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BMD Values (bmd + value)
Selected AbstractsNoninvasive estimation of bone mass in ancient vertebraeAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2004E. Gonzalez-Reimers Abstract Histomorphometry is useful in the assessment of trabecular bone mass (TBM), and thus, in the estimation of the prevalence and intensity of osteopenia in ancient population groups. However, it is a destructive method. It is therefore necessary to explore the accuracy of nondestructive approaches, such as radiography, bone mineral density (BMD) assessed by double-energy X-ray absorptiometry (DEXA), bone density (BD), or optical density (OD) in the diagnosis of osteopenia. We selected 51 vertebrae out of a total sample composed of 333 T12, L1, and L2 vertebrae belonging to adult pre-Hispanic inhabitants from El Hierro. These vertebrae underwent histomorphometrical analysis, a fine-grained film radiography with assessment of trabecular pattern following standard methods, OD, DEXA-assessed BMD, and BD. The presence of biconcave vertebrae and wedge-shaped vertebrae was also assessed by measuring anterior height (a), posterior height (p), and height at the middle point of the vertebral body (m), and further calculating the indices 2m/(a + p) ("spine score") and a/p. Significant correlations were observed between TBM and BMD (r = 0.43), TBM and BD (r = 0.49), TBM and OD (r = 0.52), BMD and OD (r = 0.51), and BMD and BD (r = 0.36), but not between TBM and the indices 2m/(a + p) and a/p. In the stepwise multiple correlation analysis between TBM and BMD, BD, and OD, OD entered into first place and BD into second place, whereas BMD became displaced; the multiple correlation coefficient was 0.63, with a standard error of 3.78. A BMD greater than 0.60 g/cm2, or a bone density greater than 0.60 g/cm3, excluded osteopenia (TBM <15%) with a specificity greater than 90%, whereas a BMD value less than 0.35 g/cm2, a BD less than 0.35 g/cm3, or optical density >1.6 excluded a normal bone mass (TBM >20%) with a specificity greater than 90%. Based on radiographic criteria on the total sample, we also conclude that the overall prevalence of vertebral fractures in the adult pre-Hispanic population of El Hierro of any age is 7.5%. Am J Phys Anthropol, 2004. © 2004 Wiley-Liss, Inc. [source] Quantitative computed tomography of the lumbar spine, not dual x-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapyARTHRITIS & RHEUMATISM, Issue 5 2002Q. Rehman Objective To determine which measurement of bone mineral density (BMD) predicts vertebral fractures in a cohort of postmenopausal women with glucocorticoid-induced osteoporosis. Methods We recruited 114 subjects into the study. All had osteopenia of the lumbar spine or hip, as demonstrated by dual x-ray absorptiometry (DXA), and were receiving long-term glucocorticoids and hormone replacement therapy (HRT). Measurements of BMD by DXA of the lumbar spine, hip (and subregions), and forearm (and subregions), quantitative computed tomography (QCT) of the spine and hip (n = 59), and radiographs of the thoracolumbar spine were performed on all subjects to assess prevalent vertebral fractures. Vertebral fracture prevalence, as determined by morphometry, required a ,20% (or ,4-mm) loss of vertebral body height. Demographic information was obtained by questionnaire. Multiple regression and classification and regression trees (CART) analyses were used to assess predictors of vertebral fracture. Results Twenty-six percent of the study subjects had prevalent fractures. BMD of the lumbar spine, total hip and hip subregions, as measured by QCT, but only the lumbar spine and total hip, as measured by DXA, were significantly associated with prevalent vertebral fractures. However, only lumbar spine BMD as measured by QCT was a significant predictor of vertebral fractures. CART analysis showed that a BMD value <0.065 gm/cm3 was associated with a 7-fold higher risk of fracture than a BMD value ,0.065 gm/cm3. Conclusion In postmenopausal women with osteoporosis induced by long-term glucocorticoid treatment who are also receiving HRT, BMD of the lumbar spine as measured by QCT, but not DXA, is an independent predictor of vertebral fractures. [source] The effect of sexual hormone abnormalities on proximal femur bone mineral density in hemodialysis patients and the possible role of RANKLHEMODIALYSIS INTERNATIONAL, Issue 1 2008Konstantinos K. DOUMOUCHTSIS Abstract Sexual hormone concentrations are commonly affected in chronic renal failure. The contribution of sex steroids to bone turnover regulation implies that sex steroid's dysfunction may be implicated in the emergence of renal osteodystrophy. This study was conducted