Journal of Clinical Densitometry最新文献

Bone quality is associated with fragility fracture in patients with hemoglobinopathies

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-21 DOI: 10.1016/j.jocd.2025.101565

Ellen B. Fung , Iman Sarsour , Raquel Manzo , Ashutosh Lal

Background: Low bone mass, defined as a bone mineral density (BMD) Z-score ≤-2.0, is common in adults with thalassemia (Thal) and sickle cell disease (SCD), though disease-specific artifacts may contribute to inaccuracies in BMD assessment. Trabecular bone score (TBS), an indicator of bone quality, is not susceptible to these challenges and may improve fracture risk prediction.

Methods: A retrospective chart review was conducted in patients with Thal or SCD who had at least one spine BMD scan by DXA in the past 10 years. The most recent scan was reanalyzed for bone quality with abnormal defined as TBS <1.2. Fracture prevalence was determined by patient report with medical record validation. Patients were compared to healthy controls who participated in previous research.

Results: Data were abstracted from 126 patients with Thal (31.7 ± 11.9 yrs, 51 % Male), 170 with SCD (24.6 ± 13.5 yrs, 43 % Male), and 64 controls (25.9 ± 8.0 yrs, 17 % Male). Abnormal TBS was more common in Thal (26 %) or SCD (7 %) compared to controls (0 %, p < 0.001). Fracture prevalence was greater in Thal (36 %) compared to SCD (23 %) and controls (16 %, p = 0.005). Fragility fractures were not observed in controls but constituted 21 % of fractures in Thal and 15 % in SCD. After adjusting for age and hypogonadism, low bone mass was associated with an increased fracture prevalence (OR: 1.8, 95 % CI: 1.03, 3.23; p = 0.041), but not with fragility fracture. In contrast, abnormal TBS was strongly associated with fragility fracture after adjustment for age, sex, and BMI (OR: 11.4, 95 % CI: 2.2, 59.1, p = 0.004).

Conclusions: Bone quality by TBS may be a valuable tool in predicting the risk of fragility fractures in young adults with hemoglobinopathies and should be considered when making decisions for anti-resorptive therapy in those with low BMD naive to fracture or where disease-specific artifacts complicate accurate spine assessment by BMD alone.

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引用次数: 0

Evaluating lower limits of body fat percentage in athletes using DXA

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-20 DOI: 10.1016/j.jocd.2025.101564

Tamara Hew-Butler , Edward Kerr III , Gloria Martinez Perez , Jordan Sabourin , Valerie Smith-Hale , Ruben Mendoza

Body fat percentage (BF%) is routinely measured in athletes to monitor training and dietary interventions. Dual energy x-ray absorptiometry (DXA) is widely considered the gold standard body composition measurement technique, but DXA BF% values measure consistently higher than other techniques. Therefore, the main purpose of this study is to determine the lowest DXA-estimated whole-body fat mass in free-living athletes with unrestricted access to food. In this cross-sectional analyses, 732 participants across 18 competitive sports (643 athletes; 88 %) plus two (male and female) “non-athlete” male and female cohorts (89 non-athletes; 12 %) underwent a whole-body DXA scan using a Horizon A Hologic™ device (software version 13.6.0.5; TBAR 1209), performed and analyzed by a single operator. The average BF % in 454 males (20.9 ± 3.8 years) was 18.2 ± 4.9 % (range 10.3 - 37.2 %), with basketball players having the lowest BF% (15.3 ± 2.6 %) and non-athletes having the highest BF% (21.6 ± 5.4 %) (1-way ANOVA between 10 teams: F = 12.3; p < 0.0001). The average BF% in 278 females (21.3 ± 5.5 years) was 27.1 ± 5.1 % (range 16.2 - 45.3 %), with runners having the lowest BF% (23.5 ± 3.5 %) and non-athletes having the highest BF% (31.7 ± 6.3 %) (1-way ANOVA between 10 teams F = 12.9; p < 0.0001). In absolute values (kg), the average body fat for males was 19.9 ± 8.0 kg (range 6.7 - 62.0 kg) and 18.9 ± 6.4 kg (range 9.2 - 49.7 kg) for females. These data suggest that the lower limits of whole-body fat mass in free-living competitive athletes is approximately 10 % for males and 16 % for females. Whether these DXA-derived fat thresholds represent “healthy” levels, or how much of these DXA-derived fat depots represent essential fat stores located within lean soft tissue mass, remains unclear.

