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1.
Arch Osteoporos ; 16(1): 36, 2021 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-33611644

RESUMEN

OBJECTIVE: The incidence of fractures in pregnancy and lactation-associated osteoporosis (PLO) is very low. Some fracture cases of PLO are associated with vertebral compression fractures, while malleolar fractures in patients with PLO are rarely reported before. CASE REPORT: A 31-year-old Han Chinese patient presented with a malleolar fracture 3 months after delivery, while she was still breastfeeding. Temporary closed reduction and plaster external fixation were performed in the emergency room. Then the patient was admitted to the orthopedic trauma ward for surgery and diagnosed as PLO by dual-energy X-ray absorptiometry (DEXA). After preoperative evaluation, the patient underwent open reduction and internal fixation. With the diagnosis of PLO, the patient was treated with weaning, bisphosphonate, and supplementation of calcium carbonate and vitamin D. During the 12-month follow-up period, the results of DEXA and laboratory examination improved gradually, and the internal fixation was removed 12 months after surgery. CONCLUSION: Orthopedic doctors should not ignore the possibility of PLO to avoid misdiagnosis of perinatal women with fractures. Improvement of functional recovery of fractures can be achieved with accurate diagnosis and individual treatment.


Asunto(s)
Fracturas por Compresión , Osteoporosis , Complicaciones del Embarazo , Fracturas de la Columna Vertebral , Absorciometría de Fotón , Adulto , Densidad Ósea , Lactancia Materna , Femenino , Fracturas por Compresión/diagnóstico por imagen , Fracturas por Compresión/etiología , Fracturas por Compresión/cirugía , Humanos , Lactancia , Osteoporosis/diagnóstico por imagen , Embarazo , Fracturas de la Columna Vertebral/diagnóstico por imagen , Fracturas de la Columna Vertebral/etiología , Fracturas de la Columna Vertebral/cirugía
2.
Arch Osteoporos ; 16(1): 41, 2021 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-33624129

RESUMEN

This is the first 5-year analysis among persons with HIV (PWH) that reports both trabecular bone score (TBS), which is a novel index that estimates bone microarchitecture, and bone mineral density (BMD) over time to evaluate the long-term impact of antiretroviral therapy (ART) on bone health. PURPOSE: HIV infection and antiretroviral therapy (ART) have been associated with decreased bone mineral density (BMD). This study aims to evaluate long-term changes in trabecular bone score (TBS), a novel index that estimates bone microarchitecture, and BMD among Chinese persons with HIV (PWH) treated with ART. METHODS: We conducted a retrospective chart review of adult PWH at a large tertiary care hospital in China. Patients who had a DXA scan prior to ART and at least one follow-up DXA after ART initiation were included. Subgroup analyses examined the TBS and BMD changes in patients who switch from a non-TDF-containing regimen to one containing TDF, as compared to those who did not switch. RESULTS: Four hundred fifty-nine PWH were included. Among 68 patients ≥ 50 years, 13 patients (19.1%) had a normal BMD but partially degraded or degraded TBS. The mean percent decrease in lumbar spine (LS) BMD nadired at 48 weeks after ART initiation and then gradually improved. Percent decrease in femoral neck (FN) and total hip (TH) BMD nadired at 96 weeks and remained stably low thereafter. After switch to a TDF-containing regimen, only percent change in TH BMD was significant (-3.2%, p = 0.006). In the regression analyses, switch to a TDF-containing regimen was not associated with long-term change in TBS or BMD. CONCLUSION: This is the first study among PWH to evaluate the long-term impact of ART on TBS and BMD. At baseline, approximately 20% of patients had a normal BMD but impaired bone microstructure based upon TBS. For patients with 5 years of exposure to ART, there is a stabilization of TBS and BMD after initial nadir in the first 144 weeks. However, FN BMD, TH BMD, and TBS remained low at 5 years relative to baseline.


Asunto(s)
Densidad Ósea , Infecciones por VIH , Absorciometría de Fotón , Adulto , Hueso Esponjoso/diagnóstico por imagen , China/epidemiología , Infecciones por VIH/tratamiento farmacológico , Humanos , Vértebras Lumbares/diagnóstico por imagen , Estudios Retrospectivos
3.
Arch Osteoporos ; 16(1): 38, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33624177

