[Bone ultrasound and diagnosis of osteoporosis: correlation of 2 quantitative ultrasound methods with bone density].
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Bone Density↗
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Factors affecting peak bone density in Japanese women.
Both genetic and environmental factors have been shown to contribute to the determination of bone density. To clarify the interaction between genetic and environmental factors affecting peak bone mass, we investigated the correlation between bone mineral density (BMD) and physical constitution, vitamin D receptor (VDR) genotype, age, age of menarche, history of menstrual dysfunction, and exercise in 157 healthy young Japanese women. History of exercise and menstrual dysfunction were significant independent predictors of BMD. The VDR genotype also affects peak bone density. Exercise has been shown to increase BMD in a similar way for each VDR genotype including those women who have the particular genotype associated with low bone density. This data indicate that there are complex gene-environmental interactions particularly in relation to menstrual history, exercise, and genetic factors during childhood/adolescence that may have implications for the development of adult BMD in women.
Adult↗
[The comparison of bone densities of mandible and coxofemoral region between senile people with edentulous jaws and those with dentate jaws].
OBJECTIVE: To observe if the senile people with edentulous jaws had lower bone dentilies of mandible and coxofemoral region than those with dentate jaws, and to find the systemic risk factors which were responsible for the tooth loss and the formation of edentulous jaws. METHODS: Two groups of senile people were selected. One group was edentulous and the other was dentate. All of them were examined by dual energy X-ray absorptiometry(DXA). RESULTS: The senile people with edentulous jaws had significantly lower bone densities of mandible(P < 0.001) and they also had lower bone densities of coxofemoral region than the dentate group people. CONCLUSION: It indicated that the decreased of bone densities of mandible and coxofemoral region was one of the systemic risk factors for tooth loss and the formation of edentulous jaws.
Age Factors↗
[Comparative histomorphometry of subchondral bone density and articular cartilage thickness in the tibial head in early human arthritis].
The articular cartilage thickness and subchondral bone density of 50 human tibial heads were histomorphometrically measured by an image analysing system and topographically examined in relation to age, sex and grade of osteoarthrosis (OA). Altogether we evaluated 12,000 items. Independent of OA the lateral tibial plateau shows a significant thicker cartilage layer than the medial. In central joint areas we find a thicker cartilage cover than in marginal. Corresponding to the literature cartilage fibrillation according to OA grade 1 and 2 (Otte 1969, Fassbender 1975) accumulates in the lateral and dorsal tibial head including the meniscus covered area. The cartilage thickness decreases with age independent of OA. Without major alterations of the topographical pattern the cartilage thickness however shows a significant increase in early OA (grade 1). For that reason measurements of the cartilage thickness and joint space narrowing are not appropriate for defining early OA. The subchondral bone density shows high values ventromedially and dorsolaterally independent of sex, age or OA. Beneath central joint areas higher values are found than marginally. Corresponding to the topical literature our results point at the model of the real loaded knee joint, which says that the mean loading forces do not act on the middle of the joint but on the medial plateau. The dorsolateral density centre could be an expression of the functional adaptation of the bended knee joint. In joint areas with cartilage fibrillation (OA grade 1) we find a significant higher subchondral bone density without major alterations of the topographical pattern. It is not possible to define cause and effect, we interpret both as result of higher joint loading.
Adolescent↗
Evaluation of cortical thickness and bone density by roentgen microdensitometry in growing males and females.
UNLABELLED: The bone mineral content (BMC) and the cortical thickness at the distal radius and at the II metacarpal were assessed in growing individuals (167 females and 158 males) by radiometric and quantitative roentgen microdensitometric methods. BMC adjusted for age and pubertal status was significantly higher in males than in females. However, the BMC corrected for bone volume (volumetric bone density, g/cm3) and the metacarpal cortical index (cortical area/total area) were identical in males and females. BMC rose progressively with age, approaching a plateau by the end of puberty. Lower but still significant increases with age were also observed for volumetric bone density of the metacarpus and the metacarpal index. These increases were also most marked by the end of pubertal maturation and might be related to diminution of bone turnover. CONCLUSION: This study provides the normative data of bone mass in growing individuals by making use of a reasonably accurate and easily available technique. The results obtained indicate that most of the differences between males and females and the changes with age are related to changes in skeletal dimension rather than density.
Absorptiometry, Photon↗
Biochemical bone markers and bone density in hip fracture patients: weak correlation in 106 women.
Biochemical markers of bone formation and bone resorption were measured preoperatively, within 18 hours after a hip fracture (n 106) and bone mineral density (BMD) was measured with quantitative computer tomography (QCT), dual-energy x-ray absorptiometry (DXA) and heel ultrasound in 63 hip fracture patients. Patients with pertrochanteric fractures had more osteoporosis in all measurements than patients with femoral neck fractures. We found no differences in biochemical markers of bone formation or bone resorption in patients with femoral neck fractures and in those with pertrochanteric fractures. Correlations between biochemical bone markers and bone density, bone mass and stiffness on admission were weak.
