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PubMed1997

Bone density measurement--a systematic review. A report from SBU, the Swedish Council on Technology Assessment in Health Care.

Because a reduction in bone density often correlates to an increased risk of fracture, bone density is usually measured in an attempt to establish the risk of fracture. The results from bone density measurement are intended to provide a potential basis for treating osteoporosis. When assessing the value of bone density measurement, the key issues concern the reliability of the various methods (i.e., how accurately they reflect bone density) and whether bone density treatment can actually prevent fracture. OSTEOPOROSIS: Humans begin to lose bone tissue as they become older. In most cases, this process is slow and gradual. Bone tissue begins to disappear when people are aged between 30 and 40 years and continues throughout life. However, bone loss varies greatly among individuals, and some elderly people show no sign of bone loss. Several factors influence both the loss of bone mass as people age and the formation of bone mass in the growing individual. The single most important factor associated with reduced bone mass is the loss of the female sex hormone (oestrogen). Tobacco smoking, lack of exercise, and low calcium levels in the diet also reduce bone density. Reduced bone density may lead to osteoporosis, which increases the risk of fracture, often affecting the vertebrae, hips and wrists. The most common direct cause of fracture, mainly among the elderly, involves falling or stumbling. Contributing factors here include diseases or medications that affect the sight, muscle strength, and balance. Osteoporosis is one of many risk factors for fractures resulting from falls. Fracture is a large and growing health problem. Each year, approximately 60,000 people in Sweden suffer some type of fracture. With an increasing percentage of elderly people in the Swedish population, it is estimated that every second woman over 50 years of age will experience fracture at some time during their remaining life. The risk in men is lower. It is essential to prevent, as far as possible, the onset of osteoporosis and other risk factors for fracture. Preventive approaches include, increased physical activity during youth when people develop their bone mass, sufficient intake of calcium in the diet among the young and old alike, and smoking cessation (or preventing people from starting to smoke). It is particularly important to treat osteoporosis effectively, or prevent osteoporosis from developing into a serious condition. This requires further research into strategies for treating osteoporosis. The various methods for measuring bone density represent an important component in such research. MEASURING BONE DENSITY: Bone density may be measured either to establish a diagnosis or to monitor changes, e.g. follow-up treatment for osteoporosis. Bone density can be estimated roughly by simply measuring height, weight, and age, but this approach has limited value for establishing the level of bone density in individuals. To a certain extent, x-ray examination can also be used to estimate the level of bone density. Special methods have been developed in recent decades for measuring bone density, and technologies for this purpose have become more widely available since the 1980s. The new methods for bone density measurement are based on either the energy/methodology used in ultrasound and magnetic resonance imaging (MRI), or on x-rays. Some methods are designed for measuring only the forearm, hip, lumbar spine, or heel bone (calcaneus), while others measure several sites in the body simultaneously. Most methods demonstrate good precision (i.e. repeated measurements yield the same results). However, to establish the bone density level reliably, methods must also be highly accurate (i.e. the values obtained by measurement must coincide with the individual's actual bone density). The accuracy of current technologies is substantially lower than their precision, so further research, technical development, and experience are required before the methods can be i

Bone Density↗

PubMed2000

The influence of gastrectomy on the change of bone metabolism and bone density.

OBJECTIVES: Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers. METHODS: Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected. RESULTS: Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p < 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p < 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups. CONCLUSION: We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.

Absorptiometry, Photon↗

PubMed1992

Racial differences in pre- and postmenopausal bone homeostasis: association with bone density.

The disparity in fracture incidence and bone mass in women of European (white) and African (black) ancestry is of unknown etiology. To determine if racial differences in bone mass reflected racial differences in the mechanisms of bone turnover underlying bone mineral loss, we measured serum osteocalcin, serum alkaline phosphatase, fasting urinary calcium and hydroxyproline excretion, 24 h urinary excretion of calcium and sodium, and dietary intakes of calcium and vitamin D in 263 healthy pre-, peri-, and postmenopausal white and black women. In addition, radial and spinal bone density were measured cross-sectionally for comparison with biochemical measures of bone turnover. The biochemical parameters thought to reflect bone resorption (fasting urinary calcium and hydroxyproline excretions) were lower in black than in white women throughout the age and menopausal stages studied. The parameters thought to reflect bone formation (alkaline phosphatase and osteocalcin), were similar in the two racial groups among the premenopausal women, but osteocalcin was significantly lower among the peri- and postmenopausal blacks. Cross sectionally measured radial bone density increased with age in premenopausal black women, but it did not change with age in the white premenopausal subjects, a statistically significant difference. In peri- and postmenopausal women radial density declined significantly with years after menopause in both racial groups, but the rate of decline was significantly slower in the black women. Lumbar bone density in premenopausal white and black women did not change with age. After menopause lumbar bone density declined significantly and similarly in both racial groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2003

[Is there a relation between weight in rats, bone density, ash weight and histomorphometric indicators of trabecular volume and thickness in the bones of extremities?].

