Normative Values of Bone Mineral Content and Bone Mineral Density Assessed by Double X-ray Absorptiometry in Congolese Urban Women

Introduction: The World Health Organization (WHO) have validated dual X-ray absorptiometry as the “gold standard” densitometric technique for assessing Bone Mineral Density (BMD) and Bone Mineral Content (BMC).The definitions of osteopenia and osteoporosis are based on its results Loss of bone mass with ageing or osteoprosis leads to decline of bone strength and fragility fractures. There are racial/ethnic differences in bone mass parameters for populations of different ethnic origins although living in the same environmental. WHO criteria for the diagnosis of osteoporosis and the associated risks of fractures are based on bone parameters assessed by dual x absorptiometry in postmenopausal Caucasian women. Studies have shown the necessity to establish reference data for bone mass measurements for each population according to habit and ethnicity.These data are lacking for Congolese populations. This study aims to establish spine and hip normative values in healthy Congolese women population and to compare them with those for Caucasian, Asian, and others ethnical groups. Materials and methods: 604 bantus women aged from 18 to 92 years were recruited after public media advertising and undergoes DXA of spine and hip. To be included in the study, women must fulfill the conditions of absence of factor affecting bone metabolism. Results: Bone mass parameters shows a growth up to the peak that is reached in the fourth decade followed by a slow decay that causes a loss of nearly 14.2% in BMD and BMC over a period of 20 years and, then a decrease more pronounced towards the sixtieth year (1.5% yearly), higher than among Caucasians Asians and Arabs. We found that the references curves for the lumbar spine and total hip are significantly differences from the Caucasian, Asean or Arab. Conclusion: Spine and hip normatives values of BMD and BMC of Congolese urban women was etablished and were different to those of compared populations

Multidetector CT in Quantitative Morphometric Assessment of Post-Menopausal Vertebral Fractures in Black Women of Central Africa

Background: Osteoporosis and major Non-Communicable Diseases (NCDs) are identified by WHO as leading cause of death worldwide. Its economic burden is heavy worldwide and in particularly in low income countries. DXA availability is poorly in our country. Spine CT scanner with sagittal reformation images are known for the ease quotation of vertebral fractures by quantitative morphometric system described by Genant et al. (1996). This study aims to determine the rate and the features of vertebral fractures in postmenopausal black women living in Kinshasa/DRC using CT scanner sagittal reconstructions.Patients and methods: 430 consecutives post-menopausal women referred for Thoraco-lumbar CT scanner from June 2011 to June 2016 were enrolled in this study and theirs CT images used to quote vertebrae.Results: 12.89% of a total of 4730 vertebrae were fractured whose more than half (7.82%) of grade 1. The fracture rate is lower than in Caucasian and ASEAN and increase with ageing and duration of menopausis (24.51% in 70 years of age and over).Conclusion: Vertebral fracture global frequency was 12.89%. Vertebral fractures are present in our population and adverse consequences will arises in terms of morbidity and mortality. Lack of infrastucture, health policy and powerty will contributes to boost for a bader pronostics.The method is reproductible and can be used as routine clinical tools in conditions of poor availability of DXA

Ultrasound Assessment of Bone Mass in Central Africans Population

Background: Osteodensitometry, a procedure increasingly accepted by clinicians to access osteoporosis is not yet fully validated by WHO. It requires the establishment of normal values and references curves for each population, and in our community, this is not yet assessed.The purpose of this study was twofold: to describe the profile of the speed of sound of proximal phalangeal metaphysis and establish references curves in central Africans and to compare them with those of other populations specially Caucasians.Methods: This cross sectional study was carried out at Kinshasa, Democratic Republic of the Congo in Central Africa from January to December 2016.Four hundred twenty four subjects aged from 20 to 87 years old, were explored and the speed of sound in theirs proximal phalanges measured using ultrasound equipment. Age, gender, hormonal status and speed of sound were collected and analyzed.Results: The mean value of the Amplitude Dependent Speed of Sound (AD-SoS) showed a growth feature with age (from 2056 m/sec at second decade of life to 2145.27 m/sec at fourth decade followed by a progressive decrease which was present in both sexes but more marked in postmenopausal women (1927.06 m/sec). This mean value was higher than in Caucasian studies. In this study, age and hormonal status seems to be the bone quality most influencing anthropometric factors as seen in many series.The curve profile with age was also a polynomial curve as seen in others populations of the world.Conclusion: This study provides normal data for phalangeal ultrasound measurements and reference curve of central Africans which were compared to those of Western studies

