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Factors relating to Bone mineral density in young and middle-aged patients with ankylosing spondylitis

Chinese Medical Journal 2021年第21期134卷 2556-2563页

作者： Xin Wu Jia-Yun Zhong Geng Wang Hu-ji Xu department of Rheumatology and Immunology Changzheng HospitalSecond Military Medical UniversityShanghai 200003China Graduate School Second Military Medical UniversityShanghai 200433China University of Queensland Diamantina Institute University of QueenslandBrisbaneAustralia Peking-Tsinghua Center for Life Sciences Tsinghua UniversityBeijing 100083China Beijing Tsinghua Chang Gung Hospital School of Clinical MedicineTsinghua UniversityBeijing 102218China

Background:Ankylosing spondylitis(AS)is a common chronic progressive rheumatic disease.The aim of this study was to explore factors influencing abnormal Bone mineral density(BMD)in young and middle-aged patients with AS.Methods:From July 2014 to August 2018,hospitalized patients with AS and health examinees in the health examination center of our clinics,ranging in age from 20 to 50 years,were monitored.The BMD of the lumbar spine and femoral neck of AS patients and those of a healthy control group were measured using dual-energy X-ray absorption.The BMDs of AS patients were compared with respect to age,course of disease,iritis,smoking habits,sex,height,weight,body mass index(BMI),medication use,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),platelet volume,platelet count,uric acid(UA),alkaline phosphatase(AKP),and calcium ion levels.Single-nucleotide polymorphisms(SNPs)related to BMD were screened using genome-wide association analysis.Results:There was no statistical difference in the proportion of abnormal bone masses between the different body parts.The BMD of all bones in AS patients was lower than that in healthy controls(Pbone mass in AS patients was correlated with sex(Pbone mass in AS patients was higher than that in healthy individual

关键词： Ankylosing spondylitis Bone mineral density Genome-wide association analysis

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Prevalence and risk factors for Bone mineral density changes in antiretroviral therapy-naive human immunodeficiency virus-infected adults:a Chinese cohort study

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Chinese Medical Journal 2020年第24期133卷 2940-2946页

作者： Yong-Qin Zeng Jiang Xiao Cui-Lin Li Yu Wang Ling Zhang Xiao-Li Pang Di Wang Juan Du Hong-Xin Zhao Department of Infection Beijing Ditan HospitalPeking UniversityBeijing 100015China Clinical and Research Center of Infectious Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Background Studies have reported that low Bone mineral density(BMD)is prevalent in human immunodeficiency virus(HIV)-infected patients;however,the factors that contribute to HIV-related BMD changes are yet to be fully understood.Due to the application of dual X-ray absorptiometry(DXA)among a select group of hospitals only,the prevalence and risk factors of low BMD in HIV-infected populations have not been intensively investigated in China.Thus,the aim of our study was to investigate the prevalence of and risk factors associated with BMD changes among antiretroviral therapy(ART)-naive HIV-positive patients in China.Methods The assessment of the prevalence of and risk factors associated with BMD changes was conducted among 156 ART-naive HIV-infected patients.Demographic and clinical data,as well as results of fasting blood tests were obtained from patients.Further,all patients underwent DXA scans to determine BMD,which was then used to classify patients with osteopenia/osteoporosis.The risk factors of reduced BMD were then evaluated using binary logistic regression.Results Among the 156 ART-naive HIV-infected participants,osteopenia and osteoporosis were diagnosed in 48.7%(76/156)and 4.5%(7/156)of patients,respectively.The lumbar spine was most likely to have reduced BMD(49.4%[77/156]),and the proportion of osteopenia in the left hip(32.7%[51/156])was higher than in the right hip(24.4%[38/156]).In the lumbar spine,bone loss rate in the L1 section(60.9%[95/156])was the most significant(L2,53.2%[83/156];L3,45.5%[71/156];L4,52.6%[82/156]).Further analysis showed that,compared with the neck(26.9%[42/156]in the left,18.6%[29/156]in the right)and the interior(15.4%[24/156]in the left,13.5%[21/156]in the right),the trochanter had the greatest probability of reduced BMD(46.2%[72/156]in the left,28.8%[45/156]in the right).In the risk factor analysis,low body mass index(BMI:<18.5 kg/m2)was positively associated with reduced BMD(Exp(B)=39.743,95%confidence interval:3.234-488.399,P=0.004),and was specifically positively correl

关键词： Human immunodeficiency virus(HIV) Antiretroviral therapy-naive Bone mineral density Body mass index

