Pub Date : 2024-10-24DOI: 10.1016/j.jocd.2024.101536
Amira Ramadan, Nessa Tantivit, Alicia Pendleton, Catherine M. Gordon, Robert H. Rosen, Nora E. Renthal
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.
国际临床骨密度测量学会（ISCD）的现行指南建议，在通过双能量 X 射线吸收测定法（DXA）计算儿科骨密度 z 值时，应考虑种族、性别和年龄因素。然而，随着患者群体的日益多样化，这些指南的应用面临着巨大的挑战，有可能导致护理中的种族偏见和系统性不公平。为了响应越来越多的呼吁，重新评估种族在临床决策中的作用，我们旨在评估一线 DXA 服务提供者应对这些挑战的准备情况。作为儿科学术学会 2024 年年会 "重新评估种族、民族和祖先在临床决策中的作用 "研讨会的一部分，我们针对来自不同中心的 DXA 技术人员进行了一项专业的匿名临床实践调查。调查的重点是他们在记录和使用种族人口统计数据方面的经验。我们的调查结果揭示了种族数据收集实践中的不一致性、患者感受到的舒适程度不同以及对种族偏见可能长期存在的担忧。这些结果突出表明，有必要制定标准化指南，以便在 DXA 检查过程中敏感、公正地收集种族相关数据，最终促进对所有患者的公平护理。
{"title":"Moving towards an equitable future: Rethinking the use of race in pediatric densitometry","authors":"Amira Ramadan, Nessa Tantivit, Alicia Pendleton, Catherine M. Gordon, Robert H. Rosen, Nora E. Renthal","doi":"10.1016/j.jocd.2024.101536","DOIUrl":"10.1016/j.jocd.2024.101536","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101536"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593321","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}
Pub Date : 2024-10-24DOI: 10.1016/j.jocd.2024.101537
Austin J. Graybeal , Sydney H. Swafford , Abby T. Compton , Megan E. Renna , Tanner Thorsen , Jon Stavres
Introduction/Background: 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.
Methodology: A total of 214 participants (129 F, 85 M) had BMC measurements collected from an existing proprietary prediction equation, embedded within a smartphone application (MeThreeSixty), and evaluated against DXA. LASSO regression was then used to develop a new BMC prediction equation using the anthropometric estimates produced by the smartphone application in a portion of the participants (n = 174), which was subsequently evaluated against DXA in the remaining sample (n = 40). BMC z-scores were calculated and used to identify the prevalence of low BMC for the existing and newly developed smartphone prediction equations and evaluated against DXA-derived z-scores.
Results: Neither BMC estimates (R2: 0.72; RMSE: 376 g) nor BMC z-scores (R2: 0.55; RMSE: 1.09 SD) produced from the existing propriety prediction equation demonstrated equivalence with DXA in the combined sample. Moreover, the existing prediction equation had a 69.6 % accuracy of identifying low BMC. LASSO regression for the newly developed smartphone prediction model produced the following equation:
BMC (g) = -2020.769 + 60.902(Black=1, 0=all other races) – 180.364(Asian=1, 0=all other races) + 24.433(height) + 1.702(weight) + 2.92(shoulder circumference) + 0.258(arm surface area) – 715.29(waist circumference/(BMI2/3 x height1/2)).
BMC (R2: 0.91; RMSE: 209 g) and BMC z-scores (R2: 0.85; RMSE: 0.61) produced from the newly developed equation in the testing sample demonstrated equivalence with DXA and had a 92.5 % accuracy of identifying low BMC.
Conclusions: Smartphone anthropometrics provide accurate and clinically relevant BMC measurements outside of an advanced setting through the use of our newly-developed smartphone prediction model.
