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Diagnostic accuracy of axial and sagittal CT measurements for osteoporosis: A multi-vertebra evaluation 轴位和矢状位CT测量对骨质疏松症的诊断准确性:多椎体评估
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-06-02 DOI: 10.1016/j.jocd.2025.101596
Sevde Nur Emir, Ahmet Kürşat Soydan, Safiye Sanem Dereli Bulut
Background: This study aims to assess the diagnostic accuracy of axial and sagittal CT-derived Hounsfield Unit (HU) values in identifying osteopenia and osteoporosis. Additionally, it investigates whether the combination of multiple vertebral levels enhances predictive performance compared to single-level assessments.
Methodology: This retrospective study included 346 patients from who underwent both dual-energy X-ray absorptiometry (DXA) and non-contrast thoracic computed tomography (CT) scans within a 6-month interval. Axial and sagittal HU measurements were obtained from key vertebral levels, including T4, T7, T10, T12, and L1. Logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the diagnostic performance of individual and combined vertebral models. Patients with vertebral metastases, hemangiomas, compression fractures, or severe deformities were excluded.
Results: The sagittal T4 vertebra measurement achieved the highest individual AUC (0.810), indicating strong diagnostic potential. Combining T4 and L1 measurements improved the AUC to 0.828, while a six-vertebra model yielded a slightly higher AUC of 0.844. Despite this marginal improvement, simpler two-vertebra models offer practical advantages in clinical settings. Optimal cut-off values were determined using Youden’s Index, with T4S at 164 HU and L1S at 133 HU, both showing high specificity but moderate sensitivity.
Conclusions: Axial and sagittal CT measurements, particularly at T4 and L1 levels, demonstrate strong potential for diagnosing osteopenia and osteoporosis. Combining multiple vertebral levels offers improved predictive accuracy, although simpler models remain effective. Opportunistic CT screening, utilizing scans performed for other clinical purposes, provides a practical and cost-effective alternative to DXA, enabling early intervention and comprehensive osteoporosis management.
背景:本研究旨在评估轴向和矢状位ct衍生的Hounsfield Unit (HU)值在识别骨质减少和骨质疏松症中的诊断准确性。此外,它还研究了与单水平评估相比,多个椎体水平的组合是否能提高预测性能。方法:这项回顾性研究包括346名患者,他们在6个月内接受了双能x线吸收仪(DXA)和胸部非对比计算机断层扫描(CT)扫描。轴向和矢状面HU测量来自关键椎体水平,包括T4、T7、T10、T12和L1。采用Logistic回归和受试者工作特征(ROC)分析来评估单个和联合椎体模型的诊断性能。排除有椎体转移、血管瘤、压缩性骨折或严重畸形的患者。结果:矢状面T4椎体测量个体AUC最高(0.810),具有较强的诊断潜力。结合T4和L1测量使AUC提高到0.828,而六椎体模型的AUC略高,为0.844。尽管有这种微小的改进,但更简单的双椎体模型在临床环境中具有实际优势。使用约登指数确定最佳临界值,T4S为164 HU, L1S为133 HU,均具有高特异性,但敏感性中等。结论:轴位和矢状位CT测量,特别是T4和L1水平,显示出诊断骨质减少和骨质疏松症的强大潜力。虽然简单的模型仍然有效,但结合多个椎体水平可以提高预测准确性。机会性CT筛查,利用其他临床目的的扫描,为DXA提供了实用和经济的替代方案,实现了早期干预和全面的骨质疏松症管理。
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引用次数: 0
Comparison of Body Composition Estimates in Hispanic Women by Dual-Energy X-ray Absorptiometry and Hydrostatic Densitometry 用双能x线吸收仪和静压密度仪估算西班牙裔妇女身体成分的比较
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-05-13 DOI: 10.1016/j.jocd.2025.101595
Sarah E. Deemer , Diana E. Kolb , Nicole L. Cipriano , Daniel L. Smith , George A. King
Introduction: Accurate assessment of body composition is critical for understanding health risks and developing appropriate interventions, particularly in underrepresented populations. The purpose of this study was to compare the body composition estimate (% body fat [%BF]) between dual-energy x-ray absorptiometry (DXA) and hydrodensitometry via hydrostatic weighing (HW) in a group of Hispanic pre-menopausal women.
Methodology: Healthy Hispanic women (n=78, age: 22–51 years, BMI: 18.5–42.5) were measured for body composition by DXA and HW at a single lab visit. %BF from HW was calculated from body density using three commonly used adult-specific equations (2-component [2-C] Siri, 2-C Brozek, 3-component [3-C] Lohman) and a 2-C Hispanic-specific equation. Comparisons between the two methods (DXA and HW) were analyzed using paired t-tests, and linear regression and Bland-Altman plots were used to assess agreement between the two methods.
