Journal of Clinical Densitometry最新文献

Purpose/Aims

To evaluate the effects of 6 and 18 mo of abaloparatide (ABL) compared with placebo (PBO) on bone mineral density (BMD) in the acetabular regions of postmenopausal women with osteoporosis (OP).

Rationale/Background

Acetabular bone loss, as may occur in OP, increases risk of acetabular fragility fractures and is associated with significant morbidity. In total hip arthroplasty (THA), low acetabular BMD adversely affects primary stability, osseointegration, and migration of acetabular cups. ABL is an osteoanabolic agent for the treatment of men and postmenopausal women with OP at high risk for fracture that increases BMD of the total hip, femoral neck, trochanter, and lumbar spine. Effects of ABL on acetabular BMD are unknown.

Methods

Hip DXA scans were obtained at baseline, 6, and 18 mo from a random subgroup of postmenopausal women (aged 49–86 y) from the phase 3 ACTIVE trial randomized to either ABL 80 µg/d or PBO (n=250/group).

Anatomical landmarks were identified in each DXA scan to virtually place a hemispherical shell model of an acetabular cup and define regions of interest corresponding to DeLee & Charnley zones 1 (R1), 2 (R2), and 3 (R3). BMD changes compared to baseline were calculated for each zone. Statistical P values were based on a mixed-effect repeated measure model adjusted for BMI, age, and baseline BMD, with covariates including DXA scanner type, treatment group, visit, and treatment/visit interaction. DXA scans were aligned via intensity-based registration onto a reference scan to depict local mean changes in BMD.

Results

BMD in all zones were similar at baseline in the ABL and PBO groups. BMD significantly increased in the ABL group at 6 and 18 mo compared with PBO (all P< 0.0001 vs PBO; Figure), with mean BMD increasing from baseline by 8.38% in R1, 7.25% in R2, and 9.73% in R3 at 18 months. BMD in the PBO group was relatively stable over time.

Implications

Treatment with ABL resulted in rapid and progressive increases in BMD of all 3 acetabular zones. Increasing acetabular BMD has the potential to improve acetabular strength, which may reduce risk of acetabular fragility fractures. With bone health optimization prior to THA, increased acetabular BMD via ABL may provide better primary stability and longevity of acetabular cups in postmenopausal women with OP.

Background: Low bone mineral density (BMD) is prevalent in individuals with β-thalassemia and is associated with increased circulating dickkopf-1 concentration. These data are limited in α-thalassemia. Therefore, we aimed to determine the prevalence of low BMD and the association between BMD and serum dickkopf-1 in adolescents with non-deletional hemoglobin H disease, a form of α-thalassemia whose severity is comparable to β-thalassemia intermedia. Methodology: The lumbar spine and total body BMD were measured and converted into height-adjusted z-scores. Low BMD was defined as BMD z-score ≤ -2. Participant blood was drawn for measurement of dickkopf-1 and bone turnover marker concentrations. Results: Thirty-seven participants with non-deletional hemoglobin H disease (59% female, mean age 14.6 ± 3.2 years, 86% Tanner stage ≥2, 95% regularly transfused, 16% taking prednisolone) were included. Over one year prior to the study, mean average pretransfusion hemoglobin, ferritin and 25-hydroxyvitamin D concentrations were 8.8 ± 1.0 g/dL, and 958 ± 513 and 26 ± 6 ng/mL, respectively. When participants taking prednisolone were excluded, the prevalence of low BMD at the lumbar spine and total body was 42% and 17%, respectively. BMD at both sites was correlated positively with body mass index z-score, and negatively with dickkopf-1 (all p-values <0.05). There were no correlations among dickkopf-1, 25-hydroxyvitamin D, osteocalcin and C-telopeptide of type-I collagen. Multiple regression analysis showed dickkopf-1 inversely associated with total body BMD z-score adjusting for sex, bone age, body mass index, pre-transfusion hemoglobin, 25-hydroxyvitamin D, history of delayed puberty, type of iron chelator and prednisolone use (p-value = 0.009). Conclusions: We demonstrated a high prevalence of low BMD in adolescents with non-deletional hemoglobin H disease. Moreover, dickkopf-1 inversely associated with total body BMD suggesting it may serve as a bone biomarker in this patient population.

