Journal of Clinical Densitometry最新文献_第7页

DXA-Measured Visceral Adipose Tissue and Incident Cardiovascular Disease Events in Middle-Aged Adults: Busselton Healthy Ageing Study dxa测量的中年人内脏脂肪组织和心血管疾病事件：Busselton健康老龄化研究

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-01 Epub Date: 2025-06-10 DOI: 10.1016/j.jocd.2025.101599

Kun Zhu , Michael Hunter , Chrianna Bharat , Kevin Murray , Jennie Hui , John P. Walsh , Joseph Hung

Background: DXA-measured visceral adipose tissue (VAT) is associated with development of metabolic syndrome in middle-aged adults, but its association with incident cardiovascular disease (CVD) has not been studied. We evaluated the longitudinal association of baseline VAT_DXA with incident CVD events within the Busselton Healthy Ageing study.

Methods: Participants (n = 4866, 54 % female, aged 46-70 years, ∼99 % white) were assessed for VAT_DXA and were followed up longitudinally for a median of 7.9 years. Outcome measures were time to incident CVD or coronary heart disease (CHD) events (defined as non-fatal hospitalisations or death). Sex-stratified associations were examined using Cox proportional hazards models adjusting for baseline age, lifestyle factors and prior CVD.

Results: Mean baseline VAT_DXA mass was 1678±877 g and 882±600 g in males and females respectively. Incident CVD and CHD events were recorded for 332 (6.8 %) and 245 (5.0 %) study participants. There was a near-linear increase in risk for CVD and CHD events with VAT_DXA in both sexes. After covariate adjustment each standard deviation (SD) increment in VAT_DXA was associated with a hazard ratio [95 % confidence interval] for incident CVD in males and females of 1.26 [1.11-1.44] and 1.30 [1.10-1.55] respectively, and a hazard ratio for CHD of 1.28 [1.11-1.49] and 1.40 [1.14-1.72] respectively. However, VAT_DXA was no longer independently associated with CVD events once adjusted for BMI and waist circumference.

Conclusion: VAT_DXA has utility for identifying middle-aged adults at greater risk for incident CVD and CHD but further studies are needed to determine if VAT_DXA can improve risk discrimination beyond anthropometric measures.

背景：dxa测量的内脏脂肪组织（VAT）与中年人代谢综合征的发展有关，但其与心血管疾病（CVD）发病率的关系尚未研究。在Busselton健康老龄化研究中，我们评估了基线VATDXA与心血管疾病事件的纵向关联。方法：对参与者（n = 4866，女性54 %，年龄46-70岁，白人99 %）进行VATDXA评估，纵向随访中位数为7.9年。结果测量是发生心血管疾病或冠心病（CHD）事件的时间（定义为非致命性住院或死亡）。使用Cox比例风险模型对基线年龄、生活方式因素和既往心血管疾病进行校正，以检验性别分层的相关性。结果：男性和女性的VATDXA平均基线质量分别为1678±877 g和882±600 g。记录了332名（6.8 %）和245名（5.0 %）研究参与者的心血管疾病和冠心病事件。VATDXA患者的CVD和CHD事件的风险在两性中均呈近线性增加。协变量调整后，VATDXA的每个标准差（SD）增量与男性和女性心血管事件的风险比[95 %置信区间]分别为1.26[1.11-1.44]和1.30[1.10-1.55]，冠心病的风险比分别为1.28[1.11-1.49]和1.40[1.14-1.72]。然而，一旦调整BMI和腰围，VATDXA不再与CVD事件独立相关。结论：VATDXA可用于识别心血管疾病和冠心病发生风险较高的中年人，但需要进一步的研究来确定VATDXA是否可以改善人体测量测量之外的风险识别。

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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

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-03-22 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。

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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

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub 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。

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引用次数: 0

Evaluation of lumbar vertebral bone quality using T1-weighted MRI: Can it differentiate normal, osteopenia, and osteoporosis? 用t1加权MRI评价腰椎骨质量：能区分正常、骨质减少和骨质疏松吗？

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-01-09 DOI: 10.1016/j.jocd.2025.101561