{"title":"Predicting bone mineral content from smartphone digital anthropometrics: evaluation of an existing application and the development of new prediction models","authors":"Austin J. Graybeal , Sydney H. Swafford , Abby T. Compton , Megan E. Renna , Tanner Thorsen , Jon Stavres","doi":"10.1016/j.jocd.2024.101537","DOIUrl":"10.1016/j.jocd.2024.101537","url":null,"abstract":"<div><div><em>Introduction/Background:</em> 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.</div><div><em>Methodology:</em> A total of 214 participants (129 F, 85 M) had BMC measurements collected from an existing proprietary prediction equation, embedded within a smartphone application (MeThreeSixty), and evaluated against DXA. LASSO regression was then used to develop a new BMC prediction equation using the anthropometric estimates produced by the smartphone application in a portion of the participants (n = 174), which was subsequently evaluated against DXA in the remaining sample (n = 40). BMC z-scores were calculated and used to identify the prevalence of <em>low BMC</em> for the existing and newly developed smartphone prediction equations and evaluated against DXA-derived z-scores.</div><div><em>Results:</em> Neither BMC estimates (R<sup>2</sup>: 0.72; RMSE: 376 g) nor BMC z-scores (R<sup>2</sup>: 0.55; RMSE: 1.09 SD) produced from the existing propriety prediction equation demonstrated equivalence with DXA in the combined sample. Moreover, the existing prediction equation had a 69.6 % accuracy of identifying <em>low BMC</em>. LASSO regression for the newly developed smartphone prediction model produced the following equation:</div><div>BMC (g) = -2020.769 + 60.902(<em>Black=1, 0=all other races</em>) – 180.364(<em>Asian=1, 0=all other races</em>) + 24.433(<em>height</em>) + 1.702(<em>weight</em>) + 2.92(<em>shoulder circumference</em>) + 0.258(<em>arm surface area</em>) – 715.29(<em>waist circumference/(BMI<sup>2/3</sup> x height<sup>1/2</sup>)</em>).</div><div>BMC (R<sup>2</sup>: 0.91; RMSE: 209 g) and BMC z-scores (R<sup>2</sup>: 0.85; RMSE: 0.61) produced from the newly developed equation in the testing sample demonstrated equivalence with DXA and had a 92.5 % accuracy of identifying <em>low BMC</em>.</div><div><em>Conclusions:</em> Smartphone anthropometrics provide accurate and clinically relevant BMC measurements outside of an advanced setting through the use of our newly-developed smartphone prediction model.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101537"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593320","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}
Pub Date : 2024-10-22DOI: 10.1016/j.jocd.2024.101539
Felipe Welter Langer , Giovanni Brondani Torri , Fernando Schaffazick , Guilherme Maia , Camila Piovesan Wiethan , Carlos Jesus Haygert , Marcos Cordeiro d'Ornellas
Introduction/background: 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.
Methodology: Patients who underwent unenhanced CT and dual-energy X-ray absorptiometry (DXA) scans within a six-month interval were assessed retrospectively. Mean CT attenuation was measured in the first lumbar vertebra (L1) in axial, coronal, and sagittal planes and compared to their respective DXA T-scores; vertebral fractures were assessed in the sagittal plane. Potential thresholds suggestive of low bone mass density (BMD) were established using receiver operating characteristics analysis.
Results: 491 patients were included (93.2 % female; mean age of 64.1 ± 9.8 years; mean interval of 63.5 days between scans). Mean L1 CT attenuation was significantly lower in osteopenic and osteoporotic patients in all CT planes (p < 0.001). Positive linear correlations were found between DXA T-scores and the average L1 attenuations in all CT planes (p < 0.001). An average L1 attenuation equal or below 100 Hounsfield Units (HU) in the sagittal plane identified low BMD (osteopenia or osteoporosis) with a specificity of 96.3 % and a positive predictive value of 96 %. In contrast, an average L1 attenuation above 180 HU demonstrated a sensitivity of 97.6 % and a negative predictive value of 94.9 % for detecting osteoporosis. Patients with L1 sagittal attenuation at or below 100 HU exhibited a significantly higher prevalence of vertebral fractures (prevalence ratio: 8.67; p < 0.001). An online calculator based on the results of this study is freely available at www.osteotc.com.br.
Conclusions: Routine CT scans can identify probable low bone density (osteopenia or osteoporosis) in Brazilian patients without additional costs or radiation exposure. Opportunistic CT screening does not substitute formal bone mineral density assessment; instead, it assists in identifying patients who may benefit from it.
