine (CBZ). Methods In a cross sectional study evaluating adults (age 20–50 y) epileptic patients receiving valproic acid or carbamazepine for at least 2 years. This study was conducted from May 2014 to May 2015 in Shahid Sadoughi Hospital of Yazd University of Medical Science, Yazd, Iran. Bone metabolism was evaluated by measurement of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP) and parathormone hormone (PTH), BMD at lumbar and femoral measured by dual energy X ray absorptiometry (DXA). SPSS software (version 18) was used for data analysis. The t-test was used for quantitative data, and the chi-squared test was used for the qualitative variables. Results Eighty two epileptic patients (mean age: 31.67±10.69 year) treated with either carbamazepine (n=41) or valproate sodium (n=41) were studied. Normal serum Ca and P levels were observed in 98.8% and 97.6% of patients respectively. Serum ALP and PTH were normal in 97.6% and 97.6% of patients. Means of Ca and P in CBZ group were significantly lower than VPA group (Ca: 9.02 vs. 9.1, p-value: 0.03 and P: 3.54 vs. 3.76 p-value: 0.004). BMD values at lumbar spine were not significant in either group (T. score CBZ: −0.43± 0.744 vs. T. score VPA: −0.615± 0.904 and p-value: 0.333) and were significantly higher than Iranian normal population BMD value at femoral neck in CBZ group was lower than VPA group (T. score CBZ: −0.707± 0.896 vs. T. score VPA: − 0.297± 0.850 p-value: 0.04). Dosage of CBZ and VPA did not correlate with BMD and biochemical parameters. Duration of CBZ use had correlation with increased ALP and duration of VPA use had correlation with decreased BMD in adult patients. Conclusion long term

  19. Effects of Hypergravity and Adrenalectomy on Total Body Bone Mineral Content in Male Rats

    NASA Technical Reports Server (NTRS)

    Girten, Beverly; Moran, Megan; Baer, Lisa; Pruitt, Sean; O'Brien, Cheryl; Arnaud, Sara; Wade, Charles; Bowley, Susan M. (Technical Monitor)

    2000-01-01

    The effects of 14 days of increased gravitational load, and the absence of adrenal stress hormones on total body bone mineral content (BMC) were examined in male Sprague-Dawley rats. Centrifugation at 2 Gs (2G) was used to increase the gravitational load, and bilateral adrenalectomy (ADX) was used to eliminate the production of adrenal stress hormones. Stationary groups at 1 G (1G) and sham operated (SHAM) animals served as controls. Thirty rats (n=6 or 8) made up the four experimental groups (1G SHAM, 1G ADX, 2G SHAM and 2G ADX). BMC was assessed by dual energy X-ray absorptiometry (DXA) and activity was determined through biotelemetry. Body mass and food intake were also measured. Multi-factorial analysis of variance (MANCOVA) and Newman Keuls post hoc tests were used to analyze significant effects (p less than 0.05) for the primary variables. Results indicated that BMC decreased significantly with increased G for both the SHAM and ADX groups. The BMC for the 1 G ADX group was also significantly lower than the 1G SHAM group, however the 2G SHAM and ADX groups were not significantly different. There was a significant decrease in body mass with increased G and there was no ADX effect on body mass. When BMC was normalized for body mass changes, there were no significant group differences. Activity level decreased with body mass, and food intake data showed there was significant hypophagia during the first few days of centrifugation. These results suggest that the decrease in total body BMC seen with hypergravity may be based to a large extent on the differences in body mass induced by the 2 G load.

  20. Relationships between body composition, muscular strength, and bone mineral density in estrogen-deficient postmenopausal women.