Sevde Nur Emir, Gülbanu Güner

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

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

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

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

背景：骨质疏松症是一种以低骨量和微结构恶化为特征的全身性骨骼疾病，对全球公共卫生构成了重大挑战。虽然诊断骨质疏松症的金标准是双能x射线吸收仪（DXA），但它的使用受到脊柱畸形和伪影等因素的限制。本研究旨在探讨常规t1加权MRI序列通过椎体骨信号（VB）与脑脊液信号（CSF）比值预测骨质减少和骨质疏松症的潜力。方法：我们对在2020年至2023年之间的6个月内接受DXA和腰椎MRI检查的患者进行了回顾性研究。排除已知椎体骨折、骨肿瘤、异质性骨髓或因退行性改变导致终板信号改变的患者，我们根据患者的DXA t评分将患者分为正常组、骨质减少组和骨质疏松组。分析T1加权矢状面MRI序列，计算各椎体（L1-L4）的T1 VB/CSF比值。结果：研究纳入376例患者，平均年龄60.8 ± 9.1岁。在正常组、骨质减少组和骨质疏松组中，T1 VB/CSF比值存在统计学差异（p ）。结论：常规腰椎MRI序列得出的T1 VB/CSF比值为骨质疏松症和骨质减少症的机会性筛查提供了一种有前途的无辐射工具。鉴于腰椎MRI经常用于脊柱疾病患者，该方法有助于早期诊断和干预，指导高危患者进一步进行DXA评估和管理。

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引用次数: 0

Development of an Algorithm to Predict Appendicular Lean Mass Index From Regional Spine and Hip Dxa Scans 从区域脊柱和髋关节Dxa扫描中预测阑尾瘦质量指数的算法开发

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

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

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

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

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

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

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

肌肉减少症的特征是进行性肌肉损失，身体功能下降和/或肌肉力量下降。肌少症的操作定义包括测量肌肉质量，最常见的是通过双能x线吸收仪（DXA）衍生的阑尾瘦质量。阑尾瘦肿块可以通过全身双dxa扫描得到；然而，作为临床护理的一部分，这些扫描不如髋关节和脊柱扫描常见。本研究的目的是开发一种算法，通过区域脊柱和髋关节双能x线吸收仪（DXA）扫描预测阑尾瘦质量指数（ALMI）。方法：我们对马尼托巴骨密度登记处的一组患者进行了回顾性横断面研究，这些患者在同一次就诊时进行了髋部、脊柱和全身DXA扫描。我们使用以下候选协变量开发了该算法：年龄、性别、身高、体重、dxa衍生的脊柱和臀部脂肪比例、dxa衍生的脊柱和臀部组织厚度。我们使用bootstrap方法在内部验证了算法。平均自举参数估计被用作最终方程。结果：676例患者的DXA扫描被纳入分析数据集。平均ALMI为6.73 (SD 1.43) kg/m2。最终的预测模型包括性别、年龄、身高、体重、脊柱脂肪分数和臀部脂肪分数。性别也是体重和臀部脂肪比例的交互因素。bootstrap验证后，模型调整后的R2为0.863，均方根误差为0.529 kg/m2，根据欧洲肌肉减少症工作组版本2预测低ALMI的AUROC为0.88。结论：髋关节和脊柱DXA扫描可用于预测阑尾瘦质量指数。未来的研究应该测试这些预测是否可以用于评估肌肉减少症和其他临床疾病之间的关系。

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

引用次数: 0

Evaluating lower limits of body fat percentage in athletes using DXA 使用DXA评估运动员体脂率下限。

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-01-20 DOI: 10.1016/j.jocd.2025.101564

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

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

体脂率（BF%）是监测运动员训练和饮食干预的常规测量方法。双能x射线吸收测定法（DXA）被广泛认为是身体成分测量技术的金标准，但DXA BF%的测量值始终高于其他技术。因此，本研究的主要目的是确定在不受食物限制的自由生活运动员中，dxa估计的最低全身脂肪量。在这个横断面分析中，732名参与者来自18个竞技项目(643名运动员；88 %)加上两个（男性和女性）“非运动员”男女组别(89名非运动员；12 %)使用Horizon a Hologic™设备(软件版本13.6.0.5；TBAR 1209)，由单个操作员执行和分析。BF % 454年男性平均(20.9 ± 3.8年)是18.2 ±4.9  %(范围10.3 - 37.2 %),篮球运动员有最低的BF %(15.3 ±2.6  %)和普通人有最高的BF %(21.6 ±5.4  %)(1路的10个团队之间的方差分析:F = 12.3;p

