Incidence of bone fracture in patients receiving luteinizing hormone‐releasing hormone agonists for prostate cancer
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Objective To investigate the incidence of bone fractures in patients receiving luteinizing hormone‐releasing hormone agonists (LHRH‐a) for prostate cancer (in whom a continued low testosterone level after the long‐term administration of these drugs reduces bone mineral density), and thus determine the risk of secondary osteoporosis. Patients and methods Between 1994 and 1999, 218 patients (mean age 77.3 years) were treated for 6 months with LHRH‐a for prostate cancer; of these, 14 (6%) had a bone fracture during their treatment. Patients with fracture associated with motor vehicle accidents were excluded. The bone density in the third lumbar vertebra was meas‐ured using quantitative computed tomography. Osteocalcin, 1,25‐(OH) 2 vitamin D, urinary type 1 collagen cross‐linked N‐telopeptides (NTx), parathyroid hormone and calcitonin were measured as metabolic markers. Results The mean age of the patients with fracture was 78 years; the mean (range) interval from the start of treatment to fracture was 28 (11–46) months. There was no case of a bone fracture at the site of a metastasis from prostate cancer. The bone density was significantly lower in the patients with a fracture than in those without. Of the bone metabolic markers, NTx was higher in those with a fracture. Conclusion There is a need to measure bone mineral density and bone metabolic markers periodically, and to evaluate secondary osteoporosis in patients receiving long‐term LHRH‐a for prostate cancer.Keywords:
Bone fracture
Bone remodeling
Objective To compare the relationship of values measured by two different bone density measure methods (QCT and DXA) with bone ash density, and evaluate the clinic value of QCT in bone density. Materials and Methods 15 pig lumbar vertebral bodies were recruited. After removal of surrounding parenchyma and adjunct, BMD was measured by both QCT and DXA. The adjunct-removed vertebrae were incinerated. The gross value of BMC and BMD respectively measured by QCT and DXA were compared with the bone ash weight and bone ash density of incinerated vertebrae. After calculated the volume BMD measured by DXA, we further calculated the skewness of cortical BMD、trabetical BMD measured by QCT and the volume BMD measured by DXA compared with bone ash density. Results The correlation of trabetical BMD、cortical BMD measured by QCT and bone ash weight、bone ash density were at a high level of significance (P0.005), and the correlation of BMC measured by DXA and the bone ash weight was the highest(r=0.9995)。The skewness of trabetical BMD (Average is 0.1489) was lower than the skewness of the volume BMD measured by DXA (Average is 0.2708). Conclusion Two bone density measure methods (QCT and DXA) are both good methods to measure BMD and diagnose osteoporosis。The trabetical BMD measured by QCT is more close to bone ash density( true BMD). Changes of bone metabolism in osteoporosis can be better and more accurately reflected BMD measured by QCT than that by DXA.
Densitometry
Dual-Energy X-ray Absorptiometry
Dual energy
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Dual-Energy X-ray Absorptiometry
Densitometry
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OBJECTIVE: We conducted this study to assess bone mineral density and to evaluate conceivable predictive factors for bone loss in patients with Crohn's disease. METHODS: One hundred-thirteen patients with Crohn's disease and 113 healthy subjects, individually matched for gender, age, and body weight were investigated. The group consisted of 68 women and 45 men. The median duration of Crohn's disease was 6 yr. Two-thirds of the patients had been subjected to intestinal resection. Seventy-seven percent had at some time been treated with corticosteroids. Bone mineral density in the lumbar spine, the hip, and the total body skeleton was measured by dual-energy X-ray absorptiometry (DEXA). RESULTS: In patients with Crohn's disease bone mineral density was not different from that of healthy controls except for a regional decrease in bone mineral density of the hip in female patients. The strongest predictors of bone mineral density were gender, age, and body weight. Corticosteroid use was only a weak predictor of diminished bone density. Duration of disease and intestinal resection had no predictive value for bone mineral density. CONCLUSIONS: Gender, age, and body weight are the major determinants of bone mineral density in patients with Crohn's disease. As in healthy individuals, the combined effect of these factors account for up to 50% of the variability in bone mineral density.
Bone disease
Dual-Energy X-ray Absorptiometry
Cross-sectional study
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Diabet. Med. 28, 872–875 (2011) Abstract Aim There are conflicting data regarding the risk of osteoporosis in patients with Type 1 diabetes. We investigated an association between diabetes, bone mineral density and prevalent fractures. Methods A single‐centre, cross‐sectional study of men and pre‐menopausal women with Type 1 diabetes ( n = 128) and a matched control group ( n = 77) was conducted. The primary outcome measure was bone mineral density and secondary measures were markers of bone metabolism and prevalent fractures. Results Hip and total body bone mineral densities were significantly lower in women with diabetes compared with control subjects. In men, no difference in bone mineral density was found. A multivariate regression analysis in women with diabetes revealed higher BMI as the strongest predictor of higher total hip, femoral neck and total body bone mineral density, whereas previous fractures were inversely associated with total hip bone mineral density and C‐terminal telopeptide of type I collagen with total body bone mineral density. Poor long‐term glycaemic control was not associated with low bone mineral density. Fracture frequency was higher in patients with diabetes compared with control subjects (1.64 vs. 0.62 per 100 patient‐years; P < 0.05). In a multivariable model, long‐term HbA 1c control was associated with increased clinical fracture prevalence (OR 1.92; 95% CI 1.09–2.75) in those with diabetes. Conclusions Type 1 diabetes contributes to low bone mineral density in women. Previous fractures and low BMI were strong predictors of impaired bone mineral density and should therefore be considered in risk estimation. Fractures are more frequent in Type 1 diabetes. Long‐term hyperglycaemia may account for impaired bone strength, independently from bone mineral density.
