scholarly journals Bone Mass and Strength and Fall-Related Fractures in Older Age

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Kirsti Uusi-Rasi ◽  
Saija Karinkanta ◽  
Kari Tokola ◽  
Pekka Kannus ◽  
Harri Sievänen
Keyword(s):  
Bone Mass ◽  
Physical Performance ◽  
Bone Structure ◽  
Mean Difference ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Fracture Group ◽  
Bone Properties ◽  
The Mean

Introduction. Low bone mineral density is a risk factor for fractures. The aim of this follow-up study was to assess the association of various bone properties with fall-related fractures. Materials and Methods. 187 healthy women aged 55 to 83 years at baseline who were either physically active or inactive were followed for 20 years. They were divided into two groups by whether or not they sustained fall-related fractures: fracture group (F) and nonfracture group (NF). At baseline, several bone properties were measured with DXA and pQCT, and their physical performance was also assessed. Results. During the follow-up, 120 women had no fall-related fractures, while 67 (38%) sustained at least one fall with fracture. NF group had about 4 to 11% greater BMD at the femoral neck and distal radius; the mean differences (95% CI) were 4.5 (0.3 to 8.6) % and 11.1 (6.3 to 16.1) %, respectively. NF group also had stronger bone structure at the tibia, the mean difference in BMC at the distal tibia was 6.0 (2.2 to 9.7) %, and at the tibial shaft 3.6 (0.4 to 6.8) %. However, there was no mean difference in physical performance. Conclusions. Low bone properties contribute to the risk of fracture if a person falls. Therefore, in the prevention of fragility fractures, it is essential to focus on improving bone mass, density, and strength during the lifetime. Reduction of falls by improving physical performance, balance, mobility, and muscle power is equally important.

scholarly journals P0856LOW BONE MASS IS SIGNIFICANTLY ASSOCIATED WITH AN INCREASED RISK OF ANEMIA IN PATIENTS WITH CKD

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Seonyeong Lee ◽  
Yooju Nam ◽  
Hyung Woo Kim ◽  
Jae Hyun Chang ◽  
Tae-Hyun Yoo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Mass ◽  
Mass Density ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Multivariable Logistic Regression Model ◽  
Increased Risk ◽  
The Relationship

Abstract Background and Aims Hypoxia has been considered to be a risk factor for osteoporosis. Several studies have reported on the close associations between the anemia and an increased risk of bone loss. However, the relationship between hemoglobin levels and bone mineral density(BMD) has not been established in chronic kidney disease (CKD) patients. Therefore, the aim of this study is to investigate the relationship between BMD and anemia in a non-dialysis CKD cohort. Method Among 2,238 patients with non-dialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD), 2,115 patients who measured hemoglobin(Hb) and BMD were included in the analysis. We defined anemia as hemoglobin(Hb) levels of < 13.0 g/dL and 12.0 g/dL for males and females, respectively. The primary endpoint was the onset of a 15% decline in Hemoglobin during follow-up. Results The mean age was 53.6 ± 12.2 years and 1,292(61.1%) patients were males. The BMD score was positively correlated with hemoglobin levels (β, 0.658; 95% CI, 0.215-1.101; P 0.004). In the multivariable logistic regression model, the prevalence of anemia was significantly higher in the osteoporosis group than that in the normal BMD group (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.03-2.46, P=0.038). Among 1010 patients without data of following hemoglobin levels, 396 (19.7%) patients developed 15% decline in hemoglobin level during a median follow-up duration of 36 (interquartile range, 10-60) months. In the fully adjusted multivariable Cox models, risk of developing the 15% decline of hemoglobin was significantly higher in the osteoporosis group (HR, 1.45; 95% CI, 1.03-2.05; P= 0.035) as compared to normal BMD group. Conclusion This study showed that low bone mass density was independently related with anemia and hemoglobin levels in patients with non-dialysis CKD. Our findings suggest that preserve bone mass be important to maintain the levels of hemoglobin with CKD patients.

scholarly journals MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 455
Author(s):  
Nico Sollmann ◽  
Nithin Manohar Rayudu ◽  
Long Yu Yeung ◽  
Anjany Sekuboyina ◽  
Egon Burian ◽  
...  
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Fracture Risk ◽  
Thoracolumbar Spine ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Osteoporotic Vertebral Fractures ◽  
The Mean ◽  
Biomechanical Strength

Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD–L2-IVD–L3 (FSU_L1–L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1–L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1–L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.

