Pub Date : 2023-07-01DOI: 10.1016/j.jocd.2023.101381
Kaixi Ding , Wei Jiang , Dingqi Li, Chaofang Lei, Chunping Xiong, Ming Lei
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.
{"title":"Bibliometric Analysis of Geriatric Sarcopenia Therapies: Highlighting Publication Trends and Leading-Edge Research Directions","authors":"Kaixi Ding , Wei Jiang , Dingqi Li, Chaofang Lei, Chunping Xiong, Ming Lei","doi":"10.1016/j.jocd.2023.101381","DOIUrl":"10.1016/j.jocd.2023.101381","url":null,"abstract":"<div><p><span>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 </span>sarcopenia<span><span> 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 </span>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.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9984583","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101418
Nour Khalil , Antonio Pinti , Rawad El Hage
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.
{"title":"The Effects of a 1-Year Recreational Kung Fu Protocol on Bone Health Parameters in a Group of Healthy Inactive Young Men","authors":"Nour Khalil , Antonio Pinti , Rawad El Hage","doi":"10.1016/j.jocd.2023.101418","DOIUrl":"10.1016/j.jocd.2023.101418","url":null,"abstract":"<div><p>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.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306155","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}
To investigate the correlation between the occurrence of G and C alleles at rs9340799 and rs2234693 of the ERα gene and the occurrence and development of bone metastasis and skeletal related events (such as bone pain, pathological fracture and osteoporosis) in HR+ breast cancer patients.
Rationale/Background
Endocrine therapy is the mainstay of treatment in HR+ breast cancers, accounting for about 70% of all breast cancers. The current literature identifies the most common metastatic site of HR+ breast cancer as the skeletal system (59.2%). A series of skeletal related events, such as bone pain, osteoporosis, hypercalcemia, and pathological fracture, have a significant impact on the life quality of breast cancer patients.However, there has been little progress in the diagnosis and treatment.ERα gene is related to the risk of breast cancer and advanced metastasis. Our previous studies showed that SNPs of the ERα gene indicated that patients with G and C alleles at rs9340799 and rs2234693 had a high incidence of abnormal bone metabolism. The effect of ERα SNPs on susceptibility to abnormal bone metabolism suggests that different gene subtypes lead to abnormal estrogen receptor function and destroy the balance of the microenvironment in bone. It is simply a natural attraction for tumor cells to induce the colonization of circulating tumor cells in bone tissue.
Methods
All subjects took AIs and came from Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine (2016.1-2017.12). Whole blood samples were collected for ERα gene DNA sequence information. Those who simultaneously contained G and C alleles were defined as group A, and those who did not contain G and C alleles or only contained a single site were defined as group B. Survival status, disease progression, and appearance time were recorded for both groups. Finally, 71 patients were followed up. Kaplan-Meier survival curves were drawn for the results and a single factor COX risk regression analysis was performed.
Results
Total follow-up duration was up to 182 months, and median follow-up was 89 months.① The K-M curve with skeletal related events as the primary endpoint was drawn for survival analysis, and the difference was statistically significant by Log-Rank test (P < 0.05). Median survival without skeletal related events in group A was 96.00 ± 12.53 months and 149.00 ± 40.92 months lower than in group B; there was no statistical difference in single factor COX risk assessment (P > 0.05). ② The K-M curve plotted with the occurrence of bone metastasis or disease progression as the primary endpoint showed a statistically significant difference by Log-Rank test (P < 0.05). The mean progression-free survival time in group A was shorter than in group B, 103.73 ± 5.23 months and 153.83 ± 12.65 months, respectively. The single factor COX risk assessment showed
{"title":"Survival Analysis of Skeletal Related Events in HR+ Breast Cancer Patients Based on Single NucleotidePolymorphism of ERα Gene","authors":"Yulian Yin (Primary Author), Yiwei Fan (Contributing Author), Meiling Chu (Contributing Author), Hongfeng Chen (Contributing Author)","doi":"10.1016/j.jocd.2023.101402","DOIUrl":"10.1016/j.jocd.2023.101402","url":null,"abstract":"<div><h3>Purpose/Aims</h3><p>To investigate the correlation between the occurrence of G and C alleles at rs9340799 and rs2234693 of the ERα gene and the occurrence and development of bone metastasis and skeletal related events (such as bone pain, pathological fracture and osteoporosis) in HR+ breast cancer patients.