{"title":"Opportunistic Screening for Low Bone Mineral Density in Routine Computed Tomography Scans: A Brazilian Validation Study","authors":"Felipe Welter Langer , Giovanni Brondani Torri , Fernando Schaffazick , Guilherme Maia , Camila Piovesan Wiethan , Carlos Jesus Haygert , Marcos Cordeiro d'Ornellas","doi":"10.1016/j.jocd.2024.101539","DOIUrl":"10.1016/j.jocd.2024.101539","url":null,"abstract":"<div><div><em>Introduction/background:</em> 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.</div><div><em>Methodology:</em> Patients who underwent unenhanced CT and dual-energy X-ray absorptiometry (DXA) scans within a six-month interval were assessed retrospectively. Mean CT attenuation was measured in the first lumbar vertebra (L1) in axial, coronal, and sagittal planes and compared to their respective DXA T-scores; vertebral fractures were assessed in the sagittal plane. Potential thresholds suggestive of low bone mass density (BMD) were established using receiver operating characteristics analysis.</div><div><em>Results:</em> 491 patients were included (93.2 % female; mean age of 64.1 ± 9.8 years; mean interval of 63.5 days between scans). Mean L1 CT attenuation was significantly lower in osteopenic and osteoporotic patients in all CT planes (<em>p</em> < 0.001). Positive linear correlations were found between DXA T-scores and the average L1 attenuations in all CT planes (<em>p</em> < 0.001). An average L1 attenuation equal or below 100 Hounsfield Units (HU) in the sagittal plane identified low BMD (osteopenia or osteoporosis) with a specificity of 96.3 % and a positive predictive value of 96 %. In contrast, an average L1 attenuation above 180 HU demonstrated a sensitivity of 97.6 % and a negative predictive value of 94.9 % for detecting osteoporosis. Patients with L1 sagittal attenuation at or below 100 HU exhibited a significantly higher prevalence of vertebral fractures (prevalence ratio: 8.67; <em>p</em> < 0.001). An online calculator based on the results of this study is freely available at <span><span>www.osteotc.com.br</span><svg><path></path></svg></span>.</div><div><em>Conclusions:</em> Routine CT scans can identify probable low bone density (osteopenia or osteoporosis) in Brazilian patients without additional costs or radiation exposure. Opportunistic CT screening does not substitute formal bone mineral density assessment; instead, it assists in identifying patients who may benefit from it.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101539"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644668","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}
Pub Date : 2024-10-22DOI: 10.1016/j.jocd.2024.101538
Süheyla Doğan Bulut , Gamze Zengin İspir , Serdar Bulut , Emine AK Aygün
Purpose: 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.
Methods: Sixty-three patients diagnosed with GAD (Generalized Anxiety Disorder) were treated with venlafaxine or duloxetine from the SNRI group, and sixty patients treated with SSRIs were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD (bone mineral density) of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The BMD of the patients was compared with that of 40 healthy controls.
Results: Bone measurements in the SNRI and SSRI users were similar to those of the healthy controls. However, osteopenic values were observed in the SSRI users, while normal bone density was found in the SNRI users. Also, the bone mineral densities were compared between patients using duloxetine and venlafaxine with healthy controls, showing similar T-score and Z-score values with no significant differences compared to the control group. However, while the lumbar region T-scores of those using duloxetine were within normal values, they were within the osteopenia range of venlafaxine and healthy controls.
Conclusion: SNRIs may have a lower risk of developing osteoporosis than SSRIs. Of the SNRIs, duloxetine appears to be safer than venlafaxine. Further randomized controlled studies are warranted to determine whether SNRI use is risky.