RESUMEN

Low bone mineral density is associated with spinal deformity. Dual-energy X-ray absorptiometry (DXA), a modality that assesses bone density, portends a theoretical means to also assess spinal deformity. We found that DXA can reliably assess spine alignment. DXA may permit surveillance of spine alignment, i.e., scoliosis in the clinical setting. PURPOSE: Osteoporosis and scoliosis are interrelated disease processes. Dual-energy X-ray absorptiometry (DXA), used to assess bone density, can also be used to evaluate spinal deformity since it captures a posteroanterior (PA) image of the lumbar spine. We assessed the use of DXA to evaluate lumbar spine alignment. METHODS: A lumbar spine DXA phantom was used to assess the effects of axial and sagittal plane rotation on lumbar bone mineral content (BMC), density (BMD), and L1-L4 Cobb angle measurements. Using two subject cohorts, intra- and inter-observer reliability and validity of using DXA for L1-L4 Cobb angle measurements in the coronal and sagittal planes were assessed. RESULTS: Axial and sagittal plane rotation greater than 15° and 10°, respectively, significantly reduced measured BMD and BMC; there was minimal effect on Cobb angle measurement reliability. In human subjects, excellent intra- and inter-observer reliability was observed using lumbar PA DXA images for Cobb angle measurements. Agreement between Cobb angles derived from lumbar PA DXA images and AP lumbar radiographs ranged from good to excellent. The mean difference in Cobb angles between supine lumbar PA DXA images and upright AP lumbar radiographs was 2.8° in all subjects and 5.8° in those with scoliosis. CONCLUSIONS: Lumbar spine rotation does not significantly affect BMD and BMC within 15° and 10° of axial and sagittal plane rotation, respectively, and minimally affects Cobb angle measurement. Spine alignment in the coronal plane can be reliably assessed using lumbar PA DXA images.


Asunto(s)
Escoliosis , Absorciometría de Fotón , Densidad Ósea , Humanos , Vértebras Lumbares/diagnóstico por imagen , Reproducibilidad de los Resultados , Escoliosis/diagnóstico por imagen
4.
Arch Osteoporos ; 16(1): 33, 2021 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-33594610

RESUMEN

Cortical thickness determined at the humerus can serve as an easy and reliable screening tool to predict the local bone status when quantitative bone mineral density (BMD) measurements are not available. It can therefore serve as a rapid screening tool in fragility fractures to identify patients requiring further diagnostic or osteoporosis treatment. INTRODUCTION: Quantitative bone mineral density (BMD) of the humerus is difficult to determine but relevant for osteoporosis and fracture treatment. Dual-energy X-ray absorptiometry (DXA) of the femur and lumbar spine overestimates the humeral BMD and is not ubiquitously available. Therefore, this study evaluated whether the cortical bone thickness (CBT) of the humerus or DXA of the forearm is able to predict humeral BMD. METHODS: Humeral BMD of 54 upper cadaver extremities (22 pairs, 10 single) (19-90 years) was determined by high-resolution peripheral-quantitative-computed-tomography (HR-pQCT) (volumetric BMD (vBMD)) and DXA (areal BMD (aBMD)) of the proximal humerus and distal forearm. Average and gauge cortical bone thickness (CBTavg/ CBTg) of the humeral diaphysis was determined from standard radiographs (XR) and computed-tomography (CT) and compared to the humeral BMD. Pearson (r) and intraclass-correlation-coefficients (ICC) were used to compare results and rater-reliability. RESULTS: CBTavg from XR strongly correlated with the humeral BMD (r = 0.78 aBMD (DXA) and r = 0.64 vBMD (HR-pQCT) (p < 0.0001)). The CBTg revealed a weaker correlation (r = 0.57 aBMD and r = 0.43 vBMD). CBT derived from XR strongly correlated to those from the CT (r = 0.82-0.90) and showed an excellent intra- and inter-rater correlation (ICC 0.79-0.92). Distal forearm aBMD correlated well with the humeral aBMD (DXA) (r = 0.77) and paired specimens highly correlated to the contralateral side (humerus r = 0.89, radius r = 0.97). CONCLUSIONS: The CBTavg can reliably be determined from standard radiographs and allows a good prediction of quantitative humeral bone mineral density (aBMD or vBMD) if measurements are not available. Furthermore, the distal forearm or the contralateral humerus can serve as a side to estimate the BMD if the ipsilateral side is impaired.


Asunto(s)
Densidad Ósea , Húmero , Absorciometría de Fotón , Hueso Cortical , Humanos , Húmero/diagnóstico por imagen , Reproducibilidad de los Resultados
5.
Medicina (B Aires) ; 81(1): 47-53, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33611244