Results: %BF was significantly higher by DXA compared to all four HW equations (P < 0.01). Based on regression analyses the mean difference scores were not different from zero for all estimates of %BF.
Conclusions: While DXA and HW are both common laboratory measures for determining %BF, given the time-efficiency, minimal participant effort, and high precision, %BF estimation by DXA appears to be an adequate and sufficient method of measurement of body composition in Hispanic women.
引言:准确评估身体成分对于了解健康风险和制定适当的干预措施至关重要,特别是在代表性不足的人群中。本研究的目的是比较一组西班牙裔绝经前妇女双能x线吸收仪(DXA)和液体静力称重(HW)的体成分估计值(体脂% [%BF])。方法:健康的西班牙裔女性(n=78,年龄:22-51岁,BMI: 18.5-42.5)在单次实验室访问时通过DXA和HW测量身体成分。根据体密度,采用三种常用的成人特异性方程(2组分[2-C] Siri, 2组分[2-C] Brozek, 3组分[3-C] Lohman)和2组分[3-C]西班牙裔特异性方程计算BF %。使用配对t检验分析两种方法(DXA和HW)之间的比较,并使用线性回归和Bland-Altman图来评估两种方法之间的一致性。结果:与所有四种HW方程相比,DXA显著提高了BF % (P <;0.01)。基于回归分析,对于所有%BF的估计,平均差异分数与零没有差异。结论:虽然DXA和HW都是确定%BF的常用实验室测量方法,但考虑到时间效率、最小的参与者努力和高精度,DXA估计%BF似乎是西班牙裔女性身体成分测量的适当和充分的方法。
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引用次数: 0
Pediatric Lateral Distal Femur Reference Ranges for Ages 1 to 18 years 1至18岁儿童股骨外侧远端参考范围
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-05-07 DOI: 10.1016/j.jocd.2025.101594
Babette S. Zemel , John A. Shepherd , Laila Kazemi , Andrea Kelly , Virginia A. Stallings , Heidi Kecskemethy , David R. Weber , Halley Wasserman , Heidi J. Kalkwarf
Introduction: Many children with musculoskeletal disorders are at high risk of fracture, and the lateral distal femur (LDF) may be the only feasible site to measure bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA). Pediatric reference ranges and adjustment for linear growth are needed to interpret BMD results.
Methods: Lateral distal femur scans by DXA were obtained on children, ages 1 to 18 y, from two clinical centers. Precision in young children was estimated from duplicate scans. Smoothed reference ranges for three regions of the LDF were generated. Prediction equations were developed to account for the effects of short or tall stature on BMD.
Results: We obtained >2400 measurements on 1,245 children and generated reference ranges for three LDF BMD regions. Precision of BMD was similar (% CV of 1.33 to 2.42 %) to estimates reported at other skeletal sites. Modest sex differences were observed, with females having greater BMD than males at older ages. Children identified as Black had greater BMD than children identified as Non-Black. Height-for-age Z-scores were associated with BMD-for-age Z-scores in pre- and peri-pubertal children, and adjustment equations were generated.
Conclusions: This study fills substantial gaps in pediatric bone health assessment for children with musculoskeletal disorders who are at high-risk of fracture by providing smoothed reference ranges for ages 1 to 18 y and equations to estimate the impact of small body size on BMD-for-age Z-scores.
