scholarly journals A Densitometric and Morphometric Analysis of the Skeleton in Adults with Varying Degrees of Growth Hormone Deficiency

2006 ◽  
Vol 91 (2) ◽  
pp. 432-438 ◽  
Author(s):  
Robert D. Murray ◽  
Judith E. Adams ◽  
Stephen M. Shalet
Keyword(s):  
Bone Mineral Density ◽  
Bone Density ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Cortical Thickness ◽  
Controlled Study ◽  
Bone Area ◽  
Mineral Density ◽  
Cross Sectional ◽  
Cortical Density

Context: Low bone mass is a characteristic feature of the adult GH deficiency (GHD) syndrome, but recent dual-energy x-ray absorptiometry (DXA) studies in patients with GH-receptor and GHRH-receptor gene mutations suggest that the situation is more complex. Objective: The objective was to define bone areal and volumetric densities and morphometry in hypopituitary adults. Design: The study was a cross-sectional case-controlled study performed between 1999 and 2001. Setting: The study was undertaken at an endocrine tertiary referral center. Patients: Thirty patients with GHD, 24 with GH insufficiency (GHI) [peak GH, 3–7 μg/liter (9–21 mU/liter)], and 30 age- and sex-matched controls were included for study. Main Outcome Measures: DXA and peripheral quantitative computed tomography (pQCT) derived bone density and morphometry were measured. Results: No densitometric or morphometric abnormalities were detected in GHD patients who acquired their deficiency during adult life. GHD adults of childhood-onset (CO-GHD) showed decreased bone mineral density at the lumbar spine and hip on DXA. pQCT of the radius showed that CO-GHD patients have normal trabecular bone mineral density and only a 2% decrease in cortical density. Radial bone area was reduced 14.5%, cortical thickness 20%, and cortical cross-sectional area 23%, culminating in a reduction in cortical bone of 25%. The “apparent” low DXA bone density in CO-GHD adults therefore relates primarily to reduced cortical thickness and smaller bone area. DXA and pQCT data derived from adults with GHI revealed no evidence of densitometric or morphometric abnormalities. Conclusions: 1) Adult-onset GHD patients have normal bone density and size. 2) CO-GHD adults have marginally reduced cortical density but significantly reduced cortical bone as a result of reduced cortical thickness and bone size. 3) GHI has no measurable impact on the skeleton.

scholarly journals Cortical bone area predicts incident fractures independently of areal bone mineral density in older men

2016 ◽  
pp. jc.2016-3177 ◽  
Author(s):  
Claes Ohlsson ◽  
Daniel Sundh ◽  
Andreas Wallerek ◽  
Martin Nilsson ◽  
Magnus Karlsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Older Men ◽  
Areal Bone Mineral Density ◽  
Bone Area ◽  
Mineral Density

scholarly journals Experimental study exploring the factors that promote rib fragility in the elderly

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christian Liebsch ◽  
Shamila Hübner ◽  
Marco Palanca ◽  
Luca Cristofolini ◽  
Hans-Joachim Wilke
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Cortical Thickness ◽  
Volume Ratio ◽  
The Elderly ◽  
Fracture Load ◽  
Surface Strain ◽  
Mineral Density ◽  
Cross Sectional ◽  
Trabecular Number

AbstractRib fractures represent a common injury type due to blunt chest trauma, affecting hospital stay and mortality especially in elderly patients. Factors promoting rib fragility, however, are little investigated. The purpose of this in vitro study was to explore potential determinants of human rib fragility in the elderly. 89 ribs from 13 human donors (55–99 years) were loaded in antero-posterior compression until fracture using a material testing machine, while surface strains were captured using a digital image correlation system. The effects of age, sex, bone mineral density, rib level and side, four global morphological factors (e.g. rib length), and seven rib cross-sectional morphological factors (e.g. cortical thickness, determined by μCT), on fracture load were statistically examined using Pearson correlation coefficients, Mann–Whitney U test as well as Kruskal–Wallis test with Dunn-Bonferroni post hoc correction. Fracture load showed significant dependencies (p < 0.05) from bone mineral density, age, antero-posterior rib length, cortical thickness, bone volume/tissue volume ratio, trabecular number, trabecular separation, and both cross-sectional area moments of inertia and was significantly higher at rib levels 7 and 8 compared to level 4 (p = 0.001/0.013), whereas side had no significant effect (p = 0.989). Cortical thickness exhibited the highest correlation with fracture load (r = 0.722), followed by the high correlation of fracture load with the area moment of inertia around the longitudinal rib cross-sectional axis (r = 0.687). High correlations with maximum external rib surface strain were detected for bone volume/tissue volume ratio (r = 0.631) and trabecular number (r = 0.648), which both also showed high correlations with the minimum internal rib surface strain (r =  − 0.644/ − 0.559). Together with rib level, the determinants cortical thickness, area moment of inertia around the longitudinal rib cross-sectional axis, as well as bone mineral density exhibited the largest effects on human rib fragility with regard to the fracture load. Sex, rib cage side, and global morphology, in contrast, did not affect rib fragility in this study. When checking elderly patients for rib fractures due to blunt chest trauma, patients with low bone mineral density and the mid-thoracic area should be carefully examined.