Authors deal with question, if there is possibility to infer bone histological structure (described by histomorphometric parameters of trabecular bone volume and trabecular thickness) from bone density, ash weight or even from weight of animal (rat). Both tibias of each of 30 intact male rats, 90 days old, were processed. Left tibia was utilized to the determination of histomorphometric parameters of undecalcified bone tissue patterns by automatic image analysis. Right tibia was used to the determination of values of bone density, using Archimedes' principle. Values of bone density, ash weight, ash weight related to bone volume and animal weight were correlated with histomorphometric parameters (trabecular bone volume, trabecular thickness) by Pearson's correlation test. One could presume the existence of relation between data, describing bone mass at the histological level (trabecular bone of tibia) and other data, describing mass of whole bone or even animal mass (weight). But no statistically significant correlation was found. The reason of the present results could be in the deviations of trabecular density in marrow of tibia. Because of higher trabecular bone density in metaphyseal and epiphyseal regions, the histomorphometric analysis of trabecular bone is preferentially done in these areas. It is possible, that this irregularity of trabecular tibial density could be the source of the deviations, which could influence the results of correlations determined. The values of bone density, ash weight and animal weight do not influence trabecular bone volume and vice versa: static histomorphometric parameters of trabecular bone do not reflect bone density, ash weight and weight of animal.

Animals↗

PubMed1999

A tibial shaft fracture sustained in childhood or adolescence does not seem to interfere with attainment of peak bone density.

High peak bone mass or density in early adulthood is an important protective factor against osteoporotic fractures in later life, but it is not known whether injuries on growing bones affect the attainment of peak bone mass and density. The purpose of this study was therefore to examine with dual-energy X-ray absorptiometry the areal bone mineral density (BMD) of the injured and uninjured extremity (the femoral neck, trochanter area of the femur, distal femur, patella, proximal tibia, and distal tibia), lumbar spine, and distal radius of young adults with a history of early life tibial shaft fracture and to find out whether the fracture had affected the attainment of peak bone density of these patients. The second objective was to clarify whether any background or clinical follow-up variable would predict the BMD difference between the affected and unaffected extremity. Thus, the BMD and clinical status of 45 patients (34 men and 11 women), who had sustained a tibial shaft fracture in childhood or in adolescence (between 7 and 15 years of age) an average 11 years before the study, were examined. The results showed that the fracture had created a small but statistically significant injured-to-uninjured side BMD difference (proximal tibia -1.7%; p = 0.011, and distal tibia 2.6%; p = 0.014), while the other sites showed no significant side-to-side differences. There were neither significant differences in the spinal or radial BMDs between the patients and their age-, height-, and weight-matched healthy controls. A further analysis of the data showed that the better the muscle strength in the injured lower limb, the lower the side-to-side BMD deficit in the proximal tibia of the same limb (r = 0.51; p < 0.001). Smoking had a significant association with the relative BMD in the injured distal tibia (mean injured-to-uninjured side BMD difference: smokers 6.1% vs. nonsmokers -0.6%, p = 0.016). Also patient's age at the time of the injury showed an association: the younger the patient at the time of the injury, the lower the side-to-side BMD deficit in the injured distal tibia (r = -0.35; p = 0.048). In conclusion, this study indicates that early life tibial fracture leads to a small long-term BMD deficit in the fractured bone while the other sites of the skeleton seem not to be affected. Thus, a tibial shaft fracture sustained in childhood or adolescence seems to only marginally interfere the attainment of peak bone density, the important predictor of the osteoporotic fractures in later life.

Absorptiometry, Photon↗

PubMed1990

[Quantitative analysis of bone density in multiple myeloma].