RESUMEN

Recently, a new consensus of the European Working Group on Sarcopenia in Older People (EWSOP2) recommended new cut-off points for the diagnosis of sarcopenia. The aim of the present manuscript was to assess the prevalence of sarcopenia in postmenopausal women and its relationship with bone mineral density, falls and fragility fractures according to EWGSOP2. In this cross-sectional study, 250 ambulatory postmenopausal women over 60 years of age were included. Lumbar spine and hip bone mineral density (BMD) and whole-body composition were assessed by dual-energy X-ray absorptiometry (DXA). Muscle strength was evaluated by handgrip dynamometry and physical performance by a 4-m walk gait speed and five-repetition sit-to-stand test. Sarcopenia was defined according to EWGSOP2 as low muscle strength (handgrip) and low muscle mass (appendicular skeletal muscle mass index by DXA). A sarcopenia prevalence of 4% was found in the whole group increasing with age being 12.5% in = 80- year-old. A higher percentage of falls, prevalence of osteoporosis and vertebral fractures were found in the sarcopenic group. Sarcopenia increased 6.0-fold the likelihood of having a fragility fracture. Women with sarcopenia had significantly lower femoral neck BMD and higher frequency of falls and vertebral fractures. According to our results, identifying patients with sarcopenia might be a useful tool to detect adults at higher risk of falls and fractures.


Asunto(s)
Sarcopenia , Absorciometría de Fotón , Accidentes por Caídas , Adulto , Anciano , Anciano de 80 o más Años , Densidad Ósea , Estudios Transversales , Femenino , Fuerza de la Mano , Humanos , Persona de Mediana Edad , Posmenopausia , Prevalencia , Sarcopenia/diagnóstico por imagen , Sarcopenia/epidemiología
6.
Medicine (Baltimore) ; 100(4): e24400, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530237

RESUMEN

ABSTRACT: Frailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.This cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70-84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index, and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of < 9 is considered frailty. To evaluate the relationship between the variables, simple and fully adjusted multivariable logistic regression analyses were performed according to sex.Among the participants, 462 (19.3%) were defined as the frail group, with a significantly high mean age of 77.9 ±â€Š4.0 years. In the logistic regression analysis of frailty based on body mass index (BMI) categories, underweight (BMI < 18 kg/m2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. Lower FFMI was associated with a higher incidence of frailty in both sexes, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and trunk fat mass index showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.Frailty was closely correlated with lower FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males, owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.


Asunto(s)
Anciano Frágil/estadística & datos numéricos , Fragilidad/epidemiología , Vida Independiente/estadística & datos numéricos , Rendimiento Físico Funcional , Factores Sexuales , Absorciometría de Fotón , Anciano , Anciano de 80 o más Años , Composición Corporal , Índice de Masa Corporal , Estudios Transversales , Femenino , Fragilidad/fisiopatología , Evaluación Geriátrica , Humanos , Modelos Logísticos , Masculino , Prevalencia , República de Corea/epidemiología , Medición de Riesgo
7.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431459

RESUMEN

Primary Sjögren's syndrome (pSS) is a chronic slowly progressive autoimmune disease characterised by lymphocytic infiltration of salivary and lacrimal glands with varying degree of systemic involvement. Renal involvement, a recognised extraglandular manifestation of pSS, is commonly related to tubular dysfunction and generally manifests as distal renal tubular acidosis (RTA), proximal RTA, tubular proteinuria and nephrogenic diabetes insipidus. Untreated long-standing RTA is known to cause metabolic bone disease. Here, we present the report of a patient with sclerotic metabolic bone disease related to pSS with combined distal and proximal RTA and negative workup for other causes of sclerotic bone disease. A significant clinical and biochemical improvement, including recovery of proximal tubular dysfunction, was noted with alkali therapy. This case suggests the need to consider pSS in the diagnostic algorithm of a patient presenting with sclerotic bone disease.


Asunto(s)
Acidosis Tubular Renal/diagnóstico , Dolor de Espalda/inmunología , Enfermedades Óseas Metabólicas/diagnóstico , Síndrome de Sjögren/diagnóstico , Absorciometría de Fotón , Acidosis Tubular Renal/sangre , Acidosis Tubular Renal/tratamiento farmacológico , Acidosis Tubular Renal/inmunología , Adulto , Fosfatasa Alcalina/sangre , Dolor de Espalda/sangre , Densidad Ósea/inmunología , Enfermedades Óseas Metabólicas/sangre , Enfermedades Óseas Metabólicas/tratamiento farmacológico , Enfermedades Óseas Metabólicas/inmunología , Femenino , Humanos , Citrato de Potasio/uso terapéutico , Cintigrafía , Síndrome de Sjögren/sangre , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/inmunología , Esqueleto/diagnóstico por imagen , Bicarbonato de Sodio/uso terapéutico
8.
Arch Osteoporos ; 16(1): 5, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33399996

