Romosozumab treatment in women with postmenopausal osteoporosis increases bone formation while decreasing bone resorption, resulting in large BMD gains to reduce fracture risk within 1 yr. DXA-based ...3D modeling of the hip was used to assess estimated changes in cortical and trabecular bone parameters and map the distribution of 3D changes in bone parameters over time in patients from 2 randomized controlled clinical trials: FRAME (romosozumab vs placebo followed by denosumab) and ARCH (romosozumab vs alendronate followed by alendronate). For each study, data from a subset of ~200 women per treatment group who had TH DXA scans at baseline and months 12 and 24 and had provided consent for future research were analyzed post hoc. 3D-SHAPER software v2.11 (3D-SHAPER Medical) was used to generate patient-specific 3D models from TH DXA scans. Percentage changes from baseline to months 12 and 24 in areal BMD (aBMD), integral volumetric BMD (vBMD), cortical thickness, cortical vBMD, cortical surface BMD (sBMD), and trabecular vBMD were evaluated. Data from 377 women from FRAME (placebo, 190; romosozumab, 187) and 368 women from ARCH (alendronate, 185; romosozumab, 183) with evaluable 3D assessments at baseline and months 12 and 24 were analyzed. At month 12, treatment with romosozumab vs placebo in FRAME and romosozumab vs alendronate in ARCH resulted in greater increases in aBMD, integral vBMD, cortical thickness, cortical vBMD, cortical sBMD, and trabecular vBMD (P < .05 for all). At month 24, cumulative gains in all parameters were greater in the romosozumab-to-denosumab vs placebo-to-denosumab sequence and romosozumab-to-alendronate vs alendronate-to-alendronate sequence (P < .05 for all). 3D-SHAPER analysis provides a novel technique for estimating changes in cortical and trabecular parameters from standard hip DXA images. These data add to the accumulating evidence that romosozumab improves hip bone density and structure, thereby contributing to the antifracture efficacy of the drug.
Osteoporosis is a major public health problem worldwide. Lower peak bone mineral density (BMD) in youth may be the single most important factor leading to the development of osteoporosis in the ...elderly. Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2005–2014, we included 18,713 individuals with complete and valid data on femoral neck, total hip and lumbar spine BMD. Generalized additive models were used to estimate the age at attainment of peak BMD and 95% confidence intervals (95%Cls); model covariates were sex, race, body mass index (BMI) and we also examine factors potentially affecting age at attainment of peak BMD. This study clearly stated that age at attainment of peak femoral neck, total hip and lumbar spine BMD were 20.5 years, 21.2 years and 23.6 years in males, and 18.7 years, 19.0 years and 20.1 years in females, respectively and age at attainment of peak BMD varied by skeletal sites and sex. The study also found that females achieved peak femoral neck, total hip and lumbar spine BMD earlier than males (all P < 0.001); race and BMI were not associated with the age at attainment of peak BMD (all P > 0.05). These results suggested that improving bone health among individuals before 20 years old may be useful for reducing future risk of osteoporosis and osteoporotic fractures.
•The age at attainment of peak femoral neck, total hip and lumbar spine BMD were 20.5, 21.2 and 23.6 years in males•The age at attainment of peak femoral neck, total hip and lumbar spine BMD were 18.7, 19.0 and 20.1 years in females•Age at attainment of peak BMD was related to sex and skeletal sites•Race and body mass index were not associated with the age at attainment of peak BMD
SCREENING OF OSTEOPOROSIS IN MEN Kirilova, E.; Nikolov, Nikolay Georgiev; Kirilov, N. ...
Rheumatology (Bulgaria),
08/2022, Volume:
30, Issue:
2
Journal Article
Peer reviewed
Open access
Underestimation of the disease osteoporosis in men is a serious problem, as osteoporotic fractures among men are frequent and they are accompanied by serious complications. Conducting DXA scans in ...men in Bulgaria is important to determine the state of their bone health.
The aim of the study was to assess the bone mineral density (BMD) and T-score of the lumbar spine and of the hip through dual-energy X-ray absorptiometry (DXA) in men and to compare their values in different age groups.