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引用次数: 0

Influence of two strength training modalities (hypertrophy vs. contrast training) on muscular strength, bone health parameters and quality of life in a group of older adults with low skeletal muscle mass index

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-15 DOI: 10.1016/j.jocd.2025.101563

Amal Antoun , Eric Watelain , Antonio Pinti , Nour Khalil , Abdel-Jalil Berro , Elie Maliha , Youssef Bassim , Rawad El Hage

The main aim of the current study was to compare the effects of two strength training modalities (hypertrophy vs. contrast training) on bone health parameters, physical performance and quality of life in a group of subjects aged 60 and above with low skeletal muscle mass index (SMI). 45 older adults voluntarily participated in this study, but only 41 (22 women and 19 men) completed it. The participants were assigned to 3 different groups: control group (CG; n = 15), contrast training group (CTG; n = 13) and hypertrophy training group (HTG; n = 13). The duration of the training protocol was six months. The experimental groups performed two sessions of strength training per week; the duration of each session was forty-five minutes. Several measurements (which included anthropometrics, body composition, bone parameters, maximal strength parameters, physical performance parameters, fracture risk and quality of life) were performed in the three groups before and after the six-month training period. The different measurements of the protocol were carried out under the same conditions with identical materials and investigators for all the participants and for each approach. The current study has demonstrated that the two training modalities show common benefits such as improving maximal strength, physical performance and quality of life parameters but have no significant effects on bone mineral density (BMD) and bone mineral content (BMC). The influence of training was marked more for improving maximal strength and reducing fracture risk for the contrast training group (who performs movements at high speed) compared to the hypertrophy training group (who performs movements at spontaneous speed). In conclusion, this study shows that both resistance training programs are effective in improving maximal strength, physical performance and quality of life in older adults with low SMI. However, this 6-month intervention was not sufficient to significantly increase BMC nor BMD values in this population.

{"title":"Influence of two strength training modalities (hypertrophy vs. contrast training) on muscular strength, bone health parameters and quality of life in a group of older adults with low skeletal muscle mass index","authors":"Amal Antoun , Eric Watelain , Antonio Pinti , Nour Khalil , Abdel-Jalil Berro , Elie Maliha , Youssef Bassim , Rawad El Hage","doi":"10.1016/j.jocd.2025.101563","DOIUrl":"10.1016/j.jocd.2025.101563","url":null,"abstract":"<div><div>The main aim of the current study was to compare the effects of two strength training modalities (hypertrophy vs. contrast training) on bone health parameters, physical performance and quality of life in a group of subjects aged 60 and above with low skeletal muscle mass index (SMI). 45 older adults voluntarily participated in this study, but only 41 (22 women and 19 men) completed it. The participants were assigned to 3 different groups: control group (CG; <em>n</em> = 15), contrast training group (CTG; <em>n</em> = 13) and hypertrophy training group (HTG; <em>n</em> = 13). The duration of the training protocol was six months. The experimental groups performed two sessions of strength training per week; the duration of each session was forty-five minutes. Several measurements (which included anthropometrics, body composition, bone parameters, maximal strength parameters, physical performance parameters, fracture risk and quality of life) were performed in the three groups before and after the six-month training period. The different measurements of the protocol were carried out under the same conditions with identical materials and investigators for all the participants and for each approach. The current study has demonstrated that the two training modalities show common benefits such as improving maximal strength, physical performance and quality of life parameters but have no significant effects on bone mineral density (BMD) and bone mineral content (BMC). The influence of training was marked more for improving maximal strength and reducing fracture risk for the contrast training group (who performs movements at high speed) compared to the hypertrophy training group (who performs movements at spontaneous speed). In conclusion, this study shows that both resistance training programs are effective in improving maximal strength, physical performance and quality of life in older adults with low SMI. However, this 6-month intervention was not sufficient to significantly increase BMC nor BMD values in this population.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101563"},"PeriodicalIF":1.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of lumbar vertebral bone quality using T1-weighted MRI: Can it differentiate normal, osteopenia, and osteoporosis?