RESUMEN

The aim was to compare the National Osteoporosis Foundation (NOF) and the UK National Osteoporosis Guideline Group (NOGG) guidelines for the detection of vertebral fractures in postmenopausal Chinese women. The NOF guidelines had higher accuracy than the UK guidelines for spinal radiography examination. PURPOSE: To compare the National Osteoporosis Foundation (NOF) and the UK National Osteoporosis Guideline Group (NOGG) guidelines for the detection of vertebral fractures in postmenopausal Chinese women. METHODS: A cross-sectional study on 255 community-dwelling postmenopausal women was conducted in Hunan province in 2017. Demographic and clinical characteristics and risk factors were recorded through questionnaires. Height and weight were measured using standard methods, and bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry. Vertebral fractures were diagnosed by radiography using semi-quantitative morphometry. RESULTS: The prevalence of vertebral fractures was 9.4%. Women with vertebral fractures were significantly older and shorter, had higher years-since menopause and height loss values and lower BMD and T-scores at the femoral neck and total hip, and were more likely to have a history of previous fractures. The sensitivity and specificity of the NOF guidelines were 91.7% and 39.8%, respectively, while the NOGG guidelines had lower sensitivity (87.5%) and specificity (32.5%). However, a higher percentage had indications for radiography in the 50-64 years age group according to the NOGG guidelines, while a higher percentage had indications for radiography in the ≥ 65 year group according to the NOF guidelines. CONCLUSIONS: The NOF guidelines were better than the NOGG guidelines for spinal radiography examination in the Chinese postmenopausal women.


Asunto(s)
Osteoporosis Posmenopáusica , Osteoporosis , Fracturas de la Columna Vertebral , Absorciometría de Fotón , Densidad Ósea , China/epidemiología , Estudios Transversales , Femenino , Humanos , Osteoporosis Posmenopáusica/diagnóstico por imagen , Osteoporosis Posmenopáusica/epidemiología , Posmenopausia , Fracturas de la Columna Vertebral/diagnóstico por imagen , Fracturas de la Columna Vertebral/epidemiología
9.
Arch Osteoporos ; 16(1): 12, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33420618

RESUMEN

PURPOSE: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily affects the axial skeleton and typically has an early onset. Although earlier onset is associated with worse prognosis, there have been few studies of bone mineral density (BMD) in adolescent patients with axSpA. METHODS: We analysed the clinical characteristics of 43 adolescent patients with axSpA at a baseline assessment and at a follow-up 2 years later. The baseline assessment included age, disease duration, treatment agents, and clinical, radiologic, and laboratory data. BMD of the lumbar spine, femoral neck, and total hip were measured by dual-energy X-ray absorptiometry during both the baseline assessment and the 2-year follow-up. We performed multivariate linear regression analyses to identify factors independently associated with BMD. We analysed the associations between changes in BMD and reductions in inflammatory markers. RESULTS: The average age of participants was 17.9 years and the mean disease duration was 2.2 years. Of the 43 patients, 10 (23%) had low BMD at any site (lumbar spine, femoral neck, and/or total hip). At baseline, multivariate analysis showed that body mass index (BMI), erythrocyte sedimentation rate (ESR), and spinal structural damage were associated with lumbar spine Z-scores. Increases in BMD in the lumbar spine were correlated with reductions in ESR (r = 0.40, P = 0.02) and C-reactive protein (CRP) (r = 0.40, P = 0.02). Increases in BMD in the total hip were correlated with reductions in CRP (r = 0.38, P = 0.03). CONCLUSION: In adolescent axSpA patients, bone health was associated with systemic inflammation and the severity of structural damage. Reduced systemic inflammation was associated with improvements in bone health.


Asunto(s)
Densidad Ósea , Espondiloartritis , Absorciometría de Fotón , Adolescente , Cuello Femoral/diagnóstico por imagen , Humanos , Estudios Longitudinales , Vértebras Lumbares/diagnóstico por imagen , Espondiloartritis/diagnóstico por imagen
10.
Arch Osteoporos ; 16(1): 13, 2021 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-33447939