Osteopenia and Osteoporosis Assessed by Dual X Absorptiometry in Sickle Cell Anemia Adults Subjects

Background: Sickle cell anemia is the most common genetic disease in sub-Saharan Africa. It is an inherited autosomal recessive disorder characterized by chronic hemolysis secondary to falciformation of red blood cells, also responsible of ischemia, bone infarction and accompanied by serious infections and organic lesions.Normal for weight at birth, Sickle cell anemia subjects have low pre puberty growth compared to normal children and also have compromised bone remodeling balance which results in decrease of bone mass and increase of bone fragility. Several studies have established that 37% to 50% of SCA patients were osteopenic or osteoporotic. This study aims to confirm the existence of bone remodeling disorders with osteoporotic translation and to compare the values found in Congolese sickle cell adults subjects to the general population.Methods: Spine and hip DXA were conducted on 270 SS homozygotes aged 18 to 50 years (121 men and 149 women) and 359 AA homozygotes as controls (138 men and 221 women), aged from 18 to 50 years old, who agreed to participate in the study, considered as a control group. AS heterozygotes were not included in the study.Results: AA subjects shows higher density (BMD) and Bone mineral content (BMC) values. Both SCA and AA controls showed the characteristic curve with peak bone mass at the fourth decade of life, followed by a decay with age. The difference in BMD and BMC with the control population ranged from 7.94% to 26.34% (average of 16.02%) which means -0.8 to -2.7 standard deviations, whereas, compared to the T -score in the Congolese population, was 11.6% to 22.15% less (average of -17.5%) equivalent of -0.9 to -2 standard deviations.The overall decrease in bone mass rate for -2.5 DS of the T-score was: -28.4% and 33.2% for -2 DS of T-score.Conclusion: SCA subjects shows high rate of osteopenia and osteoporosis and are more likely at risk for fractures

Ultrasound Assessment of Bone Mass in Central Africans Population

Background: Osteodensitometry, a procedure increasingly accepted by clinicians to access osteoporosis is not yet fully validated by WHO. It requires the establishment of normal values and references curves for each population, and in our community, this is not yet assessed.The purpose of this study was twofold: to describe the profile of the speed of sound of proximal phalangeal metaphysis and establish references curves in central Africans and to compare them with those of other populations specially Caucasians.Methods: This cross sectional study was carried out at Kinshasa, Democratic Republic of the Congo in Central Africa from January to December 2016.Four hundred twenty four subjects aged from 20 to 87 years old, were explored and the speed of sound in theirs proximal phalanges measured using ultrasound equipment. Age, gender, hormonal status and speed of sound were collected and analyzed.Results: The mean value of the Amplitude Dependent Speed of Sound (AD-SoS) showed a growth feature with age (from 2056 m/sec at second decade of life to 2145.27 m/sec at fourth decade followed by a progressive decrease which was present in both sexes but more marked in postmenopausal women (1927.06 m/sec). This mean value was higher than in Caucasian studies. In this study, age and hormonal status seems to be the bone quality most influencing anthropometric factors as seen in many series.The curve profile with age was also a polynomial curve as seen in others populations of the world.Conclusion: This study provides normal data for phalangeal ultrasound measurements and reference curve of central Africans which were compared to those of Western studies