Absorptiometry, Photon↗
Salivary calcium reflects skeletal bone density of heavy smokers.
OBJECTIVE: Our recent studies suggest, that elevated calcium concentration of saliva is characteristic of periodontitis. In this study we analyzed the effect of smoking on salivary calcium and bone density by comparing the level of salivary calcium and the ultrasound scale of bone density of heavy smokers to those of non-smokers. DESIGN: Salivary samples were collected from 603 women (50-62 years) participating in a pre-screen referral program for osteoporosis. Out of this group a total of 577 were accepted for the present study. General health, medications and tobacco smoking were recorded. The group included 487 non-smokers, 37 moderate smokers (1-10 cigarettes per day) and 53 heavy smokers (>10 cigarettes per day). Bone density was measured at the right heel by the quantitative ultrasound technique. Calcium and phosphate concentrations of saliva were measured and expressed as microg/ml of saliva. RESULTS: The ultrasonographic variables of the heel, broadband ultrasound attenuation (BUA), speed of sound (SOS) and T-score (a standard deviation unit from mean values of healthy young adults) of heavy smokers were significantly lower than those of women who did not smoke (P = 0.007, 0.014 and 0.011, respectively). Salivary calcium concentration of heavy smokers 70.5 (14.6) microg/ml was higher than that of non-smokers 64.0 (14.1) microg/ml (P = 0.001). There were no significant differences in salivary phosphate level or in the salivary flow rate between heavy smokers and non-smokers. CONCLUSIONS: Heavy smokers seem to have lower bone mineral density and higher salivary calcium than their non-smoking counterparts. We suggest that the high salivary calcium concentration of smokers is in connection with skeletal calcium disturbances.
Analysis of Variance↗
Bone density distribution and gender dominate femoral neck fracture risk predictors.
OBJECTIVE: To determine whether regional characteristics of the proximal femur could discriminate between a group of patients who had just sustained a first low-trauma femoral neck fracture (n=50) from a group of healthy volunteers (n=123). DESIGN: The application of an integral bone measurement (dual-energy X-ray absorptiometry) in conjunction with a volumetric cancellous bone density measurement (quantitative computed tomography) to the proximal femur in vivo provided an estimate of the contribution of the spatial distribution of bone density to hip fracture risk prediction. RESULTS: The primary finding of this study was a significant difference between male and female hip fracture risk predictor variables. In men with femoral neck fracture, a significant decrease in bone density throughout the proximal femur was observed. In women with femoral neck fracture, a combination of local bone deficits (significant decrease in cancellous bone at the site of fracture, and a decrease in cortical bone at the site of impact) and significantly larger proximal femur dimensions (femoral neck and head widths) was evident. CONCLUSIONS: These results imply that effective hip fracture prevention strategies may require separate approaches for men and women. Screening programs for diminished bone density at the proximal femur have proved effective in previous studies. An approach which includes examining these local bone characteristics may further improve our ability to accurately determine hip fracture risk in vivo.
Absorptiometry, Photon↗
Femur strength index predicts hip fracture independent of bone density and hip axis length.
INTRODUCTION: Proximal femoral bone strength is not only a function of femoral bone mineral density (BMD), but also a function of the spatial distribution of bone mass intrinsic in structural geometric properties such as diameter, area, length, and angle of the femoral neck. Recent advancements in bone density measurement include software that can automatically calculate a variety of femoral structural variables that may be related to hip fracture risk. The purpose of this study was to compare femoral bone density, structure, and strength assessments obtained from dual-energy X-ray absorbtiometry (DXA) measurements in a group of women with and without hip fracture. METHODS: DXA measurements of the proximal femur were obtained from 2,506 women 50 years of age or older, 365 with prior hip fracture and 2,141 controls. In addition to the conventional densitometry measurements, structural variables were determined using the Hip Strength Analysis program, including hip axis length (HAL), cross-sectional moment of inertia (CSMI), and the femur strength index (FSI) calculated as the ratio of estimated compressive yield strength of the femoral neck to the expected compressive stress of a fall on the greater trochanter. RESULTS: Femoral neck BMD was significantly lower and HAL significantly higher in the fracture group compared with controls. Mean CSMI was not significantly different between fracture patients and controls after adjustment for BMD and HAL. FSI, after adjustment for T score and HAL, was significantly lower in the fracture group, consistent with a reduced capacity to withstand a fall without fracturing a hip. CONCLUSION: We conclude that BMD, HAL, and FSI are significant independent predictors of hip fracture.