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-09 DOI: 10.1016/j.jocd.2025.101561

Sevde Nur Emir, Gülbanu Güner

Background: Osteoporosis, a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration, poses a significant public health challenge globally. While the gold standard for diagnosing osteoporosis is dual-energy X-ray absorptiometry (DXA), its use is limited by factors like spinal deformities and artifacts. This study aims to explore the potential of routine T1-weighted MRI sequences in predicting osteopenia and osteoporosis through the vertebral bone signal (VB) to cerebrospinal fluid signal (CSF) ratio.

Methodology: We conducted a retrospective study of patients who underwent both DXA and lumbar MRI within a six-month interval between 2020 and 2023. Excluding patients with known vertebral fractures, bone tumors, heterogeneous bone marrow, or endplate signal changes due to degenerative alterations, we divided the patients into normal, osteopenic, and osteoporotic groups based on their DXA T-scores. The T1-weighted sagittal MRI sequences were analyzed, and the T1 VB/CSF ratios were calculated for each vertebra (L1–L4).

Results: The study included 376 patients, with an average age of 60.8 ± 9.1 years. Statistically significant differences were found in the T1 VB/CSF ratios across the normal, osteopenic, and osteoporotic groups (p < 0.05). The L1 vertebra demonstrated the highest diagnostic performance for predicting osteoporosis, with an AUC of 0.75, a sensitivity of 88.1 %, and a specificity of 84.5 %. For differentiating osteopenia from normal, the L1 vertebra achieved an AUC of 0.68, with a sensitivity of 78.2 % and a specificity of 76.4 %. The optimal cut-off values were determined as 3.62 for osteopenia and 3.80 for osteoporosis.

Conclusion: The T1 VB/CSF ratio derived from routine lumbar MRI sequences provides a promising, radiation-free tool for opportunistic screening of osteoporosis and osteopenia. Given the frequent use of lumbar MRI for patients with spinal complaints, this method could facilitate early diagnosis and intervention, guiding high-risk patients towards further DXA evaluation and management.

{"title":"Evaluation of lumbar vertebral bone quality using T1-weighted MRI: Can it differentiate normal, osteopenia, and osteoporosis?","authors":"Sevde Nur Emir, Gülbanu Güner","doi":"10.1016/j.jocd.2025.101561","DOIUrl":"10.1016/j.jocd.2025.101561","url":null,"abstract":"<div><div><em>Background:</em> Osteoporosis, a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration, poses a significant public health challenge globally. While the gold standard for diagnosing osteoporosis is dual-energy X-ray absorptiometry (DXA), its use is limited by factors like spinal deformities and artifacts. This study aims to explore the potential of routine T1-weighted MRI sequences in predicting osteopenia and osteoporosis through the vertebral bone signal (VB) to cerebrospinal fluid signal (CSF) ratio.</div><div><em>Methodology:</em> We conducted a retrospective study of patients who underwent both DXA and lumbar MRI within a six-month interval between 2020 and 2023. Excluding patients with known vertebral fractures, bone tumors, heterogeneous bone marrow, or endplate signal changes due to degenerative alterations, we divided the patients into normal, osteopenic, and osteoporotic groups based on their DXA T-scores. The T1-weighted sagittal MRI sequences were analyzed, and the T1 VB/CSF ratios were calculated for each vertebra (L1–L4).</div><div><em>Results:</em> The study included 376 patients, with an average age of 60.8 ± 9.1 years. Statistically significant differences were found in the T1 VB/CSF ratios across the normal, osteopenic, and osteoporotic groups (<em>p</em> < 0.05). The L1 vertebra demonstrated the highest diagnostic performance for predicting osteoporosis, with an AUC of 0.75, a sensitivity of 88.1 %, and a specificity of 84.5 %. For differentiating osteopenia from normal, the L1 vertebra achieved an AUC of 0.68, with a sensitivity of 78.2 % and a specificity of 76.4 %. The optimal cut-off values were determined as 3.62 for osteopenia and 3.80 for osteoporosis.</div><div><em>Conclusion:</em> The T1 VB/CSF ratio derived from routine lumbar MRI sequences provides a promising, radiation-free tool for opportunistic screening of osteoporosis and osteopenia. Given the frequent use of lumbar MRI for patients with spinal complaints, this method could facilitate early diagnosis and intervention, guiding high-risk patients towards further DXA evaluation and management.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101561"},"PeriodicalIF":1.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of an Algorithm to Predict Appendicular Lean Mass Index From Regional Spine and Hip Dxa Scans