scholarly journals Increased development of radiographic hip osteoarthritis in individuals with high bone mass: a prospective cohort study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
April Hartley ◽  
Sarah A. Hardcastle ◽  
Monika Frysz ◽  
Jon Parkinson ◽  
Lavinia Paternoster ◽  
...  
Keyword(s):  
Bone Mass ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Mineral Density ◽  
High Bone Mass ◽  
High Bone ◽  
Subchondral Sclerosis

Abstract Background Individuals with high bone mass (HBM) have a greater odds of prevalent radiographic hip osteoarthritis (OA), reflecting an association with bone-forming OA sub-phenotypes (e.g. osteophytosis, subchondral sclerosis). As the role of bone mineral density (BMD) in hip OA progression is unclear, we aimed to determine if individuals with HBM have increased incidence and/or progression of bone-forming OA sub-phenotypes. Methods We analysed an adult cohort with and without HBM (L1 and/or total hip BMD Z-score > + 3.2) with pelvic radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Superior/inferior acetabular/femoral osteophyte and medial/superior joint space narrowing (JSN) grades were summed and Δosteophyte and ΔJSN derived. Pain and functional limitations were quantified using the WOMAC questionnaire. Associations between HBM status and change in OA sub-phenotypes were determined using multivariable linear/logistic regression, adjusting for age, sex, height, total body fat mass, follow-up time and baseline sub-phenotype grade. Generalised estimating equations accounted for individual-level clustering. Results Of 136 individuals, 62% had HBM at baseline, 72% were female and mean (SD) age was 59 (10) years. HBM was positively associated with both Δosteophytes and ΔJSN (adjusted mean grade differences between individuals with and without HBM βosteophyte = 0.30 [0.01, 0.58], p = 0.019 and βJSN = 0.10 [0.01, 0.18], p = 0.019). Incident subchondral sclerosis was rare. HBM individuals had higher WOMAC hip functional limitation scores (β = 8.3 [0.7, 15.98], p = 0.032). Conclusions HBM is associated with the worsening of hip osteophytes and JSN over an average of 8 years, as well as increased hip pain and functional limitation.

scholarly journals Clinical efficacy of treating the first metacarpal base fracture by closed reduction and percutaneous parallel  K-wire  interlocking fixation

2021 ◽  
Author(s):  
Wu Wang ◽  
Min Zeng ◽  
Junxiao Yang ◽  
Long Wang ◽  
Jie Xie ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Closed Reduction ◽  
Fracture Group ◽  
Articular Fracture ◽  
Articular Fractures ◽  
Injured Side ◽  
Uninjured Side ◽  
Flexion Extension ◽  
The Mean

Abstract Objective: To explore the clinical efficacy of treating a first metacarpal base fracture by closed reduction and percutaneous parallel K-wire interlocking fixation between the first and second metacarpals.Methods: Twenty patients treated by the above technique from October 2015 to December 2018 at our institution were retrospectively reviewed. The patients’ average age was 36 years (range, 16–61 years). Eleven patients were extra-articular fractures and nine were intra-articular fractures. The mean follow-up period was 12 months (range, 10–18 months). At the final follow-up, the functional recovery of the injured hand was assessed and compared with that of the uninjured hand.Results: All patients recovered well with no complications. In the extra-articular fracture group, the mean hand grip strength, pinch strength, and Kapandji score were 43.4 ± 7.0 kg, 9.1 ± 1.4 kg, and 9.5 ± 0.7 on the injured side and 41.7 ±6.8 kg, 8.7 ± 0.8 kg, and 9.7 ± 0.5 on the uninjured side, respectively, with no significant differences. In the intra-articular fracture group, the above indexes were 43.0 ± 6.5 kg, 9.0 ± 1.1 kg, and 9.3 ± 0.7 on the injured side and 42.1 ± 6.6 kg, 8.6 ± 1.1 kg, and 9.7 ± 0.5 on the uninjured side, respectively, also with no significant differences. The abduction and flexion-extension arc of the thumb on the injured hand were lower than those on the uninjured hand in both the extra-articular and intra-articular fracture groups, but the patients felt clinically well with respect to daily activities and strength.Conclusion: The percutaneous parallel K-wire and the interlocking fixation technique is simple, effective, and economic for first metacarpal base fractures.

scholarly journals Effect of Maternal Prenatal and Postpartum Vitamin D Supplementation on Offspring Bone Mass in Early Childhood: Follow-Up of a Randomized Controlled Trial

