Effects of Body Composition, Leptin, and Adiponectin on Bone Mineral Density in Prepubertal Girls

Body weight is positively associated with bone mineral density but the relationship between obesity and bone mineral density is unclear. Leptin and adiponectin are potential independent contributors to bone mineral density. We assessed the correlations of body composition, leptin and adiponectin with bone mineral density, and whether leptin, adiponectin and body composition determine bone mineral density independently in prepubertal girls. Forty-eight prepubertal girls were classified into obese and control groups by body mass index. Serum leptin and adiponectin levels were determined by enzyme immunoassay. Bone mineral density was measured using dual energy radiography absorptiometry and body composition was measured using bioelectrical impedance analysis. Lean and fat mass, and leptin were positively correlated with bone mineral density. Lean mass was a positive independent predictor of femoral and L-spine bone mineral density. Serum leptin was a postivie independent predictor of femoral bone mineral density. Fat mass was a negative independent predictor of femoral bone mineral density. In prepubertal girls, lean mass has a favorable effect on bone mineral density. Fat mass seems not to protect the bone structure against osteoporosis, despite increased mechanical loading. Serum leptin may play a biological role in regulating bone metabolism

Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis

Objectives: We aimed to assess the association between long-term use of inhaled corticosteroids (ICS) and bone adverse effects in patients with asthma. Design: Systematic review and meta-analysis of fracture risk and changes in bone mineral density with long-term ICS use in asthma. Methods: We initially searched MEDLINE and EMBASE in July 2013, and performed an updated PubMed search in December 2014. We selected randomised controlled trials (RCTs) and controlled observational studies of any ICS (duration at least 12 months) compared to non-ICS use in patients with asthma. We conducted meta-analysis of ORs for fractures, and mean differences in bone mineral density. Heterogeneity was assessed using the I2 statistic. Results: We included 18 studies (7 RCTs and 11 observational studies) in the systematic review. Meta-analysis of observational studies did not demonstrate any significant association between ICS and fractures in children (pooled OR 1.02, 95% CI 0.94 to 1.10, two studies), or adults (pooled OR 1.09, 95% CI 0.45 to 2.62, four studies). Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use. Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control. Conclusions ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density

In vivo assessment of the mechanical properties of the child cortical bone using quantitative computed tomography

The mechanical properties of the rib cortical bone are extremely rare on children due to difficulties to obtain specimens to perform conventional tests. Some recent studies used cadaveric bones or bone tissues collected during surgery but are limited by the number of samples that could be collected. A non-invasive technique could be extremely valuable to overcome this limitation. It has been shown that a relationship exists between the mechanical properties (apparent Young’s modulus and ultimate strength) and the bone mineral density (assessed using Quantitative Computed Tomography, QCT), for the femur and recently by our group for the adult ribs ex vivo. Thus the aim of this study was to assess the mechanical properties of the child rib cortical bone using both QCT images in vivo and the previous relationship between bone mineral density and mechanical properties of the rib cortical bone. Twenty-eight children were included in this study. Seven age-groups have been considered (1, 1.5, 3, 6, 10, 15, 18 years old). The QCT images were prescribed for various thoracic pathologies at the pediatric hospital in Lyon. A calibration phantom was added to the clinical protocol without any modifications for the patient. The protocol was approved by the ethical committee. A 3D reconstruction of each thorax was performed using the QCT images. A custom software was then used to obtain cross-sections to the rib midline. The mean bone mineral density was then computed by averaging the Hounsfield Units in a specific cross-section and by converting the mean value (Hounsfield Units) in bone mineral density using the calibration phantom. This bone mineral density was assessed for the 6th rib of each subject. Our relationship between the bone mineral density and the mechanical properties of the rib cortical bone was used to derive the mechanical properties of the child ribs in vivo. The results give values for the apparent Young’s modulus and the ultimate strength. The mechanical properties increase along growth. As an example the apparent Young’s modulus in the lateral region ranges from 7 GPa +/-3 at 1 year old up to 13 GPa +/- 2 at 18 years old. These data are in agreement with the few previous values obtained from child tissues. This methodology opens the way to in vivo measurement of the mechanical properties of the child cortical bone based on calibrated QCT images

