جستجوی مقالات مرتبط با کلیدواژه « Bone Mineral Density » در نشریات گروه « پزشکی »

Osteoporosis and osteopenia considered as severe problems in Beta thalassemia major (BTM) that can lead to bone fractures. We aimed to investigate bone mineral density status and the laboratory parameters related to bone metabolism in BTM patients and compare the statically differences between the mentioned parameters in the patients with or without bone fractures.

The results of laboratory parameters including; Hemoglobin (Hb), Calcium (Ca), Vitamin D (Vit D), Phosphorus (P), Magnesium (Mg), Alkaline Phosphatase (ALP), Ferritin (FER), Serum Iron (SFe), Thyroid Stimulating Hormone (TSH), T3, T4 and Parathyroid Hormone (PTH), and BMD (by using Dual-Energy X-ray Absorptiometry (DEXA) method) were investigated in 143 BTM patients from thalassemia center of Dezful University of Medical Sciences in 2023.

Seventy-two women and 71 men with confirmed BTM diagnosis with age range (32.4 ± 9.7) were entered in the study. Laboratory parameters including TSH, T3, T4, ALP, FER 247) and SFe showed a significant difference between fracture and non-fracture groups respectively (P≤0.05). In this study, Z-Score between -1.1 and -2.4 was considered osteopenia, and below -2.5 was osteoporosis. Among the studied patients 36.6%, 39.1% and 24.2% had normal bone density, osteopenia and had osteoporosis respectively.

Osteopenia and osteoporosis had a high frequency among the studied patients that can prone them to bone fractures. Continuous examinations of laboratory tests, especially T3, T4, TSH, FER, SFE, can be helpful for faster diagnosis and therapeutic interventions to prevent the occurrence of osteopenia and pathological fractures.

The health-related quality of life and management of patients with thalassemia has significantly improved in recent years due to standard treatments and safe blood transfusions with effective chelation therapy to reduce iron overload. Transfusion-dependent thalassemia is associated with numerous skeletal abnormalities, including osteoporosis, which is a significant cause of morbidity in these patients. Osteoporosis is characterized by low bone mass and an increased risk of fractures, particularly in the lumbar spine and in patients with extramedullary hematopoiesis. It remains a significant problem in adult transfusion-dependent thalassemia, particularly in patients under chelation therapy. A fracture history is significantly associated with lower Dual-Energy X-ray Absorptiometry (DEXA) T/Z scores, which decrease with age. Improved management and modern treatments for transfusion-dependent thalassemia patients with osteoporosis should be prioritized to prevent bone fractures and improve quality of life in older age.

Since various medications can control the rate of fractures and subsequent complications of osteoporosis, the early detection of the disease is crucial. This systematic study aimed to compare the diagnostic accuracy of Singh index (SI) with dual-energy X-ray absorptiometry (DEXA) as a benchmark standard for diagnosing osteoporosis.

The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were utilized in the current study. A detailed search was carried out using PubMed and Scopus from inception to 30 May 2022. Examining quality of the studies was performed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).

A total of 22 studies were included. In general, 50% of the studies considered SI a poor screening tool for detecting osteoporosis due to a negligible inter-observer agreement between SI and DEXA or a poor correlation of SI with the bone mineral density (BMD) category or DEXA T-score. A moderate inter-observer agreement was reported for SI in 5 (55.6%) studies. Among the studies assessing the sensitivity and specificity of SI compared to DEXA (n=13), six studies estimated a low sensitivity for SI.

While there is supporting evidence indicating the potential usefulness of SI for predicting femoral neck fractures in individuals with suspected osteoporosis, numerous studies challenge its reliability and diagnostic value as a screening tool for identifying femoral neck osteoporosis. Further primary studies are required to verify the effectiveness of the SI index in identifying populations at risk of osteoporosis. Level of evidence: V

The prevalence of short stature was reported high in thalassemia major patients. It causes mental and social problems for them. As different cut-off points for growth retardation are suggested in these patients, it is desirable to find a careful cut-off age using statistical analysis to help patients before it is too late. 