</p></div><div><h3>Rationale/Background</h3><p>Endocrine therapy is the mainstay of treatment in HR+ breast cancers, accounting for about 70% of all breast cancers. The current literature identifies the most common metastatic site of HR+ breast cancer as the skeletal system (59.2%). A series of skeletal related events, such as bone pain, osteoporosis, hypercalcemia, and pathological fracture, have a significant impact on the life quality of breast cancer patients.However, there has been little progress in the diagnosis and treatment.ERα gene is related to the risk of breast cancer and advanced metastasis. Our previous studies showed that SNPs of the ERα gene indicated that patients with G and C alleles at rs9340799 and rs2234693 had a high incidence of abnormal bone metabolism. The effect of ERα SNPs on susceptibility to abnormal bone metabolism suggests that different gene subtypes lead to abnormal estrogen receptor function and destroy the balance of the microenvironment in bone. It is simply a natural attraction for tumor cells to induce the colonization of circulating tumor cells in bone tissue.</p></div><div><h3>Methods</h3><p>All subjects took AIs and came from Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine (2016.1-2017.12). Whole blood samples were collected for ERα gene DNA sequence information. Those who simultaneously contained G and C alleles were defined as group A, and those who did not contain G and C alleles or only contained a single site were defined as group B. Survival status, disease progression, and appearance time were recorded for both groups. Finally, 71 patients were followed up. Kaplan-Meier survival curves were drawn for the results and a single factor COX risk regression analysis was performed.</p></div><div><h3>Results</h3><p>Total follow-up duration was up to 182 months, and median follow-up was 89 months.① The K-M curve with skeletal related events as the primary endpoint was drawn for survival analysis, and the difference was statistically significant by Log-Rank test (P < 0.05). Median survival without skeletal related events in group A was 96.00 ± 12.53 months and 149.00 ± 40.92 months lower than in group B; there was no statistical difference in single factor COX risk assessment (P > 0.05). ② The K-M curve plotted with the occurrence of bone metastasis or disease progression as the primary endpoint showed a statistically significant difference by Log-Rank test (P < 0.05). The mean progression-free survival time in group A was shorter than in group B, 103.73 ± 5.23 months and 153.83 ± 12.65 months, respectively. The single factor COX risk assessment showed","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46991305","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}
This study aims to evaluate the incidence of osteoporosis in patients with a BMI higher than 25 and to observe whether it offers a protective role against osteoporosis
Rationale/Background
The prevalence of obesity and the diagnosis of osteoporosis have accelerated over the past decade. The relationship between obesity and bone metabolism is complex and not well understood. Historically, obesity was thought to be protective against osteoporosis; however, several studies have challenged this belief. Even though a majority of the studies suggest that obesity has a favorable effect on bone density, it is unclear what effect obesity has on skeletal microarchitecture.
Methods
Researchers observed data from 388 patients from a community-based primary care clinic who had undergone screening for bone density or DEXA scan. The criteria for identifying individuals as having osteoporosis was based on International Osteoporosis Foundation criteria, which states that the threshold for qualification is a T-Score of less than or equal to -2.5 in one or more regions or the occurrence of a fragility fracture of the hip or vertebra. BMI values were recorded for the patients at the time of the bone density scan and patients were classified according to WHO weight criteria with underweight being a BMI less than 18.5 kg/m2, normal weight being a BMI between 18.5–24.9 kg/m2, and overweight being a BMI between 25.0–29.9 kg/m2. Of the 388 total patients, 134 were confirmed to have had osteoporosis based on the criteria.
Results
There were 134 patients who were diagnosed with osteoporosis, and the average age of a person in that group was 71 (70 for females and 81 for males). The average T-Score on a bone density scan for those individuals was -2.8. There was no preference for which region (lumbar vs. hip) was most affected within the group studied. Of the 134 patients screened for Osteoporosis, 21.6% (29/134) patients were of the ‘Obese’ BMI category, 31.3% of patients were of the ‘Overweight’ BMI category (42/134), and 23.8% (32/134) of patients were of the ‘Normal’ BMI category. Only two of the patients were underweight. Furthermore, the Chi- square test was used to evaluate Osteopenia and Osteoporosis as categories and the Obese, Overweight, Normal, and Underweight as groups. The p Value was set at 0.05, and the study found p-value to be 4.04.
The result is not significant.
Implications
From the data collected above, there appears to be no indication that obesity has a protective effect against osteoporosis. In fact, there was a higher incidence of osteoporosis in individuals with a BMI of 25 or higher when compared to other respective groups. Further studies, with a larger sample group, may be needed to effectively evaluate the relationship between BMI and osteoporosis.