Absorptiometry, Photon↗
[Bone density before and after the hormonal therapy of young women with hypergonadotropic hypogonadal amenorrhea].
Dual energy X-ray absorptiometry of bone density in the lumbar vertebral column was performed in 32 young women (mean age 24.6 [19-34] years) with hypergonadotropic hypogonadal amenorrhoea. There was a significantly lower bone density (0.74 +/- 0.27 g/cm2) than in a control group of 27 women of similar age (1.17 +/- 0.081 g/cm2; P less than 0.001). Subsequently 21 of the 32 women received cyclical hormone substitution therapy for 24 months (day 1-30: 0.625 mg conjugated oestrogens; additionally, on days 20-30: 5 mg medrogestone; followed by a seven-day pause). After 6 months bone density, compared with that of the 11 untreated women, had increased significantly (P less than 0.001). It is therefore recommended that young hypoestrogenemic women should receive early and continuous hormone substitution treatment.
Absorptiometry, Photon↗
[The value of bone density measurement--a follow-up of the conclusions in the earlier SBU report].
Osteoporotic fractures are common primarily among elderly Swedish women. Vertebral compression fractures can occur spontaneously without trauma, while wrist and hip fractures are nearly always the result of trauma. The risk of fracture increases in skeletal wasting. If bone density measurement can demonstrate osteoporosis already before fractures occur, then preventive measures could be set in. The present study, which is a systematic review of articles published from 1994 to the spring of 1998, confirms the conclusions of the 1995 report "Bone Density Measurement" from SBU, the Swedish Council on Technology Assessment in Health Care, that the relative risk of fracture can be predicted utilizing bone density measurement. The best risk assessment is achieved by taking into account both clinical risk factors and bone density.
Adult↗
Decreased bone density, elevated serum osteoprotegerin, and beta-cross-laps in Wilson disease.
Osteopathia has been reported in Wilson disease (WD), but bone density has not been measured; therefore, we performed bone mineral density (BMD), bone mineral content (BMC), and quantitative bone ultrasound (QUS) assessments, as well as measured the serum levels of osteocalcin (OCN), beta-cross-laps (beta-CTx's), and the recently discovered osteoprotegerin (OPG) and its ligand RANKL to investigate the underlying mechanism of osseous disorders. Serum OCN, beta-CTx, OPG, and RANKL levels were measured by ELISA in 21 WD patients and in 20 age- and gender-matched healthy subjects. BMD, BMC, and QUS parameters were also determined. Osteoporosis was present in 9/21 (43%) WD patients. Abnormal QUS parameters were found in 7 (33%) of the patients. Although serum OCN levels were similar in patients and controls (29.93 +/- 24.65 mg/ml vs. 29.84 +/- 6.89 mg/ml), beta-CTx and OPG levels were significantly increased in WD compared with the healthy controls (625.4 +/- 312.3 pg/ml vs. 423.6 +/- 144.3 pg/ml and p = 0.022 and 7.2 +/- 3.4 pM vs. 3.5 +/- 1.0 pM and p < 0.001, respectively). No difference was observed in the RANKL level. There was a positive correlation between OCN and beta-CTx (r = 0.55; p = 0.01). We proved high occurrence of osteoporosis in WD. Negative bone remodeling balance is a consequence of increased bone resorption, which is indicated by elevated beta-CTx. The novel finding of elevated serum OPG may reflect a compensatory reaction to enhanced osteoclast activity, despite the normal OCN level.
Adolescent↗
Bone classification: an objective scale of bone density using the computerized tomography scan.
Dental implants are subject to masticatory loads of varying magnitude. Implant performance is closely related to load transmission at the bone-to-implant interface where bone quality will be highly variable. The type and architecture of bone is known to influence its load bearing capacity and it has been demonstrated that poorer quality bone is associated with higher failure rates. To date, bone classifications have only provided rough subjective methods for pre-operative assessment, which can prove unreliable. The results of an extensive analysis of computerized tomography scans using Simplant software (Columbia Scientific Inc., Columbia, MD, USA) demonstrate that an objective scale of bone density based on the Houndsfield scale, can be established and that there is a strong correlation between bone density value and subjective quality score (P = 0.002) as well as between the bone density score and the region of the mouth (P < 0.001).
Alveolar Process↗
[Bone density in differentiated cancer of the thyroid gland treated by hormone-suppressive therapy. Study based on 51 cases].
The effect of L-Thyroxine suppressive therapy (207.3 +/- 46.1 mcg/d) on lumbar spine bone density (BMD) was assessed in 51 patients thyroidectomized for carcinoma since 1 to 19 years (mean = 6 +/- 5.4 years); the bone densities of these patients were compared with those of 51 age sex weight-matched control subjects. Trabecular bone density was evaluated by single energy quantitative tomography. The vertebral BMD was not significantly different between the patients receiving suppressive doses of L-T4 and the control group (162.8 +/- 40.4 vs 162.7 +/- 39.8 mg/cm3). We found no relationship between the duration of L-Thyroxine therapy and BMD. Thus, doses of L-T4 sufficient for suppressing plasma thyroid stimulating hormone but no high enough for causing biochemical thyrotoxicosis have no harmful effect on trabecular bone mineral density.