Data from 803 thalassemia major patients was extracted from questionnaires completed in person by the operator. They contained demographic data, family, medical, and drug history. Height and weight measurements were conducted by only one device. The mean age was 20±7 years and there were 420 females in the sample. Children (<20 years of age) constituted 47% of the participants. Patients who reported a major risk factor for osteoporosis were omitted from this study. The SPSS software, version 16 was used for the statistical analysis

Short stature was found in 32% of patients. Being 10 to 11 years old or above increased the risk of short stature, 28.5 and 21.4 times, respectively compared to younger patients (P<0.001). On the other hand, after 7 years of age up to 18 years of age, similar to 10 years of age and 11 years of age, increases the risk of short stature. Also being 27 years old and 30 years old and above increases the risk of short stature 1.4 and 1.7 times, respectively, compared to younger patients (P=0.042 and <0.018, respectively). 

Awareness of short stature and monitoring it in thalassemic patients should be done in their childhood. Accordingly, being 7 years old or above increases the risk of short stature; therefore, we suggest the start of monitoring as early as 5 years of age.

Whether the endocrine aberrations caused by polycystic ovary syndrome (PCOS) might influence bone density in women of reproductive age is controversial.

The present study aimed to compare PCOS women to a control group matched in terms of age and body mass index (BMI) regarding bone indices and to clarify the potential relationship between their hormonal changes and bone density.

This case-control study consisted of 61 PCOS patients, and 35 women with normal ovulatory function served as controls. Bone parameters, including bone mineral content (BMC) and bone mineral density (BMD) in addition to T- and Z-scores, were measured at the lumbar vertebrae, neck of the left femur, hip, and distal part of the radial bone, using dual-energy X-ray absorptiometry. Blood samples were taken to be tested for biochemical parameters and serum concentrations of insulin, osteocalcin, parathyroid hormone (PTH), vitamin D, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, dehydroepiandrosterone sulfate (DHEAS), and estradiol were measured. Insulin resistance was evaluated through the homeostatic model assessment of insulin resistance (HOMA-IR).

The results revealed greater levels of HOMA-IR and total testosterone in PCOS women than in controls. Nevertheless, the two groups were comparable in terms of bone parameters. In the control group, BMI was the only determinant of bone density at most of the skeletal sites. Nonetheless, BMI and HOMA-IR were independently and positively associated with bone indices at the femoral neck (FN) and total hip in the PCOS group. Parathyroid hormone and vitamin D concentrations were not different in the two groups. However, phosphate levels were higher in PCOS patients (P = 0.025). Osteocalcin was inversely correlated to BMI, and both groups had a negative correlation betweenDHEASand PTH. Serum phosphate was inversely and independently associated with estrogen in the PCOS group (r = -0.377, P = 0.004).

Body mass index and HOMA-IR were independent and positive determinants of FN and total hip bone density in the PCOS subjects. Nonetheless, in the non-PCOS women, BMI was the only independent determinant of bone density at most of the skeletal sites. Additionally, osteocalcin was inversely correlated with BMI in both groups.

 Despite the many therapeutic benefits of swimming, there is still conflicting evidence about its benefits for bone health and osteoporosis prevention, especially in elite swimmers according to their sex. It is known that sex differences can affect the acquisition of minerals by the bone.

 The aims of this study were to compare the bone mineral density (BMD) of swimmers with that of non-athletes (NA) and compare the corresponding values in male (MS) and female swimmers (FS).

 This cross-sectional study was performed on young athletes (18 - 24 years old) of the Iranian national swimming team, who were training for at least 11 hours per week and NA. To this end, 56 swimmers (14 males, 14 females) and NA (14 males, 14 females) were enrolled in 4 groups. The DEXA device was used to assess BMD (g/cm2) and T-scores of the proximal femur and lumbar spine.