Introduction/Background: Trabecular bone score (TBS) is an indirect measurement of bone quality and microarchitecture determined from dual-energy X-ray absorptiometry (DXA) imaging of the lumbar spine. TBS predicts fracture risk independent of bone mass/density, suggesting this assessment of bone quality adds value to the understanding of patients’ bone health. While lean mass and muscular strength have been associated with higher bone density and lower fracture risk among older adults, the literature is limited regarding the relationship of lean mass and strength with TBS. The purpose of this study was to determine associations of DXA-determined total body and trunk lean mass, maximal muscular strength, and gait speed as a measure of physical function, with TBS in 141 older adults (65-84 yr, 72.5 +/- 5.1 yr, 74% women). Methodology: Assessments included lumbar spine (L1-L4) bone density and total body and trunk lean mass by DXA, lower body (leg press) and upper body (seated row) strength by one repetition maximum tests, hand grip strength, and usual gait speed. TBS was derived from the lumbar spine DXA scan. Multivariable linear regression determined the contribution of proposed predictors to TBS. Results: After adjusting for age, sex, and lumbar spine bone density, upper body strength significantly predicted TBS (unadjusted/adjusted R²= 0.16/ 0.11, β coefficient =0.378, p=0.005), while total body lean mass index showed a trend in the expected direction (β coefficient =0.243, p=0.053). Gait speed and grip strength were not associated with TBS (p>0.05). Conclusion: Maximum strength of primarily back muscles measured as the seated row appears important to bone quality as measured by TBS, independent of bone density. Additional research on exercise training targeting back strength is needed to determine its clinical utility in preventing vertebral fractures among older adults.

Purpose/Aims

FFNM aims to create a national network of fragility fracture care, with the participation of various clinical specialists, allied health and primary care physician from different states throughout Malaysia. Fracture Liaison Service (FLS) is a relatively new approach and platform promoting fragility fracture care in Malaysia.

Rationale/Background

The Fragility Fracture Network of Malaysia (FFNM) which was formed in 2018, is a national organization aiming to promote multidisciplinary input on the three pillars of fragility fracture care which include post- fracture acute care, post-fracture rehabilitation and secondary fracture prevention.

Brief Description of the Undertaking/Best Practice

FFNM FLS Framework functions as a systematic guide to achieve these goals. It provides a common platform for all FLS to work together for a successful outcome and sustainability. It highlights the rationale and importance of an FLS to all who are interested in the initiation of FLS in their practice. The Framework provides a guide on how to initiate a new FLS or improve an existing FLS in their practice. It also illustrates the different models of care available and the success stories of some regional and global FLS models as a guide. A Minimum Common Dataset (MCD) has been designed and added into the Framework in order to assist all the FLS in Malaysia to have standardized data captured for comparison and assessment of Key Performance Indicators (KPI) that is crucial to improve services and optimize the benefit for patients.

Outcomes achieved/documented

In 2017, there was only one FLS service available (Beacon Hospital). In 2022, four years FFNM was formed, there are twenty FLS services available throughout the country, with eight being mapped on the International Osteoporosis Foundation (IOF) Capture the Fracture World Map. By establishing a framework, guidelines and standard of best practice in managing various fragility fractures, our patients presenting with fragility fractures will be allowed to return to their best functional status possible.

Conclusions

FFNM FLS Framework has been recognized and accepted as the guide for all existing FLS services to improve their outcome and also for all potential FLS services to initiate their FLS services in their hospitals.

The bibliometric analysis assesses the productivity of scholarship in a given field and provides information on the frontiers of relevant developments. However, no bibliometric analysis study has quantitatively analyzed publications in geriatric sarcopenia therapies. This study investigates the scholarly productivity and frontiers of publications in geriatric sarcopenia therapies. The bibliometric data came from English-language Web of Science Core Collection articles published between 1995 and October 19, 2022. Three software programs, R version 3.5.6, VOSviewer, and CiteSpace, were applied for this bibliometric analysis. In twenty-eight years, the annual publications in geriatric sarcopenia therapies have increased yearly, with an annual growth rate of 21.23 %. A total of 1379 publications have been published. The United States was the country with the highest number of publication signatures (n=1,537) (including joint publication releases), followed by Japan (n=1099). Journal of Cachexia, Sarcopenia, and Muscle contributed the best journal publications (n=80). The newest hot subjects in the study about geriatric sarcopenia therapy include malnutrition, obesity, insulin resistance, and cancer. This bibliometric study presents a comprehensive overview of the current and future research directions in geriatric sarcopenia therapies over the past 28 years. Overall, this study has complemented the gaps in bibliometric analysis in geriatric sarcopenia therapies. This paper will provide a valuable reference for future research in geriatric sarcopenia therapies.

The main aim of the current study was to explore the effects of a 1-year recreational Kung Fu protocol on bone health parameters (bone mineral content (BMC), bone mineral density (BMD), femoral neck geometry and composite indices of femoral neck strength) in a group of healthy inactive young men. 54 young inactive men voluntarily participated in this study, but only 51 of them completed it. The participants were assigned to 2 different groups: control group (n=31) and Kung Fu group (n=20). The Kung Fu group performed two sessions of recreational Kung Fu per week; the duration of each session was 45 minutes. The current study has demonstrated that whole body (WB) BMC, ultra-distal (UD) radius BMD, 1/3 radius BMD, total radius BMD, total forearm BMD, maximal strength, maximum oxygen consumption and jumping performance increased in the Kung Fu group but not in the control group. The percentages of variations in WB BMC, forearm BMD and physical performance parameters were significantly different between the two groups. In conclusion, this study suggests that recreational Kung Fu is an effective method to improve WB BMC, forearm BMD and physical performance parameters in young inactive men.