to evaluate sex steroids and gonadotrophins in hemodialysis (HD) patients and to investigate their role in bone homeostasis in concert with other hormones and cytokines. Bone mineral density (BMD) at the proximal femur and intact parathyroid hormone (iPTH), osteoprotegerin, soluble receptor activator of NF-,B ligand (sRANKL), prolactin, total testosterone, estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured in serum samples in 42 patients, 21 men and 21 women, on maintenance HD therapy. Possible associations between clinical characteristics, biochemical parameters, and BMD values were investigated. In male HD patients, the testosterone concentration declined significantly with aging, whereas the estradiol level increased with longer duration of HD. Concurrently, testosterone correlated negatively with sRANKL concentrations (r=,0.520, p=0.016). Luteinizing hormone levels in male patients demonstrated statistically significant negative correlations with BMD values of the proximal femur. In the entire cohort of patients, FSH and LH were negatively associated with absolute values of proximal femur BMD. Gonadotrophin and sexual hormone concentrations in HD patients are associated with bone mineral status and consequently their derangements appear to contribute to the development of bone composition abnormalities in different types of renal osteodystrophy. Furthermore, testosterone's association with sRANKL levels in male HD patients suggests that RANKL may mediate the effect of testosterone on bone metabolism in these patients. [source] Low bone mineral density in children and adolescents with inflammatory bowel disease: A population-based study from Western SwedenINFLAMMATORY BOWEL DISEASES, Issue 12 2009Susanne Schmidt MD Abstract Background: Low bone mineral density (BMD) has been recognized as a potential problem in children with inflammatory bowel disease (IBD). The aim of the study was to investigate BMD in Swedish children and adolescents with IBD and to evaluate possible factors affecting BMD. Methods: To evaluate BMD, all patients (n = 144) underwent a dual-energy X-ray absorptiometry (DXA) of the whole body and the spine. BMD values were expressed as Z-scores using normative pediatric data from Lunar (GE Medical Systems). Results: In this population-based study, the lowest BMD values were found in the lumbar spine. The entire IBD group showed significantly lower BMD Z-scores of the lumbar spine (L2,L4) in comparison to healthy references (,0.8 standard deviation [SD], range ,5.9 to 3.7 SD, P < 0.001). Decreased BMD with a Z-score < ,1 SD occurred in 46.7% of the individuals with Crohn's disease (CD) and in 47.0% of those with ulcerative colitis (UC). Low BMD with a Z-score , ,2 SD was present in 26.7% of the patients with CD and in 24.1% of the UC patients. In a multiple regression model with BMD lumbar spine as the depending variable, possible factors associated with lower BMD were male gender, low body mass index (BMI), and treatment with azathioprine. Conclusions: Low BMD is prevalent in Swedish pediatric patients with IBD. Possible risk factors for lower BMD are male gender, low BMI, and treatment with azathioprine, as a probable marker of disease course severity. (Inflamm Bowel Dis 2009) [source] Proton pump inhibitor omeprazole use is associated with low bone mineral density in maintenance haemodialysis patientsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2009A. Kirkpantur Summary Objective:, Limited studies have shown that proton pump inhibitor (PPI) therapy may decrease bone density or insoluble calcium reabsorption through induction of hypochlorhydria. However, PPI therapy may also reduce bone resorption via inhibition of osteoclastic vacuolar proton pumps. The aim of this study was to determine whether the opposing effects of PPI therapy may cause clinically important alterations in bone mineral densitometry (BMD) parameters in maintenance haemodialysis patients. Methods:, Sixty-eight maintenance haemodialysis patients were enrolled in this study. Patients were classified into two groups involving users of PPI therapy (omeprazole 20 mg/day, group 1, n = 36 patients) and non-users of acid suppression drugs (group 2, n = 32 patients). Patients had radius, hip and spine BMD assessed by dual-energy X-ray absorptiometry. Results:, The mean duration of PPI therapy with omeprazole was 27 ± 5 months. The users of PPI therapy had lower values of bone mineral density and T -scores at the anatomical regions than non-users of acid suppression drugs. Serum calcium and phosphate levels, calcium-phosphate product and serum intact parathormone levels and the ratio of users of vitamin D therapy were similar among groups. A mutivariable adjusted