Bone lesions are the main sign of neoplastic proliferation of multiple myeloma (MM), a disseminated malignant disease which originates in, invades and replaces normal bone marrow. The most characteristic radiographic pattern is a focal lytic lesion, well-defined or "punched-out", generally with no surrounding bone reaction. The association is confirmed between MM and osteoporosis, as reduced bone density (osteopenia) and pathologic fractures (ribs, spine). This paper is aimed at evaluating the importance of osteopenia in both diagnosis and prognosis of MM. Eighteen patients affected with MM were examined with quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DEXA) for bone densitometry in lumbar spine and proximal femur. The patients (12 males and 6 females) were classified according to Durie's clinical criteria and to the radiographic patterns suggested by Merlini. The results indicate the patients with an advanced clinical stage (III) and scintigraphic expansion of bone marrow to have low densitometric values on both QCT and DEXA. There was substantial agreement between the 2 methods, but DEXA had a higher number of false positives. Instrumental diagnostic protocol may be thus planned as follows: 1) conventional radiography; 2) bone marrow scintigraphy; 3) bone densitometry of lumbar spine, with QCT. The patient is then to be followed with conventional and/or digital radiography in symptomatic locations, and with bone scintigraphy.

Aged↗

PubMed1992

Age-related changes in bone density, serum parathyroid hormone, calcium absorption and other indices of bone metabolism in Chinese women.

OBJECTIVE: To study the age-related changes in bone density, serum parathyroid hormone, calcium absorption and other indices of calcium metabolism in Chinese women who habitually have a low calcium intake. DESIGN: Cross-sectional study. SUBJECTS: One hundred and fifty-six healthy Chinese women aged 20-83 years. None were on any medication or vitamin supplements. Subjects over the age of 60 years were all living in a hostel; younger subjects were nurses or subjects attending a family clinic for minor illnesses. MEASUREMENTS: Fasting blood and urine samples were collected for biochemical measurements and calcium absorption was measured using 45Ca by the method of Marshall and Nordin. Bone density was measured by dual energy X-ray densitometry (Norland X R20 X-ray bone densitometer) at the left hip and lumbar spine. Serum parathyroid hormone was measured by a chemiluminometric assay. RESULTS: Plasma ionized calcium concentration, alkaline phosphatase, bicarbonate, plasma creatinine and serum B2 microglobulin were significantly higher in the elderly than in the young, whereas plasma phosphate and the anion gap were higher in the young. Urinary excretion of calcium, phosphate and hydroxyproline were all higher in older women. Plasma parathyroid hormone concentration was positively correlated with age even after taking into account the decline in renal function (as indicated by the rise in B2 microglobulin (r = 0.506, P less than 0.001). Serum concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were not lower in the older women. Fractional calcium absorption from an oral load of radiolabelled calcium was significantly lower in the older women and 37% of the older women were below the 2.5 percentile found in the younger women. Bone density measured by dual energy X-ray densitometry was also significantly lower in the elderly. CONCLUSION: In Chinese women there is an increase in PTH and a decrease in calcium absorption with age in spite of the presence of normal vitamin D metabolites.

Absorption↗

PubMed1994

Age-related changes in cortical and cancellous vertebral bone density in girls: assessment with quantitative CT.

OBJECTIVE: Bone mass increases during growth, but little information is available about the changes in cortical and cancellous bone densities during skeletal development or their relative contributions to age-related increases in bone mass. Accordingly, separate measurements of cancellous and cortical bone density were done at each stage of sexual development in white girls during childhood and adolescence. SUBJECTS AND METHODS: Quantitative CT was used to measure the densities of cortical and cancellous bone of the lumbar spine in 96 healthy white girls 4-20 years old. The relationships among various anthropometric indexes, pubertal status, and corresponding densities of cortical and cancellous bone were then examined. RESULTS: Cortical bone density increased with age, and values were significantly correlated with the anthropometric indexes of height (r = .61), weight (r = .62), body mass index (r = .61), and muscle volume (r = .58). In contrast, cancellous vertebral bone density increased only during the later stages of puberty. Moreover, cancellous bone density in prepubertal girls was inversely related to age (r = -.27) as well as to both the volume (r = -.20) and the height (r = -.15) of the vertebral body. CONCLUSION: The results suggest that weight bearing and/or mechanical stresses are important determinants of cortical bone density in the lumbar spine throughout growth, whereas cancellous vertebral bone density is more strongly influenced by hormonal and/or metabolic factors associated with sexual development during late adolescence.

Adolescent↗

PubMed1997

[A study of bone density and lifestyles of high school girls].