    PubMed

    Sherk, Vanessa D; Palmer, Ian J; Bemben, Michael G; Bemben, Debra A

    2009-01-01

    The purpose of this study was to examine relationships between muscular strength, body composition, and bone mineral density (BMD) in untrained postmenopausal women who are not on hormone replacement therapy (HRT). Fifty-five women (age: 63.3+/-0.6yr) completed menstrual history, physical activity, and calcium intake questionnaires. Total and regional body composition and total body, anteroposterior lumbar spine, nondominant forearm, and right proximal femur BMD were measured using dual-energy X-ray absorptiometry (DXA) (GE Lunar Prodigy, Prodigy enCORE software version 10.50.086, Madison, WI). Participants performed strength tests for 3 upper body and 5 lower body resistance exercises. Women with a relative skeletal muscle mass index (RSMI) value less than 5.45 kg/m(2) were defined as a sarcopenia group (SAR). SAR had significantly (p < 0.05) lower total body and forearm BMD compared with those who were not sarcopenic. BMD sites were significantly correlated with upper body strength (UBS) and lower body strength (LBS) (r = 0.28-0.50, p < 0.01), with the strength of relationship being site specific. Strength and fat mass (FM) significantly predicted total body BMD (R(2) = 0.232-0.241, p < 0.05), FM variables predicted spine BMD (R(2) = 0.109-0.140, p < 0.05), and LBS and RSMI predicted hip BMD sites (R(2) = 0.073-0.237, p < 0.05). Body composition variables failed to significantly predict LBS. In conclusion, the contribution of body composition and strength variables to BMD varied by site as FM was more important for total body, forearm and spine BMD, and LBS exerted greater influence on the hip sites.

  1. Association of sarcopenia and physical activity with femur bone mineral density in elderly women

    PubMed Central

    Lee, Inhwan; Ha, Changduk; Kang, Hyunsik

    2016-01-01

    [Purpose] This study examined the association of femur bone mineral density (BMD) with body composition and physical activity in elderly women. [Methods] This was a cross sectional study involving 119 women with mean age of 73.1±5.5 years. Body composition parameters including body mass index (BMI), percent of body fat (%BF), appendicular skeletal muscle mass (ASM) index and femur BMD was measured by dual-energy X-ray absorptiometry (DXA). Physical activity was assessed by the uniaxial accelerometer for 7 consecutive days including weekends. Based on femur BMD T-scores, subjects were classified as optimal group, osteopenia group, and osteoporosis group. Based on ASM index, subjects were classified as normal group and sarcopenia group. According to WHO recommendations of physical activity for elderly, the subjects were classified as active group or inactive group. Logistic regression analyses were used to determine the odds ratio (OR) for osteopenia and osteoporosis. [Results] There were linear decreases for body composition parameters including weight (P=.023), BMI (P=.039), lean mass (P=.032), ASM index (P=.007) and physical activity parameters including daily of step (P<.001), low intensity physical activity (P<.001), moderate intensity physical activity (P=.001) across femur BMD levels. Compared to the normal group (OR=1), the sarcopenia group had a significantly higher OR (OR=4.823; P=.042), and the inactive group had a significantly higher OR (OR=5.478; P=.005) having osteopenia and osteoporosis when compared to the active group (OR=1). [Conclusion] The findings of this study suggested that physical activity along with a healthy nutrition should be promoted as a preventive strategy against osteopenia and osteoporosis in elderly women. PMID:27298809

  2. Long-term precision of dual-energy X-ray absorptiometry body composition measurements and association with their covariates.