odds ratio for lower bone density associated with more than 18 months of omeprazole, when all the potential confounders were considered, was 1.31 in the proximal radius, 0.982 in the femur neck, 0.939 in the trochanter and 1.192 in the lumbal spine. Conclusion:, The present data suggest that PPI therapy should be cautiously prescribed in maintenance haemodialysis patients, especially with lower BMD values. [source] Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acneINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2008Nilgun Solak Tekin Associate Professor Background, High-dose isotretinoin has been reported to have adverse effects on bone mineral density (BMD); however, studies evaluating changes in BMD with isotretinoin therapy at different dosages and with varying treatment durations have produced conflicting results. Objective, To investigate the effect of a standard, single course of isotretinoin therapy on BMD and bone turnover markers in patients with nodulocystic acne. Methods, Thirty-six patients (15 male, 21 female) with severe, recalcitrant, nodulocystic acne and 36 healthy controls (16 male, 20 female) were enrolled in the study. Patients received isotretinoin treatment for 4,6 months until a cumulative dose of 120 mg/kg had been achieved. BMD in the lumbar spine and femur was measured at baseline and at the end of therapy by dual-energy X-ray absorptiometry. Serum calcium, phosphate, parathormone, total alkaline phosphatase, osteocalcin, free deoxypyridinoline, and urinary calcium were also measured before and at the end of treatment. Results, No significant differences were found in lumbar spine and femoral BMD between the patient and control groups at the beginning of the study (P > 0.05), and no statistically significant difference was observed between the BMD values in patients at the beginning vs. the end of treatment (P > 0.05). No statistically significant difference in bone turnover markers was found between patients and controls at the beginning of the study (P > 0.05), and no statistically significant changes in bone turnover markers were observed in patients at the beginning vs. the end of treatment (P > 0.05). Conclusion, A single course of isotretinoin therapy has no clinically significant effect on bone metabolism. [source] Prevalence and predictors of osteoporosis and the impact of life style factors on bone mineral densityINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2007Abdulbari BENER Abstract Aim:, The aim of this study was to determine the prevalence and predictors of osteoporosis and the impact of life style factors on bone mineral density (BMD) in premenopausal and postmenopausal Qatari women. Methods:, This is a cross-sectional study. A total of 821 healthy Qatari women aged 20,70 years had given consent and participated and the study was conducted from June 2005 to December 2006 at the Rumaillah Hospital, Hamad Medical Corporation (HMC), Doha, State of Qatar. All subjects completed a questionnaire on reproductive and life style factors. Height and weight were measured. All subjects underwent dual-energy X-ray absorptiometry (DXA) to determine factors influencing BMD of the spine and femur. The main outcome measures were menopausal status, socio-demographic and lifestyle factors and BMD measurements. Results:, The prevalence of osteoporosis in postmenopausal women was 12.3%. BMI was significantly higher among postmenopausal women (P < 0.001) when compared to premenopausal women. The subjects who regularly consumed dairy products had better BMD at spine, neck and ward sites (P < 0.05). Those doing regular household work for 3,4 h a week had higher BMD at all sites compared to those who did not do their own household work. Multiple regression analysis showed that education level and body mass index were strong positive predictors showing high significance. Conclusion:, The relation between lifestyle and BMD were explored in Qatari women. The prevalence of osteoporosis in Qatari women is comparable to other countries. BMD values were higher in women who were taking diary products regularly, and were involved with household work. [source] The FRAX tool in French women: How well does it describe the real incidence of fracture in the OFELY cohortJOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2010Elisabeth Sornay-Rendu Abstract The FRAX tool estimates an individual's fracture probability over 10 years from clinical risk factors with or without bone mineral density (BMD) measurement. The aim of our study was to compare the predicted fracture probabilities and the observed incidence of fracture in French women during a 10-year follow-up. The probabilities of fracture at four major sites (hip, clinical