Object of the study. Height, weight, body mass index (BMI) were assessed in 359 men with a mean age of 56 years (yrs.) ± 14 yrs., BMD and T-score of the lumbar spine and femoral neck were also examined.
Methodology. Men are divided into the following age decades: 20-29 yrs., 30-39 yrs., 40-49 yrs., 50-59 yrs., 60-69 yrs., 70-79 yrs. and ≥80 yrs. Statistical program SPSS version 19.0 was used to access the data. The ANOVA test analyzes was applied to investigate if there are any statistically significant differences in BMD and T-score of the lumbar spine and femoral neck between the different age decades.
Results and conclusions. 264 men were evaluated for total BMD of the lumbar spine and 95 men had results for BMD of the femoral neck. The mean total BMD of the lumbar spine differed significantly between the individual age decades in men (p = 0.000). The mean BMD values of the femoral neck did not differ significantly in the different age decades in men (p = 0.07). 34 of 264 men (12.9%) were diagnosed with lumbar spine osteoporosis and 13 out of 93 men (14%) were diagnosed with femoral neck osteoporosis. The data obtained show a widespread prevalence of osteoporosis among men with a predominance of low values of BMD on the axial skeleton in the age range between 60 and 79 years.
Both EUCAST and CLSI recommend broth microdilution (BMD) for antimicrobial susceptibility testing of colistin, but BMD is rarely used in routine microbiology laboratories. The objective of this study ...was to evaluate five commercially available BMD products and two brands of gradient tests for colistin MIC determination using BMD according to ISO standard 20776-1 as reference.
Colistin MIC determination was performed according to the manufacturer's instructions on five commercially available BMD products (Sensititre, MICRONAUT-S, MICRONAUT MIC-Strip, SensiTest, and UMIC) and two gradient tests (Etest and MIC Test Strip). Colistin reference MICs were determined using frozen panels according to ISO standard 20776-1. An international collection of Gram-negative bacteria (n=75) with varying levels of colistin susceptibility was tested.
The colistin BMD products correlated well with reference tests, in particular for Sensititre and the two MICRONAUT products (essential agreement ≥96%: 66/69 (96%, CI 88–99%), 72/75 (96%, CI 88–99%) and 74/75 (99%, CI 92–100%)). The results were somewhat poorer for the BMD products SensiTest and UMIC: EA 88% (51/58, CI 77–95%) and 82% (61/74, CI 72–89%), respectively), and considerably poorer for the gradient tests (EA 43–71% depending on gradient test and Mueller-Hinton agar manufacturer). The gradient tests generally underestimated colistin MICs, resulting in a significant number of false susceptible results (9–18 of total 75 tests, compared with 1–3 for the BMD products).
Based on the results of this study, we advise laboratories not to trust gradient tests for colistin susceptibility testing and to use broth microdilution methods for this purpose. There are several commercial broth microdilution tests available and in principle they perform well.
OBJECTIVE:To determine whether secondary amenorrhea during teenage years influences bone mineral density (BMD) in female athletes in their 20s.
DESIGN:Original research.
SETTING:Japan Institute of ...Sports Sciences.
PARTICIPANTS:Two hundred ten elite female athletes older than 20 years were included in the study.
MAIN OUTCOME MEASURES:Information on the participantsʼ past (ie, during their teenage years) and current menstrual cycle, training time, history of stress fractures, and blood tests for hormones received was obtained. Bone mineral density of the lumbar spine was evaluated by dual-energy x-ray absorptiometry; low BMD was defined as a Z-score ≤−1. We investigated the correlation factors for low BMD in athletes in their 20s by univariable and multivariable logistic regression analysis.
RESULTS:A total of 39 (18.6%) female athletes had low BMD. Secondary amenorrhea in their teens odds ratio (OR), 7.11, 95% confidence interval (CI), 2.38-21.24; P < 0.001 and present body mass index (BMI) (OR, 0.56, 95% CI, 0.42-0.73; P < 0.001) were independent correlation factors for low BMD in the multivariable logistic regression analysis. The average Z-score for those with secondary amenorrhea in their teens and 20s, secondary amenorrhea in their 20s only, and regular menstruation was −1.56 ± 1.00, −0.45 ± 1.21, and 0.82 ± 1.11 g/cm, respectively.
