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Bone density of the arm and forearm as an age indicator in specimens of stranded striped dolphins (Stenella coeruleoalba).

The age of odontocetes living in the wild is determined mainly by analysis of dentine layers in sections of the teeth. We examined a series of specimens from striped dolphins (Stenella coeruleoalba, Meyen, 1833) that had stranded along the Italian coast of the Mediterranean sea. The present study analyzes and describes bone density in the arm and forearm of the stranded specimens, and correlates the data with total body length of the animal and age as determined by the number of dentine layers in sections of the teeth. According to our model, age can be predicted on the basis of bone density and total body length of the stranded animal. This is the first study to use bone density as a biological parameter to understand the wear and tear of life in the sea. The results suggest that bone density is a new tool for recording age in wild odontocetes.

Absorptiometry, Photon↗

A prospective study of bone density and pregnancy after an extended period of lactation with bone loss.

OBJECTIVES: To determine if pregnancy after an extended period of lactation curtails the recovery of maternal bone mineral density. METHODS: Twenty-five women who fully breast-fed their infants for at least 6 months and had a subsequent pregnancy within 18 months of initiating lactation were studied longitudinally. Twenty controls breast-fed similarly, but had no subsequent pregnancy. The women were healthy, well-nourished, and between 20-40 years old. Bone mineral density was measured by dual x-ray energy absorptiometry at the spine and hip. RESULTS: Both cases and controls lost bone mineral density with extended lactation. The case group had a bone mineral density recovery comparable to the controls. CONCLUSION: Women with the dual calcium demands of extended lactation and a subsequent pregnancy are not at risk for failure of bone recovery to pre-lactation levels.

Absorptiometry, Photon↗

Effects of functional electrical stimulation-induced lower extremity cycling on bone density of spinal cord-injured patients.

Spinal cord-injured (SCI) patients are at increased risk for fractures secondary to neurogenic osteoporosis. Earlier research claimed physical conditioning resulted in a decreased incidence or reversal of neurogenic osteoporosis. This study evaluated the effects of functional electrical stimulation-induced lower extremity cycling (FESILEC) on the bone densities of SCI patients using dual-energy x/ray absorptiometry (DEXA). The study consisted of 12 healthy male SCI patients, aged 23 to 46 (x +/- SD, 34 +/- 6) yr. The patients were post-traumatic, complete, spastic SCI; time postinjury ranged from 2 to 19 (9.7 +/- 5.1) yr. Patients participated in a three-phase training program. Phase 1 consisted of quadriceps strengthening. Phase 2 consisted of progressive sequential stimulation of quadriceps, hamstrings, and gluteal muscles, achieving a rhythmical pedaling motion on the REGYS I ergometer. Phase 3a consisted of 30-min FESILEC sessions. DEXAs were done at baseline and at completion of Phase 3a and Phase 3b. Bone densities were done of the lumbar spine levels 2-4 (L2-4), bilateral trochanters (T), Ward's triangles (WT) and femoral necks (FN). Baseline bone density indicated no difference between L2-4 of ambulatory males and SCI males. Baseline values obtained for T, WT, and FN were, respectively, 71, 82, and 79% of ambulatory values. Results after completion of the Phase 3a training program indicated no statistically significant difference compared with baseline values. There was, however, a positive trend in the lumbar spine post-Phase 3a (L2-4, P=0.056). Eight patients continued the exercise program, using a combination of upper and lower extremity cycling (Phase 3b) for a longer period of time (25 +/- 9 wk). DEXAs done after Phase 3b indicated no change relative to baseline data or data post-Phase 3a. In conclusion, although FESILEC did not significantly increase bone density in the hip parameters of chronic SCI patients, a positive trend was observed in the lumbar spine. Further research with acute intervention, such as FESILEC during the first few months post-SCI, is warranted to further evaluate a treatment regimen to prevent or reduce neurogenic osteopenia.

Absorptiometry, Photon↗

Galloping exercise induces regional changes in bone density within the third and radial carpal bones of Thoroughbred horses.