RESUMEN

This study investigated the potential role of quantitative ultrasound (QUS) to assess low bone mass in anorexia nervosa patients (AN). Bone parameters from QUS and DXA were positively correlated and significantly reduced in AN compared with controls, suggesting that QUS is a pertinent technique to assess low bone mass in these patients. PURPOSE: The aim of this study was to investigate the potential role of an alternative technique, quantitative ultrasound (QUS), to assess low bone mass in patients with anorexia nervosa (AN). METHODS: Two hundred seven young women (134 patients with AN and 73 healthy controls) with ages ranging from 14.4 to 38.4 years participated in this observational cross-sectional study. Bone mass was concomitantly evaluated by DXA to determine areal bone mineral density (aBMD; g/cm2) at hip, lumbar spine, and radius and by QUS to determine broadband ultrasound attenuation (BUA; dB/MHz) at the heel. RESULTS: BUA (66.5 ± 4.6 dB/MHz vs 61.0 ± 5.0 dB/MHz) and aBMD at the hip (0.916 ± 0.013 g/cm2 vs 0.806 ± 0.010 g/cm2), lumbar spine (0.966 ± 0.012 g/cm2 vs 0.886 ± 0.010 g/cm2), and radius (0.545 ± 0.005 g/cm2 vs 0.526 ± 0.04 g/cm2) were significantly decreased (p < 0.01) in patients with AN compared with controls. When patient and control data were pooled, BUA was significantly correlated with aBMD at the hip (r = 0.60, p < 0.001), lumbar spine (r = 0.48, p < 0.001), and radius (r = 0.40, p<0.001). In patients with AN, BUA and aBMD were mainly and positively correlated with weight, lean tissue mass, body mass index (BMI), and minimal BMI life and negatively with the duration of both disease and amenorrhea. Better concordance between the two techniques was obtained when absolute BUA and aBMD values were used according to the WHO T score classification. CONCLUSION: BUA measurement at the heel by QUS appears to be a pertinent nonionizing technique to assess low bone mass in patients with AN.


Asunto(s)
Anorexia Nerviosa , Calcáneo , Absorciometría de Fotón , Adolescente , Adulto , Anorexia Nerviosa/diagnóstico por imagen , Densidad Ósea , Huesos , Calcáneo/diagnóstico por imagen , Femenino , Humanos , Ultrasonografía , Adulto Joven
11.
Arch Osteoporos ; 16(1): 16, 2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33475880

RESUMEN

In a large population-based study of Iran, the age-standardized prevalence of osteoporosis was 24.6% in men and 62.7% in women aged ≥ 60 years. Osteoporosis was negatively associated with body mass index in both sexes, and with diabetes in men and hypertriglyceridemia in women. PURPOSE: Population aging has made osteoporosis and osteoporotic fractures an important health problem, especially in developing countries. This study aimed to explore the prevalence of osteoporosis and associated factors among the elderly population of the south-west of Iran. METHODS: Baseline data of the second stage of the Bushehr Elderly Health program was used. Spinal, total hip, or femoral neck osteoporosis was described as a BMD that lies 2.5 standard deviations or more, below the average values of a young healthy adult in the lumbar spine, total hip, or femoral neck, respectively. Osteoporosis at either site was defined as total osteoporosis. Age-standardized prevalence of osteoporosis was estimated. We used the modified Poisson regression with a robust variance estimator to identify the factors related to osteoporosis, adjusting for potential confounders. RESULTS: Overall, 2425 individuals (1166 men) aged over 60 years were included. In all, total osteoporosis was detected in 1006 (41.5%) of the participants. Using the reference value derived from Caucasian women aged 20-29 years, the age-standardized prevalence of total osteoporosis was 24.6 (95% CI: 21.9-27.3) in men, and 62.7 (95% CI: 60.0-65.4) in women. In men, osteoporosis was positively associated with age, smoking, history of fracture, and history of renal/liver diseases and negatively associated with body mass index (BMI) and diabetes. BMI, hypertriglyceridemia, and education were negatively correlated with osteoporosis in women, while years after menopause and history of fracture increased the likelihood of osteoporosis, significantly. CONCLUSION: Results support the high prevalence of osteoporosis and osteopenia in the elderly population. Considering the importance of severe complications, especially fractures, comprehensive interventions should be expanded.


Asunto(s)
Densidad Ósea , Osteoporosis , Absorciometría de Fotón , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Osteoporosis/epidemiología , Prevalencia , Factores de Riesgo , Adulto Joven
12.
Arch Osteoporos ; 16(1): 17, 2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33479804

RESUMEN

Osteoporosis is a disease with a high burden of morbidity. For its accurate diagnosis, using indigenous data as reference standards is needed. However, normative data on bone density is lacking in India. Therefore, we aimed to determine the reference range for bone density for the healthy population of north India. INTRODUCTION: Osteoporosis is a major public health problem around the globe including India, resulting in significant morbidity, mortality, and health care burden. However, the reference values used for its diagnosis are largely based on data from the western population, which may lead to over- or underdiagnosis of osteoporosis in Indians. Our study aimed to determine the reference range for bone mineral density for the healthy population of India. METHODS: This is a cross-sectional study of 825 subjects (men 380, women 445) (median age: 41 years, IQR 32-55 years), recruited by a house-to-house survey. The population was stratified into decade-wise groups and biochemical measurements including renal and liver function tests, glycated hemoglobin, serum calcium, 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density were performed in all the subjects. The T-scores for men aged > 50 years and post-menopausal women were calculated based on the data generated from this study in young men and women aged 20-40 years. RESULTS: According to the BMD manufacturer's data, which is based on the western population, 70% of the Indian men (> 50 years) and 48% of the post-menopausal Indian women had osteopenia while 18% of the men and 25% of the women had osteoporosis. However, according to the re-calculated T-scores from the current study, only 56% and 7.2% of men and 33% and 5% of women had osteopenia and osteoporosis, respectively. An age-related decline in bone mineral density, as seen in the western population, was also seen in both Indian men and women. CONCLUSION: We have established a reference database for BMD in healthy Indian adult population, which may have clinical implications for the diagnosis and intervention strategies for the management of osteoporosis.