{"title":"Relationship between Obesity and Osteoporosis","authors":"Madhu Pamganamamula M.D., BC-ADM, CDCES, CCD (Contributing Author CPI Program Director), Srinidhi Manchiraju MBBS (Primary Author), Harshavardhini Kommavarapu MBBS (Contributing Author), Gowtham Dronavalli MPA, MBA, MBBS (Contributing Author Clinical Administrator)","doi":"10.1016/j.jocd.2023.101403","DOIUrl":"10.1016/j.jocd.2023.101403","url":null,"abstract":"<div><h3>Purpose/Aims</h3><p>This study aims to evaluate the incidence of osteoporosis in patients with a BMI higher than 25 and to observe whether it offers a protective role against osteoporosis</p></div><div><h3>Rationale/Background</h3><p>The prevalence of obesity and the diagnosis of osteoporosis have accelerated over the past decade. The relationship between obesity and bone metabolism is complex and not well understood. Historically, obesity was thought to be protective against osteoporosis; however, several studies have challenged this belief. Even though a majority of the studies suggest that obesity has a favorable effect on bone density, it is unclear what effect obesity has on skeletal microarchitecture.</p></div><div><h3>Methods</h3><p>Researchers observed data from 388 patients from a community-based primary care clinic who had undergone screening for bone density or DEXA scan. The criteria for identifying individuals as having osteoporosis was based on International Osteoporosis Foundation criteria, which states that the threshold for qualification is a T-Score of less than or equal to -2.5 in one or more regions or the occurrence of a fragility fracture of the hip or vertebra. BMI values were recorded for the patients at the time of the bone density scan and patients were classified according to WHO weight criteria with underweight being a BMI less than 18.5 kg/m2, normal weight being a BMI between 18.5–24.9 kg/m2, and overweight being a BMI between 25.0–29.9 kg/m2. Of the 388 total patients, 134 were confirmed to have had osteoporosis based on the criteria.</p></div><div><h3>Results</h3><p>There were 134 patients who were diagnosed with osteoporosis, and the average age of a person in that group was 71 (70 for females and 81 for males). The average T-Score on a bone density scan for those individuals was -2.8. There was no preference for which region (lumbar vs. hip) was most affected within the group studied. Of the 134 patients screened for Osteoporosis, 21.6% (29/134) patients were of the ‘Obese’ BMI category, 31.3% of patients were of the ‘Overweight’ BMI category (42/134), and 23.8% (32/134) of patients were of the ‘Normal’ BMI category. Only two of the patients were underweight. Furthermore, the Chi- square test was used to evaluate Osteopenia and Osteoporosis as categories and the Obese, Overweight, Normal, and Underweight as groups. The p Value was set at 0.05, and the study found p-value to be 4.04.</p><p>The result is not significant.</p></div><div><h3>Implications</h3><p>From the data collected above, there appears to be no indication that obesity has a protective effect against osteoporosis. In fact, there was a higher incidence of osteoporosis in individuals with a BMI of 25 or higher when compared to other respective groups. Further studies, with a larger sample group, may be needed to effectively evaluate the relationship between BMI and osteoporosis.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41845408","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101416
Alok Tripathi , Aijaz A. John
{"title":"Removal Notice to ‘MiR-539-3p Inhibits Osteoblast Activity and Bone Formation in vivo Via Targeting LRP-’ [Journal of Clinical Densitometry 25/2 (2022) 279]","authors":"Alok Tripathi , Aijaz A. John","doi":"10.1016/j.jocd.2023.101416","DOIUrl":"10.1016/j.jocd.2023.101416","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988149","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}
This study aims to compare body composition measures between two different devices of latest generation: Horizon A SystemTM (Hologic, Waltham, MA, USA) and Lunar iDXATM (GE Healthcare, Madison, Wi, USA).
Rationale/Background
Dual-energy X-Ray Absorptiometry (DXA) is one of the reference techniques for the assessment of body composition thanks to its reliability, low irradiation, and the capacity to measure regional and total fat, lean and bone parameters. As DXA measurements vary among different devices, it is crucial to assess their similarities and differences.
Methods
Post-menopausal women from the 5th visit of the OsteoLaus cohort underwent total body DXA assessment with both devices in the same day, within one hour. Two technicians: one for Horizon A and one for Lunar iDXA performed all the scans. We compared total fat mass (TFM) and percent fat (TPF), total lean mass (TLM), appendicular lean mass (ALM), total bone mineral content (BMC) and density (BMD) between the two DXAs with T-test for means, correlation (r) and with a complete Bland Altman analysis (regression, constant agreement, relative agreement).
Results
805 participants were analyzed (age 72.9±6.8 years, BMI 25.5±4.5 kg/cm2). Compared to Lunar iDXA, Horizon A measures higher (p< 0.001) mean values for TFM +1418.1 g. (r=0.99), TPF +0.91% (r=0.99) and TLM +1090.3 g (r=0.96). Horizon A measures lower (p< 0.001) mean values for ALM -749.7 g. (r=0.97), BMC -216.3 g. (r=0.85) and BMD - 0.050g/cm2 (r=0.81). The Bland Altman analysis shows different relative and constant agreement for each comparison between the devices (cf. figures).
Implications
A trend of higher soft tissues values were seen for Horizon A SystemTM, and of bone for Lunar iDXATM. These results suggest the presence of systematic differences, calibration differences and potential confounders between these two devices. These between-devices differences might be particularly impactfull on the use of these parameters’ cut-offs in clinical setting. Further in-depth analysis with cross-calibration equations is planned. This effort is beneficial for the diagnosis and clinical follow-up of diseases that rely on DXA-derived parameters.