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Validation of quantitative computed tomography-derived areal Bone mineral density with dual energy X-ray absorptiometry in an elderly Chinese population

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Chinese Medical Journal 2014年第8期127卷 1445-1449页

作者： Cheng Xiaoguang Wang Ling Wang Qianqian Ma Yimin Su Yongbin Li Kai Department of Radiology Department of Epidemiology (Wang QQ) Beijing Jishuitan Hospital Beijing 100035 China Department of Epidemiology Beijing Jishuitan Hospital Beijing 100035 China

Background The performance of computed tomography X-ray absorptiometry （CTXA） against the dual energy X-ray absorptiometry （DXA） as standard has not been studied in Chinese population. The aim of this study was to evaluate the precision of this measurement and validate the value of quantitative computed tomography （QCT） by comparing CTXA results with DXA results in an elderly Chinese population. Methods One hundred and three females of 46 to 76 years old and 49 males of 52 to 76 years old were recruited from the Prospective Urban Rural Epidemiology study. All subjects underwent hip scans by both QCT and DXA on the same day. For precision determination, 30 subjects had duplicate DXA hip scans. The hip QCT data of a subset of 27 subjects were separately analyzed by two observers and reanalyzed by one observer at a different time. The inter- and intra-observer variations of CTXA measurement were assessed, and the difference and correlation between CTXA and DXA results were analyzed. Results The inter- and intra-observer variations of CTXA were 0.070 and 0.024 g/cm^2 in the femoral neck （FN）, and 0.030 and 0.012 g/cm2 in the total hip （TH）, which were comparable to the DXA inter-scan variations （0.013 g/cm2 for FN and 0.014 g/cm2 for TH）. The results of CTXA Bone mineral density （BMD） were highly correlated with those of DXA （R2 = 0.810 for FN and R2 = 0.878 for TH）. The BMD values of CTXA in FN and TH were lower than those of DXA by 21.0% and 17.8% （P〈0.05）, respectively. However, after appropriate transformation, the difference was eliminated and a comparable T score could be obtained. Conclusions CTXA shows good agreement with DXA for the measurement of BMD in the proximal femur, which makes QCT suitable for the quantification of bone mineral content in the hip and helpful for the diagnosis of osteoporosis.

关键词： Bone mineral density osteoporosis quantitative computed tomography dual energy X-ray absorptiometry

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Association between calcium supplementation and Bone mineral density in children:a systematic review and meta-analysis

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Frontiers of Nursing 2021年第2期8卷 169-176页

作者： Jin-Ping Gao Hong-Xia Ren Yan-Fei Wang Shi-Fan Han Chang-Tai Zhu School of Nursing Shanxi Medical UniversityTaiyuanShanxi 030001China Department of Transfusion Medicine Shanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghai 200233China

Objective:To evaluate the effects of calcium supplementation on Bone mineral density in children.Methods:The PubMed,Embase,and Cochrane library were systematically searched.The retrieve inception date was between October 2001 and October 2019.Two reviewers independently performed the data extraction and assessed methodology quality.Studies were limited to randomized clinical trials comparing calcium supplement with a placebo for Bone mineral density in children.A meta-analysis was performed to calculate standard mean difference(SMD)and 95%confidence interval(CI).Results:A total of 6 randomized controlled trials involving 408 participants(calcium supplementation group:198;placebo group:210)were finally included in this study.The meta-analysis revealed that,compared with placebos,calcium supplementation had no effect on the bone mineral densities[the whole-body:SMD with CI=0.43(-0.05-0.91),P=0.08,I2=75%;the 2nd-4th lumbar vertebrae:SMD with 95%CI=0.27(−0.17 to 0.70),P=0.07,I2=0%)].Sensitivity analysis revealed that the results of the whole-body Bone mineral density were unstable and that the bone density of the 2nd-4th lumbar spine was robust.Conclusions:The results of this meta-analysis suggested that calcium supplementation did not improve Bone mineral density in children.However,there continues to be a need for more high-quality studies to verify this fact in the future.