导读:许多患有肌肉骨骼疾病的儿童骨折风险高,股骨外侧远端(LDF)可能是双能x线骨密度仪(DXA)测量骨矿物质密度(BMD)的唯一可行部位。需要儿童参考范围和线性生长调整来解释骨密度结果。方法:通过DXA对来自两个临床中心的1至18岁的儿童进行外侧股骨远端扫描。通过重复扫描估计幼儿的精确度。生成了LDF的三个区域的平滑参考范围。开发了预测方程来解释矮或高的身材对骨密度的影响。结果:我们对1245名儿童进行了2400次测量,并生成了三个LDF BMD区域的参考范围。BMD的精度与其他骨骼部位的估计相似(% CV为1.33至2.42 %)。观察到适度的性别差异,老年女性的骨密度高于男性。黑人儿童的骨密度高于非黑人儿童。在青春期前和青春期周围儿童中,身高年龄z分数与骨密度年龄z分数相关,并生成调整方程。结论:本研究通过提供1 - 18岁的平滑参考范围和估算小体型对年龄骨密度z分数影响的方程,填补了骨折高危肌肉骨骼疾病儿童骨骼健康评估的实质性空白。
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引用次数: 0
Sprinting performance correlates with composite indices of femoral neck strength in middle-aged active men 中年运动男性短跑成绩与股骨颈力量综合指标相关
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-04-04 DOI: 10.1016/j.jocd.2025.101586
Ibrahim Fayad , Antonio Pinti , Hassane Zouhal , Rawad El Hage
The aim of the current study was to explore the relationships between 20-meter sprinting time and composite indices of femoral neck strength (compression strength index (CSI), bending strength index (BSI) and impact strength index (ISI)) in a group of middle-aged active men. 50 middle-aged active men voluntarily participated in this study. Their mean age was 45 ± 8.6 years. Body composition, total hip bone mineral density (TH BMD) and femoral neck bone mineral density (FN BMD) were evaluated by DXA. Sprinting time was negatively correlated to CSI (r = −0.52; p < 0.001), BSI (r = −0.43; p < 0.01) and ISI (r = −0.47; p < 0.001). The significant correlations between sprinting time and composite indices of femoral neck strength (CSI, BSI and ISI) remained significant after controlling for body weight, age and maximum oxygen consumption using multiple linear regressions. In conclusion, the current study suggests that sprinting performance (m/sec) is a positive determinant of CSI, BSI and ISI in middle-aged men.
本研究旨在探讨 20 米短跑时间与股骨颈强度综合指数(压缩强度指数(CSI)、弯曲强度指数(BSI)和冲击强度指数(ISI))之间的关系。50 名中年男性运动员自愿参加了此次研究。他们的平均年龄为 45 ± 8.6 岁。通过 DXA 评估了身体成分、全髋骨矿物质密度(TH BMD)和股骨颈骨矿物质密度(FN BMD)。短跑时间与 CSI(r = -0.52;p <;0.001)、BSI(r = -0.43;p <;0.01)和 ISI(r = -0.47;p <;0.001)呈负相关。在使用多重线性回归控制体重、年龄和最大耗氧量后,短跑时间与股骨颈力量综合指数(CSI、BSI 和 ISI)之间的显着相关性仍然显着。总之,本研究表明,短跑成绩(米/秒)对中年男性的 CSI、BSI 和 ISI 有积极的决定作用。
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引用次数: 0
Analysis of Changes in Bone Mineral Density by Disability Level in Patients with Myotonic Dystrophy Myopathy 强直性肌营养不良肌病患者骨密度随残疾程度变化的分析
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-04-01 DOI: 10.1016/j.jocd.2025.101584
Askeri Türken , Haşim Çapar
Purpose/introduction: The aim of this study was to determine which method can determine bone mineral changes in patients with Myotonic Dystrophy at an early age by applying age classification and Modified Rankin Scale for Neurological Disability (MRSND).
Methods: This descriptive, cross-sectional and retrospective study was conducted in 52 myopathy patients diagnosed with myotonic dystrophy. Analyses were performed using SPSS 25 and STATA 14. Frequency and percentage, mean and standard deviation values were reported and Pearson correlation, t-test, ANOVA and multiple linear regression analyses were performed. Confidence levels of 0.10, 0.05 and 0.01. The study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines for reporting cross-sectional studies (STROBE CHECKLIST).
Results: According to the regression analysis results, body mass index had a positive effect on Femoral Z Score (p < 0.01). In addition, vitamin D had a positive effect on Femoral Z Score (p < 0.05). On the other hand, MRSND had a negative effect on Femoral Z Score (p < 0.01).
Conclusion: Myotonic dystrophic myopathy has been shown to impair the mineral structure of bone. Patients with this condition have been shown to recognize possible changes in their bones earlier in using the MRSND scale.