To obtain basic data on the bone density of high school girls, the bone density of the right heel was measured in principle and their lifestyles were surveyed. The subjects were 142 girls (15-18 years, mean +/- SD = 16.5 +/- 0.8 years old) of a high school in Nagano Prefecture, who accepted our visiting bone health check. Bone density was measured with an 'Achilles' ultrasound bone-densitometer (Lunar Co.) and a self-registered questionnaire on their lifestyles was also employed in this study. The main results were as follows: 1. There were no significant correlations between Stiffness and, age, grade, bone fracture, family history, and regularity of menstruation. However, Stiffness significantly correlated to the age of menophania (r = -0.191, p = 0.002) 2. High school girls who belonged to a sports club had significantly higher bone density than other girls. Those who did-exercises which consist mainly of jumping, had significantly higher bone density than others who participated in running sports or did no exercise. There were also significant differences in the frequency of exercise and the duration of exercise. Moreover, those who had a regular exercise history had higher bone density than those who had no regular exercise history, and the mean Stiffness of the group that did exercises daily was higher than for those who did not. 3. There were no significant correlations between Stiffness and food intakes. There also were no significant difference for Stiffness concerning intake of calcium-containing food groups. Regarding the cause of weight loss of more than 2 kg/month, the mean Stiffness of the group with intense exercise was significantly higher than those in the no-weigh loss group and the group that had reduced dietary intake. 4. Regarding the relationships between bone density and the lifestyles of high school girls, a delayed age of menophania had a significantly decreasing effect on Stiffness, whereas three variables of regular exercise habits at present, body weight, and exercise histories had significantly increasing effects on Stiffness in multiple regression analysis. 5. It is considered that there may be other important factors in the relationship between bone density and lifestyle of adolescent females who are in a developmental state. Therefore, the measurement of bone density and its assessment need consideration from points of view which are different from those for middle-aged and the elderly people.

Adolescent↗

PubMed2001

Increased abdominal visceral fat is associated with reduced bone density in HIV-infected men with lipodystrophy.

OBJECTIVE: To examine the relationship between bone density and changes in regional and whole body composition in HIV-infected men with and without lipodystrophy. DESIGN: Cross-sectional, observational study of HIV-infected men with and without lipodystrophy and matched HIV-negative controls. SETTING: Tertiary care academic medical institution. PATIENTS: A total of 59 men, belonging to three different groups: HIV-positive men with lipodystrophy (n = 21), HIV-positive men without lipodystrophy (n = 20), and age-matched and body mass index-matched HIV-negative controls (n = 18). METHODS: Bone density, markers of bone turnover and indices of calcium metabolism were measured in all subjects. Quantitative computed tomography was used both to determine volumetric bone density of the spine and to quantify abdominal visceral fat. Dual energy X-ray absorptiometry was used to determine whole body composition and bone density. Statistical comparisons were performed according to lipodystrophy categorization and protease inhibitor exposure. RESULTS: Men with HIV-associated lipodystrophy had reduced lumbar spine bone density compared with both HIV-infected non-lipodystrophic men [mean +/- SD, 132 +/- 29 versus 154 +/- 30 mg/cm(3); P = 0.02] and HIV-negative controls [mean +/- SD 132 +/- 29 versus 148 +/- 18) mg/cm(3); P = 0.04]. Lumbar spine bone density was reduced significantly in HIV lipodystrophy patients independently of protease inhibitor use. In an analysis among all HIV-infected subjects, increased visceral abdominal fat area was associated with decreased lumbar spine bone density (r, -0.47; P = 0.002). The association between visceral fat and bone density remained significant (P = 0.007) after controlling for age, body mass index, lowest body weight, protease inhibitor use, and extremity fat in a multivariate regression model. Markers of bone turnover were not related to bone density or lipodystrophy status. CONCLUSIONS: Lumbar spine bone density is reduced in association with increased visceral fat in HIV-infected men with lipodystrophy. Further studies are needed to determine the mechanisms of osteopenia in HIV lipodystrophy and whether increased marrow fat occurs in such patients and affects bone density.

Absorptiometry, Photon↗

PubMed2000

The correlation of clinical lacrimal bone density and thickness, established at the time of DCR surgery, with systemic bone mineral densitometry testing.