    PubMed

    Powers, Cassidy; Fan, Bo; Borrud, Lori G; Looker, Anne C; Shepherd, John A

    2015-01-01

    Few studies have described the long-term repeatability of dual-energy X-ray absorptiometry scans. Even fewer studies have been performed with enough participants to identify possible precision covariates such as sex, age, and body mass index (BMI). Our objective was to investigate the long-term repeatability of both total and subregional body composition measurements and their associations with covariates in a large sample. Two valid whole-body dual-energy X-ray absorptiometry scans were available for 609 participants in the National Health and Nutrition Examination Survey 2000-2002. Participants with scan-quality issues were excluded. Participants varied in race and ethnicity, sex, age (mean 38.8±17.5; range 16-69 yr), and BMI (mean, 26.9±5.2; range 14.1-43.5 kg/m2). The length of time between scans ranged from 3 to 51 days (mean, 18.7±8.4). Precision error estimates for total body measures (bone mineral density, bone mineral content, lean mass, total mass, fat mass, and percent body fat) were calculated as root mean square percent coefficients of variation and standard deviations. The average root mean square percent coefficients of variation and root mean square standard deviations of the precision error for total body variables were 1.12 and 0.01 g/cm2 for bone mineral density, 1.14 and 27.3 g for bone mineral content, 1.97 and 505 g for fat mass, 1.46 and 760 g for lean mass, 1.10 and 858 g for total mass, and 1.80 and 0.59 for percent body fat. In general, only fat and lean masses were impacted by participant and scan qualities (obesity category, sex, the magnitude of the body composition variables, and time between scans). We conclude that long-term precision error values are impacted by BMI, and sex. Our long-term precision error estimates may be more suitable than short-term precision for calculating least significant change and monitoring time intervals.

  3. Diagnostic value of osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) in detecting high-risk populations for osteoporosis among elderly Chinese men.

    PubMed

    Zha, Xiao-Yun; Hu, Yu; Pang, Xiao-Na; Chang, Gui-Lin; Li, Li

    2015-03-01

    This study aims to evaluate an osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) and their combination in detecting populations at high risk for osteoporosis, and to determine the best cutoff value for the diagnosis of osteoporosis among elderly Chinese men. A group of Chinese men, aged ≥ 60 years, recruited from the health checkup population of Zhongshan Hospital, Fudan University, were included. The OSTA index was calculated from age and weight. Bone mineral density (BMD) at left hip (femoral neck, internal, and total hip) and lumbar spine (L1-L4, L-Total) was measured with dual-energy X-ray absorptiometry (DXA), and calcaneal BMD was measured with QUS. Receiver operating characteristic analysis was used to determine the best cutoff values, sensitivity, and specificity. The area under the curve (AUC) between the different screening tools was compared. Our study included 472 men with mean age of 78.0 years. The prevalence of osteoporosis was 27.7%.The best cutoff for OSTA was -3.5 for predicting men with osteoporosis at any site; this yielded a sensitivity and specificity of 47.3% and 76.8%, respectively. The AUC for OSTA was 0.676. The optimal cutoff for QUS-T score was -1.25, with a sensitivity of 80.4% and specificity of 59.7%. The AUC for QUS-T score was 0.762. Combining QUS with OSTA improved the specificity to 92.9% but reduced sensitivity to 36.1%. A new variable derived from a combination of OSTA and the QUS-T score gave a better performance, with sensitivity of 70.1% and specificity of 72.1%; the AUC for this variable was 0.771, which was greater than OSTA but not different from QUS alone. In conclusion, OSTA and QUS, respectively, and their combination may help find populations at high risk for osteoporosis, which could be an alternative method for diagnosing osteoporosis, especially in areas where DXA measurement is not accessible.

  4. A Piece of the Puzzle: The Bone Health Index of the BoneXpert Software Reflects Cortical Bone Mineral Density in Pediatric and Adolescent Patients

    PubMed Central

    Schündeln, Michael M.; Marschke, Laura; Bauer, Jens J.; Hauffa, Pia K.; Schweiger, Bernd; Führer-Sakel, Dagmar; Lahner, Harald; Poeppel, Thorsten D.; Kiewert, Cordula; Hauffa, Berthold P.; Grasemann, Corinna