目的/简介:本研究的目的是通过年龄分类和改良Rankin神经功能障碍量表(MRSND)来确定哪种方法可以确定肌强张性营养不良患者早期骨矿物质的变化。方法:对52例诊断为强直性肌营养不良的肌病患者进行描述性、横断面和回顾性研究。采用SPSS 25和STATA 14进行分析。报告频率和百分比、均值和标准差值,并进行Pearson相关、t检验、方差分析和多元线性回归分析。置信水平为0.10、0.05和0.01。本研究符合加强流行病学观察性研究报告(STROBE)声明横断面研究报告指南(STROBE CHECKLIST)。结果:根据回归分析结果,体重指数对股骨Z评分有正向影响(p <; 0.01)。此外,维生素D对股骨Z评分有正向影响(p <; 0.05)。另一方面,MRSND对股骨Z评分有负向影响(p <; 0.01)。结论:肌强直性营养不良肌病已被证明会损害骨的矿物质结构。患有这种疾病的患者在使用MRSND量表时可以更早地识别出骨骼可能发生的变化。
{"title":"Analysis of Changes in Bone Mineral Density by Disability Level in Patients with Myotonic Dystrophy Myopathy","authors":"Askeri Türken ,&nbsp;Haşim Çapar","doi":"10.1016/j.jocd.2025.101584","DOIUrl":"10.1016/j.jocd.2025.101584","url":null,"abstract":"<div><div><em>Purpose/introduction:</em> The aim of this study was to determine which method can determine bone mineral changes in patients with Myotonic Dystrophy at an early age by applying age classification and Modified Rankin Scale for Neurological Disability (MRSND).</div><div><em>Methods:</em> This descriptive, cross-sectional and retrospective study was conducted in 52 myopathy patients diagnosed with myotonic dystrophy. Analyses were performed using SPSS 25 and STATA 14. Frequency and percentage, mean and standard deviation values were reported and Pearson correlation, t-test, ANOVA and multiple linear regression analyses were performed. Confidence levels of 0.10, 0.05 and 0.01. The study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines for reporting cross-sectional studies (STROBE CHECKLIST).</div><div><em>Results:</em> According to the regression analysis results, body mass index had a positive effect on Femoral Z Score (<em>p</em> &lt; 0.01). In addition, vitamin D had a positive effect on Femoral Z Score (<em>p</em> &lt; 0.05). On the other hand, MRSND had a negative effect on Femoral Z Score (<em>p</em> &lt; 0.01).</div><div><em>Conclusion:</em> Myotonic dystrophic myopathy has been shown to impair the mineral structure of bone. Patients with this condition have been shown to recognize possible changes in their bones earlier in using the MRSND scale.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101584"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation of Lean Mass Measurements Between a Novel Whole-body X-ray Bone Densitometer (iNSiGHT C510) and Magnetic Resonance Imaging: A Single-center Comparative study 新型全身x线骨密度仪(iNSiGHT C510)与磁共振成像之间瘦质量测量的相关性:单中心比较研究
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-03-26 DOI: 10.1016/j.jocd.2025.101585
Yong-Chan Ha , Shinjune Kim , Jun-Il Yoo
Background: Sarcopenia, the age-related loss of muscle mass, increases health risks in older adults. Accurate measurement of skeletal muscle mass is critical for diagnosis. While DEXA is widely used, its extended scan time limits clinical utility. This study evaluates the accuracy of lean mass measurements from the newly developed iNSiGHT C510 X-ray bone densitometer compared to MRI, the gold standard.
Methods: This single-center, open-label clinical trial included 20 adult participants (10 males, 10 females) aged 20–70 years. Participants underwent whole-body scans using the iNSiGHT C510 and MRI. Lean and fat mass measurements were obtained from both devices. Statistical analysis included Bland-Altman plots, intraclass correlation coefficients (ICC), and concordance correlation coefficients (CCC) to assess agreement between the two methods. Linear regression analysis was performed to derive conversion formulas between C510 and MRI measurements.
Results: The study found a very strong correlation between lean mass measurements from the iNSiGHT C510 and MRI, with correlation coefficients (r) of 0.961 for the right side, 0.967 for the left, and 0.963 for combined lean mass. ICC and CCC values for lean mass were also high, indicating strong agreement between the two methods. Fat mass measurements, though moderately correlated, showed larger discrepancies compared to lean mass. The iNSiGHT C510 significantly reduced measurement time by 50 % compared to conventional DEXA scans.
Conclusion: The iNSiGHT C510 demonstrated high accuracy in measuring lean mass compared to MRI, with the added benefit of shorter measurement time, making it a practical tool for sarcopenia diagnosis and monitoring in clinical settings. However, further research with larger sample sizes and long-term assessments is needed to validate its broader clinical utility.