目的：本研究调查了绝经后妇女使用选择性5-羟色胺再摄取抑制剂（SSRI）和选择性5-羟色胺及去甲肾上腺素再摄取抑制剂（SNRI）与骨矿物质密度下降风险之间的关系：63名被诊断为GAD（广泛性焦虑症）的患者接受了SNRI组的文拉法辛或度洛西汀治疗，60名患者接受了SSRIs治疗。对所有患者的社会人口学特征、汉密尔顿焦虑量表（HAS）结果和汉密尔顿抑郁量表（HDS）评分进行了评估。通过双能 X 射线吸收仪（DXA）测量了患者股骨和腰椎部位的骨密度（BMD）。将患者的骨密度与 40 名健康对照者的骨密度进行了比较：结果：SNRI 和 SSRI 使用者的骨骼测量值与健康对照组相似。然而，SSRI 使用者出现骨质疏松，而 SNRI 使用者的骨密度正常。此外，使用度洛西汀和文拉法辛的患者与健康对照组的骨矿物质密度也进行了比较，结果显示两者的 T 值和 Z 值相似，与对照组相比无显著差异。然而，虽然使用度洛西汀的患者腰椎部位的T值在正常值范围内，但文拉法辛和健康对照组的腰椎部位的T值却在骨质疏松范围内：结论：与 SSRI 相比，SNRI 类药物患骨质疏松症的风险较低。在 SNRIs 中，度洛西汀似乎比文拉法辛更安全。需要进一步开展随机对照研究，以确定服用 SNRI 是否有风险。
{"title":"Comparison of the Effect of Selective Serotonin and Norepinephrine Reuptake Inhibitors on Bone Mineral Density with Selective Serotonin Reuptake Inhibitors and Healthy Controls","authors":"Süheyla Doğan Bulut , Gamze Zengin İspir , Serdar Bulut , Emine AK Aygün","doi":"10.1016/j.jocd.2024.101538","DOIUrl":"10.1016/j.jocd.2024.101538","url":null,"abstract":"<div><div><em>Purpose:</em> 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.</div><div><em>Methods:</em> Sixty-three patients diagnosed with GAD (Generalized Anxiety Disorder) were treated with venlafaxine or duloxetine from the SNRI group, and sixty patients treated with SSRIs were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD (bone mineral density) of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The BMD of the patients was compared with that of 40 healthy controls.</div><div><em>Results:</em> Bone measurements in the SNRI and SSRI users were similar to those of the healthy controls. However, osteopenic values were observed in the SSRI users, while normal bone density was found in the SNRI users. Also, the bone mineral densities were compared between patients using duloxetine and venlafaxine with healthy controls, showing similar T-score and Z-score values with no significant differences compared to the control group. However, while the lumbar region T-scores of those using duloxetine were within normal values, they were within the osteopenia range of venlafaxine and healthy controls.</div><div><em>Conclusion:</em> SNRIs may have a lower risk of developing osteoporosis than SSRIs. Of the SNRIs, duloxetine appears to be safer than venlafaxine. Further randomized controlled studies are warranted to determine whether SNRI use is risky.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101538"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631786","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}
Pub Date : 2024-10-16DOI: 10.1016/j.jocd.2024.101535
Lauren A. Burt , Liam T. Pond , Annabel R. Bugbird , David A. Hanley , Steven K. Boyd
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/cm2) 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.
由 DXA 得出的内脏脂肪组织（VAT）和高级髋关节分析（AHA）参数的参考数据在整个成人生命周期中都很有限。本研究的目的是为双 X 射线吸收测定法（DXA）得出的身体成分、骨小梁评分（TBS）和高级髋关节分析（AHA）参数开发针对不同年龄、部位和性别的参考数据。卡尔加里及周边地区 20 岁以上的成年人（N = 908；女性：561；男性：347）参加了这项研究。参与者接受了髋部（全髋[TH]和股骨颈[FN]）、腰椎[LS]、前臂[33%部位]和全身（iDXA，GE Lunar，GE Healthcare）的 DXA 扫描。在所有部位采集骨矿物质密度（aBMD，克/平方厘米），并通过全身扫描分析身体成分变量，包括瘦体重、脂肪量和脂肪百分比。全身 DXA 扫描评估了增值肌肉质量。对髋部扫描进行高级髋部分析（AHA），对LS扫描进行骨小梁评分（TBS），以评估骨质情况。使用位置、尺度和形状的广义相加模型（GAMLSS）方法生成了特定部位和性别的百分位曲线和表格。临床医生和研究人员可以使用这些加拿大参考数据作为工具，评估成年人整个生命周期的身体成分、TBS 和 AHA 参数。
{"title":"Canadian adult reference data for body composition, trabecular bone score and advanced hip analysis using DXA","authors":"Lauren A. Burt , Liam T. Pond , Annabel R. Bugbird , David A. Hanley , Steven K. Boyd","doi":"10.1016/j.jocd.2024.101535","DOIUrl":"10.1016/j.jocd.2024.101535","url":null,"abstract":"<div><div>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<sup>2</sup>) 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.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101535"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.jocd.2024.101534
Selvin Sundar Raj Mani , Kripa Elizabeth Cherian , Nitin Kapoor , Athul Thomas , Jeethu Joseph Eapen , Elenjickal Elias John , Sabina Yusuf , Mercy Deborah , Grace Rebekah , Anjali Mohapatra , Suceena Alexander , Vinoi George David , Santosh Varughese , Thomas V. Paul , Anna T. Valson