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 797-797
Author(s):  
Karen O'Callaghan ◽  
Shaila Shaila ◽  
Farzana Fariha ◽  
Jennifer Harrington ◽  
Abdullah Al Mahmud ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Mass ◽  
Bone Mineral ◽  
Vitamin D3 ◽  
Vitamin D Supplementation ◽  
Mean Difference ◽  
Whole Body ◽  
Musculoskeletal Health ◽  
Maternal Vitamin

Abstract Objectives Maternal vitamin D status has gained substantial attention as a modifiable contributor to offspring musculoskeletal health, yet there is a paucity of trial-derived data to corroborate effects of prenatal or postpartum vitamin D supplementation on offspring bone mass accrual. Among maternal-infant pairs in Bangladesh, we aimed to examine the hypothesized causal association of early life vitamin D exposure with musculoskeletal health in childhood. Methods In a double-blind dose-ranging trial of maternal vitamin D3 supplementation (Maternal Vitamin D for Infant Growth Trial), healthy pregnant women (n = 1300) were recruited at 17–24 weeks’ gestation and randomly assigned to receive a prenatal; postpartum regimen of 0;0,4200;0,16,800;0,28,000;0 or 28,000;28,000 IU vitamin D3/week until 26 weeks postpartum. In a follow-up study of offspring at 4 years of age (n = 642), bone mineral content (BMC) and bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry. Between-group differences were assessed by independent t-tests (28,000 IU/week prenatally vs placebo) and linear regression (each vitamin D treatment group vs placebo) with bootstrapping (1000 replications). Results Whole-body (WB), total-body-less-head (TBLH) and head-only BMC were similar in the combined high-dose prenatal and placebo groups (mean difference [95% CI] = 6.81g [−8.70, 22.32], 0.61g [−10.90, 12.13] and 1.71g [−3.54, 6.96], respectively). None of the mean values for WB or TBLH BMC or BMD in each vitamin D group were different from placebo (P > 0.05 for all comparisons). Although head BMD was slightly greater in offspring of women assigned to the 28,000;28,000 IU regimen compared to placebo (mean difference [95% CI] = 0.024g/cm2 [0.0009, 0.047], P = 0.042), the effect was attenuated and no longer significant upon adjustment for child height, weight, and sex (P = 0.11). Conclusions In a population with high prevalence of vitamin D deficiency, our findings do not support the use of maternal prenatal vitamin D supplementation, with or without postpartum supplementation, for improvement of child BMC or BMD at 4 years of age. Funding Sources Canadian Institutes for Health Research and the Bill and Melinda Gates Foundation.

P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Karataş ◽  
B E Temiz ◽  
S Mumusoglu ◽  
H Yarali ◽  
G Bozdag
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Mean Difference ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Drop ◽  
Mean Size ◽  
The Mean ◽  
Respective Figure

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

scholarly journals Long-Term Effects of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Body Composition and Bone Mass Density

Obesity Facts ◽  
2020 ◽  
pp. 1-10
Author(s):  
Julian Bühler ◽  
Silvan Rast ◽  
Christoph Beglinger ◽  
Ralph Peterli ◽  
Thomas Peters ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Body Composition ◽  
Sleeve Gastrectomy ◽  
Bone Mass ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Mass Density ◽  
Bone Mass Density

<b><i>Background:</i></b> Currently, the two most common bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Long-term data comparing the two interventions in terms of their effect on body composition and bone mass density (BMD) are scarce. <b><i>Objective:</i></b> The aim of this study was to assess body composition and BMD at least 5 years after LSG and LRYGB. <b><i>Setting:</i></b> Department of Endocrinology and Nutrition, St. Claraspital Basel and St. Clara Research Ltd., Basel, Switzerland. <b><i>Methods:</i></b>Bariatric patients at least 5 years after surgery (LSG or LRYGB) were recruited, and body composition and BMD were measured by means of dual-energy X-ray absorptiometry. Data from body composition before surgery were included in the analysis. Blood samples were taken for determination of plasma calcium, parathyroid hormone, vitamin D<sub>3</sub>, alkaline phosphatase, and C-terminal telopeptide, and the individual risk for osteoporotic fracture assessed by the Fracture Risk Assessment Tool score was calculated. After surgery, all patients received multivitamins, vitamin D<sub>3</sub>, and zinc. In addition, LRYGB patients were prescribed calcium. <b><i>Results:</i></b> A total of 142 patients were included, 72 LSG and 70 LRYGB, before surgery: median body mass index 43.1, median age 45.5 years, 62.7% females. Follow-up after a median of 6.7 years. For LRYGB, the percentage total weight loss at follow-up was 26.3% and for LSG 24.1% (<i>p</i> = 0.243). LRYGB led to a slightly lower fat percentage in body composition. At follow-up, 45% of both groups had a T score at the femoral neck below –1, indicating osteopenia. No clinically relevant difference in BMD was found between the groups. <b><i>Conclusions:</i></b>At 6.7 years after surgery, no difference in body composition and BMD between LRYGB and LSG was found. Deficiencies and bone loss remain an issue after both interventions and should be monitored.

