Comprehensive evaluation of bone health among kidney transplant recipients - A prospective, single center, observational cohort study from India
There is a paucity of studies describing trabecular bone score (TBS) and bone mineral density (BMD) in kidney transplant (KT) recipients from developing countries.
Comparison of the Effect of Selective Serotonin and Norepinephrine Reuptake Inhibitors on Bone Mineral Density with Selective Serotonin Reuptake Inhibitors and Healthy Controls
This study investigated the association between selective serotonin reuptake inhibitor (SSRI) and selective serotonin and norepinephrine reuptake inhibitor (SNRI) use and the risk of decreased bone mineral density in postmenopausal women.
Canadian adult reference data for body composition, trabecular bone score and advanced hip analysis using DXA
DXA-derived reference data for visceral adipose tissue (VAT) and advanced hip analysis (AHA) parameters spanning the entire adult lifespan are limited. The purpose of this study was to develop age-, site- and sex-specific reference data for dual X-ray absorptiometry (DXA) -derived body composition, trabecular bone score (TBS) and advanced hip analysis (AHA) parameters across the adult lifespan. Adults (N = 908; female: 561 and male: 347) from Calgary and the surrounding area over the age of 20 years participated in this study. Participants received DXA scans of their hip (total hip [TH] and femoral neck [FN]), lumbar spine [LS], forearm [33 % site] and total body (iDXA, GE Lunar, GE Healthcare). Areal bone mineral density (aBMD, g/cm) was captured at all sites, and body composition variables, including lean mass, fat mass and percent fat, were analyzed from the total body scan. VAT mass was assessed from total body DXA scans. Advanced hip analysis (AHA) was performed on hip scans and trabecular bone score (TBS) on the LS scans to assess bone quality. Site- and sex-specific centile curves and tables were generated using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) method. Clinicians and researchers can use these Canadian reference data as a tool to assess body composition, TBS and AHA parameters across the adult lifespan.
Fractal Analysis of Mandible in Panoramic Radiographs of Patients Received Radiotherapy for Nasopharyngeal Carcinoma
This study aimed to assess the impact of radiotherapy on the internal structure complexity of mandibular cortical and trabecular bone and to determine the duration required for a return to healthy values post-radiotherapy.
Moving towards an equitable future: Rethinking the use of race in pediatric densitometry
Current guidelines from the International Society for Clinical Densitometry (ISCD) recommend considering race, sex, and age in calculating pediatric bone density z-scores by Dual-Energy X-ray Absorptiometry (DXA). However, as patient populations become increasingly diverse, the application of these guidelines presents significant challenges, potentially leading to racial bias and systemic inequities in care. In response to growing calls for a reevaluation of race's role in clinical decision-making, we aimed to assess the readiness of front-line providers of DXA services to address these challenges. We conducted a professional, anonymized clinical practice survey targeting DXA technologists from various centers as part of a workshop for Reevaluation of the Role of Race, Ethnicity, and Ancestry in Clinical Decision-Making at the 2024 Annual Meeting of the Pediatric Academic Society. The survey focused on their experiences with the recording and use of race demographics. Our findings revealed inconsistencies in race data collection practices, varying levels of perceived patient comfort, and concerns about the potential perpetuation of racial bias. These results highlight the need for standardized guidelines to facilitate the sensitive and unbiased collection of race-related data during DXA exams, ultimately promoting equitable care for all patients.
Predicting bone mineral content from smartphone digital anthropometrics: evaluation of an existing application and the development of new prediction models
Bone mineral content (BMC) is most commonly evaluated using dual-energy X-ray absorptiometry (DXA), but there are several challenges that limit use of DXA during routine care. Breakthroughs in digital imaging now allow smartphone applications to automate important anthropometrics that can predict several body composition components. However, it is unknown whether the anthropometrics automated using smartphone applications can predict DXA-derived BMC.
Opportunistic Screening for Low Bone Mineral Density in Routine Computed Tomography Scans: A Brazilian Validation Study
Osteoporotic fractures are a major health concern worldwide due to high mortality rates, deterioration in quality of life, and elevated healthcare costs related to hospital treatment. However, most patients who sustain an osteoporotic fracture have never been formally screened for osteoporosis. Opportunistic screening of osteoporosis through conventional computed tomography (CT) scans performed for unrelated reasons could help identify patients with low bone mass. There are currently no studies validating the opportunistic screening of low bone mass through CT in South America. The aim of our study is to assess whether conventional CT scans could be used for the opportunistic screening of osteopenia and osteoporosis in Brazilian patients.