This study was performed to test the hypothesis that a localised bone hypertrophy could occur within the subchondral cancellous architecture of the third and radial carpal bones. Using 2 levels of controlled and defined exercise, it was observed that a high intensity treadmill exercise protocol resulted in functional adaptation of the carpal bones. The increase in trabecular thickening and density was seen to be localised to those regions underlying common sites of cartilage degradation, the interface of the thickened trabeculae with the normal architecture in the third carpal bone was coincident with a common site of clinical fractures. The bone changes were determined both qualitatively on examination of slab radiographs and quantified by dual energy x-ray absorptiometry. The findings from this study are relevant to mechanical factors involved in the pathophysiology of joint degeneration. The potential clinical implications of this study are in relation to changes in the type and duration of exercise regimens used in training of equine athletes. The rapid response of bone to mechanical stimulation has implications in the longer term for localised cartilage degradation. Imaging techniques could be developed to monitor these early bone changes in the specific areas identified in this study and thus allow appropriate changes in training intensity to minimise subsequent damage to the articular surface.

Absorptiometry, Photon↗

Changes in local bone density after knee arthroplasty. The use of quantitative computed tomography.

Loosening is a serious problem in total arthroplasty and early detection of bone loss in the vicinity of an implant would help in its investigation. We present a method for the objective evaluation of bone adjacent to metallic implants in which a modified technique of quantitative computed tomography (QCT) is used to reconstruct cross-sectional images with few artefacts. We have used this technique in 19 patients with knee arthroplasties to monitor the changes in bone density around the tibial stem of the prosthesis. In the first weeks after operation all patients showed a decrease in bone density ranging from 0.4% to 3.6% per month. One year after arthroplasty bone density had stabilised and only minor changes were observed. Our work indicates that modified QCT is a sensitive method for the long-term monitoring of the anchorage of implants and allows the early detection of osteolytic changes.

Aged↗

Generalized osteoarthritis associated with increased insulin-like growth factor types I and II and transforming growth factor beta in cortical bone from the iliac crest. Possible mechanism of increased bone density and protection against osteoporosis.

OBJECTIVE: To investigate whether growth factors stored in bone might explain the increased bone density and resistance to osteoporosis in generalized osteoarthritis. METHODS: Levels of insulin-like growth factor (IGF) types I and II and transforming growth factor beta (TGF beta) were measured in extracts of cortical bone from the iliac crest obtained at necropsy from subjects with or without osteoarthritis of the hands. RESULTS: Concentrations of IGF-I, IGF-II, and TGF beta were significantly higher in extracts of bone powder from subjects in the osteoarthritis group than in extracts from subjects in the control group. CONCLUSION: The results suggest that the increased bone density and resistance to osteoporosis in patients with osteoarthritis may be associated with increased skeletal concentrations of IGF-I, IGF-II, and TGF beta and may reflect a generally increased biosynthetic activity of osteoblasts in these patients.

Aged↗

The relative roles of intragenic polymorphisms of the vitamin d receptor gene in lumbar spine degeneration and bone density.

STUDY DESIGN: A retrospective cohort study. OBJECTIVES: To compare the magnitudes of the associations of TaqI polymorphisms of the vitamin D receptor gene with bone density and lumbar spine degeneration in the same sample. SUMMARY OF BACKGROUND DATA: Vitamin D receptor gene variations are associated with osteoporosis, osteoarthritis, and disc degeneration. Their role in these conditions remains poorly understood. METHODS: Bone density of the spine and femur were determined through DEXA, and lumbar disc degeneration was determined from magnetic resonance imaging assessments of signal intensity, disc narrowing, bulging, anular tears, herniations, and osteophytes. Associations between these measures and TaqI polymorphisms of the coding region of the Vitamin D receptor locus were examined in a population-based sample of 142 men. RESULTS: The strongest associations were with signal intensity and anular tears, which were worse for the subjects with tt genotypes than for those with TT genotypes in the L4-S1 spine discs. Conversely, the prevalences of disc bulges and osteophytes were lowest for the tt genotype. Bone density, disc height, and herniations did not differ significantly by genotype. CONCLUSIONS: The strongest association of Vitamin D receptor TaqI polymorphisms with degeneration in nonmineralized connective tissues suggests that the underlying mechanism of TaqI polymorphisms is not specific to bone. This study demonstrated for the first time that those with the tt genotype had more anular tears than those with the TT genotype, a finding that should stimulate further analyses of this gene in conditions that result in back pain. The apparent discrepancies of the associations of the tt genotype with lower signal intensity and more anular tears, but less bulges and osteophytes, could be explained if bulging and osteophytes primarily represented remodeling related to lifetime physical loading.