spine, shoulder, or wrist) and at the hip were calculated with the FRAX tool in 867 women aged 40 years and over from the Os des Femmes de Lyon (OFELY) cohort. The incidence of fracture was observed over 10 years. Thus 82 women sustained 95 incident major osteoporotic (OP) fractures including 17 fractures at the hip. In women aged at least 65 years (n,=,229), the 10-year predicted probabilities of fracture with BMD were 13% for major OP fractures and 5% for hip fractures, contrasting with 3.6% and 0.5% in women younger than 65 years (p,<,.0001). The predicted probabilities of both major OP and hip fractures were significantly higher in women with osteoporosis (n,=,77, 18% and 10%) and osteopenia (n= 390, 6% and 2%) compared with women with normal BMD (n,=,208, 3% and <1%; p,<,.0001. The predicted probabilities of fracture were two and five times higher in women who sustained an incident major OP fracture and a hip fracture compared with women who did not (p,<,.0001). Nevertheless, among women aged at least 65 years with low BMD values (T -score , ,1; n,=,199), the 10-year predicted probability of major OP fracture with BMD was 48% lower than the observed incidence of fractures (p,<,.01). A 10-year probability of major OP fracture higher than 12% identified more women with incident fractures than did BMD in the osteoporotic range (p,<,.05). In French women from the OFELY cohort, the observed incidence of fragility fractures over 10 years increased with age following a pattern similar to the predicted probabilities given by the FRAX tool. However, in women aged at least 65 years with low BMD, the observed incidence of fractures was substantially higher than the predicted probability. © 2010 American Society for Bone and Mineral Research. [source] Associations Between Baseline Risk Factors and Vertebral Fracture Risk in the Multiple Outcomes of Raloxifene Evaluation (MORE) StudyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2004Olof Johnell Abstract Different risk factors may influence the effectiveness of osteoporosis therapies. The interaction of 30 baseline risk factors and the effectiveness of raloxifene in the MORE study were assessed. The efficacy of raloxifene in reducing vertebral fractures is largely independent of the presence of clinical risk factors for osteoporotic fractures. Introduction: The aim of this analysis was to determine the effect of different risk factors on the effectiveness of raloxifene to reduce vertebral fractures in the Multiple Outcomes of Raloxifene Evaluation (MORE) study using logistic regression models. Materials and Methods: The association was assessed using univariate analyses and a multivariate model between 30 potential risk factors at baseline and the risk of vertebral fractures after 3 years in the placebo group, as well as the interaction of risk factors with raloxifene therapy (at a dose of 60 or 120 mg/day). Results and Conclusions: In the univariate analysis of the placebo group, after adjusting for baseline lumbar spine BMD (LS BMD), short stature (odds ratio [OR] = 1.18), age (OR = 1.38), years since menopause (OR = 1.38), impaired cognitive function, visuospatial capabilities (OR = 1.19), impaired musculoskeletal strength (OR = 1.23), low femoral neck BMD (OR = 1.21), and prior vertebral fracture (OR = 4.95) were significantly associated with the incidence of new vertebral fractures. In the univariate analysis, significant interactions were observed between raloxifene treatment and age (p = 0.04), serum triglycerides (p = 0.03), LS BMD (p = 0.08), and diabetes mellitus (p = 0.04). In the multivariate analysis, the effectiveness of raloxifene was independent of almost all risk factors, with the exception of baseline serum triglyceride level and LS BMD, suggesting an increased efficacy of raloxifene in patients with increased triglyceride levels (p = 0.006) and lower LS BMD values (p = 0.008) at baseline. These data suggest that the efficacy of raloxifene in reducing vertebral fractures is largely independent of the presence of clinical risk factors for osteoporotic fractures. [source] Bone mineral metabolism changes in epileptic children receiving valproic acidJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2004N Öner Objective: The aim of this study was to evaluate bone mineral density (BMD) in epileptic children receiving valproic acid (VPA) and to determine differences between osteopenic and non-osteopenic children. Methods: Thirty-three epileptic children, receiving VPA for at least 6 months, were compared with 33 healthy children for BMD. BMD was measured by dual-energy X-ray absorptiometry at lumbar vertebrae, femoral neck and greater trochanter. Serum calcium, phosphorus, alkaline phosphates, osteocalcin