Lumbar Osteoarthritis in Patients with Osteoporosis Evaluated with the Lane and Wilke Scale and its Effect on Dexa Scores
This study aimed to compare bone mineral density (BMD) values in patients with lumbar osteoarthritis (OA) with and without osteoporosis (OP). This study evaluated the effect of lumbar osteoarthritis in patients with osteoporosis on Dexa scores using the Lane and Wilke scale.
Lumbar Spine Densitometry in People with Spinal Cord Injury: Investigation of Potential Sources of Errors
People with spinal cord injury (SCI) experience a considerable loss of bone after the injury. Lumbar spine (LS) bone mineral density (BMD) has been reported to be within the normal range, or even higher when assessed with DXA, in people with SCI; hence, it has been hypothesized that sources of error may spuriously increase LS BMD. The aim of this study was to describe the frequency of potential sources of error that may alter LS BMD measurement in a cohort of individuals with chronic SCI at baseline and over a 2-year period.
Identifying Key Genes and Their Associated Molecular Pathways in Lupus Nephritis-Osteoporosis: An In-Silico Analysis
Nephritis and osteoporosis are debilitating medical conditions that significantly impact human health and reduce quality of life. To develop potential therapeutic strategies for these disorders necessitates understanding the genetic and molecular mechanisms. Here, we employed bioinformatics techniques purposed to find key genes and associated pathways responsible for nephritis-osteoporosis comorbidity. Six microarray datasets of systemic lupus erythematosus (SLE) and osteoporosis were retrieved from the Gene Expression Omnibus (GEO) database. Post normalization of data sets LIMMA package was utilized for differential expression analysis, among the datasets 44 differentially expressed genes (DEGs) were identified. The identified 44 genes were further analyzed for gene ontology (GO) where it was found that these genes are involved in defense response, organism interactions, and response to external stimuli. In predicting the molecular function, they were involved in several biological processes including binding to lipopolysaccharides and having peptidase and hydrolase activities. Firstly, the identified genes were primarily associated with certain granules such as specific granules and secretory granules in the aspect of cellular components. Enrichment analysis pointed out the potential pathways linked to the immune system, neutrophil degranulation, innate immunity, and immune response to tuberculosis. To examine interactions among DEGs, a complex protein-protein interaction (PPI) network was built, resulting in the identification of seven hub genes, CXCL8, ELANE, LCN2, MMP8, IFIT1, MX1, and ISG15. The study suggests that these elucidated hub genes might have high potential to be exploited as promising biomarkers and therapeutic targets in nephritis-osteoporosis. Taken together, this study provided deeper insights into the genetic and molecular basis for the comorbidity of nephritis and osteoporosis.
Correlation between Body Composition and Bone Mineral Density Differs by Sex and Skeletal Site in Overweight and Obese Chinese Subjects
Previous studies have yielded inconsistent results regarding the relationship between obesity and bone mineral density (BMD). The aim of this study was to determine the influence of body composition on BMD and the serum sclerostin level in overweight and obese adults. The study had a cross-sectional design and included 90 men and 118 women with a body mass index ≥25. Fat mass, lean mass, and spinal and pelvic BMD were measured using dual-emission X-ray absorptiometry. Subcutaneous fat, visceral fat, and lean mass were measured between L2 and L3 by 16-slice spiral computed tomography. The serum sclerostin level was determined by enzyme-linked immunosorbent assay. Pearson analysis showed that fat mass and appendicular lean mass were positively correlated with spinal BMD in both sexes. A positive association of both fat mass and lean mass with pelvic BMD, which was stronger in women, was also found. Partial correlation analysis showed the positive association between fat mass and BMD was significantly attenuated but the positive association between lean mass and pelvic BMD remained after adjustment for age and body weight. A negative correlation was observed between visceral fat and spinal and pelvic BMD only in women, and the positive association between lean mass with pelvic BMD was more obvious in women than in men, indicating body composition seemed to have a greater impact on the BMD in women. The serum sclerostin level was positively associated with BMD but not with body composition. These findings suggest that the correlation between body composition and BMD is influenced by sex and skeletal site.