scholarly journals Bone Morphology in 46 BXD Recombinant Inbred Strains and Femur-Tibia Correlation

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yueying Zhang ◽  
Jinsong Huang ◽  
Yan Jiao ◽  
Valentin David ◽  
Mehmet Kocak ◽  
...  
Keyword(s):  
Bone Mass ◽  
Recombinant Inbred ◽  
Bone Microarchitecture ◽  
Strain Differences ◽  
Inbred Strains ◽  
Morphological Properties ◽  
Mouse Strains ◽  
Bone Morphology ◽  
Mineral Density ◽  
Bone Properties

We examined the bone properties of BXD recombinant inbred (RI) mice by analyzing femur and tibia and compared their phenotypes of different compartments. 46 BXD RI mouse strains were analyzed including progenitor C57BL/6J (n=16) and DBA/2J (n=15) and two first filial generations (D2B6F1 and B6D2F1). Strain differences were observed in bone quality and structural properties (P<0.05) in each bone profile (whole bone, cortical bone, or trabecular bone). It is well known that skeletal phenotypes are largely affected by genetic determinants and genders, such as bone mineral density (BMD). While genetics and gender appear expectedly as the major determinants of bone mass and structure, significant correlations were also observed between femur and tibia. More importantly, positive and negative femur-tibia associations indicated that genetic makeup had an influence on skeletal integrity. We conclude that (a) femur-tibia association in bone morphological properties significantly varies from strain to strain, which may be caused by genetic differences among strains, and (b) strainwise variations were seen in bone mass, bone morphology, and bone microarchitecture along with bone structural property.

scholarly journals Low Bone Mass and Osteoporosis in Hispanic Acute Lymphoblastic Leukemia Survivors. Is It a Real Problem ?

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 5015-5015
Author(s):  
Alfonso Orozco ◽  
Juan Rangel-Patiño ◽  
Mayra Valdez-Carrizales ◽  
Roberta Demichelis
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Mass ◽  
Bone Mineral ◽  
Research Funding ◽  
Lymphoblastic Leukemia ◽  
Mineral Density ◽  
High Prevalence

Abstract Introduction: The survival rates in children and adolescent or young adults with acute lymphoblastic leukemia (ALL) have improved in the last decades. Cancer survivors can have reduced bone mineral density (BMD) related both to the underlying disease and the treatment. This can persist for up to 20 years, increasing the risk of osteopenia / osteoporosis and the development of fractures that can generate disability and loss of function. The risk factors for the development of disorders of BMD in the adult ALL survivors has been little studied and there are no formal guideline recommendations on the long-term follow-up and treatment of these patients. We evaluated ALL-survivor patients in Mexico; both ALL and osteoporosis are more prevalent in Hispanic patients, therefore we implemented conducting a dual-energy x-ray absorptiometry (DXA) during follow-up. Primary objective: Our main objective was to know the prevalence of alterations in bone mineral density (BMD) in a cohort of Hispanic ALL-survivors. Secondary objectives: To identify risk factors and the incidence of complications associated with BMD alterations. Methods: An observational, case-control study in a cohort of adult ALL survivors with follow-up at a referral center´s acute leukemia clinic in Mexico City. We include patients with more than one year of elective cessation of treatment in whom a DXA was performed as the routine follow-up for survivors. We compared the characteristics of the cases (patients with alterations in BMD) with the controls (patients without alterations in BMD). We define alterations in BMD by the WHO and the International Society of clinical DXA: the term of low BMD was used for younger patients and osteoporosis/osteopenia for older. Results: 61 ALL survivors were identified, 86.9% had B-Cell ALL and 13.1% T-Cell ALL. The median age at diagnosis was 12 years (1-55 years) and at the time of the study, 27 years (20-69 years). The majority (78.8%) had less than 18 years-old at diagnosis. The median follow-up from treatment cessation to densitometry was 142 months (10-499 months). An alteration in BMD was found in 63.9% of the patients: 84.6% were classified as low BMD for age and 15.4% as osteopenia/osteoporosis. The most frequently affected site was the spine (40%) followed by the hip and spine (32.5%) and the hip (10%). The median T-score and Z-score by area are shown in Table 1. Table 2 shows the characteristics of ALL-survivors with or without alterations in BMD. The median follow-up time was not different between the 2 groups. Gender, age at diagnosis, the use of induction dexamethasone and other chemotherapeutic agents, vitamin D deficiency, and hypogonadism were not associated with an increased risk of alterations in BMD. Receiving induction chemotherapy between 8 and 18 years of age (age where the highest bone mass is acquired) does not affect in the BMD at follow-up. During follow-up, three patients developed fractures: one pathological and 2 associated with trauma. The patient with a pathological fracture is a man with ALL diagnosed at 8 years of age and had an ankle fracture at 12 years associated with osteoporosis. Discussion and Conclusions: Alterations in BMD are very frequent in our cohort of ALL-survivors despite being a very young population (90% are under 50 years of age). We could not replicate the classically associated risk factors for altered BDM. We only found a non-significant trend for hematopoietic-stem cell transplantation (HSCT) and radiotherapy. This was previously been associated with alterations in different hormonal axes. Despite the high-prevalence of alterations in BMD, the incidence of fractures is very low. This may be related to the fact that it is unknown how to interpret DXA in a group of patients who received chemotherapy/radiotherapy in growth stages. Despite the limitations (small number of patients, the time between treatment and densitometry is heterogeneous and hormonal axes are not measured in all patients), given the high prevalence of BMA alterations, a better understanding of DXA findings in this group of patients is needed. Figure 1 Figure 1. Disclosures Rangel-Patiño: Bristol: Consultancy; Abbvie: Speakers Bureau. Demichelis: AMGEN: Consultancy, Speakers Bureau; Novartis: Consultancy, Research Funding, Speakers Bureau; Astellas: Consultancy; Bristol/Celgene: Consultancy, Speakers Bureau; Jazz: Consultancy; ASH: Research Funding; Gilead: Consultancy; Abbvie: Consultancy, Speakers Bureau.