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引用次数: 0

The association of hip bone mineral density (BMD) with incident major osteoporotic and hip fractures varies by body mass index 髋部骨密度（BMD）与重大骨质疏松症和髋部骨折的关系因体重指数而异

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-02-18 DOI: 10.1016/j.jocd.2025.101577

John T. Schousboe , Neil Binkley , William D. Leslie

Background: Bone mineral density (BMD) measurement is less precise amongst those with body mass index (BMI) > 30 kg/m². We hypothesized that the association of BMD with incident hip and major osteoporotic fractures (MOF; hip, clinical vertebral, forearm, or humerus) becomes weaker with increasing BMI.

Methodology: Our study population was 75,391 individuals age ≥ 50 years who had a bone density test in the province of Manitoba 1998 to 2018. BMD of the total hip was assessed on GE Lunar densitometers. Incident MOF and hip fractures were ascertained using linked health claims data over a mean (SD) follow-up of 8.6 (5.3) years. The associations of total hip BMD with incident major osteoporotic and hip fractures were estimated with Cox proportional hazards models including an interaction term between BMI category and BMD to test if the association of BMD with incident fractures varies by BMI.

Result: The multivariable adjusted associations of total hip BMD with incident MOF did not vary by BMI (hazard ratio [HR] 1.56, 95 % C.I. 1.30, 1.85 for BMI ≥ 40 kg/m²; HR 1.36, 95 % C.I. 1.17, 1.58 for BMI <18.5 kg/m²; p-value for interaction 0.14). However, the association of total hip BMD with incident hip fracture was stronger for those with BMI ≥ 35 kg/m² (HR 2.16, 95 % C.I. 1.71, 2.74) compared to those with BMI <18.5 kg/m² (HR 1.48, 95 % C.I. 1.19, 1.84, p-value 0.001 for interaction).

Conclusion: The associations of total hip BMD with incident major osteoporotic and hip fracture are as strong for those with very high BMI as for those with normal BMI. However, total hip BMD may have a weaker association with incident hip fracture among underweight individuals. Further studies to confirm and explain this finding are warranted.

背景：骨矿物质密度（BMD）测量在身体质量指数（BMI） >；30 kg / m2。我们假设骨密度与髋部和主要骨质疏松性骨折(MOF；髋部、临床椎体、前臂或肱骨)随着BMI的增加而变弱。方法：我们的研究人群是1998年至2018年在马尼托巴省进行骨密度测试的75,391名年龄≥50岁的个体。采用GE Lunar骨密度仪评估全髋骨密度。MOF和髋部骨折的发生率是通过平均（SD） 8.6（5.3）年随访的相关健康声明数据确定的。采用Cox比例风险模型，包括BMI类别和BMD之间的相互作用项，以检验BMD与骨折事件的相关性是否因BMI而异，评估髋部总骨密度与骨质疏松症和髋部骨折事件的相关性。结果：经多变量调整后的全髋关节骨密度与MOF的相关性不因BMI而变化(风险比[HR] 1.56, 95 % ci . 1.30, 1.85, BMI≥40 kg/m2；HR 1.36, 95 % ci 1.17, 1.58 BMI <18.5 kg/m2；相互作用的p值为0.14)。然而，与BMI≥35 kg/m2 （HR 2.16, 95 % C.I. 1.71, 2.74）的患者相比，BMI≥18.5 kg/m2 （HR 1.48, 95 % C.I. 1.19, 1.84， p值0.001）的患者，髋部总骨密度与髋部骨折的相关性更强。结论：与BMI正常者相比，BMI正常者髋部骨密度与骨质疏松和髋部骨折发生率的相关性同样强。然而，在体重过轻的个体中，髋部骨密度与髋部骨折的相关性较弱。进一步的研究证实和解释这一发现是有必要的。