 All the swimmers had significantly higher BMD of the femur neck, trochanter, Ward’s triangle, and lumbar spine than NA (males/females) (P < .05). Also, the BMD of FS (except in trochanter and Ward’s triangle) was significantly higher than MS (P < .05). Finally, T-scores of FS in lumbar spine and femur neck areas were significantly higher than MS and NA (P < .05).

 Unexpectedly, BMD relatively improved by performing competitive swimming. Meanwhile, FS, especially in the femur neck, seemed more adaptable to swimming-related loads and BMD acquisition in comparison to MS. Further studies are needed to determine the definitive response to bone acquisition by sex, given the limitations of the present study.

The present study aimed to determine the prevalence of low bone mineral density (BMD)and low bone mineral content (BMC) as chronic complications of juvenile systemic lupus erythematosus(JSLE) and identify the associated variables and patient characteristics to investigate the relationshipbetween BMD and influential factors. This cross-sectional study enrolled 54 patients with JSLE, including 38 females and 16 males. The BMDand BMC were assessed by dual-energy X-ray absorptiometry in the hip (femoral neck) and the lumbar spine. LowBMD was considered a Z-score < -2. The study investigated the association of BMC and Z-score with the currentdaily dose of corticosteroids, the daily dose of corticosteroids at disease onset, the duration of disease, the durationof steroid treatment, the time from the onset of symptoms to diagnosis, and renal involvement. The prevalence of low BMD in the lumbar spine and the femoral neck was 14.8% and 18.5%, respectively;the reduction of BMD was more significant in the femoral neck compared to the lumbar spine. Osteoporosis wasdetected in one patient. The multiple linear regression analysis found a significant association between a higherdaily corticosteroid dose and lower BMC of the femoral neck and the lumbar spine. In addition, patients receivinghigher doses of corticosteroids at disease onset showed better follow-up bone mineral densitometry results. Based on the findings of this study, JSLE more affects the femoral neck than the lumbar spine. Patientsreceiving a more robust treatment with higher doses of corticosteroids at disease onset (to control the inflammatoryprocesses) showed better spinal BMC results. A higher dose of daily corticosteroid treatment during assessmentwas identified as a risk factor for low BMD. Level of evidence: IV

The menopause stage in women reduces estrogen levels and bone indicators. This study compared the effects of highintensity resistance training (HIRT) and low-intensity resistance training (LIRT) on bone mineral density (BMD) and bone mineral content (BMC), T-score, and Z-score in postmenopausal women with osteopenia.

A randomized controlled trial was conducted among 45 postmenopausal women, aged 50 to 60, who were randomly assigned into 3 parallel groups (n = 15 in each). The exercise program was performed by the interventional groups—the HIRT and LIRT groups—at 4 different intensities, 3 times a week for 24 weeks: 8 repetitions at 80% of 1 repetition maximum and 16 repetitions at 40% of 1 repetition maximum. The evaluated areas (BMD, BMC, T-score, and Z-score) included the lumbar spine (LS) and the femur neck (FN) using a DEXA machine. One-way analysis of covariance and Bonferroni's post hoc tests were used for data analysis.

The results indicated significant differences in BMD, BMC, T-scores, and Z-scores between the means of the LS and the FN in all groups. In addition, significant differences were revealed in the BMC of the LS, the BMD, T-scores (P < 0.001), Z-scores (P = 0.001), and in the BMC of the FN (P < 0.001), the BMD (P = 0.001), T-scores, and Z-scores (P < 0.001), respectively. In addition, the HIRT group's bone indices were considerably greater than those of the LIRT group (P < 0.00). Nonetheless, LIRT was significantly greater than that of the control group (P > 0.00).

According to the current findings, HIRT seems to be the most effective training program compared with LIRT for bone indicators improvement in the femur neck and the lumbar spine among postmenopausal women with osteopenia.