目的/目的本研究旨在比较两种最新一代不同设备:Horizon A SystemTM (Hologic, Waltham, MA, USA)和Lunar iDXATM (GE Healthcare, Madison, Wi, USA)之间的身体成分测量。原理/背景双能x射线吸收仪(DXA)是评估身体成分的参考技术之一，因为它的可靠性，低辐射，以及测量区域和总脂肪，瘦和骨参数的能力。由于DXA测量在不同的设备之间有所不同，因此评估它们的相似性和差异性至关重要。方法OsteoLaus队列第5次访问的绝经后妇女在同一天1小时内使用两种装置进行全身DXA评估。两名技术人员:一名负责地平线A，一名负责月球iDXA，负责所有的扫描工作。我们比较了两个DXAs之间的总脂肪量(TFM)和脂肪百分比(TPF)、总瘦质量(TLM)、阑尾瘦质量(ALM)、总骨矿物质含量(BMC)和密度(BMD)，采用均值t检验、相关性(r)和完整的Bland Altman分析(回归、恒定一致、相对一致)。结果共分析805名参与者(年龄72.9±6.8岁，BMI 25.5±4.5 kg/cm2)。与月球iDXA相比，地平线A测量值更高(p<0.001) TFM +1418.1 g (r=0.99)、TPF +0.91% (r=0.99)和TLM +1090.3 g (r=0.96)的平均值。地平线A测量较低(p<平均值为ALM -749.7 g. (r=0.97)， BMC -216.3 g. (r=0.85)和BMD - 0.050g/cm2 (r=0.81)。Bland Altman的分析表明，在设备之间的每次比较中，不同的相对一致性和恒定一致性(参见图表)。结论Horizon A SystemTM有较高软组织值的趋势，Lunar iDXATM有较高骨值的趋势。这些结果表明，这两种设备之间存在系统差异、校准差异和潜在的混杂因素。这些设备之间的差异可能对临床设置中这些参数截止值的使用特别有影响。计划使用交叉校准方程进行进一步深入分析。这一努力对依赖dxa衍生参数的疾病的诊断和临床随访是有益的。
{"title":"Body composition comparison between Horizon A System and Lunar iDXA: The OsteoLaus Cohort","authors":"Colin Vendrami MD, MSc MD-PhD Student (Primary Author) , Enisa Shevroja MD, PhD (Contributing Author) , Guillaume Gatineau MSc (Contributing Author) , Elena Gonzalez Rodriguez MD, PhD (Contributing Author) , Lamy Olivier Prof., MD, PhD (Contributing Author) , Didier Hans Prof., MD, PhD Professor (Contributing Author)","doi":"10.1016/j.jocd.2023.101386","DOIUrl":"10.1016/j.jocd.2023.101386","url":null,"abstract":"<div><h3>Purpose/Aims</h3><p>This study aims to compare body composition measures between two different devices of latest generation: Horizon A SystemTM (Hologic, Waltham, MA, USA) and Lunar iDXATM (GE Healthcare, Madison, Wi, USA).</p></div><div><h3>Rationale/Background</h3><p>Dual-energy X-Ray Absorptiometry (DXA) is one of the reference techniques for the assessment of body composition thanks to its reliability, low irradiation, and the capacity to measure regional and total fat, lean and bone parameters. As DXA measurements vary among different devices, it is crucial to assess their similarities and differences.</p></div><div><h3>Methods</h3><p>Post-menopausal women from the 5th visit of the OsteoLaus cohort underwent total body DXA assessment with both devices in the same day, within one hour. Two technicians: one for Horizon A and one for Lunar iDXA performed all the scans. We compared total fat mass (TFM) and percent fat (TPF), total lean mass (TLM), appendicular lean mass (ALM), total bone mineral content (BMC) and density (BMD) between the two DXAs with T-test for means, correlation (r) and with a complete Bland Altman analysis (regression, constant agreement, relative agreement).</p></div><div><h3>Results</h3><p>805 participants were analyzed (age 72.9±6.8 years, BMI 25.5±4.5 kg/cm2). Compared to Lunar iDXA, Horizon A measures higher (p< 0.001) mean values for TFM +1418.1 g. (r=0.99), TPF +0.91% (r=0.99) and TLM +1090.3 g (r=0.96). Horizon A measures lower (p< 0.001) mean values for ALM -749.7 g. (r=0.97), BMC -216.3 g. (r=0.85) and BMD - 0.050g/cm2 (r=0.81). The Bland Altman analysis shows different relative and constant agreement for each comparison between the devices (cf. figures).</p></div><div><h3>Implications</h3><p>A trend of higher soft tissues values were seen for Horizon A SystemTM, and of bone for Lunar iDXATM. These results suggest the presence of systematic differences, calibration differences and potential confounders between these two devices. These between-devices differences might be particularly impactfull on the use of these parameters’ cut-offs in clinical setting. Further in-depth analysis with cross-calibration equations is planned. This effort is beneficial for the diagnosis and clinical follow-up of diseases that rely on DXA-derived parameters.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44984191","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101390
Gayle Frazzetta MD, FAAFP
Case Description
Atypical Femur Fracture on Denosumab and Prednisone with Multiple Vertebral Compression Fractures, Frailty, and Diminishing Quality of Life CO is a 70yo female with end-stage O2 and steroid dependent COPD/asthma with multiple thoracic and lumbar compression fractures contributing/causing non-ambulatory status and impairment of ADL's. She was treated with denosumab(Prolia) 2011-2015 until atypical femur fracture (figure 1) and metatarsal fracture occurred. She was on risedronate(Actonel) prior to this, 2004-2007, until side effects of esophageal spasm/GI irritation occurred and therapy was discontinued. Teriparatide(Forteo) was offered after discontinuing denosumab however patient noted possibility of bone cancer and declined it.