Lifestyle correlates of low bone mineral density in Albanian women

Aim: The aim of this study was to assess the association of lifestyle/behavioral factors with low bone mineral density in Albanian women, a transitional country in the Western Balkans. Methods: A cross-sectional study was conducted in Tirana city in 2010 including a population-based sample of 549 women aged 35 years and above (response rate: 92%). Low bone mineral density (osteopenia and/or osteoporosis defined as a bone mineral density T-score less than -1) was assessed with a bone ultrasound device which is simple and easy to use for screening of bone mineral density in population-based studies. Binary logistic regression was used to determine the relationship of low bone mineral density with behavioral factors in this study population. Results: The prevalence of low bone mineral density in this study population was 28.4% (156/549). In multivariable-adjusted logistic regression models, low bone mineral density was positively associated with smoking (OR=4.1, 95%CI=2.2-7.4) and coffee consumption (OR=2.3, 95%CI=1.3-4.1), but inversely related to overweight and obesity (OR=0.4, 95%CI=0.2-0.7 and OR=0.3, 95%CI=0.2-0.6, respectively). Conclusion: This study offers useful evidence about the lifestyle/behavioral determinants of low bone mineral density among women in this transitional South Eastern European population. Health professionals and policymakers in Albania should be aware of the major behavioral factors which increase the risk of low bone mineral density in order to provide correct treatment and control of this condition in the general population

Linking of psoriasis with osteopenia and osteoporosis: A cross‑sectional study

Psoriasis is a multisystem disease which has been related to vitamin‑D deficiency through chronic inflammation. This psoriasis‑related inflammatory state and vitamin‑D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis. Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients. Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density

RELATIONSHIP BONE MINERAL DENSITY AND RESORPTION OF ALVEOLAR

Osteoporosis is a degenerative disease characterized by reduced metabolic bone mass and bone micro-architect so that the risk of failure. Low bone mineral density is a clinical condition in patients with osteoporosis.Abstract:\ud \ud Objectives: Osteoporosis is a degenerative disease characterized by reduced metabolic bone mass and bone micro-architect so that the risk of failure. Low bone mineral density is a clinical condition in patients with osteoporosis. The high rate of decline in bone mineral density can lead to tooth loss. The purpose of this study was to determine the relationship of reduction in bone mineral density of the alveolar bone resorption so expect no early prevention of tooth loss in people with osteoporosis and osteopenic.\ud Methods: The sampling method using a random sampling technique. The sample consisted of 36 subjects included men and women with age group 20-71 years. The tools used to retrieve the data is dual energy x-ray absorptiometry (DXA) to assess bone mineral density reduction. Alveolar bone resorption in maxillary incisors with the technique of panoramic radiographs. Data obtained by measuring bone mineral density at the spine, articulatio radiocarpalis, femoral neck. In bone mineral density T-score (WHO, 2003) as follows: Osteoporosis is a bone mineral density <-2.5. Osteopenia is bone mineral density between -1 SD and - 2.5. When normal bone mineral density> -1. Alveolar bone resorption measured if there is loss of bone in the maxillary incisors, alveolar crest more than 2 mm apical to the CEJ toward the limit. \ud Results: Obtained bone mineral density: normal = 8, osteopenic = 15, osteoporosis = 13. Alveolar bone resorption: no resorption = 8, resorption 2-4 mm = 16 and resorption of > 4 mm = 12. \ud Test performed correlation analysis with SPSS version 21, the results of the study there is a relationship between age and bone density value of r = 0.378, between age and alveolar bone resorption value of r = 0.442, between bone mineral density and alveolar bone resorption r = 0.368. \ud Conclusion:There is a relationship between bone mineral density and resorption of alveolar and associated with increased age.\ud Key word: bone mineral density, alveolar resorptio

Osteopaenia - a marker of low bone mass and fracture risk

Areal bone mineral density is commonly categorised into normal bone mineral density, osteopaenia and osteoporosis on the basis of nominal thresholds recommended by the World Health Organization. However, bone mineral density is a continuous variable and there is a strong association between lower bone mineral density and greater risk for fracture. Fracture risk is not negligible in persons with moderate deficits in bone mineral density. Although absolute fracture risk is greatest for individuals with osteoporosis, more than half of the fractures arise from those with osteopaenia, and even normal bone mineral density, a probable consequence of greater numbers of individuals at risk in these categories. However, areal bone mineral density measurements used commonly in clinical practice do not detect differences in bone tissue properties, geometry and microarchitecture, which contribute to bone strength. Newer technologies such as high-resolution peripheral computed tomography have the advantage of assessing trabecular and cortical components of bone separately, in addition to geometric characteristics of the skeleton. Quantifying these parameters and considering clinical risk factors that affect fracture risk independent of bone quantity and quality, may better discriminate between high- and low-risk individuals. This would improve the decision-making for targeting appropriate interventions, either lifestyle or medication, to reduce thepublic health burden of fractures

The Effect of FRAX on the Prediction of Osteoporotic Fractures in Urban Middle-aged and Elderly Healthy Chinese Adults