Metabolic syndrome (MetS) is comprised of a clustering of various cardiovascular risk factors that can also affect bone health. We aimed the associations between MetS and bone mineral density (BMD) and trabecular bone score (TBS) in subjects with abdominal adiposity. Individuals with body mass index less than 25 kg/m2 were enrolled from the SUVINA study and allocated into two groups according criteria of IDF for metabolic syndrome. TBS T-score and Z/T score of fore skeletal region were measured using dual-energy X-ray absorptiometry (DXA). SPSS software was used for statistical analysis and p value 0<0.05 was considered significant. DXA measurements were made in 201 participants, of whom 75 had MetS and 126 did not. Scores related to the neck of femur and total femur, radius Z-score and TBST-score were lower in subjects with MetS (all P<0.05). Subjects with FBG≥100 had lower TBST-score (p < 0.05). SBP≥130 and DBP≥85 in subjects, led to the lower TBST-score, and lumbar T-score (both P < 0.05). Subjects with (LDL-C≥160 mg/dl) had lower TBST-score, neck of femur Z score, and total femur T/Z scores (all P < 0.05). TBST-score and scores related to neck of femur, and total femur were lower in participants with serum cholesterol≥200 mg/dl (P < 0.05). MetS is negatively associated with TBS and BMD scores. Higher levels of LDL-C and cholesterol were the most associated factors related to TBST-score decrease. The neck of femur was the most vulnerable skeletal against the MetS components increment.

 Osteoporosis is a known entity in individuals with celiac disease (CD).

 The aim of this study was to evaluate bone mineral density (BMD) measurements in children with CD.

 This was a retrospective design study in a tertiary hospital in Turkey.

 Totally 106 patients were included, and the mean age was 10.2 ± 3.9 years. The mean L1-L4 Z score was 0.730 ± 0.197 (based on sex and height in Turkish children). About 20.7% (n = 22) had a history of at least one fracture and/or bone pain. Bone mineral density values obtained from lumbar (L1-L4) vertebrae were significantly lower in patients with a prior fracture and/or bone pain compared to the patient group without a fracture (0.822 ± 0.242 g/cm2 vs 0.706 ± 0.178 g/cm2, respectively; P = 0.047). L1-L4 Z score (based on sex and height in Turkish children) was lower in patients with a body mass index (BMI) SDS value below -2 (moderately or severely malnourished) than those with a BMI SDS above -2 (0.02 ± 1.19 vs 1.4 ± 1.82, respectively; P = 0.014). A moderate positive correlation (r = 0.547; P < 0.01) was found between somatomedin-C (IGF-1) level and L1-L4 BMD (g/cm2) measurement. It was remarkable that low BMD was not identified in any patients using L1-L4 Z-score by height and L1-L4 Z-score by age of Turkish children. Nine (8.5%) patients were found to have low BMD using the United States (US) age- and sex-specific L1-L4 Z-score from the GE Healthcare Lunar iDXA system.

 Bone mineral density should be screened considering risk factors for suboptimal bone health in children with celiac disease. False "normal" BMD interpretations can be avoided by taking into account the model of the BMD measuring device and by using the device's normal ranges in case of inconsistency with the Turkish reference values.

The current study aims to evaluate bone mineral density (BMD) in patients with celiac disease who were referred to the celiac clinic of Shahid Rahimi Hospital in Khorramabad, Iran, in 2020.

Extraintestinal presentations of celiac disease are widespread and, if neglected, can be devastating. Osteoporosis, one of the extraintestinal manifestations of celiac disease, often remains undiagnosed until advanced stages and can impose a significant burden on patients with celiac and health systems. Nonetheless, the prevalence and characteristics of osteoporosis in celiac disease are unknown in Iran.

This was a cross-sectional study at the celiac clinic of Shahid Rahimi Hospital in Khorramabad, Iran. Participants were 48 patients under 18 years diagnosed with Marsh II and Marsh III stages of celiac disease (who need to be on a gluten-free diet) at the pediatrics celiac clinic in 2020. All patients were recruited, completed a questionnaire, and had their blood biochemical parameters analyzed. Then their bone mineral density (BMD) was measured through dual-energy x-ray absorptiometry at the Asia Imaging Center in Khorramabad under the supervision of a radiologist and pediatric rheumatologist.