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引用次数: 0

Influence of two strength training modalities (hypertrophy vs. contrast training) on muscular strength, bone health parameters and quality of life in a group of older adults with low skeletal muscle mass index 两种力量训练方式（肥厚训练与对比训练）对一组骨骼肌质量指数低的老年人肌肉力量、骨骼健康参数和生活质量的影响

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-01-15 DOI: 10.1016/j.jocd.2025.101563

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

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

本研究的主要目的是比较两种力量训练方式（肥厚训练和对比训练）对60岁及以上低骨骼肌质量指数（SMI）受试者的骨健康参数、身体表现和生活质量的影响。45名老年人自愿参加了这项研究，但只有41人（22名女性和19名男性）完成了这项研究。参与者被分为三个不同的组：对照组（CG）；n = 15)，对照训练组(CTG；n = 13)和肥大训练组(HTG；n = 13)。培训协议的期限为6个月。实验组每周进行两次力量训练；每次会议的持续时间为45分钟。在六个月的训练前后，对三组进行了多项测量（包括人体测量学、身体成分、骨骼参数、最大力量参数、物理性能参数、骨折风险和生活质量）。该方案的不同测量是在相同的条件下，对所有参与者和每种方法使用相同的材料和调查员进行的。目前的研究表明，这两种训练方式都有共同的好处，如提高最大力量、身体表现和生活质量参数，但对骨矿物质密度（BMD）和骨矿物质含量（BMC）没有显著影响。与肥厚训练组（以自然速度进行运动）相比，训练在提高最大力量和降低骨折风险方面的影响更明显。总之，本研究表明，两种抗阻训练方案都能有效地提高低重度精神障碍老年人的最大力量、身体表现和生活质量。然而，这6个月的干预不足以显著增加该人群的BMC和BMD值。

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引用次数: 0

Bioelectrical phase angle and impedance vectors are related to leg hip-femur density and bone geometry parameters in adolescent male soccer players 青少年男性足球运动员的腿部-髋-股骨密度和骨几何参数与生物电相位角和阻抗矢量有关

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-03-09 DOI: 10.1016/j.jocd.2025.101579

Marcus Vinícius de Oliveira Cattem, Josely Correa Koury

Background: Bone geometry parameters are essential for evaluating bone health and fracture risk in soccer players, whose physical demands affect their bone characteristics. However, studies on adolescent soccer players linking raw bioelectrical data to bone data are lacking, in addition to potential discrepancies in phase angle (PhA) values obtained using single-frequency (SF-BIA) and multifrequency (MF-BIA) bioelectrical impedance devices.

Aims: In this cross-sectional study, we aimed to compare raw bioelectrical impedance data (resistance (R), reactance (Xc), and PhA values) obtained using SF-BIA and MF-BIA devices and test the relationships among PhA and bioelectrical impedance vector analysis (BIVA) with bone mineral density (BMD), and leg hip-femur geometry (HF-G) parameters in adolescent male soccer players.

Methods: Raw bioelectrical impedance data were assessed using the SF-BIA and MF-BIA devices at a frequency of 50 kHz. The HF-G parameters were obtained by dual-energy X-ray absorptiometry. BIVA was used to compare bone data considering BMD and HF-G median values.

Results: Overall, 59 adolescent male soccer players participated in this study. Raw SF-BIA data had lower R values (-19.3 %, p < 0.001), but higher Xc (+5.3 %, p < 0.001) and PhA values (+20.3 %, p < 0.001) than when using MF-BIA data. PhA values obtained using SF-BIA (r = 0.27, p = 0.04) or MF-BIA (r = 0.43, p < 0.001) were positively correlated with total hip-femur BMD. Considering BIVA, the ellipses differed for the total BMD (p = 0.0018), neck BMD (p = 0.026), and cross-sectional area (p = 0.024).

Conclusion: The PhA and R values obtained using SF-BIA were higher than those obtained using MF-BIA, possibly because of the technological differences between the devices. However, the MF-BIA data suggests that PhA and BIVA can be used as tools for continuous use to warn of possible imbalances in bone tissue.

