Hypovitaminosis D and prevalent asymptomatic vertebral fractures in Moroccan postmenopausal women

BACKGROUND: Hypovitaminosis D is associated to accentuated bone loss. However, association between osteoporotic vertebral fractures (VFs) and vitamin D status has not been clearly established. OBJECTIVE: To determine serum vitamin D status and to assess the association of vitamin D status with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women. METHODS: from June to September 2010, 178 menopausal women 50 years old and over were enrolled in this cross-sectional study. The mean ± SD (range) age, weight, height and BMI were 58.8 ± 8.2 (50 to 79) years, 73.2 ± 13.8 (35 to 119) Kgs, 1.56 ± 0.06 (1.43 – 1.79) m and 29.8 ± 5.9 (17.5 – 49.8) kg/m(2), respectively. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured. RESULTS: Among the 178 women, 45 (25.2%) had densitometric osteoporosis, and on VFA, VFs (grade 2 or 3) were detected in 20.2% while grade 1 were identified in 33.1%. The mean values of serum levels of 25(OH)D were 15.8 ± 11.6 ng/ml (range: 3.0 – 49.1) with 152 patients (85.3%) having levels <30 ng/ml (insufficiency) and 92 (51.6%) <10 ng/ml (deficiency). Stepwise regression analysis showed that presence of VFs was independently related to age, 25(OH)D and densitometric osteoporosis. CONCLUSION: our study shows that advanced age, hypovitaminosis D and osteoporosis are independent risk factors for asymptomatic VFs in Moroccan postmenopausal women

Risk factors of osteoporosis in healthy Moroccan men

<p>Abstract</p> <p>Background</p> <p>Although not as common as in women, osteoporosis remains a significant health care problem in men. Data concerning risk factors of osteoporosis are lacking for the male Moroccan population. The objective of the study was to identify some determinants associated to low bone mineral density in Moroccan men.</p> <p>Methods</p> <p>a sample of 592 healthy men aged 20-79 years was recruited from the area of Rabat, the capital of Morocco. Measurements were taken at the lumbar spine and proximal femurs using DXA (Lunar Prodigy Vision, GE). Biometrical, clinical, and lifestyle determinants were collected. Univariate, multivariate, and logistic regression analyses were performed.</p> <p>Results</p> <p>the mean (SD) age of the patients was 49 (17.2) years old. The prevalence of osteoporosis and osteopenia were 8.7% and 52.8%, respectively. Lumbar spine and hip BMD correlated significantly with age, weight and BMI. When comparing the subjects according to the WHO classification, significant differences were revealed between the three groups of subjects for age, weight and BMI, prevalence of low calcium intake and low physical activity. The multiple regression analysis found that only age, BMI, and high coffee consumption were independently associated to the osteoporotic status.</p> <p>Conclusion</p> <p>ageing and low BMI are the main risk factors associated with osteoporosis in Moroccan men.</p

Le doigt pelvien: une anomalie osseuse rare

The pelvic finger is a rare anatomical abnormality characterized by the development of a bony structure in the soft tissues adjacent to the pelvis. Its origin is still unknown, but the theory suggests an abnormality occurring at the stage of mesenchymal bone growth during the first six weeks of embryogenesis. We present the case of a 40-year old patient, very athletic seeing the doctor for mechanical pain in the right groin that occurred during a training session. The clinical examination revealed a painful right hip mobilization without limitation of the movement. The remainder of the examination showed no somatic abnormalities. Face radiography of the pelvis revealed a bony finger-shaped protrusion articulating with the upper, outer corner of the roof of the right acetabulum (A). Computed tomography showed the pelvic finger, with a well-differentiated cortical bone articulating with the roof of the right acetabulum (B) and extending in the anterior-inferior direction (C). This problem may occur at any level of the pelvic bone, and can even be located entirely within the soft tissues of the abdominal wall. CT is useful in these cases because it helps to establish a differential diagnosis (bone tumors, osteochondroma, myositis ossificans and avulsion fracture of the pelvis). Occasionally the pelvic finger may be bilateral or multiple. It is usually asymptomatic and discovered incidentally. It can sometimes be a source of pain, difficult or functional disability because of its proximity to the articulation. In this case, surgical excision may be necessary. The Pan African Medical Journal 2016;2

PERFORMANCE OF QUANTITATIVE ULTRASOUND AND SIX OSTEOPOROSIS RISK INDEXES IN MENOPAUSAL WOMEN: VALIDATION AND COMPARATIVE EVALUATION STUDY.

<p><strong>Background:</strong> A number of questionnaire-based systems and the use of portable quantitative ultrasound scanners (QUS) have been devised in an attempt to produce a cost-effective method of screening for osteoporosis.<br /><strong>Objective:</strong> to assess the sensitivity and specificity of different techniques and their ability to act as screening tools in relation to dual energy X-ray absorptiometry (DXA).<br /><strong>Methods:</strong> 295 white postmenopausal women aged over 60 were enrolled. Each subject completed a standardized questionnaire which permits the measure of six osteoporosis indexes and had bone mineral density (BMD) measured using QUS and DXA. Sensitivity and specificity of the different techniques in relation to DXA were plotted as receiver-operating characteristic (ROC) curves at DXA T-score total hip ≤ -2.5 (osteoporosis).<br /><strong>Results:</strong> BUA sensitivity and specificity values were respectively 76.8% and 51.2% at the total hip. The optimal cut-off T-score for QUS was -2 at the total hip. The osteoporosis self-assessment tool (OST) provided consistently the highest AUC (0.80) among the clinical tools and had the best sensitivity and specificity balance (90.2%-44.5%). OST negative likelihood ratio was 0.22.<br /><strong>Conclusion:</strong> OST (based only on the weight and the age) performed slightly better than QUS and other risk questionnaires in predicting low BMD at the total hip</p

Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

Aim of the work: The aim of this study was to assess the influence of anti-cyclic citrullinated peptide (anti-CCP) on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA). Patients and methods: One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dose were identified. Anti-CCP and Rheumatoid factor (RF) were determined. Disease activity score (DAS28) was assessed and functional repercussion measured by the Health Assessment Questionnaire-disability index (HAQ-DI). Radiological status was assessed by the Sharp/van der Heijde (SvH) erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results: Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1%) patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate (ESR), rheumatoid factor titer and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions: Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention. Keywords: Rheumatoid arthritis, Anti-cyclic citrullinated peptide, Disease activity, Joint damage, Bone los