The mean age of the children was 9.96±3.17 years. The minimum and maximum ages of the participants were 4 and 17 years, respectively. Of all 48 children who were included (48), 34 (70.8%) were female, and 14 (29.2%) were male. In the femoral region bone densitometry, 35.4% were normal, 41.7% had lower limit normal, and 22.9% had low bone density. In the lumbar region, 39.6% were normal, 25% were Lower limit normal, and 35.4% had low bone density. No significant correlation was found between age, sex, place of residence, Marsh stage, gluten-free diet, and bone densitometry in both lumbar and femoral regions. Nonetheless, we detected a statistically significant relationship between bone density in the lumbar region and two HLA types, namely HLA DQ8 and HLA DQ2/8 (P=0.016).

The results of the current study provided further evidence that all children with advanced celiac disease should be screened for metabolic bone diseases. Besides those in Marsh II and Marsh III, patients in Marsh I stage should also be investigated for low bone mineral density.

Psoriasis is one of the most common skin diseases. For the first time in Iran, we conducted a case-control study to evaluate bone mineral density in patients with psoriasis vulgaris in comparison with a healthy control group (20 individuals in each group). Our study sample included patients referred to the dermatology clinic of Razi Hospital in Ghaemshahr, Iran, between May and October 2019. Densitometry was performed by the DEXA method on the 2nd to 4th lumbar vertebrae and hip bone. Patients’ demographic information and Psoriasis Area Severity Index (PASI) scores were recorded and analyzed using SPSS version 22.

The mean T-score in the case and control groups were -0.47 ± 1.04 and -0.19 ± 0.45, respectively (P = 0.274). The mean T-score had a significant inverse correlation with an age of 40 years or above (r = -0.873 and P < 0.001), disease duration of more than five years (r = -0.599, P = 0.05), and PASI score (r = -0.523, P = 0.001), but had a positive correlation with sunlight exposure (r = 0.581, P < 0.001).

Considering the decrease in bone density in patients with psoriasis and its relationship with the disease severity and duration and the effectiveness of sunlight in increasing bone density, preventive treatment should be provided for all patients to increase bone density and prevent osteoporosis.

Sport is one of the best ways to prevent osteoporosis; however, not all sports have the same impact on bones, for instance, swimming (SW) may have no effect or be harmful. Elite athletes are the best choice to detect the effects of any sport. Thus, this study was conducted firstly to compare the bone mineral density (BMD) and bone mineral content (BMC) of elite athletes in vol leyball (VB), basketball (BB), and long-distance running (LR) together, and secondly to compare those corresponding values in SW athletes with those of non-athletes (NA). The subjects (n=58) of this cross-sectional study included elite male athletes (members of Iran's national teams, with a minimum of 12-15 hours of training per week) and NA (control; C) who were divided into BB, VB, LR, SW (n=12 for each), and C (n=10) groups. The DEXA scan measured the amount of BMD and BMC values in the lumbar spine (LS; L2-L4) and proximal femur (PF; neck, trochanter, and Ward’s triangle) areas. In the LS areas, LR had significantly higher BMD than the BB, VB, SW, and C groups (P<0.001), while for BMC, both LR and VB were significantly superior to other groups (P<0.001). Moreover, the BMD and BMC of the PF areas of VB and BB were significantly higher than those of the LR, SW, and C groups (P<0.001). Finally, in all areas, SW showed significantly higher BMD and BMC, compared to the C group (except for trochanter and femur neck BMC) (P<0.05). LR athletes showed the most bone acquisition in the LS areas and VB players in the PF areas, while BB players ranked third in osteoporosis prevention in the mentioned regions. Unexpectedly, SW athletes also had better BMD and BMC than NA; therefore, after weight-bearing sports, this type of sport can be effective in bone acquisition. Level of evidence: III