BACKGROUND. Due to a growing concern with regard to the relationship between osteoporosis and fractures, we wished to examine the correlation of systemic bone density with lacrimal bone characteristics (thickness and density), as measured at the time of dacryocystorhinostomy (DCR). Significant correlation would suggest that oculoplastic surgeons may screen for osteoporosis during DCR. METHODS. A prospective study of the bone mineral density in patients (n=32) undergoing DCR was conducted. During DCR, the lacrimal bone thickness and density were estimated clinically. Postoperatively, the systemic bone density was measured by dual-energy x-ray absorptiometry (DEXA) scanning. The data were analyzed using Student's t-test, Pearson correlation and Pearson chi-square methods. RESULTS. Analyzed in a bivariate arrangement, significant correlation (p<0.05) was detected between the systemic bone density (as measured at two sites, the femoral head and lumbar spine) and the lacrimal bone characteristics (thickness and density). Therefore, the lower the lacrimal bone thickness or density, the lower the systemic bone density. INTERPRETATION. With the finding of significant correlation between lacrimal bone thickness and density and systemic bone density, oculoplastic surgeons can screen for osteoporosis during DCR. If low-density thin bone is encountered during DCR, the patient's general practitioner should be alerted.

Journal Article↗

PubMed2000

Dexa-measured bone density changes over time after intertrochanteric hip fractures.

The local bone density after an intertrochanteric hip fracture changes over time. In this study, bone density was measured in proximal femur and third lumbar vertebrae in patients treated for an intertrochanteric hip fracture at various periods. There were 60 patients (mean age 71.4 years) and 50 control patients (mean age 62.4 years). Bone density measurements were performed with Dual energy X-ray absorptiometry (DEXA). Bilateral measurements of the greater trochanter, lesser trochanter and femoral diaphysis as well as the third lumbar vertebrae were performed. Each area showed different course of change. The bone density of the greater trochanter and the lesser trochanter in the injured side increased after three months as compared with the control. After three years, the bone density of the greater trochanter decreased. The bone density of the femoral diaphysis and the third vertebrae gradually decreased over time. The authors suggest that bone density changes under the influence of callus formation, bone remodeling, decrease in daily activity, and use of ambulatory aids, etc.

Absorptiometry, Photon↗

PubMed1991

Effect of dietary calcium on bone density in growing rabbits.

Reductions in peak bone mass at skeletal maturity may increase the risk for the subsequent development of osteoporosis. Although changes in calcium intake can modify the rate of decline in bone density in the mature skeleton, longitudinal assessments of the effect of dietary calcium supplementation during skeletal growth on peak bone mass have not been done in humans or experimental animals. Thus quantitative computed tomography (QCT) was used to monitor changes in vertebral bone density at 6-wk intervals during growth from 8 wk of age until skeletal maturity at 35 wk in male New Zealand White rabbits maintained on diets containing 0.15% (low Ca), 0.45% (normal Ca), or 1.35% (high Ca) calcium. Serum parathyroid hormone (PTH) and calcitriol levels increased, and renal calcium excretion decreased in low Ca compared with normal Ca; in contrast, serum calcitriol levels decreased and renal calcium excretion increased from control values in high Ca. Vertebral bone density by QCT did not differ during growth between high Ca and normal Ca, and peak values at epiphyseal closure also did not differ in these two groups. Vertebral bone density was lower, however, throughout the study in low Ca, and peak values at epiphyseal closure remained below those in either normal Ca or high Ca. Quantitative bone histology revealed decreases in cortical thickness in the third lumbar vertebra in low Ca, whereas trabecular bone area did not differ among groups; there was no histological evidence of osteomalacia in low Ca. Thus dietary calcium restriction during growth reduces peak bone mass at skeletal maturity, but raising dietary calcium intake above normal levels does not increase peak bone mass in this experimental model.

Animals↗

PubMed1995

Computational method for determination of bone and joint loads using bone density distributions.

Because bone structure is influenced by mechanical loading during ontogeny, the geometry and density distribution of bones contain information about their loading histories. Based on a mathematical theory relating stress history to bone remodeling, we have developed a method to determine dominant bone loading conditions using an optimization procedure. We applied this load determination method using a simplified two-dimensional bone-end finite element model, for which a standard density distribution had been calculated under a given set of loading conditions. With this density distribution, the optimization procedure was used to determine the original loads from a broad set of many plausible basic load distributions and locations. The optimization procedure adjusted the magnitude of each basic load to achieve the desired tissue level attractor stress stimulus throughout the model. The results show that the density-based bone load determination method yields accurate results for basic test cases and, thus, may have potential for estimating in vivo bone loads for both extant and extinct animals.