关键词： children calcium Bone mineral density meta-analysis randomized controlled trial

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Associations between Geriatric Nutrition Risk Index,Bone mineral density and body composition in type 2 diabetes patients

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World Journal of Diabetes 2024年第3期15卷 403-417页

作者： Xiao-Xiao Zhu Kai-Feng Yao Hai-Yan Huang Li-Hua Wang Department of Pediatrics The Second Affiliated Hospital of Nantong UniversityFirst People’s Hospital of Nantong CityNantong 226001Jiangsu ProvinceChina Department of Nursing The Second Affiliated Hospital of Nantong UniversityFirst People’s Hospital of Nantong CityNantong 226001Jiangsu ProvinceChina Department of Endocrinology The Second Affiliated Hospital of Nantong UniversityFirst People’s Hospital of Nantong CityNantong 226001Jiangsu ProvinceChina

BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,Bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,Pbone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,Pbone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated w

关键词： Geriatric Nutrition Risk Index Bone mineral density Skeletal muscle mass Type 2 diabetes

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Serum sclerostin levels associated with lumbar spine Bone mineral density and bone turnover markers in patients with postmenopausal osteoporosis

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Chinese Medical Journal 2013年第13期126卷 2480-2484页

作者： XU Xiao-juan SHEN Lin YANG Yan-ping LU Fu-rong ZHU Rui SHUAI Bo LI Cheng-gang WU Man-xiang Department of Integrated Traditional Chinese Medicine and Western Medicine Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430022 China

Background Sclerostin, expressed exclusively by osteocytes, is a negative regulator of bone formation. To gain insights into the action of sclerostin in postmenopausal osteoporosis, we evaluated serum sclerostin levels in postmenopausal women and investigated its possible associations with bone turnover markers in patients with postmenopausal osteoporosis. Methods We detected serum sclerostin, and measured lumbar spine Bone mineral density in 650 Chinese postmenopausal women. We also assessed serum levels of 13-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin, 25-hydroxyvitamin D, and estradiol. Results Serum sclerostin levels were lower in postmenopausal osteoporotic women compared with non-osteoporotic postmenopausal women （（38.79＋7.43） vs. （52.86＋6.69） pmol/L, P 〈0.001）. Serum sclerostin was positively correlated with lumbar spine Bone mineral density （r=0.391, P 〈0.001） and weakly negatively correlated with [3-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin （t= -0.225, P 〈0.001; r= -0.091, P=0.046; r= -0.108, P=0.018; respectively） in postmenopausal osteoporosis. There was no significant association of serum sclerostin with age, body mass index, 25-hydroxyvitamin D, and estradiol （r= -0.004, P=0.926; r=0.067, P=0.143; r=0.063, P=0.165; r= -0.045, P=0.324; respectively）.Conclusion Sclerostin may be involved in the pathogenesis of postmenopausal osteoporosis and may play a role in bone turnover.

关键词： sclerostin,＂ postmenopausal osteoporosis Bone mineral density

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Relatively High Bone mineral density in Chinese Adolescent Dancers Despite Lower Energy Intake and Menstrual Disorder

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Biomedical and Environmental Sciences 2010年第2期23卷 130-136页

作者： LI-CHEN YANG YAN LAN JING HU YAN-HUA YANG QIAN ZHANG ZHEN-WU HUANG JIAN-HUA PIAO Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention Beijing 100050 China Beijing Dance Academy Beijing 100081 China

Objective The effect of dietary restriction, intense exercise and menstrual dysfunction on Bone mineral density remains controversial. The aim of this study was to assess the skeletal health status and relationship between Bone mineral density and nutrient intake, menstrual status, estrogen level and other factos in Chinese adolescent dancers. Methods Sixty dancers and 77 healthy controls underwent measurements of bone density, body composition, and estrogen level. Nutrient intake, menstrual status and physical activity were assessed with questionnaires. The correlation between these factors were analyzed. Results The dancers under study had a significantly lean body mass index （18.3±1.4 kg/m^2 vs. 21.7±3.1 kg/m^2）, lower percentage of body fat （0.25±0.05 vs. 0.34±0.04） and later age at menarche （14.0±0.9 y vs. 13.0±1.3 y）, and the estrogen level, daily calorie and fat intake in them were also lower than in the controls. All the dancers undertook intensive physical activity every day and up to 69% of them suffered from irregular menarche. Yet they had relatively high BMD and BMC of the total body and legs than the controls after adjusting for BM1 and age. Site-specific BMD was positively correlated to BMI, body composition and training hours per week and negatively correlated to the age at menarche and menstrual frequency. Conclusions The relatively high BMD and BMC of the dancers at the total body and legs were probably caused by high levels of weight-bearing physical activity. To ameliorate disordered eating, especially low energy intake might be helpful to prevent the Triad and to improve the bone health in adolescent dancers.