One of the most critical complications of bariatric surgery (BS), which has been widely discussed recently, is its adverse effects on the health of the bones and skeletal system. Studies show that bone mineral density (BMD) decreases significantly in the early years after BS Nutritional deficiencies are a common complication of BS that can last for monthsto years aftersurgery. For example, calcium absorption willsignificantly reduce after BS The role of gut hormones, endocrine factors, and adipokines in altering bone metabolism should never be overlooked. The available information and guidelines emphasize the periodic evaluation of BMD in patients undergoing BS The method of measuring BMD after BS is essential. DXA and quantitative computed tomography (QCT) are two convenient methods for measuring BMD. Many studies indicate a more detailed study of microarchitecture and cortical and trabecular bone mass with the help of QCT. The overall risk of fractures increases years after BS There are some recommendations for overcoming the adverse effects of BS on bone health. Endurance and resistance exercise after BS can help to mitigate BMD reduction and bone changes. In this review, we will explain each of these points in detail.

Muscle-induced insulin-like growth factor 1 (IGF-1) and fibroblast growth factor 2 (FGF-2) are important factors for muscle growth and maintenance.

This study aimed to investigate the effect of 12 weeks of Theraband resistance training on IGF-1 and FGF-2 levels and their relationships with myokines on bone mineral density (BMD) in older women with osteosarcopenic obesity.

In this single-blind randomized clinical trial, 48 older women with osteosarcopenic obesity (mean age: 64.63 ± 3.68 years; fat percentage 45.4 ± 6.6%; BMI 33.1 ± 3.71 kg/m2; and T score of bone minerals density of femur and 1-4 lumbar spine -1.86 ± 1.42, based on the results of the DEXA test) were randomly divided into control (n = 22) and training (n = 26) groups. The training group performed 12 weeks of Theraband resistance training for all major muscle groups. Blood samples were collected 48 hours before and 12 weeks after the intervention.

After 12 weeks, a significant difference was observed in IGF-1 (P = 0.033) levels in the training group compared to the control group. Also, FGF-2 (P = 0.003) and IGF-1 (P = 0.013) levels increased significantly in the training group. However, there was no significant relationship between IGF-1 (P = 0.240) and FGF-2 (P = 0.806) levels and BMD.

Theraband resistance training can be an appropriate training strategy to improve muscle mass in older adults with osteosarcopenic obesity by increasing IGF-1 and FGF-2 levels.

The role of exercise in osteoporosis prevention has been proven. Nevertheless, there is no consensus about the types of sports, especially at professional levels. Non-impact sports such as swimming may have a negative effect or no effect.

Thus, the present study aimed to compare the effect of different sports on bone mineral content (BMC) and bone mineral density (BMD) of elite female athletes.

This was a cross-sectional study consisting of 48 athletes in five groups of long-distance running, volleyball, basketball, swimming (n = 12 for each), and ten control subjects. For measuring the lumbar spine (L2 - L4) and proximal femur (femoral neck, trochanter, and Ward’s triangle), the dual-energy X-ray absorptiometry (DEXA) method was applied.

Indicated that the running, basketball, and volleyball groups had a significantly higher lumbar spine and proximal femur BMD than the swimming and control groups (P < 0.05). Running resulted in significantly higher lumbar spine BMC compared to volleyball, basketball, swimming, and control groups, respectively (P < 0.01), while basketball had higher proximal femur BMC than running and controls (P < 0.01). The Z-score of the lumbar spine in the running was significantly higher than in basketball, swimming, and controls (P < 0.05), while basketball had a significantly higher femur neck Z-score than volleyball, running, and controls (P < 0.001). Finally, the swimmers had significantly higher Z-scores in the lumbar and the proximal femur than non-athletes (P < 0.001).

Although all sports are effective for improving the bone health, the swimmers had much better bone status than non-athletes, while the sports of long-distance running and basketball were more efficient than others; therefore, a combination of endurance and jumping exercises seems to be the best way to prevent osteoporosis.