Asunto(s)
Densidad Ósea , Osteoporosis , Absorciometría de Fotón , Adulto , Estudios Transversales , Estudios Epidemiológicos , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Osteoporosis/diagnóstico por imagen , Osteoporosis/epidemiología , Adulto Joven
13.
Arch Osteoporos ; 16(1): 11, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33415510

RESUMEN

This is a survey study concerning osteoporosis care during the COVID-19 pandemic in the Netherlands. Respondents reported that osteoporosis care stagnated and lower quality of care was provided. This leads to the conclusion that standardization of osteoporosis care delivery in situations of crisis is needed. PURPOSE: During the initial phase of the COVID-19 pandemic, there was no guidance of professional societies or guidelines on the organization of osteoporosis care in case of such a crisis, and treatment relied on local ad hoc strategies. Experiences from the current pandemic need to be taken into account for the near future, and therefore, a national multidisciplinary survey was carried out in the Netherlands. METHODS: A survey of 17 questions concerning the continuation of bone mineral density measurements by Dual Energy X-ray absorptiometry (DXA), outpatient clinic visits, and prescription of medication was sent to physicians, nurses, nurse practitioners, and physician assistants working in the field of osteoporosis. RESULTS: 77 respondents finished the questionnaire, of whom 39 (50.6%) reported a decline in DXA-scanning and 36 (46.8%) no scanning at all during the pandemic. There was an increase in remote consultations for both new and control patient visits (n = 48, 62.3%; n = 62, 81.7% respectively). Lower quality of care regarding fracture prevention was reported by more than half of the respondents (n = 44, 57.1%). Treatment with intravenous bisphosphonates and denosumab was delayed according to 35 (45.4%) and 6 (6.3%) of the respondents, respectively. CONCLUSION: During the COVID-19 pandemic, osteoporosis care almost completely arrested, especially because of the discontinuation of DXA-scanning and closing of outpatient clinics. More than half of the respondents reported a substantial lower quality of osteoporosis care during the COVID pandemic. To prevent an increase in fracture rates and a decrease in patient motivation, adherence and satisfaction, standardization of osteoporosis care delivery in situations of crisis is needed.


Asunto(s)
Osteoporosis , Absorciometría de Fotón , Humanos , Países Bajos/epidemiología , Osteoporosis/diagnóstico por imagen , Osteoporosis/epidemiología , Pandemias , Encuestas y Cuestionarios
14.
Metabolism ; 114: 154399, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33058848

RESUMEN

BACKGROUND: Little is known about the relationships of dihydrotestosterone (DHT), a more potent androgen than testosterone (T), with bone mineral density (BMD) and fracture risk. Our objectives were to evaluate the relationships of T, DHT and sex hormone binding globulin (SHBG) with BMD, fracture risk, and lean body mass (LBM). METHODS: We evaluated 1128 older men free of cardiovascular disease in a prospective cohort study using data from the Cardiovascular Health Study. T and DHT were measured by liquid chromatography-tandem mass spectrometry and SHBG by fluoroimmunoassay. Our outcomes included incident hip fracture (n = 106) over a median of 10.2 years and BMD and LBM by dual-energy x-ray absorptiometry (n = 439). RESULTS: In Cox regression models mutually adjusted for T, SHBG, and covariates, each standard deviation increment in DHT (0.23 ng/ml) was associated with a 26% lower risk of hip fracture (adjusted hazard ratio [aHR] 0.74, 95% confidence interval (CI) 0.55-1.00, p = 0.049). Similarly, SHBG was associated with fracture in mutually adjusted models (aHR HR 1.26, 95% CI, 1.01-1.58, p = 0.045). In contrast, T (aHR, 1.16, 95% CI, 0.86-1.56, p = 0.324) was not significantly associated with fracture in mutually adjusted models. T, DHT and SHBG were not associated with BMD. T and DHT were both positively associated with LBM in individual models. CONCLUSIONS: In older men, DHT was inversely associated with hip fracture risk and SHBG was positively associated with hip fracture risk, while T was not. Future studies should elucidate the mechanisms by which DHT affects bone health.