    2016-01-01

    Introduction Suspected osteopathology in chronically ill children often necessitates the assessment of bone mineral density. The most frequently used methods are dual-energy X-ray-absorption (DXA) and peripheral quantitative computed tomography (pQCT). The BoneXpert software provides an automated radiogrammatic method to assess skeletal age from digitalized X-rays of the left hand. Furthermore, the program calculates the Bone Health Index (BHI), a measure of cortical thickness and mineralization, which is obtained from indices of three metacarpal bones. In our study, we analyzed the manner in which BHI information provided by BoneXpert compares with DXA or pQCT measurements in youths. Study Design The BHI was retrospectively obtained using digitalized X-rays of the left hand and compared with the results of 203 corresponding DXA readings (Lunar Prodigy, GE Healthcare) of the lumbar vertebrae and femur as well as 117 pQCT readings (XCT 900, Stratec) of the distal radius. Results The BHI values showed a strong positive correlation with the DXA readings at each and all lumbar vertebrae (L1 –L4: r = 0.73; P < 0.0001). The age-adjusted Z-score of L1 –L4 and the height-adjusted score showed a positive correlation with the BHI-SDS (standard deviation score, r = 0.23; P < 0.002 and r = 0.27; P < 0.001, respectively). Total bone mineral density, as assessed via pQCT, also positively correlated with the BHI (r = 0.39; P < 0.0001), but the trabecular values displayed only a weak correlation. Conclusions The BHI obtained using BoneXpert can be a useful parameter in the assessment of bone health in children in most cases. This technique provides observer-independent information on cortical thickness and mineralization based on X-ray imaging of the hands. PMID:27014874

  5. Catch up in bone acquisition in young adult men with late normal puberty.

    PubMed

    Darelid, Anna; Ohlsson, Claes; Nilsson, Martin; Kindblom, Jenny M; Mellström, Dan; Lorentzon, Mattias

    2012-10-01

    The aim of this study was to investigate the development of bone mineral density (BMD) and bone mineral content (BMC) in relation to peak height velocity (PHV), and to investigate whether late normal puberty was associated with remaining low BMD and BMC in early adulthood in men. In total, 501 men (mean ± SD, 18.9 ± 0.5 years of age at baseline) were included in this 5-year longitudinal study. Areal BMD (aBMD) and BMC, volumetric BMD (vBMD) and cortical bone size were measured using dual-energy X-ray absorptiometry (DXA) and pQCT. Detailed growth and weight charts were used to calculate age at PHV, an objective assessment of pubertal timing. Age at PHV was a strong positive predictor of the increase in aBMD and BMC of the total body (R(2) aBMD 11.7%; BMC 4.3%), radius (R(2) aBMD 23.5%; BMC 22.3%), and lumbar spine (R(2) aBMD 11.9%; BMC 10.5%) between 19 and 24 years (p < 0.001). Subjects were divided into three groups according to age at PHV (early, middle, and late). Men with late puberty gained markedly more in aBMD and BMC at the total body, radius, and lumbar spine, and lost less at the femoral neck (p < 0.001) than men with early puberty. At age 24 years, no significant differences in aBMD or BMC of the lumbar spine, femoral neck, or total body were observed, whereas a deficit of 4.2% in radius aBMD, but not in BMC, was seen for men with late versus early puberty (p < 0.001). pQCT measurements of the radius at follow-up demonstrated no significant differences in bone size, whereas cortical and trabecular vBMD were 0.7% (p < 0.001) and 4.8% (p < 0.05) lower in men with late versus early puberty. In conclusion, our results demonstrate that late puberty in males was associated with a substantial catch up in aBMD and BMC in young adulthood, leaving no deficits of the lumbar spine, femoral neck, or total body at age 24 years.

  6. Enhanced bone mass and physical fitness in young female handball players.

    PubMed

    Vicente-Rodriguez, G; Dorado, C; Perez-Gomez, J; Gonzalez-Henriquez, J J; Calbet, J A L