Compression fracture bracing and walker to wheelchair transition occurred about 2 months prior to referral for treatment recommendations. PMH: osteoporosis, COPD, asthma, osteoarthritis, low back pain with scoliosis and kyphosis, hypertension, previous smoker-quit 2010 (+/-25 pack year hx), hypokalemia, ocular migraines PSH: femur repair, cataracts, tubal ligation Meds: lisinopril 40mg, prednisone 10mg alternating with 5mg qd, tiotropium inhaled, montelukast 10mg, symbicort 160/4.5 2 puffs bid, albuterol prn (uses daily), ipratropium/alb nebs bid prn, potassium chloride 20meq qd, fluticasone NS qHS, cetirizine 10mg bid, cyclobenzaprine 5mg prn, acetaminophen prn Supplements: multivitamin, glucosamine/chondroitin qd, Vit D 2000IU qd, Ca citrate/D 315-200 qd FamHX: mother: breast cancer & OP Social Hx: married, retired piano instructor, rare alcohol, attends pulmonary rehab 2x/week until recent compression fracture, now unable due to pain ROS: unintended weight loss, prednisone dependent x 10 years; unable to tolerate multiple attempts at prednisone taper, significant pain reported from new compression fracture with mobility impairment Imaging Studies XRays: Thoracic spine (2 months prior to eval)1. Scoliosis 2. Multilevel age- indeterminate compression fractures, T10-12. Estimated 50% vertebral body height loss, no change. Mild, anterior compression deformity L1, stable compared to 2018. 2 week follow-up X-ray to above:
1. New mild anterior compression deformity of L2 with approximately 15% vertebral height loss. 2. Unchanged T10-L1 compression fractures. 4mm anterolisthesis of L4 on L5 without change. DXA: recent; Hip T score, total -3.5, femoral neck -4.1, Spine (L1-4) T score -3.0 Comparison to study done 5 years prior: Hip: loss of 16.3%, spine: stable Labs: (Pertinent) Vitamin D 35, CBC:
{"title":"Atypical Femur Fracture on Denosumab and Prednisone with Multiple Vertebral Compression Fractures, Frailty and Diminishing Quality of Life","authors":"Gayle Frazzetta MD, FAAFP","doi":"10.1016/j.jocd.2023.101390","DOIUrl":"10.1016/j.jocd.2023.101390","url":null,"abstract":"<div><h3>Case Description</h3><p>Atypical Femur Fracture<span><span><span> on Denosumab and </span>Prednisone<span><span><span> with Multiple Vertebral Compression Fractures, </span>Frailty, and Diminishing </span>Quality of Life CO is a 70yo female with end-stage O2 and steroid dependent COPD/asthma with multiple thoracic and lumbar compression fractures contributing/causing non-ambulatory status and impairment of ADL's. She was treated with denosumab(Prolia) 2011-2015 until atypical femur fracture (figure 1) and </span></span>metatarsal fracture occurred. She was on risedronate(Actonel) prior to this, 2004-2007, until side effects of esophageal spasm/GI irritation occurred and therapy was discontinued. Teriparatide(Forteo) was offered after discontinuing denosumab however patient noted possibility of bone cancer and declined it.</span></p><p><span><span>Compression fracture bracing and walker to wheelchair transition occurred about 2 months prior to referral for treatment<span><span> recommendations. PMH: osteoporosis, COPD, asthma, </span>osteoarthritis<span><span>, low back pain with scoliosis and </span>kyphosis, hypertension, previous smoker-quit 2010 (+/-25 pack year hx), </span></span></span>hypokalemia<span><span><span>, ocular migraines PSH: femur repair, cataracts, </span>tubal ligation Meds: </span>lisinopril<span><span> 40mg, prednisone 10mg alternating with 5mg qd, tiotropium inhaled, montelukast 10mg, </span>symbicort<span><span><span> 160/4.5 2 puffs bid, albuterol </span>prn (uses daily), ipratropium/alb </span>nebs<span> bid prn, potassium chloride 20meq qd, </span></span></span></span></span>fluticasone<span><span><span> NS qHS, cetirizine<span> 10mg bid, cyclobenzaprine 5mg prn, acetaminophen prn Supplements: </span></span>multivitamin, glucosamine/chondroitin qd, Vit D 2000IU qd, Ca citrate/D 315-200 qd FamHX: mother: breast cancer & OP Social Hx: married, retired piano instructor, rare alcohol, attends pulmonary rehab 2x/week until recent compression fracture, now unable due to pain </span>ROS<span><span>: unintended weight loss, prednisone dependent x 10 years; unable to tolerate multiple attempts at prednisone taper, significant pain reported from new compression fracture with mobility impairment Imaging Studies XRays: Thoracic spine (2 months prior to eval)1. Scoliosis 2. Multilevel age- indeterminate compression fractures, T10-12. Estimated 50% </span>vertebral body height loss, no change. Mild, anterior compression deformity L1, stable compared to 2018. 