and VPA levels were also determined. Results: Patient's osteocalcin levels were significantly higher (P = 0.02) and femur and trochanter BMD values were significantly lower (P = 0.04 and P = 0.03, respectively). Duration of VPA therapy was significantly longer and doses of VPA were significantly higher in seven osteopenic patients compared with 26 non-osteopenic patients. Osteopenic patients (4.6 ± 2.4 years) were younger than non-osteopenic patients (7.8 ± 3.2 years) (P = 0.01). Conclusion: Long-term and high dose VPA therapy may cause osteopenia, primarily in younger epileptic children. These patients should be followed closely by BMD measurements. [source] Bone mineral density among cirrhotic patients awaiting liver transplantationLIVER TRANSPLANTATION, Issue 5 2004Rana Paramvir Sokhi Osteoporosis is an important and common complication in patients with chronic liver disease. The goal of this study was to determine the bone mineral density (BMD) in different subgroups among pretransplant cirrhotic patients. BMD of the lumbar vertebrae (L) and femoral neck (F) were obtained in 104 consecutive cirrhotic patients. Descriptive and inferential statistics were used to compare the BMD among various groups. The mean BMD in males (n = 54) and females (n = 50) at L were 1.28 ± 0.25 g/cm2 and 1.13 ± 0.20 g/cm2, respectively (P = .001); at F they were 1.03 ± 0.14 and 0.91 ± 0.17, respectively (P < .0001). Among males, BMD at L in Child-Turcotte-Pugh class B and C were 1.40 ± 0.21 and 1.13 ± 0.20, respectively (P = .001); at F they were 1.11 ± 0.10 and 0.93 ± 0.13, respectively (P < .0001). Among females, BMD at L in Child-Turcotte-Pugh class B and C were 1.27 ± 0.18 and 1.05 ± 0.16, respectively (P = .0003); at F they were 1.02 ± 0.16 and 0.83 ± 0.12, respectively (P = .001). The BMD in premenopausal females (n = 15) and postmenopausal females (n = 35) at L were 1.20 ± 0.19 and 1.11 ± 0.20, respectively (P = .15); at F they were 0.97 ± 0.17 and 0.88 ± 0.16, respectively (P = .12). The BMD in postmenopausal females on hormone replacement therapy (n = 19) and on no hormone replacement therapy (n = 16) at L were 1.07 ± 0.17 and 1.14 ± 0.23, respectively (P = .29); at F they were 0.85 ± 0.15 and 0.91 ± 0.18, respectively (P = .33). The BMD values between etiologic groups were not significantly different. The overall prevalence of osteopenia and osteoporosis were 34.6% and 11.5%, respectively, being significantly higher in females than in males. In conclusion, significant difference in BMD values exists between males and females, as well as between Child-Turcotte-Pugh class B and C patients with cirrhosis. In addition, there is no significant influence of menopausal status, hormone replacement therapy, and etiology of cirrhosis on BMD. (Liver Transpl 2004;10:648,653.) [source] Relation of bone mineral density with clinical and laboratory parameters in pre-pubertal children with cystic fibrosisPEDIATRIC PULMONOLOGY, Issue 7 2009Nazan Cobanoglu MD Abstract To study bone mineral density (BMD) of pre-pubertal cystic fibrosis (CF) children, and its relation with clinical and laboratory parameters, we enrolled 16 CF (8 girls) (4,8 years), and 16 control children (8 girls) (4,8 years). After anthropometric measurements, BMD, serum calcium, phosphorus, total alkaline phosphatase (ALP), 25-hydroxy vitamin D (25-OHD), parathyroid hormone, osteocalcin, tumor necrosis factor (TNF)-,, soluble TNF-, receptor 2 (sTNFR2), and soluble IL-2 receptor (sIL-2R) levels, and urinary calcium and hydroxyproline excretions were assessed. Disease severity of CF patients was determined with Shwachman,Kulczycki clinical and Brasfield radiological scoring systems. The mean Shwachman,Kulczycki and Brasfield scores of CF patients were indicating well-controlled disease. The anthropometric measurements, mean BMD values, and serum calcium, phosphorus and parathyroid hormone levels were within normal range and similar in both groups. Serum osteocalcin levels were lower, and ALP and 25-OHD levels were higher in CF. Although 24-hr urinary calcium excretions was higher in CF patients, hydroxyproline excretions were similar in both groups. There was no difference between two groups for the serum levels of sIL-2R, TNF-, and sTNFR2. Children with low vertebral z -scores had higher serum sIL-2R levels in both groups, but the same relation could not be shown for TNF-, and sTNFR2. We may speculate that younger, healthier and well-nourished patients with CF may have normal BMD, but the bone disease develop as patients get older because of the other contributing factors. Future well-designed longitudinal studies with large cohorts might show a relation with BMD and cytokines in CF. Pediatr Pulmonol. 