关键词： Adolescent dancers Bone mineral density Nutrient intake Menstrual status Estrogen level

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Characteristics of Rat Lumbar Vertebral Body Bone mineral density and Differential Segmental Responses to Sex Hormone Deficiency:a Clinical Multidetector Computed Tomography Study

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Biomedical and Environmental Sciences 2012年第6期25卷 607-613页

作者： DENG Min WANG Yi Xiang James F. GRIFFITH LU Gang Anil T AHUJA POON Wai S Department of Imaging and Interventional Radiology Prince of Wales Hospital the Chinese University of Hong Kong Shatin N.T. Hong Kong China Division of Neurosurgery Department of Surgery Prince of Wales Hospital the Chinese University of Hong Kong Shatin N.T. Hong Kong China

Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline Bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.

关键词： Bone mineral density Quantitative computed tomography, Rat Vertebra Orchiectomy Ovariectomy Cortical bone Trabecular bone

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Bone mineral density in fracture neck of femur patients:What's the significance?

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World Journal of Orthopedics 2022年第2期13卷 160-170页

作者： Hussam Elamin Ahmed Oday Al-Dadah Department of Trauma and Orthopaedic Surgery South Tyneside District HospitalHarton LaneSouth Tyneside NE340PLUnited Kingdom Translational and Clinical Research Institute Faculty of Medical SciencesNewcastle UniversityNewcastle-upon-Tyne NE24HHUnited Kingdom

BACKGROUND The National Institute for Health and Care Excellence(NICE)guidelines have advised further research is required into investigating the added prognostic value of Bone mineral density(BMD)in the assessment of fracture risk with the Fracture Risk Assessment Tool(FRAX)score.AIM To investigate the significance of BMD in fracture neck of femur patients and compare it to the outcome of the FRAX score.METHODS Inclusion criteria for this study were all patients who underwent dual-energy Xray absorptiometry(DXA)scan following fracture neck of femur between 2015 and 2017.Analysis of BMD,FRAX scores and patient demographic data was undertaken.RESULTS A total of 69 patients were included in the study,mean age 74.1 years.There was no significant difference between mean BMD of the femoral neck in males(0.65)as compared to females(0.61)(P=0.364).Analyses showed no significant correlation between BMD and menopause age(rs=-0.28,P=0.090).A significant difference was seen of the femoral neck BMD between the different fracture pattern types(P=0.026).A stronger correlation was observed between BMD of femoral neck and FRAX major score(rs=-0.64,P<0.001)than with BMD of lumbar spine and FRAX major score(rs=-0.37,P=0.003).CONCLUSION This study demonstrated that BMD of the femoral neck measured by DXA scan is of added prognostic value when assessing patients for risk of fracture neck of femur in combination with the FRAX predictive scoring system.

关键词： Fracture neck of femur Bone mineral density Fracture Risk Assessment Tool score Fragility fracture Osteoporosis

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Can Bone mineral density affect intra-operative blood loss of mini-invasive posterior lumbar interbody fusion?

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Laparoscopic, Endoscopic and Robotic Surgery 2020年第3期3卷 66-69页

作者： Yong He Chao Liu Yue Huang Department of Orthopaedics Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province Hangzhou 310016China

Objective:Many factors affect intraoperative blood loss(BL)in mini-invasive posterior lumbar interbody fusion(PLIF)procedures,but only few has examined.Specifically,the impact of Bone mineral density(BMD)levels on intraoperative BL.This study aims to examine the correlation between these two factors.Methods:Retrospective review of 120 patients with low back disorders who were scheduled to undergo mini-invasive PLIF from October 2018 to October 2019 was performed.Patients were divided into two groups based on BMD of the lumbar spine:normal group and abnormal group(osteoporosis and osteopenia).Comparison of age,gender,BMD,BL,BMI,prothrombin time,activated partial thromboplastin time,haemoglobin concentration,intraoperative mean arterial pressure,platelet count,and operative time(OT)between the two groups,and correlation analysis of BMD and BL were conducted.Results:The mean BL of patients in the abnormal group was remarkably higher than that in the normal group:357.22±152.55 ml and 259.37±125.90 ml respectively(p<0.001).The partial correlation coefficient between BL and BMD was0.45(p<0.001).The results of univariate regression analysis demonstrated that only BMD,gender,and OT were related to BL(BMD,r=0.427,p<0.001;gender,r=0.211,p=0.024;OT,r=0.318,p=0.001).While multivariate linear regression analysis demonstrated that patients with lower BMD and longer OT had a higher amount of intraoperative BL(p<0.001).Conclusions:BMD is an important factor influencing intraoperative BL in mini-invasive PLIF.It should be assessed routinely as a part of the preoperative examination to improve preoperative assessment and ensure patient safety.

关键词： Bone mineral density Blood loss Mini-invasive posterior lumbar interbody fusion

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