2 week follow-up X-ray to above:</span></span></p><p><span><span>1. New mild anterior compression deformity of L2 with approximately 15% vertebral height loss. 2. Unchanged T10-L1 compression fractures. 4mm anterolisthesis of L4 on L5 without change. DXA: recent; Hip T score, total -3.5, </span>femoral neck -4.1, Spine (L1-4) T score -3.0 Comparison to study done 5 years prior: Hip: loss of 16.3%, spine: stable Labs: (Pertinent) </span>Vitamin D<span><span> 35, CBC: ","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47933263","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101397
Neil P. Sheth MD (Contributing Author) , Renaud Winzenrieth PhD (Contributing Author) , Ludovic Humbert PhD (Contributing Author) , Paul J. Kostenuik PhD (Contributing Author) , Yamei Wang PhD (Contributing Author) , John I. Boxberger PhD (Primary Author) , Mathias P. Bostrom MD (Contributing Author)
Purpose/Aims
We hypothesized that local improvements in bone mineral density (BMD) would be observed following 6 and 18 mo of abaloparatide versus placebo in hip regions corresponding to femoral Gruen zones that influence the fixation and stability of femoral stems in hip arthroplasty.
Rationale/Background
Low BMD at the time of total hip arthroplasty (THA) increases the risk of compromised implant stability and delayed osseointegration (1). Abaloparatide, a synthetic analog to PTHrP(1-34), is FDA approved for the treatment of men and postmenopausal women with osteoporosis. Abaloparatide increases spine and hip BMD and reduces the risk of vertebral and nonvertebral fractures (2).
Methods
A subset of 500 postmenopausal women with osteoporosis from the ACTIVE trial (2) who received abaloparatide or placebo (n=250/group) were randomly selected. Hip DXA scans obtained after 6 and 18 mo of treatment underwent 3D modeling via 3D-Shaper software (3), and a virtual Stryker (Mahwah, NJ) Accolade II hip stem was optimally sized and positioned within each 3D-DXA scan. Periprosthetic regions corresponding to Gruen zones 1, 2, 6, and 7 were assessed for volumetric BMD (vBMD) (integral, cortical, trabecular) and cortical thickness (zones 3, 4, and 5 were beyond the DXA region of interest). Treatment comparisons were made with P values derived from a mixed-effect model for repeated measures.
Results
Abaloparatide significantly increased integral vBMD compared with placebo in Gruen zones 1, 2, 6, and 7 at 6 and 18 mo (P< 0.01 for all) (Table 1). The largest percent increases were in zones 1 and 7. Abaloparatide increased cortical vBMD at 18 mo in all 4 analyzed zones (P< 0.01), increased trabecular vBMD at 6 and 18 mo in zones 1 and 7 (P< 0.0001), and increased cortical thickness at 6 months in zones 1, 6, and 7 (P< 0.01) and in all zones at 18 months (P< 0.001). Color maps of cross-sectional group mean change in vBMD demonstrates more robust BMD accrual with abaloparatide (Figure 1).
Implications
Abaloparatide significantly increased vBMD and cortical thickness in virtual Gruen zones 1, 2, 6, and 7 compared with placebo. Abaloparatide may represent an effective agent for bone health optimization prior to THA by inducing orthopedically important localized gains in BMD. Additional research into preoperative augmentation and postoperative treatment is warranted. References: 1. Aro HT et al. Acta Orthop 2012;83;107-14; 2. Miller PD et al. JAMA 2017;317:442; 3. Winzenrieth R et al. Osteoporos Int 2021;32:575–83.