Adult↗
Bone density, vitamin D nutrition, and parathyroid hormone levels in women with dementia.
OBJECTIVE: To determine whether patients with dementia have reduced bone mass, altered vitamin D, or parathyroid hormone status. DESIGN: Survey. SETTING: University hospital outpatient department. PARTICIPANTS: Twenty women with DSM-III-R mild dementia living in the community were compared with 40 cognitively normal community-dwelling women, matched for age, who had been recruited as part of studies in elderly twins. MEASUREMENTS: Bone density at the lumbar spine and neck of femur by dual-energy X-ray absorptiometry, intact serum PTH, and 25-hydroxyvitamin D levels. MAIN RESULTS: There was no significant difference in bone density between the subjects with mild dementia and the age- and sex-matched controls. The intact PTH (mean +/- SD) in the demented subjects was 4.9 +/- 2.1 pmol/L compared with 2.9 +/- 1.7 pmol/L in the twin controls (P < .01). The mean 25-hydroxyvitamin D in the demented subjects was 61 +/- 33 nmol/L, whereas it was 90 +/- 38 nmol/L in the twin controls (P < .01). CONCLUSIONS: We conclude that there were no significant differences in the bone density of community-dwelling women with mild dementia compared with normals. However, there were significant differences in parathyroid hormone and vitamin D levels between the two groups, suggesting that there is a high prevalence of subclinical hypovitaminosis D in demented women in the community.
Absorptiometry, Photon↗
Prevalence of the metabolic syndrome in a Bulgarian female population referred for bone density testing.
OBJECTIVE: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional clinical study. Subjects were 444 consecutive 30- to 75-year-old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 +/- 15.19 years; mean BMI, 26.10 +/- 5.71 kg/m2. Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist-to-hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.-Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg-to-leg analyser (Tanita TBF-215; Tanita Corporation, Tokyo, Japan). RESULTS: Of all women, 56.76% had a BMI > 25 kg/m2, 45.95% had a waist circumference > 88 cm, and 64.64% had a waist-to-hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program-Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%. DISCUSSION: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large-scale prevention programs are needed in this field.
Adult↗
Influence of previous bilateral partial tubal resection on symptoms, hormones, lipids, and bone density in postmenopausal women.
The late effect of bilateral partial tubal resection (BPTR) on symptoms, hormone and lipid levels, and bone density in postmenopausal women was analyzed. Thirty-six postmenopausal women in whom BPTR was accomplished were studied; they were matched by age with a group without BPTR. They were subdivided according to time since BPTR into two groups: < or = 15 years > 15 years since the procedure. In both groups, the patients' general data were analyzed as well as the frequency of climacteric symptoms; serum levels of follicule-stimulating hormone (FSH), estradiol, total cholesterol, HDL-C, LDL-C, and triglycerides; and bone density in lumbar spine, femoral neck, Ward's triangle, and trochanter. The statistical analysis was done for the symptoms with chi-squared and for the rest of variables with Student's t-test. When comparing the groups, no differences were found in analyzed parameters; only hot flashes and sweating associated with hot flashes were frequently found in the BPTR group when the analysis was done in the group without any division. With the groups subdivided, hot flashes were found more frequently in the group for whom it had been more than 15 years since the BPTR procedure. The BPTR did not influence hormone and lipid levels or bone density.
Adult↗
Bone density in Type 1 Gaucher disease.
Skeletal involvement is a major source of complications in patients with Type 1 Gaucher disease. To investigate the bone density and potential usefulness of bone densitometry in Gaucher disease, dual-energy X-ray absorptiometry was used to measure the density of the lumbar spine, femoral neck, trochanter, and distal radius in 61 adult patients ranging in age from 22 to 77 years. The mean bone density at each site was significantly lower than expected for age and sex. The severity of the osteopenia correlated significantly with other clinical indicators of disease severity, including the N370S/84GG genotype, prior splenectomy, and hepatomegaly. The bone density measurements also correlated significantly with the severity of skeletal disease as assessed by skeletal radiography. Vertebral density remained an independent predictor of the severity of bone involvement even after controlling for age, sex, weight, genotype, splenectomy, and hepatomegaly. These findings suggest that bone density measurements provide a quantitative assessment of bone involvement in Type 1 Gaucher disease, which may permit serial, noninvasive monitoring of bone changes in this progressive disorder.
Absorptiometry, Photon↗