Background: There is a paucity of studies describing trabecular bone score (TBS) and bone mineral density (BMD) in kidney transplant (KT) recipients from developing countries. Study setting: This prospective observational study, from a tertiary teaching hospital in India assessed clinical, biochemical parameters including bone turnover markers and dual-energy X-ray absorptiometry (DXA) for BMD/TBS, hip structural analysis (HSA) and vertebral fracture assessment (VFA) at pre-KT, 3 months and 12 months post-KT. Results: A total of 53 KT recipients (90.6% living related) were recruited from August 2019 to March 2020 and followed till 1-year post-KT. The mean age was 33.9±10.4 years, 71.7% were males, and 11.5% had a history of pre-KT steroid use. Baseline fractures pre-KT as assessed by VFA were seen in 4 patients (7.5%). Mean BMD at spine and femoral neck and HSA variables at narrow neck and femoral shaft continued to decline till 3 months, but stabilised and reached pre-KT values 12 months post-KT. However, TBS and bone turn over markers continued to decline till 12 months post-KT (p value <0.001). New onset vertebral fractures were seen in 2(3.7%) and 1 patient (2.3%) at 3- and 12-months post-KT respectively. Pre-KT BMD significantly influenced bone health at 12 months post-KT, with patients in each quartile maintaining a similar trajectory over the follow up period (p < 0.001). Conclusion: Despite significant improvement in kidney function following transplant, TBS and BMD of the spine significantly decreased mainly in the early post-KT period suggesting the effect of immunosuppressants on the bone. Strategies to improve bone health in KT patients are warranted.
{"title":"Comprehensive evaluation of bone health among kidney transplant recipients – A prospective, single center, observational cohort study from India","authors":"Selvin Sundar Raj Mani , Kripa Elizabeth Cherian , Nitin Kapoor , Athul Thomas , Jeethu Joseph Eapen , Elenjickal Elias John , Sabina Yusuf , Mercy Deborah , Grace Rebekah , Anjali Mohapatra , Suceena Alexander , Vinoi George David , Santosh Varughese , Thomas V. Paul , Anna T. Valson","doi":"10.1016/j.jocd.2024.101534","DOIUrl":"10.1016/j.jocd.2024.101534","url":null,"abstract":"<div><div><em>Background:</em> There is a paucity of studies describing trabecular bone score (TBS) and bone mineral density (BMD) in kidney transplant (KT) recipients from developing countries. <em>Study setting:</em> This prospective observational study, from a tertiary teaching hospital in India assessed clinical, biochemical parameters including bone turnover markers and dual-energy X-ray absorptiometry (DXA) for BMD/TBS, hip structural analysis (HSA) and vertebral fracture assessment (VFA) at pre-KT, 3 months and 12 months post-KT. <em>Results:</em> A total of 53 KT recipients (90.6% living related) were recruited from August 2019 to March 2020 and followed till 1-year post-KT. The mean age was 33.9±10.4 years, 71.7% were males, and 11.5% had a history of pre-KT steroid use. Baseline fractures pre-KT as assessed by VFA were seen in 4 patients (7.5%). Mean BMD at spine and femoral neck and HSA variables at narrow neck and femoral shaft continued to decline till 3 months, but stabilised and reached pre-KT values 12 months post-KT. However, TBS and bone turn over markers continued to decline till 12 months post-KT (p value <0.001). New onset vertebral fractures were seen in 2(3.7%) and 1 patient (2.3%) at 3- and 12-months post-KT respectively. Pre-KT BMD significantly influenced bone health at 12 months post-KT, with patients in each quartile maintaining a similar trajectory over the follow up period (<em>p</em> < 0.001). <em>Conclusion:</em> Despite significant improvement in kidney function following transplant, TBS and BMD of the spine significantly decreased mainly in the early post-KT period suggesting the effect of immunosuppressants on the bone. Strategies to improve bone health in KT patients are warranted.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101534"},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548697","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}
Purpose: 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.
Materials and Methods: Panoramic radiographs from patients undergoing radiotherapy for nasopharyngeal carcinoma were analyzed before and after treatment. Four groups were formed based on post-radiotherapy radiography timing (0-6 months, 6-12 months, 12-24 months, and 24-36 months), comprising a total of 59 cases and 118 radiographs. Fractal analysis was conducted on four bilateral regions (ROI) in both trabecular and cortical bone on each radiograph. Additionally, measurements of inferior alveolar canal width and mandibular cortical width were performed. Mean and maximum radiation dose values to the mandible were measured, and their correlation with changes in fractal dimension, inferior alveolar canal width, and mandibular cortical width values was assessed.