{"title":"Abaloparatide Increases Bone Mineral Density in Regions Corresponding to Gruen Zones 1, 2, 6, and 7 in Postmenopausal Women With Osteoporosis","authors":"Neil P. Sheth MD (Contributing Author) , Renaud Winzenrieth PhD (Contributing Author) , Ludovic Humbert PhD (Contributing Author) , Paul J. Kostenuik PhD (Contributing Author) , Yamei Wang PhD (Contributing Author) , John I. Boxberger PhD (Primary Author) , Mathias P. Bostrom MD (Contributing Author)","doi":"10.1016/j.jocd.2023.101397","DOIUrl":"10.1016/j.jocd.2023.101397","url":null,"abstract":"<div><h3>Purpose/Aims</h3><p>We hypothesized that local improvements in bone mineral density (BMD) would be observed following 6 and 18 mo of abaloparatide<span> versus placebo in hip regions corresponding to femoral Gruen zones that influence the fixation and stability of femoral stems in hip arthroplasty.</span></p></div><div><h3>Rationale/Background</h3><p>Low BMD at the time of total hip arthroplasty (THA) increases the risk of compromised implant stability and delayed osseointegration<span><span> (1). Abaloparatide, a synthetic analog to PTHrP(1-34), is FDA approved for the treatment of men and </span>postmenopausal women<span> with osteoporosis. Abaloparatide increases spine and hip BMD and reduces the risk of vertebral and nonvertebral fractures (2).</span></span></p></div><div><h3>Methods</h3><p>A subset of 500 postmenopausal women with osteoporosis from the ACTIVE trial (2) who received abaloparatide or placebo (n=250/group) were randomly selected. Hip DXA scans obtained after 6 and 18 mo of treatment underwent 3D modeling via 3D-Shaper software (3), and a virtual Stryker (Mahwah, NJ) Accolade II hip stem was optimally sized and positioned within each 3D-DXA scan. Periprosthetic regions corresponding to Gruen zones 1, 2, 6, and 7 were assessed for volumetric BMD (vBMD) (integral, cortical, trabecular) and cortical thickness (zones 3, 4, and 5 were beyond the DXA region of interest). Treatment comparisons were made with P values derived from a mixed-effect model for repeated measures.</p></div><div><h3>Results</h3><p>Abaloparatide significantly increased integral vBMD compared with placebo in Gruen zones 1, 2, 6, and 7 at 6 and 18 mo (P< 0.01 for all) (Table 1). The largest percent increases were in zones 1 and 7. Abaloparatide increased cortical vBMD at 18 mo in all 4 analyzed zones (P< 0.01), increased trabecular vBMD at 6 and 18 mo in zones 1 and 7 (P< 0.0001), and increased cortical thickness at 6 months in zones 1, 6, and 7 (P< 0.01) and in all zones at 18 months (P< 0.001). Color maps of cross-sectional group mean change in vBMD demonstrates more robust BMD accrual with abaloparatide (Figure 1).</p></div><div><h3>Implications</h3><p>Abaloparatide significantly increased vBMD and cortical thickness in virtual Gruen zones 1, 2, 6, and 7 compared with placebo. Abaloparatide may represent an effective agent for bone health optimization prior to THA by inducing orthopedically important localized gains in BMD. Additional research into preoperative augmentation and postoperative treatment is warranted. References: 1. Aro HT et al. Acta Orthop 2012;83;107-14; 2. Miller PD et al. JAMA 2017;317:442; 3. Winzenrieth R et al. Osteoporos Int 2021;32:575–83.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41901092","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101387
Jonathan Bennett MS (Primary Author) , Michael Wong PhD (Contributing Author) , Carla Prado (Contributing Author) , Steven Heymsfield MD (Contributing Author) , John Shepherd PhD (Contributing Author)
Beyond overall obesity, VAT storage is associated with adverse metabolic parameters that increase the risk of heart disease, stroke, and type II diabetes. Computed tomography (CT) and magnetic resonance imaging (MRI) technologies have been used to define thresholds of VAT associated with MetS, however these techniques are of limited availability for clinical risk assessment. Dual energy X-ray absorptiometry (DXA) is accurate compared to VAT measures from CT and MRI, however differences in scanning region and algorithms results in device-specific VAT estimates. We recently generated cross-calibration equations for DXA systems, allowing DXA measures to be compared to CT and MRI and providing more access to VAT assessments for the determination of VAT thresholds as well as the ability to assess presence of “risky” VAT levels in clinical practice. The purpose of this review was to identify published studies defining VAT thresholds to determine characteristics that define the “risky” threshold.
Methods
We identified previously published studies establishing VAT thresholds associated with increased cardiometabolic risk, obtained using CT, MRI, and DXA imaging technologies. We compared characteristics of these studies to determine the factors necessary to identify “risky” VAT thresholds.
Results
We identified 46 studies that derived VAT-specific thresholds associated with MetS in adults, published across populations with diverse sample size, age, and ethnicity. Lower average VAT as well as risk thresholds were found in females. When stratified by age or menopausal status, lower VAT thresholds were primarily observed in lower age or premenopausal categories. Values varied across ethnicities, with level thresholds often lower in Asian populations (70- 136 cm2) compared to Caucasian (85.6-165.9 cm2) and other populations. A universal VAT threshold is not yet feasible, supporting the need for more population-specific thresholds to identify increased MetS risk.
Implications
Excess VAT accumulation above a certain threshold is strongly linked to MetS risk, however the need for age-, sex- and ethnic-specific thresholds in necessary. The development of thresholds based on sex is necessary to reduce the risk of underestimation of “risky” VAT in females. Additionally, these findings suggest that different adipose tissue regions may have differential effects on metabolic disease risk among race/ethnic groups.