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-04 DOI: 10.1016/j.jocd.2024.101560

Krista Rossum , Mackenzie R. Alexiuk , Clara Bohm , William D. Leslie , Navdeep Tangri

Introduction: Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Operational definitions of sarcopenia include a measurement of muscle mass, most often from dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass. Appendicular lean mass can be derived from whole-body dual-DXA scans; however, these scans are performed less commonly than hip and spine scans as part of clinical care. The objective of our study was to develop an algorithm to predict appendicular lean mass index (ALMI) from regional spine and hip dual-energy X-ray absorptiometry (DXA) scans.

Methods: We performed a retrospective cross-sectional study using a subset of patients from the Manitoba Bone Mineral Density Registry who had hip, spine, and whole-body DXA scans at the same visit. We developed the algorithm using the following candidate covariates: age, sex, height, weight, DXA-derived spine and hip fat fraction, DXA-derived spine and hip tissue thickness. We internally validated the algorithm using the bootstrap method. Mean bootstrap parameter estimates were used as the final equation.

Results: DXA scans from 676 patients were included in the analytic dataset. Mean ALMI was 6.73 (SD 1.43) kg/m². The final predictive model included sex, age, height, weight, spine fat fraction and hip fat fraction. Sex also acted as an interaction term on weight and hip fat fraction. After bootstrap validation, model adjusted R2 was 0.863, root mean square error was 0.529 kg/m², and AUROC to predict low ALMI per the European Working Group on Sarcopenia version 2 was 0.88.

Conclusion: Hip and spine DXA scans can be used to predict appendicular lean mass index. Future studies should test whether these predictions can be used to assess relationships between sarcopenia and other clinical conditions.

{"title":"Development of an Algorithm to Predict Appendicular Lean Mass Index From Regional Spine and Hip Dxa Scans","authors":"Krista Rossum , Mackenzie R. Alexiuk , Clara Bohm , William D. Leslie , Navdeep Tangri","doi":"10.1016/j.jocd.2024.101560","DOIUrl":"10.1016/j.jocd.2024.101560","url":null,"abstract":"<div><div><em>Introduction:</em> Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Operational definitions of sarcopenia include a measurement of muscle mass, most often from dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass. Appendicular lean mass can be derived from whole-body dual-DXA scans; however, these scans are performed less commonly than hip and spine scans as part of clinical care. The objective of our study was to develop an algorithm to predict appendicular lean mass index (ALMI) from regional spine and hip dual-energy X-ray absorptiometry (DXA) scans.</div><div><em>Methods:</em> We performed a retrospective cross-sectional study using a subset of patients from the Manitoba Bone Mineral Density Registry who had hip, spine, and whole-body DXA scans at the same visit. We developed the algorithm using the following candidate covariates: age, sex, height, weight, DXA-derived spine and hip fat fraction, DXA-derived spine and hip tissue thickness. We internally validated the algorithm using the bootstrap method. Mean bootstrap parameter estimates were used as the final equation.</div><div><em>Results:</em> DXA scans from 676 patients were included in the analytic dataset. Mean ALMI was 6.73 (SD 1.43) kg/m<sup>2</sup>. The final predictive model included sex, age, height, weight, spine fat fraction and hip fat fraction. Sex also acted as an interaction term on weight and hip fat fraction. After bootstrap validation, model adjusted R2 was 0.863, root mean square error was 0.529 kg/m<sup>2</sup>, and AUROC to predict low ALMI per the European Working Group on Sarcopenia version 2 was 0.88.</div><div><em>Conclusion:</em> Hip and spine DXA scans can be used to predict appendicular lean mass index. Future studies should test whether these predictions can be used to assess relationships between sarcopenia and other clinical conditions.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101560"},"PeriodicalIF":1.7,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to “Follow-up Bone Mineral Density Testing: 2023 Official Positions of the International Society for Clinical Densitometry” Journal of Clinical Densitometry: Assessment and Management of Musculoskeletal Health Vol 27(1), 101440,2024 临床骨密度测量杂志》：临床骨密度测量杂志：肌肉骨骼健康的评估与管理》，第 27 卷（1），第 101440 期，2024 年。