Adult↗

Value of measuring bone density serial changes on a picture archiving and communication systems (PACS) monitor in distraction osteogenesis.

Serial changes of bone density in 26 femora and 22 tibiae that underwent leg lengthening by distraction osteogenesis were investigated by measuring the pixel value shown on a picture archiving and communication systems (PACS) monitor. The pixel value of the original cortex did not change significantly until the external fixator was removed. The pixel value of the distraction sites did not change significantly for the first 5-6 weeks/cm, but rapidly increased after 7 weeks/cm in the femur and tibia, then slowly increased after 8 weeks/cm. The serial changes of the pixel value of the distracted bone showed a sigmoid curve, rather than a straight increasing line. The relative pixel values of the lengthening sites were >95% in three of the four cortices at external fixator removal. Thus, the pixel value of PACS is a rapid and easy method for the detection of bone density changes in distraction osteogenesis.

Absorptiometry, Photon↗

Bone density and mineral metabolism in thyroidectomized patients treated with long-term L-thyroxine.

1. A decreased bone mass has been reported in patients with endogenous hyperthyroidism, but the effect on bone density and mineral metabolism of thyroxine administration in thyroidectomized patients is still controversial. To further contribute to this debate, we studied 25 women thyroidectomized for thyroid cancer on long-term treatment with thyroid-stimulating hormone-suppressive doses of L-thyroxine. Twenty-one sex- and age-matched normal subjects were also studied as a control group. 2. The bone density of the spine and serum calcitonin, calcitriol and parathyroid hormone concentrations were not different when the whole patient group was compared with the control subjects, nor when the patients and control subjects were compared according to their menopausal status. However, post-menopausal thyroidectomized patients showed significantly lower bone mass (P < 0.001) than premenopausal patients. 3. L-Thyroxine-treated patients showed significantly higher levels of bone alkaline phosphatase and urine hydroxyproline excretion than control subjects (P < 0.003 and P < 0.001, respectively). These differences were still present when patients and control subjects were analysed according to their menopausal status. However, bone alkaline phosphatase was significantly higher in postmenopausal than in premenopausal women only in L-thyroxine-treated patients (P < 0.05). In postmenopausal L-thyroxine-treated patients a negative correlation between time since menopause and bone mass (P < 0.05) and a positive correlation between bone alkaline phosphatase and hydroxyproline excretion (P < 0.03) were also found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Serum osteoprotegerin is a major determinant of bone density development and prevalent vertebral fracture status following cardiac transplantation.