CONCLUSIONS:Secondary amenorrhea for at least 1 year during teenage years in female athletes and BMI at present was strongly associated with low BMD in their 20s.
Prior nonmelanoma skin cancer (NMSC), a biomarker of cumulative lifetime sun exposure, is associated with reduced fracture risk later in life. The mechanism is unknown.
Prospective cohort analysis of ...1,099 community-dwelling adults aged 50-80 years with baseline and 10 year follow up assessments. Histopathologically-confirmed NMSC diagnosis was established by linkage with the Tasmanian Cancer Registry. Bone mineral density (BMD) and vertebral deformity were quantified by DXA, 25(OH)D by radioimmunoassay, bone microarchitecture by high resolution peripheral quantitative CT, melanin density by spectrophotometry and skin photosensitivity and clinical fracture by questionnaire. 25(OH)D <50 nmol/L was considered deficient.
Participants with a NMSC reported prior to baseline were less likely to sustain an incident vertebral deformity over 10 years (RR=0.74, p=0.036). There were similar reductions for other fracture types but these did not reach significance. Prior NMSC was associated with baseline (RR=1.23, p=0.005) and 10 year longitudinal (RR=5.9, p=0.014) vitamin D sufficiency and greater total body BMD (β=0.021g/cm2, p=0.034), but not falls risk or muscle strength. The relationship between prior NMSC and bone microarchitecture was age dependent (pinteraction<0.05). In the oldest age tertile, prior NMSC was associated with greater volumetric BMD (β=57.8–62.6, p=0.002–0.01) and less porosity (β= -4.6 – -5.2, p=0.002–0.009) at cortical, compact cortical and outer transitional zones.
Prior NMSC was associated with fewer incident fractures in community-dwelling older adults. This protective association is most likely mediated by modifiable fracture risk factors associated with an outdoor lifestyle, including 25(OH)D, BMD and bone microarchitecture.
Background: Low BMD is a common problem in major thalassaemia patient, but the use of DXA in chronic disease children with smaller bones, has some problems. Utilizing bone mineral apparent density ...(BMAD) helps in preventing this obstacle. Testing the usefulness of this method in resolving the effects of bone size on BMD by comparing the BMD and BMAD of our thalassemics with results of our healthy ones, is our goal. Methods: Sample size was 110 cases with mean age of 9.6 ± 4.3 y/o and contained 73 males. Gauge of BMDs done by dual x-ray absorptiometry. Then BMAD was calculated. We did comparison of BMDs and BMADs results of thalassemic children with results of healthy Iranian pediatrics. Results: Mean of femoral BMD and BMAD, spinal BMD and BMAD was 0.579±0.134 g/cm2, 0.162±0.096 g/cm3, 0.563±0.118 g/cm2 and 0.107±0.015, respectively. When results of 9-18 patients compared with BMDs and BMADs of normal children, BMD of femur and BMD and BMAD of spine of patients found significantly lower (P-values, 0.003, <0.001, <0.001, respectively). BMAD of femur of patients was not significantly different from normals. Conclusion: When bone mineral density of femur modifies by bone mineral apparent density formula, the remarkable difference between BMD of patients and normals; vanishes. Utilizing bone mineral apparent density helps in interpretation of femoral dual X-ray absorptiometry at least in thalassemic patients. As the results of vertebrae, after modification by calculating BMAD, remains significantly different, we cannot bring forward BMAD for mentioned aim in the spine of thalassemics.
La dystrophie musculaire de Duchenne (DMD) et Becker (BMD) sont des troubles alléliques récessifs liés à l’X. Elles sont consécutives à des mutations affectant le gène de la dystrophine DMD.
Le but ...de notre étude est de rapporter le profilmutationnel des patients DMD/BMD observés dans l’Est Algérien.
L’étude a porté sur 73 patients remplissant les critères diagnostiques de dystrophinopathies. Tous les patients nous ont été orientés du service de neurologie du CHU de Constantinedurant la période 2014-2017. L’analyse du gène DMD a été réalisée par les techniques suivantes : PCR Multiplex, MLPA et le séquençage de nouvelle génération (NGS).