背景:骨骼肌减少症,与年龄相关的肌肉质量损失,增加了老年人的健康风险。准确测量骨骼肌质量对诊断至关重要。虽然DEXA被广泛使用,但其延长的扫描时间限制了临床应用。本研究评估了新开发的iNSiGHT C510 x射线骨密度仪与MRI(金标准)相比的瘦质量测量的准确性。方法:这项单中心、开放标签的临床试验包括20名年龄在20 - 70岁之间的成人受试者(10男10女)。参与者使用iNSiGHT C510和MRI进行全身扫描。从这两种设备中获得了瘦和脂肪质量测量值。统计分析包括Bland-Altman图、类内相关系数(ICC)和一致性相关系数(CCC)来评估两种方法之间的一致性。进行线性回归分析,得出C510与MRI测量值之间的转换公式。结果:研究发现iNSiGHT C510测量的瘦质量与MRI之间存在很强的相关性,右侧的相关系数(r)为0.961,左侧为0.967,综合瘦质量为0.963。瘦质量的ICC和CCC值也很高,表明两种方法之间的一致性很强。脂肪质量测量虽然有一定的相关性,但与瘦质量相比,差异更大。与传统的DEXA扫描相比,iNSiGHT C510显着减少了50%的测量时间。结论:与MRI相比,iNSiGHT C510在测量瘦质量方面具有较高的准确性,并且测量时间更短,使其成为临床诊断和监测肌肉减少症的实用工具。然而,需要更大样本量的进一步研究和长期评估来验证其更广泛的临床应用。
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引用次数: 0
Periprosthetic Bone Mineral Density Change after Total Knee Arthroplasty in Vietnamese Population 越南人口全膝关节置换术后假体周围骨矿物质密度的变化
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-03-22 DOI: 10.1016/j.jocd.2025.101583
Hoc Nguyen Van , Khanh Nguyen Manh , Hoang Le Xuan
Objectives: After total knee arthroplasty (TKA), bone structure changes around prosthetics gradually appear. Adverse changes, such as decreased bone mineral density (BMD) and bone remodeling, can lead to joint loosening, affecting surgical outcomes. The study aims to detect BMD changes in the bone around the artificial knee early after TKA.
Methods: We performed a prospectively descriptive study on 54 patients who were operated at Viet Duc University Hospital from 4/2017 to 4/2019. Bone density was measured using dual-energy X-ray absorptiometry (DEXA) at the seventh days, 3,6,12, and 24 months post-surgery.
Results: The BMD in the medial metaphyseal region of interest decreased by 10.36 %, 11.5 %, 11.88 %, and 12.13 % at 3, 6, 12, and 24 months respectively, compared to 7 days post-surgery. The lateral metaphyseal region of interest decreased by 6.09 %, 6.47 %, 6.97 %, and 7.1 % and the tibial diaphyseal region of interest decreased by 3.75 %, 4.66 %, 5.91 %, and 5.8 % over the same follow-up periods. The BMD in the femoral condyle region of interest decreased by 8.15 %, 8.62 %, 9.24 %, and 10.65 % compared to the corresponding 7-day period at 3,6,12, and 24 months post-surgery.
Conclusion: The periprosthetic BMD rapidly reduced in the first 3 months, then gradually decreased. After 24 months of follow-up, the BMD in the medial metaphyseal region of interest decreased the most.
目的:全膝关节置换术后,假体周围骨结构的变化逐渐显现。不利的变化,如骨密度(BMD)降低和骨重塑,可导致关节松动,影响手术结果。本研究旨在检测膝关节置换术后早期人工膝关节周围骨的骨密度变化。方法:对2017年4月至2019年4月在越南大学医院手术的54例患者进行前瞻性描述性研究。术后第7天、3、6、12、24个月采用双能x线骨密度仪(DEXA)测量骨密度。结果:与术后7天相比,内侧干骺端感兴趣区骨密度在术后3、6、12和24个月分别下降了10.36 %、11.5 %、11.88 %和12.13 %。在相同的随访期间,外侧干骺端感兴趣区分别减少了6.09 %、6.47 %、6.97 %和7.1 %,胫骨干骺端感兴趣区分别减少了3.75 %、4.66 %、5.91 %和5.8 %。与术后3、6、12和24个月相应的7天时间相比,股骨髁感兴趣区域的BMD分别下降了8.15% %、8.62% %、9.24% %和10.65 %。结论:假体周围骨密度在前3个月迅速下降,随后逐渐下降。随访24个月后,内侧干骺端感兴趣区域的骨密度下降最多。
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引用次数: 0
An Examination of Patient Knowledge and Education in Patients with Osteoporosis, Osteopenia, and Normal Bone Density 骨质疏松症、骨质减少症和正常骨密度患者的知识和教育检查
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-03-19 DOI: 10.1016/j.jocd.2025.101578
Ahdad Ziyar , Alexander Bolufer , Emily Littman , Shazia Beg
Introduction: Osteoporosis represents a preventable and often treatable condition that is responsible for 1.5 million fractures annually in the United States. Proper patient knowledge represents a crucial aspect of disease management and has potential implications in treatment adherence and lifestyle modification. By examining how much patients know about their own diagnosis, their disease knowledge, and what resources they would like to use, we aim to lay the groundwork for developing efficient patient education resources. Methodology: We surveyed 52 individuals and collected data on demographics, bone density test results, disease knowledge, and educational sources both used and preferred. This was done to learn how much patients know about their condition on a fundamental level. Results: 50% of participants diagnosed with osteoporosis correctly self-reported their condition, as did 21.1% diagnosed with osteopenia. Between the normal, osteopenia, and osteoporosis groups there were no significant differences between participants’ scores on the patient knowledge questionnaire. The resources most used by patients were handouts/brochures and internet/personal research, and patients reported a preference for learning directly from their doctor/nurse. Conclusion: Osteoporosis is associated with millions of fragility fractures occurring annually worldwide. Our study showed a consistent level of knowledge across patients with normal bone mineral density, osteopenia, and osteoporosis, suggesting the need for targeted education efforts, particularly for those with severe forms of the disease. We confirmed the invaluable role of medical personnel in teaching patients about bone density loss. It is through efficient learning that patients can be empowered to take charge of their health.