The Relationship between Bony Changes of the Mandibular Condyle and Eichner Index
The aim of this study was to evaluate whether degenerative bone changes in the mandibular condyle on cone beam computed tomography images are associated with the Eichner index.
Effects of Two Types of Resistance Training Modalities (Hypertrophy vs. Contrast Training) on Bone Parameters in a Group of Healthy Elderly Women
The aim of the present study was to explore the effects of two types of resistance training modalities (hypertrophy training vs. contrast training) on bone health parameters in a group of healthy elderly women. Forty-nine healthy elderly women whose ages range between 60 and 70 years were included in this study. The study population was randomly divided into three groups: hypertrophy training group (HTG; n=16), contrast training group (CTG; n=16) and control group (CG; n=17). Bone mineral density (BMD) values at the whole body (WB), lumbar spine (L1-L4), total hip (TH) and femoral neck (FN) were measured by DXA before and after 12 months of resistance training. Composite indices of femoral neck strength were calculated. WB BMD, L1-L4 BMD, TH BMD and FN BMD increased in the contrast training group. WB BMD and L1-L4 BMD increased in the hypertrophy training group, while TH BMD and FN BMD remained unchanged. Significant decreases in WB BMD, L1-L4 BMD, TH BMD and FN BMD were observed in the control group. The contrast training group showed the highest improvements in BMD values compared to the two other groups. Both experimental groups (HTG and CTG) showed similar significant improvements in composite indices of femoral neck strength and muscular strength. In conclusion, contrast training and hypertrophy training can stimulate bone gain at clinically important sites of osteoporotic fractures in elderly women.
Effects of Lumbar Spine Vertebral Fractures on Trabecular Bone Score (TBS): The Manitoba BMD Registry
Trabecular bone score (TBS) is a BMD-independent risk factor for fracture. During BMD reporting, it is standard practice to exclude lumbar vertebral levels affected by structural artifact. It is uncertain whether TBS is affected by lumbar spine fractures. The current study examined the effect of lumbar spine compression fractures on TBS measurements. We identified 656 individuals with vertebral fractures (mean age 75.8 ± 7.9 years, 90.9% female) who had lumbar spine DXA, TBS measurements from L1-L4 and vertebral fracture assessment (VFA) for identifying vertebral fractures. There were 272 cases with lumbar spine fractures and 384 controls with only thoracic spine fractures. L1 TBS and BMD were significantly greater in those with than without lumbar fractures (p< 0.001) but did not significantly differ for other vertebral levels or for L1-L4 combined. TBS and BMD measurements were then renormalized to remove level-specific differences (denoted rTBS and rBMD). The mean difference (all fractured minus all non-fractured vertebrae) was +0.040 (+3.3%) for rTBS and +0.088 g/cm (+9.5%) for rBMD (both p <0.001). The largest effect was for L1 with mean difference +0.058 (+4.9%) for rTBS and +0.098 g/cm (+10.6%) for rBMD (both p <0.001). The mean difference between fractured and non-fractured levels for rTBS was +0.028 (+2.4%) for grade 1, +0.036 (+3.0%) for grade 2 and +0.059 (+5.0%) for grade 3 fractures; for rBMD +0.051 (+5.5%), +0.076 (+8.2%) and +0.151 (+16.4%) g/cm, respectively. The impact of excluding lumbar vertebral levels with fracture from the L1-L4 TBS measurement overall was small (-0.011 [-1.0%]; p<0.001) and was also small for grade 3 fractures (-0.020 [-1.7%]; p<0.001). In summary, TBS is mildly increased by VFA-confirmed lumbar vertebral fractures, but the percentage effect is much smaller (less than half) than seen for BMD and minimally affects TBS measured from L1-L4. This would support the use of L1-L4 without exclusions in individuals with lumbar vertebral fractures.
Bone Mineral Density Monitoring in Contiguous versus Non-Contiguous Lumbar Vertebrae: The Manitoba BMD Registry
Only change in bone mineral density (BMD) on repeat DXA that exceeds the 95% least significant change (LSC) should be considered clinically meaningful. Frequently lumbar spine DXA must be reported after omitting vertebrae with localized structural artifact, which reduces measurement precision. Previous reports have raised concerns of higher least significant change (LSC) when spine BMD is based on non-contiguous rather than contiguous vertebrae. The current study was performed to compare lumbar spine LSC and BMD response to intervening anti-osteoporosis medication use from non-contiguous versus contiguous vertebrae.