scholarly journals KORELASI KADAR CRP, TNF-α DAN BONE MINERAL DENSITY DENGAN CARBOXYTERMINAL CROSSLINKED TELOPEPTIDE TYPE I OF COLLAGEN DI PENDERITA ARTRITIS REUMATOID

2018 ◽  
Vol 18 (2) ◽  
pp. 77
Author(s):  
Kusworini Handono ◽  
BP Putra Suryana ◽  
Sulistyorini Sulistyorini
Keyword(s):  
Bone Mineral Density ◽  
Bone Resorption ◽  
Bone Mass ◽  
Bone Mineral ◽  
Mass Density ◽  
Bone Mass Density ◽  
Bone Resorption Marker ◽  
Type I ◽  
Mineral Density ◽  
Tnf Α

Rheumatoid Arthritis (RA) is a systemic autoimmune disease accompanied by decreasing bone mass density and ultimately leads toosteoporosis. The cause of decreased bone mass density is still unknown, but the inflammation has been suspected as an important factor.The correlation between the severity of inflammation with the decrease in bone mass density in Indonesian RA patients has not been muchstudied. The purpose of this study was to know the assessment in the correlation between levels of C-reactive protein (CRP), Tumour NecrosisFactor-α (TNFα) and bone mineral density (BMD) with bone resorption marker CTx-1 β-Cross Laps in premenopausal RA patients.Thisobservational study using cross sectional design, was carried out in the Rheumatology Clinic and Central Laboratory of RSSA, Malang fromAugust 2009 until October 2010. All 47 RA patients were diagnosed according to revised of the 1997 American College of Rheumatology(ACR). Measurement of CRP levels uses turbidimetry method, TNF-α and CTX-1 β-Cross Laps levels using ELISA methods and the measurementof BMD using DEXA. The results of this study showed mean levels of CRP were 4.288±1.775 g/L, TNF-α were 322.077±275.248 pg/mLand CTX-1 β-Cross Laps were 0.588±0.139 ng mL. The correlation of CRP and TNF-α levels with CTX-1 β-Cross Laps level were r=0.5832,p=0.453 and r=0.615, p=0.041. Correlation of CTX-1 β-Cross Laps level and Femoral Neck BMD was r=–0.469, p=0.143 and r=0.248,p=0.799 for L average BMD. There was no correlation between CRP level and BMD results with bone resorption marker CTX-1 β-Cross Laps,but there is a significant correlation between high levels of TNFα with CTX-1 β-Cross Laps. It seems that TNF-α appears to be contributed tothe decrease of bone mass density in RA patients.

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