Asunto(s)
Envejecimiento/fisiología , Densidad Ósea/fisiología , Dihidrotestosterona/sangre , Fracturas de Cadera/epidemiología , Testosterona/sangre , Absorciometría de Fotón , Anciano , Anciano de 80 o más Años , Composición Corporal/fisiología , Fémur/diagnóstico por imagen , Fracturas de Cadera/metabolismo , Articulación de la Cadera/diagnóstico por imagen , Humanos , Incidencia , Masculino , Estudios Prospectivos , Riesgo , Globulina de Unión a Hormona Sexual/metabolismo , Espectrometría de Masas en Tándem
15.
Eur J Endocrinol ; 184(1): 107-122, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33112262

RESUMEN

Objective: Hypogonadism is common in HIV-infected men. The relationship between health status, sex steroids and body composition is poorly known in HIV. The aim was to investigate the association between health status (comorbidities/frailty), body composition, and gonadal function in young-to-middle-aged HIV-infected men. Design: Prospective, cross-sectional, observational study. Methods: HIV-infected men aged <50 years and ongoing Highly Active Antiretroviral Therapy were enrolled. Serum total testosterone (TT), estradiol (E2), estrone (E1) were measured by liquid chromatography-tandem mass spectrometry, LH and FSH by immunoassay. Free testosterone (cFT) was calculated by Vermeulen equation. Body composition was assessed by dual-energy X-ray absorptiometry and abdominal CT scan. Multimorbidity (MM) and frailty were defined as ≥3 comorbidities and by a 37-item index, respectively. Results: A total of 316 HIV-infected men aged 45.3 ± 5.3 years were enrolled. Body fat parameters were inversely related to cFT and TT, and directly related to E1 and E2/testosterone (TS) ratio. Patients with MM had lower cFT (P < 0.0001) and TT (P = 0.036), and higher E1 (P < 0.0001) and E2/TS ratio (P = 0.002). Frailty was inversely related to cFT (R2 = 0.057, P < 0.0001) and TT (R2 = 0.013, P = 0.043), and directly related to E1 (R2 = 0.171, P < 0.0001), E2 (R2 = 0.041, P = 0.004) and E2/TS ratio (R2 = 0.104, P < 0.0001). Conclusions: Lower TT and cFT, higher E1, E2/TS ratio and visceral fat were independently associated to poor health status and frailty, being possible hallmarks of unhealthy conditions in adult HIV-infected men. Overall, MM, frailty and body fat mass are strictly associated to each other and to sex steroids, concurring together to functional male hypogonadism in HIV.


Asunto(s)
Tejido Adiposo , Estrona/sangre , Infecciones por VIH/fisiopatología , Hipogonadismo/fisiopatología , Testosterona/sangre , Absorciometría de Fotón , Adulto , Terapia Antirretroviral Altamente Activa , Composición Corporal , Estudios Transversales , Fragilidad/fisiopatología , Fragilidad/virología , VIH , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Estado de Salud , Indicadores de Salud , Humanos , Hipogonadismo/virología , Masculino , Persona de Mediana Edad , Multimorbilidad , Estudios Prospectivos
16.
Ter Arkh ; 92(6): 33-36, 2020 Jul 09.
Artículo en Ruso | MEDLINE | ID: mdl-33346490

RESUMEN

AIM: Determine whether bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry can be used as predictor of increased risk of death in hemodialysis patients. MATERIALS AND METHODS: A prospective study was performed of 516 patients with chronic kidney disease treated with hemodialysis (men 265, women 251, mean age 44.811.4 years) who were observed for 5.73.2 years. Before inclusion in the study, in all patients was analyzed bone mineral density using dual-energy X-ray absorptiometry in three standard departments: lumbar vertebrae, proximal femur and distal forearm. The probability analysis of the outcome was carried out using the KaplanMeier method and Cox. RESULTS: During follow-up period 111 (21.5%) patients died, 50.5% from cardiovascular events. Survival analysis by KaplanMeier method allowed to prove the increased risk of death from cardiovascular pathology in hemodailysis patients with low bone mineral density of all evaluated areas. Step-by-step multivariate Cox regression analysis showed that the T score of the femur, showing the difference of BMD of the patient with normal value of BMD for young adult, had the greatest prognostic significance. CONCLUSION: Reduced bone mineral density in patients receiving hemodialysis is associated with an increased risk of death from cardiovascular disease. Dual energy x-ray absorptiometry can be used for assessment of this risk.