背景：足球运动员的身体需求影响其骨骼特征，因此骨几何参数对于评估其骨骼健康和骨折风险至关重要。然而，除了使用单频（SF-BIA）和多频（nf - bia）生物电阻抗装置获得的相位角（PhA）值可能存在差异外，还缺乏将原始生物电数据与骨骼数据联系起来的青少年足球运动员研究。目的：在这项横断面研究中，我们旨在比较使用SF-BIA和MF-BIA装置获得的原始生物电阻抗数据(电阻（R)，电抗（Xc）和PhA值），并测试PhA和生物电阻抗矢量分析（BIVA）与青少年男性足球运动员骨密度（BMD）和腿-髋-股骨几何（HF-G）参数之间的关系。方法：使用SF-BIA和MF-BIA装置在50 kHz频率下评估原始生物电阻抗数据。采用双能x射线吸收法测定HF-G参数。BIVA用于比较考虑BMD和HF-G中位数的骨数据。结果：共有59名青少年男性足球运动员参与本研究。原始SF-BIA数据较低R值(-19.3 % p & lt; 0.001),但高Xc(+ 5.3 % p & lt; 0.001)和PhA值(+ 20.3 % p & lt; 0.001)比使用MF-BIA数据。使用SF-BIA （r = 0.27,p = 0.04）或MF-BIA （r = 0.43,p <； 0.001）获得的PhA值与髋-股骨总骨密度呈正相关。考虑到BIVA，椭圆在总骨密度（p = 0.0018）、颈部骨密度（p = 0.026）和横截面积（p = 0.024）上存在差异。结论：SF-BIA法测得的PhA和R值高于MF-BIA法测得的PhA和R值，可能与两种器械的工艺差异有关。然而，MF-BIA数据表明PhA和BIVA可以作为持续使用的工具来警告骨组织中可能存在的不平衡。

{"title":"Bioelectrical phase angle and impedance vectors are related to leg hip-femur density and bone geometry parameters in adolescent male soccer players","authors":"Marcus Vinícius de Oliveira Cattem, Josely Correa Koury","doi":"10.1016/j.jocd.2025.101579","DOIUrl":"10.1016/j.jocd.2025.101579","url":null,"abstract":"<div><div><em>Background:</em> Bone geometry parameters are essential for evaluating bone health and fracture risk in soccer players, whose physical demands affect their bone characteristics. However, studies on adolescent soccer players linking raw bioelectrical data to bone data are lacking, in addition to potential discrepancies in phase angle (PhA) values obtained using single-frequency (SF-BIA) and multifrequency (MF-BIA) bioelectrical impedance devices.</div><div><em>Aims:</em> In this cross-sectional study, we aimed to compare raw bioelectrical impedance data (resistance (R), reactance (Xc), and PhA values) obtained using SF-BIA and MF-BIA devices and test the relationships among PhA and bioelectrical impedance vector analysis (BIVA) with bone mineral density (BMD), and leg hip-femur geometry (HF-G) parameters in adolescent male soccer players.</div><div><em>Methods:</em> Raw bioelectrical impedance data were assessed using the SF-BIA and MF-BIA devices at a frequency of 50 kHz. The HF-G parameters were obtained by dual-energy X-ray absorptiometry. BIVA was used to compare bone data considering BMD and HF-G median values.</div><div><em>Results:</em> Overall, 59 adolescent male soccer players participated in this study. Raw SF-BIA data had lower R values (-19.3 %, <em>p</em> < 0.001), but higher Xc (+5.3 %, <em>p</em> < 0.001) and PhA values (+20.3 %, <em>p</em> < 0.001) than when using MF-BIA data. PhA values obtained using SF-BIA (<em>r</em> = 0.27, <em>p</em> = 0.04) or MF-BIA (<em>r</em> = 0.43, <em>p</em> < 0.001) were positively correlated with total hip-femur BMD. Considering BIVA, the ellipses differed for the total BMD (<em>p</em> = 0.0018), neck BMD (<em>p</em> = 0.026), and cross-sectional area (<em>p</em> = 0.024).</div><div><em>Conclusion:</em> The PhA and R values obtained using SF-BIA were higher than those obtained using MF-BIA, possibly because of the technological differences between the devices. However, the MF-BIA data suggests that PhA and BIVA can be used as tools for continuous use to warn of possible imbalances in bone tissue.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101579"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725633","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