OBJECTIVE: We aimed to analyze the applicability of a fracture risk assessment tool for the prediction of osteoporotic fractures in middle-aged and elderly healthy Chinese adults. METHODS: A standard questionnaire was administered, and bone mineral density was measured in residents visiting the Dongliu Street Community Health Service Center. Paired t-tests were used to compare the FRAX-based probabilities of fractures estimated with and without consideration of bone mineral density. Risk stratification and partial correlation analyses were applied to analyze the associations between FRAX-based probabilities and body mass index or bone mineral density at different sites. RESULTS: A total of 444 subjects were included in this study. Of these subjects, 175 (39.59%) were diagnosed as osteoporotic, and 208 (47.06%) were diagnosed as osteopenic. The Kappa value for the detection of osteoporosis at the L1-L4 lumbar spine and femoral neck was 0.314. The FRAX-based 10-year major osteoporotic fracture probability and hip osteoporotic fracture probability estimated without considering bone mineral density were 4.93% and 1.64%, respectively; when estimated while considering bone mineral density, these probabilities were 4.97% and 1.54%, respectively. A significant positive association was observed between the FRAX-based fracture probabilities estimated with and without consideration of bone mineral density, while significant negative associations between body mass index and the estimated FRAX-based fracture probabilities after adjustment for age and the estimated FRAX-based fracture probabilities and femoral neck bone mineral density were identified. These results remained the same after controlling for lumbar spine bone mineral density. CONCLUSIONS: The Chinese FRAX model could predict osteoporotic fracture risk regardless of whether bone mineral density was considered and was especially appropriate for predicting osteoporotic fractures of the femoral neck

Studies in Calcium, Parathyroid Hormone and Calcitonin Metabolism and Associated Skeletal Disorders

The association of hyperparathyroidism with Paget’s disease, the changes in bone mineral density after parathyroidectomy, the surgical experience with a large number of patients with hyperparathyroidism, the findings of stable bone mineral density and renal function in hyperparathyroid patients during long term follow up, and, most importantly, in a large study continued over several decades, the reduced life expectancy of patients with primary hyrperparathyroidism are described. The effective use of salmon calcitonin in a large number of patients with Paget’s disease, the use of pentagastrin to stimulate calcitonin release in persons with suspected occult medullary thyroid carcinoma, the evaluation of the impact of quantified exercise on circulating calcitonin, the evaluation of the interaction of circulating calcitonin with osteoblastic and osteoclastic function in bone in patients with chronic renal failure are described. The usefulness of the measurement of bone mineral density in the diagnosis and follow up of patients with osteoporosis, the value of the use of intravenous pamidronate in the treatment of osteoporosis, the finding that bone mineral density is a predictor of mortality in patients with chronic renal failure, the finding that long term treatment of postmenopausal women with formononetin reduces serum LDL cholesterol but does not preserve bone mineral density, the finding of low bone mineral density in persons with chronic fatigue syndrome, the failure of supplemental vitamin D to preserve bone mineral density in post-menopausal women, the effect of inhaled steroids on the bone mineral density of children, the finding that the heterozygous C282Y HFE mutation in postmenopausal women is associated with low bone mineral density and that venesection in a premenopausal woman with haemochromatosis improved bone mineral density are described. The findings of a high serum vasopressin in persons with hypercalcaemia and a high serum 1,25-OH vitamin D in a person with T-cell lymphoma are described. An extensive study of the role of FGF-23 in the clinical manifestations of oncogenic osteomalacia, and a unique study of cell function in a patient with fibrogenesis imperfecta ossium are described. The first description of diabetes insipidus in a patient with hypoparathyroidism is presented

Change in bone mineral density in post menopausal women with rheumatoid arthritis

Introduction: Low bone mass is a serious complication of post menopausal women with rheumatoid arthritis. We determined the Change in Bone Mineral Density in postmenopausal women with rheumatoid arthritis. Methods: This retrospective cohort study was carried out on consecutive postmenopausal women with rheumatoid arthritis who were referred to the Azar 5th teaching hospital affiliated to Golestan University of Medical Sciences, North of Iran in 2009. The required data were gathered from the patients' medical records. The data were analyzed using SPSS software and statistical tests. Results: We studied 98 postmenopausal women with rheumatoid arthritis. Mean number of years since menopause and mean duration of disease were 9.39 and 5.13 respectively. T Score mean in femoral neck and lumbar spines was -1.45±1.26 and -2.45±1.44 respectively. The overall prevalence of osteoporosis at both the lumbar spine and femoral neck was 13.3. We have found a significant correlation between age, duration of disease, duration of menopause and bone mineral density (P-Value<0.01). Conlusion: Our results indicate a negative effect of age, number of years since menopause and duration of disease on bone mineral density. So, BMD should be measured in high risk women prior to the implementation of any treatment or prevention program