2009; 44:706,712. © 2009 Wiley-Liss, Inc. [source] Association Among Serum Fetuin-A Level, Coronary Artery Calcification, and Bone Mineral Densitometry in Maintenance Hemodialysis PatientsARTIFICIAL ORGANS, Issue 10 2009Alper Kirkpantur Abstract Patients with end-stage renal disease have a very high prevalance and extent of arterial calcification. A number of studies suggest that similar pathophysiologic mechanisms are responsible for development and progression of calcification of atherosclerotic plaque and bone formation. Fetuin-A is a potent calcification inhibitor and is expressed in bone, with not-yet well-defined functions. The aim of this study was to investigate the relation between bone mineral densitometry parameters, coronary artery calcification, and serum fetuin-A levels. In a cross-sectional design, we included 72 maintenance hemodialysis (HD) patients and 30 age- and gender- matched healthy controls. Serum fetuin-A levels were studied both in maintenance HD patients and healthy controls. Maintenance HD patients had radius, hip, and lumbar spine bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry and coronary artery calcification score (CACS) measured by electron-beam computed tomography. The associations between site-specific BMD parameters, CACS, and serum fetuin-A levels were studied in maintenance HD patients. CACS, mass, and volume of plaques in coronary arteries were significantly higher in patients with a T-score below ,2.5 than above in the proximal region of the radius, neck and trochanter of the femur, and the lumbar spine. Mean serum fetuin-A concentration was 0.636 ± 0.118 g/L in maintenance HD patients and it was less than healthy controls (0.829 ± 0.100 g/L, P < 0.0001). CACS, mass, and volume of plaques in coronary arteries correlated significantly with the serum fetuin-A levels. Moreover, significant positive correlations were shown between the serum fetuin-A levels, BMD values, and T-scores of proximal radius, neck, and trochanter of the femur, but not with the lumbar spine. The present study demonstrates an association between serum fetuin-A levels, coronary artery calcification, and bone mineral densities,except for the lumbar spine, in maintenance HD patients. However, the results should be interpreted with caution because of the cross-sectional design of the study. [source] Vitamin D status in female patients with primary hyperparathyroidism: does it play a role in skeletal damage?CLINICAL ENDOCRINOLOGY, Issue 1 2004Vincenzo Carnevale Summary objective, Vitamin D deficiency, even subclinical, has been considered to worsen the skeletal damage in primary hyperparathyroidism (PHPT). Our study aimed to investigate the impact of vitamin D status on skeletal involvement in PHPT. design and measurements, A cross-sectional study was designed involving 62 female patients with PHPT. Serum total calcium (tCa), phosphate (P), creatinine (Cr) and total alkaline phosphatase activity (AP), together with 24-h (uCa 24 h) and spot fasting (uCa/Cr) urinary calcium, were measured by autoanalyser; ionized calcium (iCa) was assessed by an ion-specific electrode; intact parathyroid hormone (PTH) was measured by immunoradiometric assay (IRMA) and 25-hydroxyvitamin D (25-OHD) by radioimmunoassay (RIA). Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) at lumbar spine in 58 patients, and at femoral neck, Ward's triangle, greater trochanter, intertrochanteric line and total hip in 56 patients. The associations of all variables with age, 25-OHD, body mass index (BMI) and PTH were studied by linear multiple regression analysis, using progressively restricted models. results, The model including age, 25-OHD, PTH and BMI showed significant regression with BMD values. PTH, age and BMI exerted a leading role in determining such a significance, while no significant regression was found between the parameters studied and 25-OHD; this was confirmed by Pearson's linear correlation analysis. The progressively restricted models showed significant regression of BMD at femoral neck, femoral intertrochanteric line and total hip with age, BMI and PTH. BMD measured at the Ward's triangle and greater trochanter showed significant regression with age and BMI, and that measured at lumbar spine with age. conclusions, Our data indicate that in primary hyperparathyroidism patients the influence of 25-hydroxyvitamin D levels on bone mineral density, if any, was overwhelmed by the effects of parathyroid hormone excess, age and body mass index. The latter unequally affected bone mineral density of various measured sites with different composition. [source] Does subclinical hypercortisolism adversely affect the bone mineral density of patients with adrenal incidentalomas?CLINICAL