Results: Fractal dimension values in regions over trabecular bone showed a statistically significant decrease in all groups, although no significant difference was observed among the four groups. In ROI-4 from cortical bone, a significant fractal dimension decrease was noted in all groups except the 0-6 month group. The magnitude of fractal dimension decrease was higher in the 12-24 and 24-36 month groups compared to the 0-6 month group. inferior alveolar canal width and mandibular cortical width values significantly decreased post-radiotherapy in all groups, with a consistent decrease across the groups.
Conclusions: Radiotherapy induces a reduction in the internal complexity of trabecular and cortical bone structures in the mandible. Osteoradionecrosis risk persists even three years post-radiotherapy, suggesting a cautious approach to interventional procedures on the bone.
{"title":"Fractal Analysis of Mandible in Panoramic Radiographs of Patients Received Radiotherapy for Nasopharyngeal Carcinoma","authors":"Rabia Duman Tepe , Kubra Ozkaya Toraman , Kivanc Bektas Kayhan , Ilknur Ozcan , Hulya Cakir Karabas","doi":"10.1016/j.jocd.2024.101531","DOIUrl":"10.1016/j.jocd.2024.101531","url":null,"abstract":"<div><div><em>Purpose:</em> 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.</div><div><em>Materials and Methods:</em> Panoramic radiographs from patients undergoing radiotherapy for nasopharyngeal carcinoma were analyzed before and after treatment. Four groups were formed based on post-radiotherapy radiography timing (0-6 months, 6-12 months, 12-24 months, and 24-36 months), comprising a total of 59 cases and 118 radiographs. Fractal analysis was conducted on four bilateral regions (ROI) in both trabecular and cortical bone on each radiograph. Additionally, measurements of inferior alveolar canal width and mandibular cortical width were performed. Mean and maximum radiation dose values to the mandible were measured, and their correlation with changes in fractal dimension, inferior alveolar canal width, and mandibular cortical width values was assessed.</div><div><em>Results:</em> Fractal dimension values in regions over trabecular bone showed a statistically significant decrease in all groups, although no significant difference was observed among the four groups. In ROI-4 from cortical bone, a significant fractal dimension decrease was noted in all groups except the 0-6 month group. The magnitude of fractal dimension decrease was higher in the 12-24 and 24-36 month groups compared to the 0-6 month group. inferior alveolar canal width and mandibular cortical width values significantly decreased post-radiotherapy in all groups, with a consistent decrease across the groups.</div><div><em>Conclusions:</em> Radiotherapy induces a reduction in the internal complexity of trabecular and cortical bone structures in the mandible. Osteoradionecrosis risk persists even three years post-radiotherapy, suggesting a cautious approach to interventional procedures on the bone.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101531"},"PeriodicalIF":1.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548698","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}
Pub Date : 2024-10-01DOI: 10.1016/j.jocd.2024.101533
William D. Leslie , Neil Binkley , Didier Hans
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/cm2 (+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/cm2 (+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/cm2, 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.
{"title":"Effects of Lumbar Spine Vertebral Fractures on Trabecular Bone Score (TBS): The Manitoba BMD Registry","authors":"William D. Leslie , Neil Binkley , Didier Hans","doi":"10.1016/j.jocd.2024.101533","DOIUrl":"10.1016/j.jocd.2024.101533","url":null,"abstract":"<div><div>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<sup>2</sup> (+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<sup>2</sup> (+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<sup>2</sup>, 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.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 4","pages":"Article 101533"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425968","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}
Pub Date : 2024-08-24DOI: 10.1016/j.jocd.2024.101522
Grace L. Rose , Alex N. Boytar , Isabel N. King , Morgan J. Farley , Michelle Maugham-Macan , Tina L. Skinner , Kate A. Bolam , Mia A. Schaumberg
Introduction: 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.
Objective: To quantify the same- and between-day reliability of morphological pQCT at proximal and distal segments of the forearm, shank, and thigh, and explore the influence of participant body size, age, and sex on outcome reliability.
Methods: Men and women (49 % female, 18-85 years, n=72-86) completed two consecutive-day pQCT testing sessions, where repeat measurements were conducted on day-one for technical error, and between-day for biological error quantification. Testing was undertaken following best practice body composition testing guidance, including standardized presentation and consistent time-of-day.