Asunto(s)
Enfermedades Cardiovasculares , Osteoporosis , Absorciometría de Fotón , Adulto , Densidad Ósea , Enfermedades Cardiovasculares/diagnóstico por imagen , Femenino , Humanos , Vértebras Lumbares/diagnóstico por imagen , Masculino , Osteoporosis/diagnóstico por imagen , Estudios Prospectivos , Diálisis Renal , Adulto Joven
17.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(10): 672-681, dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-197680

RESUMEN

La obesidad sarcopénica se ha asociado con mayor discapacidad y morbimortalidad. Sin embargo, todavía existen pocos estudios sobre el papel de la sarcopenia en las comorbilidades asociadas a la obesidad en individuos con edad inferior a 65 años. La etiopatogenia es multifactorial pero parece que los mediadores inflamatorios y la resistencia a la insulina desempeñan un papel relevante. Aunque no existe un consenso claro sobre su definición y métodos diagnósticos, hay un creciente interés por disponer de biomarcadores que ayuden a su detección y seguimiento. Respecto al tratamiento, se postula el abordaje multimodal, que básicamente se fundamenta en recomendaciones dietéticas, ejercicio y eventualmente cirugía bariátrica


Sarcopenic obesity has been associated with greater disability, morbidity and mortality. However, at present, there are few studies regarding the role of sarcopenia in the evolution of the comorbidities associated with obesity in individuals less than 65 years of age. The pathogenesis is multifactorial and uncompletely ilucidated, but it seems that inflammatory mediators and insulin resistance play an important role. Although there is no clear consensus on its definition and diagnostic methods, there is a growing interest in finding biomarkers useful for the detection and monitoring. Regarding the treatment, a multimodal approach is recomended, based on dietary recommendations, exercise and eventually bariatric surgery


Asunto(s)
Humanos , Obesidad/complicaciones , Sarcopenia/patología , Obesidad/diagnóstico , Obesidad/fisiopatología , Sarcopenia/fisiopatología , Encuestas y Cuestionarios , Antropometría , Absorciometría de Fotón/métodos , Tomografía Computarizada por Rayos X , Diabetes Mellitus Tipo 2 , Disfunción Cognitiva , Calidad de Vida , Ejercicio Físico
18.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-33318265

RESUMEN

We present a 9-year-old male child having history of fractures on trivial trauma with a family history of the same. He was treated for osteogenesis imperfecta (OI; zolendronate, calcium and vitamin D) and showed clinical improvement. On evaluating his bone health using dual energy X-ray absorptiometry and peripheral quantitative CT, we found that the child had bone density within the reference range but a smaller bone mass for his height, low muscle mass and thin bones with a lower strength strain index in comparison with healthy children. Our case suggests that treatment with bisphosphonates results in increase in bone density; however, bones remain thin and the lean body mass in these children may also be low. Controlled physical activity to improve muscle health and newer approaches to improve bone geometry would result in better bone health in children with OI.


Asunto(s)
Absorciometría de Fotón , Densidad Ósea , Osteogénesis Imperfecta/diagnóstico por imagen , Osteogénesis Imperfecta/fisiopatología , Tomografía Computarizada por Rayos X , Conservadores de la Densidad Ósea/uso terapéutico , Calcio/uso terapéutico , Niño , Difosfonatos/uso terapéutico , Fracturas Óseas/etiología , Fracturas Óseas/prevención & control , Humanos , Masculino , Osteogénesis Imperfecta/tratamiento farmacológico , Tomografía Computarizada por Rayos X/métodos , Vitamina D/uso terapéutico , Ácido Zoledrónico/uso terapéutico
19.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(6): 541-544, 2020 Dec 08.
Artículo en Chino | MEDLINE | ID: mdl-33314865

RESUMEN

The Dual energy X-ray absorptiometry is the most commonly used for measuring bone mineral density. This method involves core clinical functions, phantom and database. This article discusses the three key issues of dual energy X-ray absorptiometry evaluation, including core clinical functions, phantom and database. This article aims at helping manufacturers to scientifically carry out relevant processes during research and development and also manufacturers may refer to this article when they apply for registration.


Asunto(s)
Absorciometría de Fotón , Densidad Ósea , Bases de Datos Factuales , Humanos , Fantasmas de Imagen
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1295-1299, 2020 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-33147932

RESUMEN

To explore the threshold effect of body mass index (BMI) on bone mineral density (BMD) in Chinese women living in the fluorosis area, we conducted a cross-sectional study and recruited 722 women in rural areas in Henan Province, China. After detection and analyses, we found that compared with the normal BMI group, the risk of osteoporosis in the overweight and obese groups were reduced by 32% and 69%, respectively. Threshold effect analysis showed that BMD was positively correlated with BMI when BMI was 16.8-31.2 kg/m2; while when BMI was greater than 31.2 kg/m2, the correlation reached saturation. The correlation observed between low-to-moderate fluoride exposure and BMD in rural women was not significant.


Asunto(s)
Densidad Ósea , Osteoporosis , Absorciometría de Fotón , Índice de Masa Corporal , China/epidemiología , Estudios Transversales , Femenino , Humanos
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