Osteoprotegerin (OPG) is an antiresorptive cytokine and a key regulator of osteoclastogenesis and activity. Since OPG is downregulated by glucocorticoids and cyclosporine A in vitro we examined whether immunosuppressive therapy would play a role in the development of transplantation osteoporosis. We enrolled 57 cardiac transplant recipients (median time since transplantation, 3.2 years (1.1-11.5 years)) in this cross-sectional study. Standardized spinal X-rays as well as hip bone density measurements were performed in all patients. Serum OPG was determined using a commercially available ELISA. Vertebral fractures were present in 56% of the patients. Bone densities of all femoral neck subregions were correlated to serum OPG concentrations (r values between 0.40 and 0.48, all P < 0.005). Multiple regression analysis revealed OPG levels to be independently correlated to femoral neck Z scores (r = 0.49, P = 0.002). After adjustment for age, BMI, neck Z score, renal function, and months since transplantation, serum OPG was the only significant predictor of prevalent vertebral fractures (P = 0.001). In a separate 6-month prospective study of 14 heart transplant recipients receiving calcium and vitamin D serum OPG levels fell by 41% (P = 0.0004) after 3 months and 47% (P = 0.0001) after 6 months following cardiac transplantation. Bone loss at the lumbar spine and femoral neck after 6 months was correlated to the decrease in serum OPG at 6 months (r = 0.82, P < 0.0001, and r = 0.60, P = 0.02, respectively) as well as 3 months after cardiac transplantation (r = 0.65, P = 0.01, and r = 0.69, P = 0.006, respectively). Serum OPG alone accounted for 67% of the variance of lumbar spine bone density changes over the first 6 months posttransplantation. We conclude that serum OPG levels decline consistently in all patients following initiation of immunosuppressive therapy and are independently correlated with changes in bone density. We hypothesize that OPG plays a major role in the development of transplantation osteoporosis.

Aged↗

Femoral bone density and changes therein associated with differing histories of pregnancy and lactation in aged rats.

OBJECTIVE: To examine the effect of prior pregnancy and lactation on bone density in aged rats. MATERIALS AND METHODS: 2 month-old female Fischer-344 rats were divided into 4 groups: 1)13 rats were allowed to get pregnant and to nurse their offspring for two or three cycles; 2)14 rats were allowed to get pregnant two or three times and were immediately separated from their young after each delivery prior to lactation; 3)10 rats were not allowed to become pregnant; and 4)7 rats were sacrificed at the beginning of the experiment. All rats were fed ad libitum. After the rats had completed two or three pregnancies with or without subsequent lactation, all were fed a restricted diet until they were 25 months old (aged rats). Then they were sacrificed and both femurs were removed from each rat. One bone was used for analysis of mineral content and the other bone was used for photodensitometry of the diaphysis. RESULTS: 31 rats (83.8% ) survived until they were sacrificed. The femurs of the aged rats showed increased ash weight compared to those of 2 month-old rats. Aged rats with prior pregnancies with or without subsequent lactation had higher femoral ash weight than those without prior pregnancies. There were no differences among aged rats in regard to marrow diameter, bone diameter, cortical width or bone density of the diaphysis in femur by photodensitometry. CONCLUSION: In aged rats, past pregnancies but not lactation were related to increases in bone density of the femur.

Aging↗

Anabolic effects of insulin on bone suggest a role for chromium picolinate in preservation of bone density.

Activation of osteoclasts by parathyroid hormone (PTH) is mediated by PTH stimulation of osteoblasts, and is dependent on a PTH-induced rise in protein kinase C activity. Physiological levels of insulin reduce the ability of PTH to activate protein kinase C in osteoblasts, suggesting that insulin may be a physiological antagonist of bone resorption. In addition, insulin is known to promote collagen production by osteoblasts. These findings imply that efficient insulin activity may exert an anabolic effect on bone, and rationalize the many clinical studies demonstrating reduced bone density in Type I diabetes. Recently, the insulin-sensitizing nutrient chromium picolinate has been found to reduce urinary excretion of hydroxyproline and calcium in postmenopausal women, presumably indicative of a reduced rate of bone resorption. This nutrient also raised serum levels of dehydroepiandrosterone-sulfate, which may play a physiological role in the preservation of postmenopausal bone density. The impact of chromium picolinate (alone or in conjunction with calcium and other micronutrients) on bone metabolism and bone density, merits further evaluation in controlled studies.

Animals↗

Oophorectomy status and bone density in older, hysterectomized women.