The Effect of Smoking Cessation versus Current Smoking on Fracture Risk: The Manitoba BMD Registry
Current tobacco smoking is included in FRAX calculator for fracture risk assessment. It is unknown whether previous smoking increases the risk of fracture. The current analysis was performed to compare incident fracture risk associated with current smoking, smoking cessation and non-smoking. The study population comprised 18,115 individuals aged 40 years and older (mean age 68.8 years, 95.1% female) from a large clinical registry of DXA tests for the Province of Manitoba, Canada, with two consecutive visits (mean interval 4.4 years) where current smoking was recorded. Smokers (N=1620) were defined as those reporting current smoking at visit 2 (index date), non-smokers (N=15,942) as answering no to current smoking at both visits, and ex-smokers (N=553) as answering yes to current smoking at visit 1 but no at visit 2. Incident fractures were identified through healthcare data linkage. Compared with non-smokers, risk for any incident fracture (primary outcome) was significantly greater in current smokers (hazard ratio [HR] 1.41, 95% CI 1.19-1.67 adjusted for age/sex; HR 1.22, 95% CI 1.03-1.44 full adjusted) and ex-smokers (HRs 1.56, 95% CI 1.19-2.024 and 1.42, 95% CI 1.09-1.86, respectively). Similar directions and magnitudes of effect were seen for incident major osteoporotic fractures and hip fractures (secondary outcomes), with point estimates for ex-smokers that were close to current smokers. In summary, recent smoking cessation was associated with ongoing increased short-term fracture risk similar to current smoking. Larger studies are needed to better define the time course of fracture risk after smoking cessation.
Technical and Biological Reliability of pQCT Measured Bone and Muscle Tissue Quality Across the Age-Span
Reliable peripheral quantitative computed tomography (pQCT) assessment is essential to the accurate longitudinal reporting of bone and muscle quality. However, the between-day reliability of pQCT and the influence of age on outcome reliability is currently unknown.
Diagnosing (severe) Osteoporosis by Hologic vs. Lunar Measurements: A Single-Center Retrospective Study
Although different dual-energy X-ray absorptiometry (DXA) scanners provide different bone mineral density (BMD) values, there is not a gold standard DXA scanner. T-score is used to facilitate the interpretation of BMD, and osteoporosis (OP) is diagnosed based on T-scores. In this retrospective study, we aimed to evaluate the BMD and T-score differences between Lunar Prodigy and Hologic Horizon DXA scanners.
Comparison of Mineral Density of Dental Structures of Ancient Human Skeletons from the Roman Period with Modern-Day Human Dental Structures
Comparison of maxillary, mandibular, dental crown and root mineral density in human skeletons identified in historical excavations with today's human maxillary, mandibular dental crown and root.
Team Sports Practice and Bone Health: A Systematic Review and Meta- Analysis
The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators "AND", "OR", "NOT": (``men'' OR ``man'' OR ``women'' OR ``woman'') AND (``bone mineral density'' OR ``BMD'' OR ``bone mineral content'' OR ``BMC'' OR ``peak bone mass'' OR ``mechanical loading'' OR ``osteoporosis'' OR ``bone geometry'' OR ``bone resistance'') AND (``team sport'' OR ``sport'' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players''). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.
Bone Health ECHO Case Report: Orbital Inflammation after Zoledronate Infusion
Prior to the initiation of intravenous bisphosphonate therapy for osteoporosis, the impact on ocular health is not routinely discussed with patients. This is due to the scarcity of data on the association between bisphosphonates and ocular side effects, resulting in lack of provider awareness to effectively counsel patients. Furthermore, there is little consensus among clinicians on the safety of re-challenging with intravenous bisphosphonate treatment following ocular complications. This is a case report of a patient who developed orbital inflammation four days after receiving a zoledronate infusion. This case was discussed amongst health care providers and osteoporosis experts during a meeting of Bone Health Extension for Community Healthcare Outcomes (ECHO) virtual platform, which was established in 2015.