骨质疏松症是一种可预防且通常可治疗的疾病,每年在美国造成150万例骨折。适当的患者知识代表了疾病管理的一个关键方面,并对治疗依从性和生活方式的改变具有潜在的影响。通过检查患者对自己的诊断、疾病知识的了解程度,以及他们想要使用的资源,我们的目标是为开发有效的患者教育资源奠定基础。方法:我们调查了52个人,收集了人口统计学、骨密度测试结果、疾病知识和常用和首选的教育来源的数据。这样做是为了了解患者在基本层面上对自己的病情了解多少。结果:50%被诊断为骨质疏松的参与者正确地自我报告了他们的病情,21.1%被诊断为骨质减少。在正常组、骨质疏松组和骨质疏松组之间,参与者在患者知识问卷上的得分没有显著差异。患者使用最多的资源是讲义/小册子和互联网/个人研究,患者报告更倾向于直接从他们的医生/护士那里学习。结论:骨质疏松症与全球每年发生的数百万例脆性骨折有关。我们的研究显示,正常骨密度、骨质减少和骨质疏松患者的知识水平是一致的,这表明有必要进行有针对性的教育,特别是对那些患有严重疾病的患者。我们证实了医务人员在教导患者骨密度损失方面的宝贵作用。只有通过有效的学习,病人才能掌握自己的健康。
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引用次数: 0
Optimal kidney-tonifying traditional chinese medicines for postmenopausal osteoporosis: A network meta-analysis of randomized controlled trials 最佳补肾中药治疗绝经后骨质疏松症:随机对照试验的网络荟萃分析
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-03-11 DOI: 10.1016/j.jocd.2025.101581
Xin'e Zhong , Liyun Li , Weiliang Wan
Objective: To evaluate the efficacy and safety of different kidney-tonifying Chinese medicines (KTCMs) combined with bisphosphonates (BPs) in postmenopausal osteoporosis (PMOP) patients.
Methods: This study included 15 randomized controlled trials (RCTs) involving a total of 1,360 PMOP patients to compare the efficacy and safety of various KTCMs combined with BPs. A systematic search was conducted in eight medical databases (CNKI, PUBMED, Web of Science, Cochrane, EMBASE, Wanfang, VIP, and TCM Online). The inclusion criteria were as follows: (1) participants were postmenopausal women with PMOP; (2) the intervention involved different KTCMs combined with BPs; (3) outcome measures included pain Visual Analog Scale (VAS) scores, lumbar spine bone mineral density (BMD), femoral neck BMD, serum osteocalcin levels, and the incidence of adverse events. A network meta-analysis was performed to integrate data, calculating mean differences (MD) with 95 % confidence intervals (CIs). SUCRA values were used to rank treatment efficacy and assess the relative advantages of different regimens. League tables were used to visually present direct and indirect comparisons of treatments, while funnel plots were used to evaluate publication bias. The quality of the included studies was assessed using the Cochrane risk-of-bias tool.
Results: GSK + BPs and JWEX + BPs were the most effective in pain relief, while GSK + BPs showed the best efficacy in improving lumbar spine and femoral neck BMD. LWDH + BPs demonstrated superior performance in promoting bone metabolism. Safety analysis indicated a low incidence of adverse events, with no statistically significant difference between the experimental and control groups (p > 0.05).
Conclusion: This study suggests that GSK + BPs and JWEX + BPs are the most effective combinations for pain relief and BMD improvement, while LWDH + BPs and GSK + BPs have advantages in promoting bone metabolism. The combination of KTCMs with BPs can effectively improve PMOP with high safety, offering significant clinical value.