    2004-11-01

    This study evaluates the effect of physical activity on the bone content (BMC) and density (BMD) in 51 girls (14.2+/-0.4 yr). Twenty-four were placed in the handball group as they have been playing handball for at least 1 year (3.9+/-0.4). The other 27 who did not perform in any kind of regular physical activity other than that programmed during the compulsory physical education courses comprised the control group. Bone mass and areal density were measured by dual-energy X-ray absorptiometry (DXA). The maximal leg extension isometric force in the squat position with knees bent at 90 degrees and the peak force, mean power, and height jumped during vertical squat jump were assessed with a force plate. Additionally, 30-m run (running speed) and 300-m run (as an estimate of anaerobic capacity) tests were also performed. Maximal aerobic capacity was estimated using the 20-m shuttle-run tests. Compared to the controls, handballers attained better results in the physical fitness tests and had a 6% and 11% higher total body and right upper extremity lean mass (all P<0.05). The handballers showed enhanced BMC and BMD in the lumbar spine, pelvic region, and lower extremity (all P<0.05). They also showed greater BMC in the whole body and enhanced BMD in the right upper extremity and femoral neck than the control subjects (all P<0.05). As expected, total lean mass strongly correlated with total and regional BMC and BMD (r=0.79-0.91 P<0.001). Interestingly, 300-m running speed correlated with BMC and BMD variables (r=0.59-0.67 and r=0.60-0.70, respectively; all P<0.001). Multiple regression analysis showed that the 30-m running speed test, combined with the height and body mass, has also predictive value for whole-body BMC and BMD (R=0.93 and R=0.90, P<0.001). In conclusion, handball participation is associated with improved physical fitness, increased lean and bone masses, and enhanced axial and appendicular BMD in young girls. The combination of anthropometric and fitness

  7. High intensity resistance training: effects on bone in older men and women.

    PubMed

    Maddalozzo, G F; Snow, C M

    2000-06-01

    There is evidence that high intensity resistance training promotes bone maintenance in older women, however, the effect of high intensity free weight training has not been investigated in older men or women. Furthermore, little is known about the chronic effect of weight training on serum insulin growth factor-I (IGF-I) in this population. We compared the effects of a moderate intensity seated resistance-training program with a high intensity standing free weight exercise program on bone mass and serum levels of IGF-I and IGFBP3 in healthy older men and women. Twenty-eight men (54.6 +/- 3. 2 years) and 26 nonestrogen-replaced women (52.8 +/- 3.3 years) served as their own controls for 12 weeks, then were randomly assigned to a moderate or high intensity training group and trained three times/week for 24 weeks. Prior to and after the control period and at the end of training, bone mass and body composition were assessed by dual energy X-ray absorptiometry (DXA), muscle strength by isokinetic dynamometry, muscular power by Wingate Anaerobic Power Test, and IGF-I by radioimmunoassay (RIA). A repeated measures analysis of covariance (ANCOVA) revealed that high intensity training resulted in a gain in spine BMD in men (1.9%), P < 0.05, but not in women, whereas moderate intensity training produced no changes in either gender at this site. Increases were observed at the greater trochanter, P < 0.03, in men regardless of training intensity, but not in women at any hip site. However, when compared with zero, both men and women in the high intensity group demonstrated significant increases in trochanteric BMD (1.3% and 2. 0%, respectively) and a decrease in femoral BMD (-1.8%). Neither circulating serum IGF-I nor IGFBP3 were altered by either training regimen, but both training programs resulted in improvements in total body strength (37.62%) and lean mass (males 4.1%, females 3. 1%). We conclude that although resistance training of moderate to high intensity produced

  8. A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study.

    PubMed

    Waring, Avantika C; Harrison, Stephanie; Fink, Howard A; Samuels, Mary H; Cawthon, Peggy M; Zmuda, Joseph M; Orwoll, Eric S; Bauer, Douglas C