Nos patients avaient un âge moyen de 4 ans avec un âge moyen de début de 3 ans. La DMD a été observée dans 70 % des cas et la BMD dans 30 % des cas. Les délétions ont été observées dans 83,5 % des cas, Les duplications dans 2,8 % des cas et les mutations ponctuelles dans les 13,7 % des cas restants. Notre étude a participé à la mise en évidence de 2 nouvelles mutations ponctuelles.
Nos résultats se rapprochent des grandes séries de la littérature, en plus notre étude a participé à la mise en évidence de 2 nouvelles mutations ponctuelles non encore rapportées dans la littérature.
L’objectif de notre travail a été atteint, nos perspectives seraient d’établir des corrélations entre le phénotype et le génotype et de participer aux grands essais cliniques.
Summary
The rationale of this study was to examine the effectiveness of 6-month high-impact step aerobics (SA) or moderate-intensity resistance training exercise (RT) on bone mineral density (BMD) ...and bone bending strength in sedentary women. Results show that SA enhanced BMD in the heel, lower leg, and lumbar spine 2.
Introduction
To determine the effectiveness of 6 months of high-impact step aerobics (SA) or moderate-intensity resistance training (RT) on areal bone mineral density (aBMD) and tibial bending strength in sedentary premenopausal women.
Methods
Sixty-nine women (20–35 years old) who were randomly assigned to RT (
n
= 22), SA (
n
= 26), or non-treatment control (CON,
n
= 21) groups completed the study. SA had a minimum of 50 high-impact landings each training session. RT had a periodized lower body resistance training program incorporating eight exercises (65–85% of 1 repetition maximum: 1-RM). Both RT and SA met 3 times weekly. aBMD was assessed using dual X-ray absorptiometry (DXA). Tibial bending strength was assessed using mechanical response tissue analysis (MRTA). Measurements at 6 months were compared to baseline using ANCOVA, adjusted for baseline measures and covariates with
α
= 0.05.
Results
Calcaneus aBMD (0.0176 vs -0.0019 or -0.0009 g/cm
2
relative to RT,
p
< 0.004, and CON,
p
< 0.006, respectively), lower leg aBMD (0.0105 vs -0.0036 g/cm
2
, relative to RT,
p
= 0.02), and lumbar spine 2 (L2) aBMD (0.0082 vs -0.0157 g/cm
2
relative to CON,
p
< 0.02) were significantly greater in the SA group after 6 months. Tibial bending strength and bone resorption biomarkers were unchanged in all three groups after 6 months.
Conclusion
Sedentary premenopausal women engaging in 6 months of high-impact aerobic exercise improved aBMD in the calcaneus, lower leg, and L2.
The Scientific Committee (SC) reconfirms that the benchmark dose (BMD) approach is a scientifically more advanced method compared to the NOAEL approach for deriving a Reference Point (RP). Most of ...the modifications made to the SC guidance of 2009 concern the section providing guidance on how to apply the BMD approach. Model averaging is recommended as the preferred method for calculating the BMD confidence interval, while acknowledging that the respective tools are still under development and may not be easily accessible to all. Therefore, selecting or rejecting models is still considered as a suboptimal alternative. The set of default models to be used for BMD analysis has been reviewed, and the Akaike information criterion (AIC) has been introduced instead of the log‐likelihood to characterise the goodness of fit of different mathematical models to a dose–response data set. A flowchart has also been inserted in this update to guide the reader step‐by‐step when performing a BMD analysis, as well as a chapter on the distributional part of dose–response models and a template for reporting a BMD analysis in a complete and transparent manner. Finally, it is recommended to always report the BMD confidence interval rather than the value of the BMD. The lower bound (BMDL) is needed as a potential RP, and the upper bound (BMDU) is needed for establishing the BMDU/BMDL per ratio reflecting the uncertainty in the BMD estimate. This updated guidance does not call for a general re‐evaluation of previous assessments where the NOAEL approach or the BMD approach as described in the 2009 SC guidance was used, in particular when the exposure is clearly smaller (e.g. more than one order of magnitude) than the health‐based guidance value. Finally, the SC firmly reiterates to reconsider test guidelines given the expected wide application of the BMD approach.
http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2017.EN-1147/full
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