Animals↗

PubMed1995

Evaluation of bone density with peripheral quantitative computed tomography in healthy premenopausal, perimenopausal, and postmenopausal women.

We compared bone mass in premenopausal, perimenopausal, and postmenopausal women using peripheral quantitative computed tomography to measure separately cortical, trabecular, and total bone density. Trabecular bone density was lower (p < 0.05) in the perimenopausal women than in the healthy premenopausal women. In perimenopausal women, trabecular bone density showed a significant linear regression with age (r = 0.554, p < 0.001), but cortical bone density did not (r = 0.130, p = 0.447). The group of postmenopausal women had significantly lower bone mass in all three bone compartments than the premenopausal and perimenopausal women. These findings confirm the existence of a significant loss of trabecular bone mass in the perimenopausal period.

Adult↗

PubMed1982

The relationship between bone density, mineral content, and mechanical strength in the femoral neck.

The bone density, mineral content and average shear stress in bending at failure were measured in vitro in 33 femoral necks of women and men of different ages. The correlations between these three parameters as well as their correlation with the Singh index were carefully analyzed and found to show that the Singh index is of no clinical value. The best correlation exists between bone density and shear stress at failure. Practically no correlation is found between the breaking stress and Singh index. The breaking stress decreases with age much faster than the bone density or bone mineral content. The correlation between the work to fracture and the bone density or its mineral content is only moderate. The bone density is best indicator for the compressive bone strength. The changes of bone strength are apparently influenced by factors other than the bone density and mineral content, although the possibility that small changes in bone density or mineral content cause large changes in bone strength cannot be excluded.

Absorptiometry, Photon↗

PubMed1998

Compromised bone density 11.4 years after diagnosis of anorexia nervosa.

This investigation evaluated bone density in 36 premenopausal women (mean +/- SD age = 29.5 +/- 8.4 years) an average of 11.4 years after diagnosis for anorexia nervosa. Twenty-nine women were aged 20-45 years, and seven were aged 16-19 years. Body composition, age of menarche, length of amenorrhea, estrogen exposure, and lumbar spine and proximal femur bone density were determined. Average appendicular bone density for those > or = 20 years was found to meet World Health Organization T score criteria for osteopenia: total femur T = -1.22 and femoral neck T = -1.33. The average total lumbar Z score for all 36 participants was -0.95, which was 90% of the mean for their age, and the mean Z scores for adolescent subjects were within 91% of the mean for their age (Z = -0.84). Years of estrogen exposure were correlated with lumbar mineral content (r = 0.50, p = 0.002). A modest but significant inverse relationship was observed between length of amenorrhea and femoral and lumbar bone density. The total proximal femur and trochanteric bone densities were best predicted, using stepwise regression, by the number of years after diagnosis and years of amenorrhea, respectively (R2 = 0.23, p = 0.02 and R2 = 0.21, p = 0.04). Lumbar density was best predicted by years of amenorrhea and current percent of ideal body weight (%IBW)(R2 = 0.25, p = 0.02). Length of amenorrhea, estrogen exposure, and %IBW independently contribute to axial and appendicular bone density. Because of risk for compromised bone density, women with a history of anorexia nervosa should be followed longitudinally to maximize premenopausal bone replacement.

Absorptiometry, Photon↗

PubMed1998

Relationship between bone density and osteoarthritis in a skeletal population from London.

To determine whether bone density was related to the presence of osteoarthritis in past populations, bone density was determined directly on bone slices taken from the fourth lumbar vertebra of a series of skeletons from a cemetery in London used from the middle 18th to the early 19th centuries. Eighty male and 57 female skeletons were studied and standard anthropological methods were used to determine age and gender. Osteoarthritis was diagnosed by the presence of eburnation on joint surfaces. The mean bone density in the males was 0.351 (+/-0.071) g/cm2, and in the females 0.332 (+/-0.091); this difference was statistically significant (p = 0.045). There was a significant, negative relationship with bone density and age in females (p = 0.0023), but not males (p = 0.073). Forty-seven of the males and 30 of the females had osteoarthritis, the most commonly affected joints being the facet joints of the spine and the hands. For the males there was no significant difference in bone density in those with or without osteoarthritis, but in females the bone density was significantly lower (p = 0.021) in those with osteoarthritis than in those without. The reasons why this result differs from modern populations in which patients with osteoarthritis tend to have higher bone density are discussed, and it is suggested that the most plausible explanation may relate to differences in nutritional status between past and modern populations.

Adult↗