    2013-03-01

    Excess thyroid hormone is associated with increased bone loss and fracture risk in older women, but few data exist for men. We sought to determine if thyroid function is independently associated with bone loss and fracture risk in older men. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) study, a cohort of community-dwelling U.S. men aged 65 years and older. Using a case-cohort design, fasting baseline serum archived at -80°C was assayed for thyroid-stimulating hormone (thyrotropin) (TSH) and free thyroxine (FT4) in 397 men with confirmed nonspine fracture, including 157 hip fractures, and 1420 randomly selected men without fracture. TSH and FT4 were analyzed as continuous variables and as thyroid function categories (subclinical hyperthyroid, euthyroid, and subclinical hypothyroid). Hip dual-energy X-ray absorptiometry (DXA) (Hologic QDR4500) was measured at baseline and after a mean follow-up of 4.6 years. Incident nonspine fractures were centrally adjudicated. Bone loss was evaluated with multivariate regression methods and fractures risk was evaluated using hazard models that accounted for the case-cohort sampling, adjusted for age, clinic-site, body mass index (BMI), race, physical activity, corticosteroid use, smoking, alcohol intake, and thyroid medication use. In fully adjusted analyses, TSH was not associated with risk of nonspine fracture (relative hazard [RH] 0.92 per SD decrease in TSH; 95% confidence interval [CI], 0.74-1.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.01-1.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.00-1.47). There was no association between TSH or FT4 and bone loss, and fracture risk did not differ significantly by thyroid function category. We conclude that although neither TSH nor FT4 are associated with bone loss, lower serum TSH may be associated with an increased risk of hip fractures in older men.

  9. Bone Microarchitecture Assessed by HR-pQCT as Predictor of Fracture Risk in Postmenopausal Women: The OFELY Study.

    PubMed

    Sornay-Rendu, Elisabeth; Boutroy, Stephanie; Duboeuf, François; Chapurlat, Roland D

    2017-03-09

    Several cross-sectional studies have shown that impairment of bone microarchitecture contributes to skeletal fragility. The aim of this study was to prospectively investigate the prediction of fracture (Fx) by bone microarchitecture assessed by high-resolution peripheral computed tomography (HR- pQCT) in postmenopausal women. We measured microarchitecture at the distal radius and tibia with HR-pQCT in the OFELY study, in addition to areal BMD with dual-energy X-ray absorptiometry (DXA) in 589 women, mean ± SD age 68 ± 9 years. During a median [IQ] 9.4 [1.0] years of follow-up, 135 women sustained an incident fragility Fx, including 81 women with a major osteoporotic Fx (MOP Fx). After adjustment for age, women who sustained Fx had significantly lower total and trabecular volumetric densities (vBMD) at both sites, cortical parameters (area and thickness at the radius, vBMD at the tibia), trabecular number (Tb.N), connectivity density (Conn.D), stiffness, and estimated failure load at both sites, compared with control women. After adjustment for age, current smoking, falls, prior Fx, use of osteoporosis-related drugs, and total hip BMD, each quartile decrease of several baseline values of bone microarchitecture at the radius was associated with significant change of the risk of Fx (HR of 1.39 for Tb.BMD [p = 0.001], 1.32 for Tb.N [p = 0.01], 0.76 for Tb.Sp.SD [p = 0.01], 1.49 [p = 0.01] for Conn.D, and 1.27 for stiffness [p = 0.02]). At the tibia, the association remained significant for stiffness and failure load in the multivariate model for all fragility Fx and for Tt.BMD, stiffness, and failure load for MOP Fx. We conclude that impairment of bone microarchitecture-essentially in the trabecular compartment of the radius-predict the occurrence of incident fracture in postmenopausal women. This assessment may play an important role in identifying women at high risk of fracture who could not be adequately detected by BMD measurement

  10. A Losing Battle: Weight Regain Does Not Restore Weight Loss-Induced Bone Loss in Postmenopausal Women

    PubMed Central

    Villalon, Karen L.; Gozansky, Wendolyn S.; Van Pelt, Rachael E.; Wolfe, Pam; Jankowski, Catherine M.; Schwartz, Robert S.; Kohrt, Wendy M.

    2013-01-01

    Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m2. They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (−1.7 ± 3.5%; P = 0.002) and hip (−0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (−0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: −3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss. PMID:21852813

  11. Gender differences in trabecular bone architecture of the distal radius assessed with magnetic resonance imaging and implications for mechanical competence.