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-01 DOI: 10.1016/j.jocd.2024.101540

Linsey U. Gani , Chanika Sritara , Robert D. Blank , WeiWen Chen , Julie Gilmour , Ruban Dhaliwal , Ranjodh Gill

引用次数: 0

Effect of a High-Impact Exercise Program on Hip Strength Indices in a Group of Obese Women after Bariatric Surgery 高强度运动计划对减肥手术后肥胖妇女髋关节力量指数的影响。

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-01 DOI: 10.1016/j.jocd.2024.101556

Emne Hammoud , Christophe Jacob , Antonio Pinti , Nour Khalil , Zaher El Hage , Hechmi Toumi , Rawad El Hage

The purpose of this study was to explore the influence of a 12-month high-impact physical training program (descending stairs) on bone health in a group of young obese women who had undergone bariatric surgery (type sleeve). Fifty-two premenopausal women with a body mass index (BMI) > 35 kg/m² (range: 35.06–60.97 kg/m²), aged 19–47 years old were included in this study. Patients were randomized to either exercise group (EG), control group (CG) or observational group (OG). 2 to 3 weeks post-bariatric surgery (BS), EG underwent a 12-month semi-supervised high impact (descending stairs) exercise program, CG performed a 12-month oriental dance activity while the third OG received only standard medical care. Patients were assessed before BS and 12 months post-BS for body composition, bone mineral density (BMD) and femoral neck geometry. Bone parameters were evaluated by DXA. At baseline, there were no significant differences among the three groups in the clinical characteristics and the bone variables. 12 months after the surgery, there were some group*time interactions. The 3 groups showed significantly lower whole body BMD (−1.8; −2.9; −4.2 % respectively for EG; CG and OG). The EG showed a significant increase of the femoral neck BMD (+1.4 %; p < 0.05), the femoral neck cross-sectional area (+4.6 %; p < 0.05), and the femoral neck cross-sectional moment of inertia (+15.7 %; p < 0.01) while all these values decreased significantly in the 2 other groups. The total hip BMD decreased in all groups, but the EG showed less significant total hip variation, and lumbar spine BMD decreased significantly only in the OG. This study mainly shows that the stair descent can be considered as an effective high-impact physical exercise for obese women who have undergone bariatric surgery. This kind of exercise has significant effects in maintaining or reducing the loss of BMD at the femoral neck and the total hip. Finally, since the EG group showed significant increases in femoral neck geometry variables, this study suggests that this kind of training could be efficient at reducing the hip fracture risk.

本研究的目的是探讨12个月的高强度体育训练计划（下楼梯）对一组接受减肥手术（袖型）的年轻肥胖女性骨骼健康的影响。本研究纳入52名年龄19-47岁，体重指数（BMI） bbb35 kg/m2（范围：35.06-60.97 kg/m2）的绝经前妇女。患者随机分为运动组（EG）、对照组（CG）和观察组（OG）。减肥手术（BS）后2- 3周，EG进行了12个月的半监督高强度（下楼梯）锻炼计划，CG进行了12个月的东方舞蹈活动，而第三组OG只接受了标准的医疗护理。在BS前和BS后12个月评估患者的身体成分、骨密度（BMD）和股骨颈几何形状。DXA评估骨参数。在基线时，三组在临床特征和骨变量方面无显著差异。手术后12个月，有一些小组时间的互动。3组小鼠全身骨密度均显著降低(-1.8；-2.9;EG -4.2 %；CG和OG)。EG显示股骨颈骨密度显著升高(+1.4 %；p

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引用次数: 0

Bone Health ECHO Case Report: Is it Paget's Disease? 骨健康回声病例报告：是佩吉特病吗？

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-01 DOI: 10.1016/j.jocd.2024.101550

Melissa F. Cohen , Rachel Pessah-Pollack , E. Michael Lewiecki

A 54-year-old woman was referred by her rheumatologist for evaluation of an elevated serum alkaline phosphatase (ALP) in the setting of polyarthritis. The metabolic work-up was significant for an elevated bone fraction of alkaline phosphatase isoenzymes, and high bone turnover markers, including fasting C- telopeptide (CTX). A diagnosis of Paget's disease of bone (PDB) was considered. A whole-body nuclear bone scan showed diffuse increased uptake in the calvarium, suggestive of PDB, with no other localizing areas of increased uptake. Skull X-rays show mild sclerosis and medullary expansion of the posterior parietal bones and occiput, interpreted by the radiologist as unlikely to be PDB with a high level of uncertainty. Bone density testing with dual-energy X-ray absorptiometry showed low bone mass (osteopenia) with fracture probability that was below the treatment threshold. The case was presented and discussed on Bone Health ECHO, a virtual community of practice with the aim of enhancing global capacity to deliver best practice skeletal health care. The results of the discussion are presented here.