Artificial intelligence for opportunistic osteoporosis screening with a Hounsfield Unit in chronic obstructive pulmonary disease patients 人工智能用于慢性阻塞性肺疾病患者霍斯菲尔德单元的机会性骨质疏松症筛查

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-04-01 Epub Date: 2025-02-13 DOI: 10.1016/j.jocd.2025.101576

Yali Li, Yan Wu

Introduction: To investigate the accuracy of an artificial intelligence (AI) prototype in determining bone mineral density (BMD) in chronic obstructive pulmonary disease (COPD) patients using chest computed tomography (CT) scans.

Methodology: This study involved 1276 health checkups and 1877 COPD patients who underwent chest CT scans from April 2020 to December 2021. Automated identification, segmentation, and Hounsfield Unit (HU) measurement of the thoracic vertebrae were performed using the musculoskeletal module of the AI-Rad Companion Chest CT (Siemens Healthineers, Er langen, Germany). Patients were divided into three groups: normal BMD, osteopenia, and osteoporosis, with quantitative CT (QCT) as the standard for analysis. The correlation between the HU and BMD values from T8 to T12 and T11-T12 vertebrae was analyzed using Linear regression analysis. The diagnostic performance of the HU values from T8 to T12 and T11-T12 vertebrae for osteoporosis was evaluated using the receiver operating characteristic curve.

Results: The HU values strongly correlated with BMD values in health checkups and COPD patients (R²=0.881‒0.936 and 0.863‒0.927, P < 0.001). The Box-and-Whisker plot showed significant differences between HU and BMD values for T11-T12 vertebrae in normal BMD, osteopenia, and osteoporosis groups in two datasets (P < 0.001). The AUC was 0.970-0.982 and 0.944-0.961 in health checkups and COPD patients for detecting osteoporosis, with a sensitivity of 92.27 %‒97.42 % and 79.48 %‒90.24 % and a specificity of 86.35 %‒92.69 % and 82.81 %‒90.94 %. The optimal thresholds were 99.5‒120.5 HU and 104.5‒123.5 HU, respectively.

Conclusions: The AI software achieved high accuracy for automatic opportunistic osteoporosis screening in COPD patients, which may be a complementary method for quickly screening the population at high risk of osteoporosis.

前言：研究人工智能（AI）原型在使用胸部计算机断层扫描（CT）确定慢性阻塞性肺疾病（COPD）患者骨矿物质密度（BMD）的准确性。方法：本研究涉及1276名健康检查和1877名COPD患者，他们在2020年4月至2021年12月期间接受了胸部CT扫描。使用AI-Rad胸部CT的肌肉骨骼模块（Siemens Healthineers, Er langen, Germany）对胸椎进行自动识别、分割和霍斯菲尔德单元（Hounsfield Unit， HU）测量。将患者分为骨密度正常组、骨质减少组和骨质疏松组，以定量CT （QCT）作为分析标准。采用线性回归分析T8 ~ T12和t11 ~ T12椎体HU与BMD值的相关性。采用受试者工作特征曲线评价T8 ~ T12和t11 ~ T12椎体HU值对骨质疏松症的诊断价值。结果：健康体检及COPD患者的HU值与BMD值呈强相关（R2= 0.881-0.936、0.863-0.927，P值 <； 0.001）。盒须图显示，在两个数据集中，骨密度正常组、骨质疏松组和骨质疏松组中，T11-T12椎体的HU值和骨密度值存在显著差异（P <； 0.001）。健康体检及COPD患者骨质疏松检测AUC分别为0.970 ~ 0.982、0.944 ~ 0.961，敏感性分别为92.27 % ~ 97.42 %、79.48 % ~ 90.24 %，特异性分别为86.35 % ~ 92.69 %、82.81 % ~ 90.94 %。最佳阈值分别为99.5 ~ 120.5 HU和104.5 ~ 123.5 HU。结论：AI软件在COPD患者骨质疏松自动机会性筛查中取得了较高的准确率，可作为快速筛查骨质疏松高危人群的一种补充方法。

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引用次数: 0