INTRODUCTION: This study examined the long-term effects of hysterectomy, with and without bilateral oophorectomy, and treatment with estrogen replacement on bone mineral density in older hysterectomized women. METHODS: Subjects were 346 women 60-89 years of age, who were participants in the Rancho Bernardo Study and attended a follow-up clinic visit in 1988-1991. Bone density was measured at the ultradistal wrist, midshaft radius, lumbar spine and hip. RESULTS: Of these women, 182 had a hysterectomy with conservation of one or both ovaries and 164 had a hysterectomy with bilateral oophorectomy. Current estrogen users had the highest bone densities; those who never used estrogen replacement had the lowest. Only 9.1% of oophorectomized women, compared to 19.2% of those with ovarian conservation had never used estrogen (P < .01). After adjustment for covariates including estrogen replacement therapy, hysterectomized women with ovarian conservation had marginally higher bone densities at the wrist (P < .09) and spine (P < .06) than oophorectomized women. We found significant differences only among women currently using estrogen (P < .05 for wrist and P < .01 for spine densities, respectively). Bone density did not differ at any site by oophorectomy status among past or never users of estrogen. CONCLUSIONS: Hysterectomized women who use estrogen replacement therapy have better bone density, regardless of a bilateral oophorectomy. In addition, bilateral oophorectomy may not have a long-term negative effect on bone density; hysterectomized women who do not use estrogen appear to have equivalent bone density whether or not they had a bilateral oophorectomy.

Aged↗

[Evaluation of bone density of the calcaneum using ultrasound attenuation in menopausal women].

The results of bone density of the calcaneum measured with ultrasound in 107 menopaused women were compared with reference values provided by the manufacturer of the Walker Sonics machine and with the results of quantitative densitometry obtained with computed tomography of the calcaneum and lumbar vertebrae. The coefficient of correlation was 0.57 for the calcaneum and 0.45 for the vertebrae and was confirmed by the kappa index which was 0.58 and 0.54 respectively, indicating that bone density measurement with ultrasound attenuation is a simple non-invasive non-radiating technique which is a promising method for exploring osteoporosis in menopaused women.

Adult↗

Circulating estradiol and osteoprotegerin as determinants of bone turnover and bone density in postmenopausal women.

Osteoprotegerin (OPG) is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF kappa B ligand. OPG has been shown to be an important inhibitor of osteoclast differentiation and activation in rodent models. Estrogen is known to suppress bone resorption, and the action of estrogen on bone may be mediated by OPG. The relationship between endogenous estrogen and circulating OPG levels and bone status in human populations is unclear. Thus, the aim of this study was to investigate the relationship between biochemical markers of bone turnover and bone density and circulating OPG and endogenous estradiol levels in a population-based cohort of postmenopausal women. Subjects were 180 women ages 55-91 yr (mean age, 67 yr). Serum estradiol was measured using an auto-analyzer. Serum concentrations of OPG were determined by ELISA. Markers of bone formation and resorption were measured by standard methods. Bone mineral density at total body, total hip, femoral neck, and lumbar spine was measured by dual energy x-ray absorptiometry. There was a significant inverse relationship between estradiol and all bone turnover markers (r-values from -0.46 to -0.23; P < 0.05). Serum estradiol was positively related to absolute bone density at all sites and to change in bone density at the hip and femoral neck by univariate analysis (r-values from 0.15-0.29; P < 0.05). We observed a weak inverse association between OPG and serum-based bone turnover markers (r-values -0.18 and -0.16; P < 0.05). There was a significant positive relationship between OPG and bone mineral density at total body, total hip, and femoral neck (r-values from 0.17-0.2; P < 0.05) by univariate analysis, which was lost after adjustment for age and body mass index. There was a significant weak positive relationship between circulating OPG and serum estradiol (r = 0.18; P < 0.02). We observed no significant relationships between OPG and bone turnover markers measured in urine. We conclude that the variation in circulating endogenous estradiol levels is an important factor contributing to levels of bone turnover and bone density at the menopause. Our observations also suggest that circulating levels of OPG may reflect OPG activity in bone and are related to circulating endogenous levels of estradiol. We have previously reported high levels of variability in urine markers of bone resorption, and we suggest that this could account for the absence of a significant association between these markers and circulating OPG.