一位54岁的女性被她的风湿病学家推荐评估血清碱性磷酸酶（ALP）在多发性关节炎的设置升高。代谢锻炼对碱性磷酸酶同工酶的骨分数升高和高骨转换标志物（包括空腹C-端肽（CTX））具有重要意义。考虑诊断为骨佩吉特病（PDB）。全身核骨扫描显示颅骨弥漫性摄取增加，提示PDB，未见其他局部摄取增加。颅骨x光显示轻度硬化症，后顶骨和枕骨髓样扩张，放射科医生认为不太可能是PDB，具有高度的不确定性。双能x线骨密度测定显示骨量低（骨质减少），骨折概率低于治疗阈值。该病例在骨骼健康ECHO上进行了介绍和讨论，这是一个虚拟的实践社区，旨在提高全球提供最佳骨骼保健实践的能力。讨论的结果在这里提出。

引用次数: 0

Bone Health ECHO Case Report: Rare Cases of Hypophosphatemia and Low-Traumatic Fractures in Patients with Type 1 Diabetes Mellitus 骨健康ECHO病例报告：1型糖尿病患者低磷血症和低创伤性骨折的罕见病例。

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-01 DOI: 10.1016/j.jocd.2024.101552

Zhanna Belaya , Sofia Gronskaia , Olga Golounina , Mikhail Degtyarev , Natalia Tarbaeva , Liudmila Rozhinskaya , Valentin Fadeyev , Svetlana Rodionova , Galina Melnichenko , E. Michael Lewiecki

Bone Health ECHO (Extension of Community Healthcare Outcomes) is a virtual community of practice that has been connecting healthcare professionals online once weekly for the past 10 years. A key component of each ECHO session is presentation and discussion of patient cases with diagnostic and treatment dilemmas. Here we present two wheelchair-bound female patients aged 47 years (Patient 1) and 34 years (Patient 2), both with type 1 diabetes mellitus (T1DM). They were admitted to our hospital due to multiple fractures and muscle weakness. Since age 8 years, both women suffered from T1DM. Patient 1 had extremely poor glycemic control over the whole period of diabetes with frequent cases of ketoacidosis (glycated hemoglobin [HbA1c] varied 10.0–14.2 %), with multiple end-stage complications of DM including anuria requiring hemodialysis from age 37 years. Patient 2 had minimal DM complications and maintained HbA1c within an individual goal (5.0–6.1 %). Both patients had low fasting phosphate and elevated alkaline phosphatase on laboratory evaluation. In the patient with anuria (Patient 1), after careful evaluation of all possible causes of hypophosphatemia, we found the most likely cause to be the effects of constantly repeated intracellular phosphate depletion due to poorly compensated T1DM. While achieving stable glucose control in hospital care, her phosphate levels gradually returned within the reference range. In the younger patient (Patient 2), tumor-induced osteomalacia (TIO) was diagnosed. After tumor removal her symptoms and laboratory results normalized.

These cases illustrate two different causes of hypophosphatemia in patients with similar skeletal presentations in association with T1DM.