目的:评价不同补肾中药联合双磷酸盐(BPs)治疗绝经后骨质疏松症(PMOP)的疗效和安全性。方法:本研究纳入15项随机对照试验(RCTs),共1360例PMOP患者,比较各种中药联合bp的疗效和安全性。系统检索了8个医学数据库(CNKI、PUBMED、Web of Science、Cochrane、EMBASE、万方、VIP、TCM Online)。纳入标准如下:(1)研究对象为绝经后绝经期妇女;(2)不同ktcm联合bp干预;(3)结局指标包括疼痛视觉模拟量表(VAS)评分、腰椎骨密度(BMD)、股骨颈骨密度(BMD)、血清骨钙素水平和不良事件发生率。采用网络荟萃分析整合数据,以95 %置信区间(ci)计算平均差异(MD)。采用SUCRA值对治疗效果进行排序,并评估不同方案的相对优势。排位表用于直观地呈现治疗的直接和间接比较,而漏斗图用于评估发表偏倚。使用Cochrane风险偏倚工具评估纳入研究的质量。结果:GSK + bp和JWEX + bp缓解疼痛的效果最好,GSK + bp改善腰椎和股骨颈骨密度的效果最好。LWDH + bp在促进骨代谢方面表现优异。安全性分析显示,不良事件发生率低,实验组与对照组比较,差异无统计学意义(p >; 0.05)。结论:本研究提示GSK + bp和JWEX + bp是缓解疼痛和改善骨密度最有效的组合,而LWDH + bp和GSK + bp在促进骨代谢方面具有优势。中药联合bp可有效改善PMOP,安全性高,具有重要的临床价值。
{"title":"Optimal kidney-tonifying traditional chinese medicines for postmenopausal osteoporosis: A network meta-analysis of randomized controlled trials","authors":"Xin'e Zhong ,&nbsp;Liyun Li ,&nbsp;Weiliang Wan","doi":"10.1016/j.jocd.2025.101581","DOIUrl":"10.1016/j.jocd.2025.101581","url":null,"abstract":"<div><div><em>Objective:</em> To evaluate the efficacy and safety of different kidney-tonifying Chinese medicines (KTCMs) combined with bisphosphonates (BPs) in postmenopausal osteoporosis (PMOP) patients.</div><div><em>Methods:</em> This study included 15 randomized controlled trials (RCTs) involving a total of 1,360 PMOP patients to compare the efficacy and safety of various KTCMs combined with BPs. A systematic search was conducted in eight medical databases (CNKI, PUBMED, Web of Science, Cochrane, EMBASE, Wanfang, VIP, and TCM Online). The inclusion criteria were as follows: (1) participants were postmenopausal women with PMOP; (2) the intervention involved different KTCMs combined with BPs; (3) outcome measures included pain Visual Analog Scale (VAS) scores, lumbar spine bone mineral density (BMD), femoral neck BMD, serum osteocalcin levels, and the incidence of adverse events. A network meta-analysis was performed to integrate data, calculating mean differences (MD) with 95 % confidence intervals (CIs). SUCRA values were used to rank treatment efficacy and assess the relative advantages of different regimens. League tables were used to visually present direct and indirect comparisons of treatments, while funnel plots were used to evaluate publication bias. The quality of the included studies was assessed using the Cochrane risk-of-bias tool.</div><div><em>Results:</em> GSK + BPs and JWEX + BPs were the most effective in pain relief, while GSK + BPs showed the best efficacy in improving lumbar spine and femoral neck BMD. LWDH + BPs demonstrated superior performance in promoting bone metabolism. Safety analysis indicated a low incidence of adverse events, with no statistically significant difference between the experimental and control groups (<em>p</em> &gt; 0.05).</div><div><em>Conclusion:</em> This study suggests that GSK + BPs and JWEX + BPs are the most effective combinations for pain relief and BMD improvement, while LWDH + BPs and GSK + BPs have advantages in promoting bone metabolism. The combination of KTCMs with BPs can effectively improve PMOP with high safety, offering significant clinical value.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101581"},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
DXA and cardiovascular disease in rheumatoid arthritis: A scoping review 类风湿性关节炎的 DXA 与心血管疾病:范围综述
IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-03-10 DOI: 10.1016/j.jocd.2025.101582
Mina Ebrahimiarjestan , Miriam O'sullivan , Attracta Brennan , Erjiang E , Bryan Whelan , Lan Yang , Tingyan Wang , Carmel Silke , Ming Yu , Mary Dempsey , John J. Carey
DXA technology is widely available today in many regions of the world. There is a growing realization of the value of DXA not only for osteoporosis management but also for sports medicine, sarcopenia, and the assessment of cardiovascular disease and mortality. Such features may be of particular interest for populations with a greater risk of these outcomes such as those with diabetes mellitus or rheumatoid arthritis. Recent systematic reviews and meta-analyses show DXA can robustly predict fractures, cardiovascular disease, dementia and mortality. Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting multiple organs including synovial joints, bone and other tissues. People suffering from RA have a greater propensity to osteoporotic fracture, cardiovascular disease, infection and premature death, which is well recognised. RA is the only unique disease included in some fracture risk algorithms such as FRAX, and so RA patients are often referred for a DXA scan to evaluate their risk of osteoporosis. We have previously shown vertebral fractures, aortic calcification and cardiovascular disease are prevalent in our RA population, with strong association. In this paper we performed a scoping review of published literature in Medline and Embase to better understand the current status of DXA and cardiovascular disease in RA populations. 822 papers were identified in an initial search of which 7 papers reflecting 2,038 RA patients from 7 different countries were included. Study design included 4 cross-sectional, 2 longitudinal and 1 case-control. All included associations with various cardiovascular measures, while only 1 included clinical events as an outcome. Our results suggest this is an area which remains relatively unexplored but has substantial important clinical potential.