Aged↗

The effect of anorexia nervosa on skin thickness, skin collagen and bone density.

The effects of anorexia nervosa on skin thickness, skin collagen content and bone density were investigated in a cross-sectional study of 36 women with anorexia nervosa with a 4-year median duration of amenorrhoea and compared with a group of 33 women of comparable age without anorexia and with normal periods. The median skin thickness, assessed radiologically, was significantly reduced (P less than 0.01) from 0.88 mm in the comparison group to 0.70 mm in the anorectic group and the median collagen content was significantly reduced from 209 micrograms/mm2 in the comparison group to 164 micrograms/mm2 in the anorectic group (P less than 0.05). The median bone density in the comparison group was 0.93 gHA/cm2 at the lumbar spine and 0.84 gHA/cm2 at the proximal femur. These values were greatly reduced in the women with anorexia nervosa to 0.77 gHA/cm2 and 0.65 gHA/cm2 respectively (P less than 0.01). Our findings confirm the loss of bone mass with anorexia and demonstrate the coexistent loss of skin thickness and skin collagen content. This association supports the hypothesis that a generalized loss of collagen is a major factor in the causation of osteoporosis following oestrogen deficiency.

Adolescent↗

Low bone density is an etiologic factor for stress fractures in athletes.

OBJECTIVE: To determine whether low bone density and other risk factors for osteoporosis are associated with stress fractures in athletes. DESIGN: Case-control study. SETTING: Institutional sports injury clinic with primary and secondary care. PARTICIPANTS: Twenty-five athletes (nineteen women) with scintigraphically confirmed stress fractures matched for sex, age, weight, height, and exercise history with 25 control athletes with no history of bone injury. MEASUREMENTS AND MAIN RESULTS: Bone mineral density measured by dual-energy x-ray absorptiometry was significantly lower in athletes with fractures than in control athletes: In the spine, bone mineral density was 1.01 +/- 0.14 g/cm2 in athletes with fractures and 1.11 +/- 0.13 g/cm2 in control athletes (P = 0.02). In the femoral neck, it was 0.84 +/- 0.09 g/cm2 in athletes with fractures and 0.90 +/- 0.11 g/cm2 in control athletes (P = 0.005). It was also significantly lower in the Ward triangle (P = 0.01) and the greater trochanter (P = 0.01). Eight athletes with fractures and no control athletes had less than 90% of predicted age-related spine density (P = 0.01), and three athletes with fractures had bone mineral densities that were 2 SDs or more below this predicted level. More athletes with fractures than control athletes had current menstrual irregularity (amenorrhea or oligomenorrhea) (P less than 0.005). Fewer athletes with fractures were using oral contraceptives (P less than 0.05). Seven-day diet records indicated similar energy and nutrient intakes, except athletes with fractures had lower calcium intakes (697 +/- 242 mg/d compared with 832 +/- 309 mg/d; P = 0.02). Dairy product intake was lower in athletes with fractures since leaving high school (P less than 0.05). The incidence of a family history of osteoporosis was similar in both groups. CONCLUSIONS: In athletes with similar training habits, those with stress fractures are more likely to have lower bone density, lower dietary calcium intake, current menstrual irregularity, and lower oral contraceptive use.

Adult↗

Quantitative measurement of bone density using gamma-ray computed tomography.

A special purpose gamma-ray computed tomography scanner has been developed for precise measurements of bone density in the human appendicular skeleton. Details of the scanner's hardware and of the software organization for system control and data analysis are given, together with an outline of the theoretical basis for conversion of measured linear attenuation coefficients to physical bone densities. Performance of the system was evaluated on bone-like phantoms. Clinically, a precision of +/- 0.5% is obtained for bone density determinations. This device is being used in experimental studies and clinical investigations.

Bone Resorption↗