scholarly journals Sex Hormone Status May Modulate Rate of Expansion of Proximal Femur Diameter in Older Women alongside Other Skeletal Regulators

2007 ◽  
Vol 92 (1) ◽  
pp. 304-313 ◽  
Author(s):  
S. Kaptoge ◽  
N. Dalzell ◽  
E. Folkerd ◽  
D. Doody ◽  
K.-T. Khaw ◽  
...  
Keyword(s):  
Bone Mineral ◽  
Proximal Femur ◽  
Sex Hormone ◽  
Vitamin D Metabolites ◽  
Mineral Density ◽  
Hip Geometry ◽  
Cross Sectional ◽  
Narrow Neck ◽  
Section Modulus ◽  
Hormone Status

Abstract Context: Little is known of associations between hip geometry and skeletal regulators. This is important because geometry is a determinant of both hip function and resistance to fracture. Objective: We aimed to determine the effects of sex hormone status and other candidate regulators on hip geometry and strength. Subjects and Methods: A random sample of 351 women aged 67–79 had two to four hip dual-energy x-ray absorptiometry scans performed over 8 yr of follow-up. Hip structural analysis software was used to measure subperiosteal diameter (PD) and the distance from the center of mass to the lateral cortical margin (d-lat) on three 5-mm-thick cross-sectional regions: narrow neck, intertrochanter, and shaft. Section modulus (Z), bone mineral density (grams per centimeter squared), and an index of bone mineral content (cross-sectional area) were calculated as estimators of bone strength. Serum analytes measured at baseline included SHBG, estradiol, PTH, creatinine, albumin, vitamin D metabolites, and glutamate- and γ-carboxyglutamate-osteocalcin (OC). A linear mixed model was used to model associations with predictor variables, including testing whether the predictors significantly modified the effect of aging. Results: Aging was associated with increasing PD and d-lat, and higher baseline SHBG significantly modified this effect, in the case of PD, increasing the rates of change at the narrow neck region by 19% for SHBG level 2 sd higher than population mean (P = 0.026). Higher baseline creatinine was independently associated with faster increases in PD and d-lat with aging (P < 0.041). Z declined faster with aging if baseline PTH was higher, and higher albumin had a contrary effect. Z was positively associated with free estradiol and inversely associated with SHBG and glutamate-OC. Conclusion: These results show large effects of SHBG on the regulation of proximal femur expansion and bending resistance, probably acting as a surrogate for low bioavailable estrogen. Potentially important effects for fracture resistance in old age were also revealed for PTH, markers related to renal function and the nutritional markers albumin and undercarboxylated OC.

Bone Mineral Density Assessment by DXA vs. QCT in Postmenopausal Females with Central Obesity

2020 ◽  
Vol 13 (2) ◽  
pp. 153-161
Author(s):  
Lejla Milisic ◽  
Sandra Vegar-Zubovic ◽  
Amina Valjevac ◽  
Suada Hasanovic-Vučković
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Central Obesity ◽  
Quantitative Computed Tomography ◽  
Normal Weight ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.

Bone mineral density and sex hormone status in intellectually disabled women on progestin-induced amenorrhea

2009 ◽  
Vol 88 (4) ◽  
pp. 428-433 ◽  
Author(s):  
Maria Arvio ◽  
Päivi Kilpinen-Loisa ◽  
Aila Tiitinen ◽  
Kari Huovinen ◽  
Outi Mäkitie
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Sex Hormone ◽  
Intellectually Disabled ◽  
Mineral Density ◽  
Hormone Status ◽  
Disabled Women

scholarly journals Selective Determinants of Low Bone Mineral Mass in Adult Women with Anorexia Nervosa

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Andrea Trombetti ◽  
Laura Richert ◽  
François R. Herrmann ◽  
Thierry Chevalley ◽  
Jean-Daniel Graf ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Apparent Density ◽  
Proximal Femur ◽  
Control Group ◽  
Adult Women ◽  
Mineral Density ◽  
Hip Geometry ◽  
Bone Mineral Apparent Density

We investigated the relative effect of amenorrhea and insulin-like growth factor-I (sIGF-I) levels on cancellous and cortical bone density and size. We investigated 66 adult women with anorexia nervosa. Lumbar spine and proximal femur bone mineral density was measured by DXA. We calculated bone mineral apparent density. Structural geometry of the spine and the hip was determined from DXA images. Weight and BMI, but not height, as well as bone mineral content and density, but not area and geometry parameters, were lower in patients with anorexia nervosa as compared with the control group. Amenorrhea, disease duration, and sIGF-I were significantly associated with lumbar spine and proximal femur BMD. In a multiple regression model, we found that sIGF-I was the only significant independent predictor of proximal femur BMD, while duration of amenorrhea was the only factor associated with lumbar spine BMD. Finally, femoral neck bone mineral apparent density, but not hip geometry variables, was correlated with sIGF-I. In anorexia nervosa, spine BMD was related to hypogonadism, whereas sIGF-I predicted proximal femur BMD. The site-specific effect of sIGF-I could be related to reduced volumetric BMD rather than to modified hip geometry.

scholarly journals Reduction of trabecular and cortical volumetric bone mineral density at the proximal femur in patients with acromegaly

2016 ◽  
Vol 174 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Elena Valassi ◽  
Iris Crespo ◽  
Jorge Malouf ◽  
Jaume Llauger ◽  
Anna Aulinas ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Disease Duration ◽  
Quantitative Computed Tomography ◽  
Cross Sectional Study ◽  
Volumetric Bone Mineral Density ◽  
Inverse Association ◽  
Mineral Density ◽  
Cross Sectional

ObjectiveData on dual energy absorptiometry (DXA)-measured bone mineral density (BMD) at the level of the total hip (TH) and femoral neck (FN) in patients with acromegaly (ACRO) are conflicting. Increase in bone size associated with ACRO may limit the reliability of DXA. Our objective is to evaluate trabecular and cortical volumetric BMD (vBMD) across the proximal femur in ACRO patients.DesignCross sectional study in a clinical research center.PatientsThirty-five ACRO patients (19 males; mean age, 48±7 years; BMI, 27.5±4.4 kg/m2; 17 with active disease) and 35 age, gender, and BMI-matched controls.ResultsvBMD was assessed by quantitative computed tomography at the level of the TH, FN, trochanter (TR), and intertrochanteric (IT). Trabecular vBMD was lower in both total and active ACRO as compared with controls (P<0.01). Cortical vBMD was lower in ACRO patients (active and controlled) vs controls at both TH and TR sites (P<0.05). These findings were confirmed when only eugonadal patients were analyzed. Both total cross sectional area (CSA) and average cortical thickness (ACT) were greater in ACRO patients vs controls (P<0.05). An inverse association between disease duration and trabecular vBMD at TH (r=−0.42, P=0.023) and IT (r=−0.41, P=0.026) was also found.ConclusionBoth cortical and trabecular vBMD are reduced at the proximal femur in ACRO patients, regardless of gender, gonadal status, and disease activity. Disease duration is negatively associated with trabecular vBMD at the TH and IT.

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