    PubMed

    Hudelmaier, Martin; Kollstedt, A; Lochmüller, E M; Kuhn, V; Eckstein, F; Link, T M

    2005-09-01

    High-resolution magnetic resonance imaging (hrMRI) has recently made it possible to evaluate trabecular bone structure in vivo. Despite obvious gender differences in fracture incidence at the distal radius, little is known about gender differences in trabecular bone microarchitecture and its relationship to the structural strength of the forearm. The aim of this study was to determine trabecular bone structure in the distal radius of elderly women and men and its correlation with failure loads of the distal radius as determined in a fall configuration. Specifically, we tested the hypotheses that structural indices differ between women and men and that they offer information that is independent from BMD for predicting structural strength. Intact right arms were obtained from 73 formalin-fixed cadavers (age 80+/-11 years, 43 women, 30 men). Trabecular structural indices (apparent bone volume fraction [app. BV/TV], trabecular number [app. Tb.N], trabecular separation [app. Tb.Sp], trabecular thickness [app. Tb.Th] and fractal dimension [Frac.Dim]) were assessed in the distal metaphysis, using hrMRI with 156 microm in-plane resolution and proprietary digital image analysis, while BMD was measured with dual X-ray absorptiometry (DXA). Women displayed significantly lower BMD (-29.8%, p <0.001), app. BV/TV (-8.2%, p <0.05) and app. Tb.Th (-10.2%, p <0.001) than men, whereas app. Tb.N, app. Tb.Sp. and fractal dimension did not differ significantly. Structural parameters differed between normal and osteopenic women (BV/TV: -11%, p <0.01; Tb.Th: -8%, p <0.001) and between normal and osteoporotic women BV/TV: -21%, p <0.001; Tb.Th: -16%, p <0.001). App. BV/TV, app. Tb.Th and fractal dimension provided information independent from BMD in the prediction of radial failure loads in multiple regression models. These findings imply that it should be of clinical interest to monitor both bone mass and trabecular microstructure for predicting osteoporotic fracture risk.

  12. Bone fractal analysis.

    PubMed

    Feltrin, Gian Pietro; Stramare, Roberto; Miotto, Diego; Giacomini, Dario; Saccavini, Claudio

    2004-06-01

    Fractal analysis is a quantitative method used to evaluate complex anatomic findings in their elementary component. Its application to biologic images, particularly to cancellous bones, has been well practiced within the past few years. The aims of these applications are to assess changes in bone and the loss of spongious architecture, indicate bone fragility, and to show the increased risk for fracture in primary or secondary osteoporosis. The applications are very promising to help complete the studies that can define bone density (bone mineral density by dual energy x-ray absorptiometry or quantitative computed tomography), and also have the capacity to distinguish the patients with a high or low risk for fracture. Their extension to the clinical fields, to define a test for fracture risk, is still limited by difficult application to the medical quantitative imaging of bones, between correct application at superficial bones and unreliable application to deep bones. The future evolution and validity do not depend upon fractal methods but upon well-detailed imaging of the bones in clinical conditions.

  13. Non-Invasive Investigation of Bone Adaptation in Humans to Cumulative Daily Mechanical Loading

    NASA Technical Reports Server (NTRS)

    Whalen, Robert; Cleek, Tammy; Sode, Miki

    2003-01-01

    The goal of our research is to better understand the functional relationship between cumulative daily skeletal loading generated by daily activity and the regulation of bone density and bone structure. We have proposed the calcaneus and tibia as useful model bone sites loaded by internal forces in equilibrium with the ground reaction force during gait. The daily history of the ground reaction force is a good relative measure of daily lower limb and calcaneal loading that can be compared to bone density and structure of the calcaneus and cross-sectional geometry of the tibia and fibula. Over the past several years, we have developed image-processing technologies to improve our ability to measure bone density and structure in the calcaneus and lower leg non-invasively with computed tomography and bone densitometry, or DXA. The objective of our current research effort is to determine the accuracy and precision of our CT and DXA image processing methods.

  14. Polymorphisms in Genes Involved in the NF-κB Signalling Pathway Are Associated with Bone Mineral Density, Geometry and Turnover in Men