scholarly journals Response to Letter: “Cortical Bone Area Predicts Incident Fractures Independently of Areal Bone Mineral Density in Older Men”

2017 ◽  
Vol 102 (5) ◽  
pp. 1782-1782 ◽  
Author(s):  
Claes Ohlsson ◽  
Daniel Sundh ◽  
Andreas Wallerek ◽  
Martin Nilsson ◽  
Magnus Karlsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Older Men ◽  
Areal Bone Mineral Density ◽  
Bone Area ◽  
Mineral Density

scholarly journals Type 2 diabetes and Change in Total Hip Bone Area and Bone Mineral Density in Elderly Swedish Men and Women

2021 ◽  
Author(s):  
Adam Mitchell ◽  
Tove Fall ◽  
Håkan Melhus ◽  
Lars Lind ◽  
Karl Michaëlsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Cross Sectional Study ◽  
Bone Area ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip

Abstract Context In a cross-sectional study, we found an association between type 2 diabetes mellitus (T2DM) and smaller bone area together with a greater bone mineral density (BMD) at the total hip. Objective To investigate these associations longitudinally, by studying T2DM status (no T2DM n=1521, incident T2DM n=119 or prevalent T2DM n=106) in relation to changes in total hip bone area and BMD. Methods In three cohorts, the Swedish Mammography Cohort Clinical (SMCC; n=1060, Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; n=483) and Uppsala Longitudinal Study of Adult Men (ULSAM; n=203), with repeat assessment of T2DM status and dual energy x-ray absorptiometry (DXA) measurements of total hip bone area and BMD on average 8 years apart, a linear regression model was used to assess the effect of T2DM status on change in bone area and BMD at the total hip. Results After meta-analysis, the change in bone area at the total hip was 0.5% lower among those with incident T2DM compared to those without T2DM (-0.18 cm 2 [95% CI -0.30, -0.06]). The change in bone area was similar among those with prevalent T2DM compared to those without (0.00 cm 2 [95% CI -0.13, 0.13]). For BMD, the combined estimate was 0.004 g/cm 2 (95% CI -0.006, 0.014) among those with incident T2DM and 0.010 g/cm 2 (95% CI -0.000, 0.020) among those with prevalent T2DM, compared to those without T2DM. Conclusion Those with incident T2DM have a lower expansion in bone area at the total hip compared to those without T2DM.

scholarly journals Effect of Tissue-Selective Estrogen Complex on Hip Structural Geometry in Postmenopausal Women: A 12-Month Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Bo Mi Kim ◽  
Sung Eun Kim ◽  
Dong-Yun Lee ◽  
DooSeok Choi
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Cortical Thickness ◽  
Bone Geometry ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Mineral Density ◽  
Hip Geometry ◽  
Cross Sectional

BackgroundHip structural analysis (HSA) is a method for evaluating bone geometry reflecting bone structural and biomechanical properties. However, tissue-selective estrogen complex (TSEC) treatment effects on HSA have not been investigated.ObjectiveThis study was performed to evaluate the effect of TSEC treatment on hip geometry in postmenopausal Korean women. The treatment was given for 12 months, and hip geometry was measured by HSA.Materials and MethodsA total of 40 postmenopausal women who received TSEC containing conjugated estrogen 0.45 mg and bazedoxifene 20 mg for treating vasomotor symptoms were included in this retrospective cohort study. The changes in bone mineral density and parameters of HSA including the outer diameter, cross-sectional area, cross-sectional moment of inertia, cortical thickness, section modulus, and buckling ratio as determined by dual-energy X-ray absorptiometry were compared before and after 12 months of TSEC treatment.ResultsMean age and years since menopause were 55.1 and 4.5 years, respectively. Total hip bone mineral density significantly increased by 0.74% after treatment (P=0.011). The changes in HSA were mainly demonstrated in the narrow femoral neck: cross-sectional area (P=0.003) and cortical thickness (P&lt;0.001) increased significantly. For the shaft region, only SM decreased significantly after treatment (P=0.009). However, most parameters did not change significantly with TSEC treatment in the intertrochanteric and shaft regions.ConclusionsOur findings demonstrate that 12 months of TSEC treatment could improve bone geometry as measured by HSA. The findings suggest that TSEC might be an interesting option for the prevention of fracture as well as osteoporosis in postmenopausal women.