Results: All measurements of bone were classified as having ‘good’ to ‘excellent’ reliability [intraclass correlation coefficient (r=0.786- 0.999], as were measurements of muscle area (ICC r=0.991-0.999) and total fat (r=0.996-0.999). However, between- and same-day muscle density measurements at the thigh and forearm were classified as ‘poor’ (r=0.476) and ‘moderate’ (r=0.622), respectively. Likewise, intramuscular fat area at the thigh was classified as ‘moderate’ (r=0.737) for between-day measurement. Biological error was inflated compared to technical error by an average of 0.4 % for most measurements. Error values tended to increase proportionally with the amount of tissue quantified and males had significantly greater biological error for measurement of distal tibial bone (p<0.002) and trabecular area (p<0.002). Biological error was inflated among older adults for measurement of forearm muscle density (p<0.002).
Conclusions: Most pQCT outcomes can be implemented with confidence, especially outcomes that assess bone area and density at any of the radial, tibial, and femoral sites investigated herein. However, it is important to account for the influence of biological measurement error in further studies, especially for muscle and intramuscular fat outcomes derived by pQCT.
{"title":"Technical and biological reliability of pQCT measured bone and muscle tissue quality across the age-span","authors":"Grace L. Rose , Alex N. Boytar , Isabel N. King , Morgan J. Farley , Michelle Maugham-Macan , Tina L. Skinner , Kate A. Bolam , Mia A. Schaumberg","doi":"10.1016/j.jocd.2024.101522","DOIUrl":"10.1016/j.jocd.2024.101522","url":null,"abstract":"<div><p><em>Introduction:</em> 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.</p><p><em>Objective:</em> To quantify the same- and between-day reliability of morphological pQCT at proximal and distal segments of the forearm, shank, and thigh, and explore the influence of participant body size, age, and sex on outcome reliability.</p><p><em>Methods:</em> Men and women (49 % female, 18-85 years, n=72-86) completed two consecutive-day pQCT testing sessions, where repeat measurements were conducted on day-one for technical error, and between-day for biological error quantification. Testing was undertaken following best practice body composition testing guidance, including standardized presentation and consistent time-of-day.</p><p><em>Results:</em> All measurements of bone were classified as having ‘good’ to ‘excellent’ reliability [intraclass correlation coefficient (r=0.786- 0.999], as were measurements of muscle area (ICC r=0.991-0.999) and total fat (r=0.996-0.999). However, between- and same-day muscle density measurements at the thigh and forearm were classified as ‘poor’ (r=0.476) and ‘moderate’ (r=0.622), respectively. Likewise, intramuscular fat area at the thigh was classified as ‘moderate’ (r=0.737) for between-day measurement. Biological error was inflated compared to technical error by an average of 0.4 % for most measurements. Error values tended to increase proportionally with the amount of tissue quantified and males had significantly greater biological error for measurement of distal tibial bone (<em>p</em><0.002) and trabecular area (<em>p</em><0.002). Biological error was inflated among older adults for measurement of forearm muscle density (<em>p</em><0.002).</p><p><em>Conclusions:</em> Most pQCT outcomes can be implemented with confidence, especially outcomes that assess bone area and density at any of the radial, tibial, and femoral sites investigated herein. However, it is important to account for the influence of biological measurement error in further studies, especially for muscle and intramuscular fat outcomes derived by pQCT.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 4","pages":"Article 101522"},"PeriodicalIF":1.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142198697","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}
Pub Date : 2024-08-23DOI: 10.1016/j.jocd.2024.101526
Xiang Chen , Yanhong Guo , Fangli Zhou , Xi Wang , Suyuan Wang , Chenghui Zhang , Mingxia Li , Yunhong Wu
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.
{"title":"Correlation between body composition and bone mineral density differs by sex and skeletal site in overweight and obese Chinese subjects","authors":"Xiang Chen , Yanhong Guo , Fangli Zhou , Xi Wang , Suyuan Wang , Chenghui Zhang , Mingxia Li , Yunhong Wu","doi":"10.1016/j.jocd.2024.101526","DOIUrl":"10.1016/j.jocd.2024.101526","url":null,"abstract":"<div><p>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.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 4","pages":"Article 101526"},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095761","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}
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