目前,DXA技术在世界许多地区得到广泛应用。越来越多的人认识到DXA不仅在骨质疏松症管理方面有价值,而且在运动医学、肌肉减少症、心血管疾病和死亡率评估方面也有价值。这些特征可能对糖尿病或类风湿关节炎等高危人群特别有意义。最近的系统综述和荟萃分析显示,DXA可以可靠地预测骨折、心血管疾病、痴呆和死亡率。类风湿性关节炎(RA)是一种慢性炎症性疾病,影响包括滑膜关节、骨骼和其他组织在内的多个器官。患类风湿性关节炎的人更容易发生骨质疏松性骨折、心血管疾病、感染和过早死亡,这是众所周知的。RA是FRAX等一些骨折风险算法中唯一包含的独特疾病,因此RA患者经常被推荐进行DXA扫描以评估其骨质疏松症的风险。我们之前的研究表明,在我们的RA人群中,椎体骨折、主动脉钙化和心血管疾病普遍存在,并有很强的相关性。在本文中,我们对Medline和Embase上发表的文献进行了范围综述,以更好地了解RA人群中DXA和心血管疾病的现状。在最初的检索中确定了822篇论文,其中7篇论文反映了来自7个不同国家的2038名RA患者。研究设计包括4个横断面、2个纵向和1个病例对照。所有研究都包括与各种心血管指标的关联,而只有1项研究将临床事件作为结果。我们的结果表明,这是一个相对未开发的领域,但具有重要的临床潜力。
{"title":"DXA and cardiovascular disease in rheumatoid arthritis: A scoping review","authors":"Mina Ebrahimiarjestan ,&nbsp;Miriam O'sullivan ,&nbsp;Attracta Brennan ,&nbsp;Erjiang E ,&nbsp;Bryan Whelan ,&nbsp;Lan Yang ,&nbsp;Tingyan Wang ,&nbsp;Carmel Silke ,&nbsp;Ming Yu ,&nbsp;Mary Dempsey ,&nbsp;John J. Carey","doi":"10.1016/j.jocd.2025.101582","DOIUrl":"10.1016/j.jocd.2025.101582","url":null,"abstract":"<div><div>DXA technology is widely available today in many regions of the world. There is a growing realization of the value of DXA not only for osteoporosis management but also for sports medicine, sarcopenia, and the assessment of cardiovascular disease and mortality. Such features may be of particular interest for populations with a greater risk of these outcomes such as those with diabetes mellitus or rheumatoid arthritis. Recent systematic reviews and meta-analyses show DXA can robustly predict fractures, cardiovascular disease, dementia and mortality. Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting multiple organs including synovial joints, bone and other tissues. People suffering from RA have a greater propensity to osteoporotic fracture, cardiovascular disease, infection and premature death, which is well recognised. RA is the only unique disease included in some fracture risk algorithms such as FRAX, and so RA patients are often referred for a DXA scan to evaluate their risk of osteoporosis. We have previously shown vertebral fractures, aortic calcification and cardiovascular disease are prevalent in our RA population, with strong association. In this paper we performed a scoping review of published literature in Medline and Embase to better understand the current status of DXA and cardiovascular disease in RA populations. 822 papers were identified in an initial search of which 7 papers reflecting 2,038 RA patients from 7 different countries were included. Study design included 4 cross-sectional, 2 longitudinal and 1 case-control. All included associations with various cardiovascular measures, while only 1 included clinical events as an outcome. Our results suggest this is an area which remains relatively unexplored but has substantial important clinical potential.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101582"},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704219","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}
引用次数: 0
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Journal of Clinical Densitometry
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