scholarly journals Assessment of Bone Mineral Density in Patients Undergoing Hemodialysis; An Iranian Population-Based Study

2021 ◽  
Vol 24 (8) ◽  
pp. 599-606
Author(s):  
Saeid Amirkhanlou ◽  
Gholamreza Roshandel ◽  
Mehrdad Aghaei ◽  
Hossein Mohebi ◽  
Sahab-Sadat Tabatabei ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Density ◽  
Bone Mineral ◽  
Mass Density ◽  
Population Based ◽  
Cross Sectional Study ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Cross Sectional ◽  
Low Bone Density

Background: End-stage renal disease (ESRD) is a condition in which bone turnover and metabolism is impaired; thus, osteoporosis and low bone density are subsequently inevitable. We aimed to determine bone mineral density (BMD) and biochemical markers, and associated factors in hemodialysis (HD) patients. Methods: Patients aged 30-70 years undergoing HD between 2015 to 2019 were enrolled in this cross-sectional study. BMD measured by dual energy x-ray absorptiometry (DEXA) and biochemical laboratory tests were assessed in 200 patients undergoing HD. Statistical analysis was based on t test, Pearson, regression and Mann-Whitney tests using SPSS 16. Results: Two hundred patients were investigated. Sixty percent of the patients were female. Mean ± SD of participants’ age was 58.6 (±11.63) years and mean ± SD for duration of HD was 45.69 (± 43.76) months. Osteoporosis was found in 48% (n=96) and low bone density in 36% (n=76) of our patients. General osteoporosis was more frequent in those undergoing HD for more than 3 years, although not significantly (P=0.093, odds ratio [OR]=0.37). However, regional osteoporosis in hip and femoral neck, but not spine vertebrae, were significantly higher after three years of HD (P=0.036, OR=0.27; P=0.042, OR=0.27; and P=0.344, OR=0.56, respectively). Increased body mass index (BMI) correlated negatively with osteoporosis (P=0.050). Conclusion: With increasing age and duration of HD, BMD decreases. Higher BMI was associated with higher bone mass density. Bone density assessment seems to be necessary in patients undergoing HD.

scholarly journals Thyroid hormone status within the physiological range affects bone mass and density in healthy men at the age of peak bone mass

2011 ◽  
Vol 164 (6) ◽  
pp. 1027-1034 ◽  
Author(s):  
Greet Roef ◽  
Bruno Lapauw ◽  
Stefan Goemaere ◽  
Hans Zmierczak ◽  
Tom Fiers ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Bone Density ◽  
Bone Mass ◽  
Thyroid Hormones ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Peak Bone Mass ◽  
Bone Area ◽  
Mineral Density ◽  
Healthy Men

ContextThe hormonal factors involved in the regulation of peak bone mass (PBM) in men have not been fully investigated. Apart from gonadal steroids and somatotropic hormones, thyroid hormones are known to affect bone maturation and homeostasis and are additional candidate determinants of adult bone mass.ObjectiveWe aimed to investigate between-subject physiological variation in free and total thyroid hormone concentrations, TSH, and thyroid binding globulin (TBG) in relation to parameters of bone mass, geometry, and mineral density in healthy men at the age of PBM.Design and settingWe recruited 677 healthy male siblings aged 25–45 years in a cross-sectional, population-based study. Areal and volumetric bone parameters were determined using dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). Total and free thyroid hormones, TBG, and TSH were determined using immunoassays.ResultsFree and total thyroid hormone concentrations were inversely associated with bone mineral density (BMD) and bone mineral content (BMC) at the hip and total body (free triiodothyronine (FT3), total T3 (TT3), and total T4 (TT4)) and at the spine (FT3). TBG was negatively associated with BMC and areal BMD at all sites. At the radius, cortical bone area was inversely associated with TT3, TT4, and TBG, and trabecular bone density was inversely associated with free thyroxine, TT4, and TBG. We observed inverse associations between cortical bone area at the mid-tibia and FT3, TT3, TT4, and TBG. No associations between TSH and DXA or pQCT measurements were found.ConclusionIn healthy men at the age of PBM, between-subject variation in thyroid hormone concentrations affects bone density, with higher levels of FT3, TT3, TT4, and TBG being associated with less favorable bone density and content.

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