ENDOCRINOLOGY, Issue 1 2003D. Hadjidakis Summary objective Subclinical hypercortisolism (SH) is detected increasingly in a substantial proportion of patients with incidentally discovered adrenal adenomas. The clinical implications of SH are currently unclear. Osteoporosis is a well-known complication of glucocorticoid excess. So far, the impact of SH on bone mineral density (BMD) has been studied in a limited number of reports with discordant results. In the present study we evaluated the BMD in a large cohort of post-menopausal women with adrenal incidentalomas. patients and measurements,Forty-two post-menopausal women with incidentally discovered adrenal masses and radiological features highly suggestive of benign adrenal adenomas were investigated. All patients underwent a standard low-dose dexamethasone suppression test (LDDST; 0·5 mg 6-hourly for 2 days). The diagnosis of subclinical hypercortisolism (SH) was based on post-LDDST cortisol concentrations of > 70 nmol/l. According to this criterion patients were subdivided into two groups: with (n = 18; group A) or without (n = 24; group B) SH. There was no significant difference in age, years since menopause and body mass index between these groups. BMD was measured at L2,L4 vertebrae and three sites of the proximal femur by the dual energy X-ray absorptiometry (DEXA) method. results Post-menopausal women with SH (group A) exhibited slightly but significantly lower absolute and age-adjusted BMD values compared to group B patients in the femoral neck (BMD g/cm2: 0·72 ± 0·08 vs. 0·79 ± 0·09; Z -score: ,0·20 ± 0·82 vs. +0·43 ± 0·94, P < 0·05) and trochanter (BMD g/cm2: 0·60 ± 0·09 vs. 0·69 ± 0·10; Z -score: ,0·32 ± 1·0 vs. +0·30 ± 1·05, P < 0·01). BMD measurements of the Ward's triangle were also lower in group A patients but the difference did not reach statistical significance (BMD g/cm2: 0·60 ± 0·10 vs. 0·68 ± 0·13, P = 0·06). There was no difference in the lumbar vertebrae between the two groups (BMD g/cm2: 0·888 ± 0·13 vs. 0·90 ± 0·16, P = 0·78; z-score: +0·50 ± 1·16 vs. +0·11 ± 1·5, P = 0·36). The number of patients in the osteoporotic range was minimal with no significant difference between the two groups. However, the frequency of osteopenia in group A was significantly greater than in group B patients in the trochanter and Ward's triangle areas. Serum osteocalcin (BGP) levels were significantly lower in group A compared to group B patients (18·6 ± 8·6 vs. 26·2 ± 8·1 ng/ml, P < 0·01); no difference existed regarding parathyroid hormone (PTH) concentrations (43 ± 15·6 vs. 41·2 ± 14·8 pg/ml, P = 0·72). conclusions In this series, post-menopausal women with subclinical hypercortisolism had lower absolute and age-adjusted BMD values and a higher rate of osteopaenia in the trabecular loaded and mixed cortical,trabecular bone of proximal femur. These data demonstrate that the subtle hypercortisolism of patients with adrenal incidentalomas may have an adverse effect on the bone mass of these patients. [source] A comparison of bone mineral density in the spine, hip and jaws of edentulous subjectsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2007Nicholas A. Drage Abstract Objectives: The aim was to investigate the relationship between bone mineral density (BMD) of the jaws (mandible and maxilla) and other skeletal sites. In addition, the influence of gender, smoking and the number of years without natural teeth were examined. Materials and methods: 18 edentulous patients (9 females, 9 males) with a mean age of 67.1 (sd 12.6) years had DXA scans to assess the BMD of the lumbar spine and hip, together with the ramus, body and symphysis of the mandible and the anterior of the maxilla. Results: BMD values for the ramus were similar to those for the femur but significantly lower than the lumbar spine. The body and anterior mandible had higher values and the anterior maxilla lower values than both the femur and ramus. The ramus BMD showed moderately strong relationships with the standard measures of BMD in the spine and hip, but the BMD of other areas of the jaws showed no relationship with skeletal sites. The BMD for both the hip and the ramus showed an inverse relationship with increasing age. There was no statistically significant relationship between BMD of hip, spine and jaw and either years edentulous or cigarette years. (207) Conclusions: Although the ramus of the mandible may show correlation of BMD with skeletal sites, the areas of the jaws where implants may be placed do not. Therefore BMD of the skeletal sites could not be used to predict BMD of the jaws. The BMD of the jaws as measured by DXA showed no relationship with either years edentulous or cigarette smoking. [source] | ||||||||||