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• The purposes of this study were to compare the lumbar spine bone mineral density of eumenorrheic and amenorrheic white subjects aged 15 to 21 years, and to describe the femoral neck bone mineral density in the eumenorrheic subjects. Twenty-eight eumenorrheic females had lumbar bone mineral density (mean±SD) of 1.213±0.117 g/cm2, and femoral neck bone mineral density of 1.032± 0.092 g/cm2measured with dual energy x-ray absorptiometry. Bone mineral density at neither site was related to age, energy intake, or calcium intake. Femoral neck bone mineral density was related to energy expenditure. Body composition was measured with total body electrical conductivity, and bone mineral density at both sites was related to body weight as much as fat-free mass. Eight amenorrheic subjects had a lumbar spine bone mineral density of 1.057± 0.113 g/cm2, which was lower than in the eumenorrheic group. However, when controlling for weight, this difference was not significant. Peak lumbar and femoral neck bone mineral density may be reached at midadolescence. (AJDC. 1992;146:31-35)
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Through testing the bone mineral density of the elderly in Qiqiharto analyze the relation and differences in bone mineral density of different ages and gender and the probability of osteoporosis.As a result,it isfound that the elderly in different ages and gender own different bone density.With the age increasing,bone density declines,whereas the risk of osteoporosis increases,which happens to the femalemore easily than male.
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Body weight is positively associated with bone mineral density but the relationship between obesity and bone mineral density is unclear. Leptin and adiponectin are potential independent contributors to bone mineral density. We assessed the correlations of body composition, leptin and adiponectin with bone mineral density, and whether leptin, adiponectin and body composition determine bone mineral density independently in prepubertal girls. Forty-eight prepubertal girls were classified into obese and control groups by body mass index. Serum leptin and adiponectin levels were determined by enzyme immunoassay. Bone mineral density was measured using dual energy radiography absorptiometry and body composition was measured using bioelectrical impedance analysis. Lean and fat mass, and leptin were positively correlated with bone mineral density. Lean mass was a positive independent predictor of femoral and L-spine bone mineral density. Serum leptin was a positive independent predictor of femoral bone mineral density. Fat mass was a negative independent predictor of femoral bone mineral density. In prepubertal girls, lean mass has a favorable effect on bone mineral density. Fat mass seems not to protect the bone structure against osteoporosis, despite increased mechanical loading. Serum leptin may play a biological role in regulating bone metabolism.
Bioelectrical Impedance Analysis
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Some studies suggest that patients with diabetes mellitus have an increased incidence of osteoporosis, but others have disputed it. The mechanisms of reduced bone density in diabetes are unclear but excessive calcium loss in the urine is generally accepted as one of the factors which contribute to bone loss in diabetes. Whole body bone densitometry makes possible to estimate the total body calcium concentration which might be influenced by urinary calcium loss and other humoral factors. To elucidate the possible direct relationship between total body calcium and reduced bone density, we examined the total body calcium, total body fat and the bone mineral density of the lumbar and femur with densitometry (Dual Energy X-ray Absorptiometry) in 93patients with type II diabetes mellitus end 316nondiabetic normal controls, Serum osteocalcin levels also measured by radioimmunoassay in all the patients. The results are summarized as follows: l) The bone mineral density declined with age in both diabetics and the control group but had no significnat differences statistically. 2) Thirty-six patients with diabetes (37.9%) had reduced bone mineral density below one standard deviation (1SD) of the normal controls. 3) The total body calcium concentration correlated highly to the total body bone density. 4) The femur bone density correlated more significantly than the lumbar bone density to the whole body bone density. 5) There were no correlations between the whole body bone density and total body fat or serum osteocalcin levels.
Densitometry
Urinary calcium
Dual-Energy X-ray Absorptiometry
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OBJECTIVE: We conducted this study to assess bone mineral density and to evaluate conceivable predictive factors for bone loss in patients with Crohn's disease. METHODS: One hundred-thirteen patients with Crohn's disease and 113 healthy subjects, individually matched for gender, age, and body weight were investigated. The group consisted of 68 women and 45 men. The median duration of Crohn's disease was 6 yr. Two-thirds of the patients had been subjected to intestinal resection. Seventy-seven percent had at some time been treated with corticosteroids. Bone mineral density in the lumbar spine, the hip, and the total body skeleton was measured by dual-energy X-ray absorptiometry (DEXA). RESULTS: In patients with Crohn's disease bone mineral density was not different from that of healthy controls except for a regional decrease in bone mineral density of the hip in female patients. The strongest predictors of bone mineral density were gender, age, and body weight. Corticosteroid use was only a weak predictor of diminished bone density. Duration of disease and intestinal resection had no predictive value for bone mineral density. CONCLUSIONS: Gender, age, and body weight are the major determinants of bone mineral density in patients with Crohn's disease. As in healthy individuals, the combined effect of these factors account for up to 50% of the variability in bone mineral density.
Cross-sectional study
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