{"title":"Medical imaging measurement of visceral adipose tissue thresholds associated with increased risk of cardiometabolic disease","authors":"Jonathan Bennett MS (Primary Author) , Michael Wong PhD (Contributing Author) , Carla Prado (Contributing Author) , Steven Heymsfield MD (Contributing Author) , John Shepherd PhD (Contributing Author)","doi":"10.1016/j.jocd.2023.101387","DOIUrl":"https://doi.org/10.1016/j.jocd.2023.101387","url":null,"abstract":"<div><h3>Purpose/Aims</h3><p>Identify visceral adipose tissue (VAT) thresholds associated with increased cardiometabolic disease risk.</p></div><div><h3>Rationale/Background</h3><p>Beyond overall obesity, VAT storage is associated with adverse metabolic parameters that increase the risk of heart disease, stroke, and type II diabetes. Computed tomography (CT) and magnetic resonance imaging (MRI) technologies have been used to define thresholds of VAT associated with MetS, however these techniques are of limited availability for clinical risk assessment. Dual energy X-ray absorptiometry (DXA) is accurate compared to VAT measures from CT and MRI, however differences in scanning region and algorithms results in device-specific VAT estimates. We recently generated cross-calibration equations for DXA systems, allowing DXA measures to be compared to CT and MRI and providing more access to VAT assessments for the determination of VAT thresholds as well as the ability to assess presence of “risky” VAT levels in clinical practice. The purpose of this review was to identify published studies defining VAT thresholds to determine characteristics that define the “risky” threshold.</p></div><div><h3>Methods</h3><p>We identified previously published studies establishing VAT thresholds associated with increased cardiometabolic risk, obtained using CT, MRI, and DXA imaging technologies. We compared characteristics of these studies to determine the factors necessary to identify “risky” VAT thresholds.</p></div><div><h3>Results</h3><p>We identified 46 studies that derived VAT-specific thresholds associated with MetS in adults, published across populations with diverse sample size, age, and ethnicity. Lower average VAT as well as risk thresholds were found in females. When stratified by age or menopausal status, lower VAT thresholds were primarily observed in lower age or premenopausal categories. Values varied across ethnicities, with level thresholds often lower in Asian populations (70- 136 cm2) compared to Caucasian (85.6-165.9 cm2) and other populations. A universal VAT threshold is not yet feasible, supporting the need for more population-specific thresholds to identify increased MetS risk.</p></div><div><h3>Implications</h3><p>Excess VAT accumulation above a certain threshold is strongly linked to MetS risk, however the need for age-, sex- and ethnic-specific thresholds in necessary. The development of thresholds based on sex is necessary to reduce the risk of underestimation of “risky” VAT in females. Additionally, these findings suggest that different adipose tissue regions may have differential effects on metabolic disease risk among race/ethnic groups.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49737306","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 : 2023-07-01DOI: 10.1016/j.jocd.2023.101369
John A. Shepherd
The International Society for Clinical Densitometry convenes a Position Development Conference (PDC) every 2 to 3 years to make recommendations for guidelines and standards in the field of musculoskeletal measurement and assessment. The recommendations pertain to clinically relevant issues regarding the acquisition, quality control, interpretation, and reporting of measures of various aspects of musculoskeletal health. These PDCs have been meeting since 2002 and have generated 214 Adult, 26 FRAX, 41 pediatric, and 9 general nomenclature consideration positions, for a total of 290 positions. All positions are justified by detailed documents that present the background and rationale for each position. However, the linkage to these publications is not maintained by the ISCD or any other publication such that physicians cannot easily understand the etiology of the positions. Further, the wording of many positions has changed over the years after being reviewed by subsequent PDCs. This scoping review captures the references, changes, and timeline associated with each position through the 2019 PDC. It is meant to serve as a guide to clinicians and researchers for intelligent use and application of the positions.
{"title":"Positions of The International Society for Clinical Densitometry and Their Etiology: A Scoping Review","authors":"John A. Shepherd","doi":"10.1016/j.jocd.2023.101369","DOIUrl":"10.1016/j.jocd.2023.101369","url":null,"abstract":"<div><p>The International Society for Clinical Densitometry<span><span> convenes a Position Development Conference (PDC) every 2 to 3 years to make recommendations for guidelines and standards in the field of musculoskeletal measurement and assessment. The recommendations pertain to clinically relevant issues regarding the acquisition, quality control, interpretation, and reporting of measures of various aspects of musculoskeletal health<span>. These PDCs have been meeting since 2002 and have generated 214 Adult, 26 FRAX, 41 </span></span>pediatric, and 9 general nomenclature consideration positions, for a total of 290 positions. All positions are justified by detailed documents that present the background and rationale for each position. However, the linkage to these publications is not maintained by the ISCD or any other publication such that physicians cannot easily understand the etiology of the positions. Further, the wording of many positions has changed over the years after being reviewed by subsequent PDCs. This scoping review captures the references, changes, and timeline associated with each position through the 2019 PDC. It is meant to serve as a guide to clinicians and researchers for intelligent use and application of the positions.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930512","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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