骨健康ECHO（社区医疗保健结果扩展）是一个虚拟的实践社区，在过去的10年里，每周一次在线连接医疗保健专业人员。每个ECHO会议的一个关键组成部分是介绍和讨论诊断和治疗困境的患者病例。本文报告了两名女性患者，年龄分别为47岁（患者1）和34岁（患者2），均患有1型糖尿病（T1DM）。他们因多处骨折和肌肉无力而入院。从8岁开始，两名女性都患有T1DM。患者1在整个糖尿病期间血糖控制极差，经常发生酮症酸中毒（糖化血红蛋白[HbA1c]变化10.0-14.2 %），从37岁开始出现多种糖尿病终末期并发症，包括无尿需要血液透析。患者2有最小的糖尿病并发症，HbA1c维持在个人目标范围内（5.0-6.1 %）。在实验室评估中，两例患者空腹磷酸盐低，碱性磷酸酶升高。在无尿患者（患者1）中，在仔细评估了低磷血症的所有可能原因后，我们发现最可能的原因是由于代偿不良的T1DM引起的不断重复的细胞内磷酸盐消耗的影响。在医院治疗中血糖得到稳定控制后，患者的磷酸盐水平逐渐回到参考范围内。在年轻患者（患者2）中，诊断为肿瘤诱导的骨软化症（TIO）。肿瘤切除后，她的症状和化验结果恢复正常。这些病例说明了两种不同原因的低磷血症患者具有相似的骨骼表现，并与T1DM相关。

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引用次数: 0

Associations between Bone Mineral Density and WOMAC Scores in Healthy Individuals: Insights from the Qatar Biobank 健康个体骨密度与WOMAC评分之间的关系：来自卡塔尔生物库的见解

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-01 DOI: 10.1016/j.jocd.2024.101547

Mohammed Al-Hamdani , Farah Issa , Marah Abdulla , Saja A. Abdallah , Amal Al-Haidose , Atiyeh M. Abdallah

Background: Bone mineral density (BMD) is an indicator of bone health that predicts future bone fractures. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is used to assess the severity of symptoms related to pain, stiffness, and function in diseased hip and knee joints. Here we assessed whether BMD measured at specific sites predicts WOMAC scores in healthy individuals whilst controlling for sociodemographic variables.

Methodology: BMD, sociodemographic, and WOMAC data were collected from 1764 healthy adult individuals attending the Qatar Biobank (QBB). Multiple linear regression was used to examine associations between sociodemographic factors, total body BMD and BMD related to specific skeletal sites (including femoral (femoral neck and trochanter), trunk, pelvis and total spine), and the three WOMAC subscales (pain, stiffness, and physical function).

Results: After controlling for sociodemographic variables, total body and specific BMD measures did not predict pain. However, BMD measures significantly contributed to predicting stiffness after controlling for sociodemographic variables (R² = 0.065, ΔF(7, 1724) = 3.34, p = 0.002), with a higher total body BMD associated with increased stiffness and a higher trunk BMD associated with decreased stiffness. Total body BMD measures also significantly contributed to predicting compromised physical function (R² = 0.091, ΔF(7, 1724) = 3.762, p < 0.001) after controlling for sociodemographic variables, with a higher total body BMD associated with an increase in compromised physical function.

Conclusion: Total body BMD seems to be a more important predictor of stiffness and physical function than specific skeletal sites BMD measures. Monitoring BMD may have important implications for osteoarthritis patients.

背景：骨矿物质密度（BMD）是骨骼健康的一个指标，可以预测未来的骨折。西安大略和麦克马斯特大学骨关节炎指数（WOMAC）用于评估患病髋关节和膝关节疼痛、僵硬和功能相关症状的严重程度。在这里，我们评估了在控制社会人口变量的同时，在特定部位测量的BMD是否可以预测健康个体的WOMAC评分。方法：BMD、社会人口学和WOMAC数据来自卡塔尔生物银行（QBB）的1764名健康成年人。使用多元线性回归来检验社会人口学因素、全身骨密度和与特定骨骼部位（包括股骨（股骨颈和股骨粗隆）、躯干、骨盆和全脊柱）相关的骨密度以及三个WOMAC亚量表（疼痛、僵硬和身体功能）之间的关系。结果：在控制了社会人口学变量后，全身和特定骨密度测量不能预测疼痛。然而，在控制了社会人口学变量后，骨密度测量显著有助于预测刚度（R2 = 0.065，ΔF（7,1724） = 3.34,p = 0.002），较高的全身骨密度与刚度增加相关，较高的躯干骨密度与刚度降低相关。在控制了社会人口学变量后，总体骨密度测量也显著有助于预测身体功能受损（R2 = 0.091，ΔF（7,1724） = 3.762,p < 0.001），较高的总体骨密度与身体功能受损的增加相关。结论：与特定骨骼部位的骨密度测量相比，总体骨密度似乎是一个更重要的刚度和身体功能的预测指标。监测骨密度可能对骨关节炎患者有重要意义。

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引用次数: 0