Search Results (18)

Background/Objectives: The skeletal system reaches peak bone mass through modeling and remodeling processes, influenced by environmental, dietary, hormonal, and genetic factors. In children with endocrinopathies, disturbances in bone mass and mineralization may correlate with hormonal levels, but conditions like short stature or obesity can confound DXA results. This study aimed to assess the prevalence of decreased bone mineral density (BMD) in children with endocrine disorders and evaluate the impact of auxological and hormonal abnormalities on BMD. Methods: This study analyzed medical records of 148 children (mean age 11.85 ± 3.34 years); 73 girls and 75 boys). Conditions included obesity (22.9%), short stature (47.9%), precocious puberty (10.1%), and other diagnoses. Clinical data included primary diagnosis, height, body weight, pubertal stage, and serum concentrations of calcium, phosphate, alkaline phosphatase, 25OHD, PTH, osteocalcin, Crosslaps, TSH, fT4, IGF-1, IGF-BP3, cortisol, estradiol, testosterone, and bone age. DXA scans were performed at the total body less head (TBLH) and lumbar spine (Spine) projection. Results: Low bone mass (aBMD Z-score ≤ −2) was found in 34.46% at TBLH and 15.54% at the Spine. After height adjustment (HAZ adjustment), the prevalence of low bone mass decreased to 11.4% at TBLH and 4.1% at the Spine. In the short stature group, the normalization of Z-scores for height significantly reduced abnormal results. A positive correlation was found between DXA parameters and age, height standard deviation score (HSDS), BMI SDS, estradiol, testosterone, IGF-1, and IGF-BP3. A negative correlation existed between vitamin D and DXA parameters. Bone turnover markers (osteocalcin and Crosslaps) also negatively affected bone mass. No significant correlations were found with PTH, TSH, fT4, or cortisol. In children with growth retardation, lower aBMD_HAZ Z-scores were observed in those with decreased IGF-1. Positive correlations existed between BMI SDS, IGF-1, and adjusted aBMD Z-scores. Conclusions: Children with endocrine disorders, especially those with short stature, are at risk for bone mineralization disorders. Height normalization is crucial for accurate DXA interpretation and avoiding overdiagnosis. Positive influences on bone mass include height, BMI, IGF-1, estradiol, and testosterone, while negative factors include bone turnover markers and low vitamin D. Full article

(1) Background: A decrease in bone mineral density has been noted not only in at-risk patients (e.g., postmenopausal women) but also in young and middle-aged individuals due to changes in lifestyle. The aim of the study was to find a possible correlation for dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) with cone beam computed tomography (CBCT) of the jaws. (2) Methods: A total of 24 patients (14 women and 10 men aged 25 to 50 years) with partial secondary tooth loss and vitamin D insufficiency underwent cone beam computed tomography of the jaws and skeletal mineral density assessment using DXA (n = 12) and QCT (n = 12). (3) Results: When conducting CBCT of the jaws, a predominance of bone tissue type D3 (350–850 Hu) on the upper jaw (p > 0.05 (F = 0.68) and D2 (850–1350 Hu) on the lower jaw (p > 0.05 (F = 1) was revealed. According to the results of QCT densitometry of the skeleton, signs of osteopenia were found in four patients (with vitamin D3 deficiency) (33%) according to DXA; signs of osteopenia were found in six patients (with severe deficiency and deficiency of vitamin D3) (50%). The difference between QCT and DXA was not significant (p > 0.05) for each group. The significant strong correlation between CBCT and DXA or QCT was not found (p > 0.05). (4) Conclusions: Primary changes in bone density can be detected earlier in the dental system using cone beam computed tomography of the jaws. At the same time, the question of using a specific densitometry method—DXA or QCT—remains open, as their results correlating with CBCT optical density was not approved. Full article

Background: Celiac disease (CD) has been linked with increased susceptibility to osteoporosis; therefore, we aimed to explore whether, in a group of patients with CD, body composition parameters impact bone parameters. Methods: This study covered 56 adults—47 women and 9 men—with CD, and 20 healthy controls—16 women and 4 men. Densitometry of the lumbar spine (L1–L4) and femoral neck (FN) was conducted using dual-energy X-ray absorptiometry (DXA). Body mass was measured by bioimpedance method. Furthermore, serum 25(OH)D and ionized calcium concentration were determined. Results: We found osteopenia in the FN in 19.65% of patients and in L1–L4 in 26.79% of the patients. One patient displayed evidence of osteoporosis in the L1–L4 region, while two patients (3.57%) exhibited similar findings in the FN. Significant positive correlations were observed between bone mineral density (BMD) and body mass, fat-free mass (FFM), muscle mass, and basal metabolic rate (BMR) for both L1–L4 and the FN, and body mass index (BMI) of L1–L4. Conclusions: In conclusion, people with CD are at an increased risk of decreased BMD. Patients with lower body mass, FFM, muscle mass, BMI, and BMR more often present with osteopenia and osteoporosis. Full article

Introduction: The study of BMD provides only partial information on bone health in patients undergoing TSH suppression therapy due to differentiated thyroid cancer (DTC). The trabecular bone score (TBS), a new parameter assessing bone microarchitecture, is proposed for studying bone in this context. This study aimed to analyze their long-term use in patients with DTC. Methods: Bone mineral density (BMD) was measured by dual X-ray densitometry (DXA) and TBS was assessed with iNsigth software (version 2.0, MediImaps, France) in 145 postmenopausal patients with DTC. Vertebral fractures (VFs) were identified using a semi-quantitative X-ray method. Results: The BMD at the end of this study did not differ from the initial measurement. However, the TBS decreased from 1.35 ± 0.1 to 1.27 ± 0.1 (p = 0.002). Increased levels of PTH, osteocalcin, and bone alkaline phosphatase (BAP) were observed, suggesting enhanced bone remodeling. There was an increase in the prevalence of osteoporosis and osteopenia (40.6% and 16.5% to 46.6% and 18.6%, respectively). The proportion of patients with partially degraded and totally degraded TBS increased from 31% and 15.1% to 48.9% and 24.8% by the end of this study. Among the 30 patients with VFs, there were no significant differences in age, body mass index (BMI), calcium intake, alcohol consumption, smoking, radioiodine, therapy, or thyroid parameters compared to those without VFs. The odds ratio for VFs increased with osteopenia (OR 2.63). Combining TBS with BMD did not improve discrimination. Conclusions: The TBS decreased while the BMD remained unchanged. The percentage of patients with osteoporosis and osteopenia, whether partially degraded or totally degraded, increased by the end of this study. The predominant discordance was found in partially degraded microarchitectures, with a higher proportion of osteopenic patients compared to those with normal or osteoporotic bone density. The AUC of the combination of TBS and BMD did not enhance discrimination. TBS, radioactive iodine therapy, and sedentary lifestyle emerged as the main distinguishing factors for DTC patients with VFs. Full article

Body composition assessment using instruments such as dual X-ray densitometry (DXA) can be complex and their use is often limited to research. This cross-sectional study aimed to develop and validate a densitometric method for fat mass (FM) estimation using 3D cameras. Using two such cameras, stereographic images, and a mesh reconstruction algorithm, 3D models were obtained. The FM estimations were compared using DXA as a reference. In total, 28 adults, with a mean BMI of 24.5 (±3.7) kg/m² and mean FM (by DXA) of 19.6 (±5.8) kg, were enrolled. The intraclass correlation coefficient (ICC) for body volume (BV) was 0.98–0.99 (95% CI, 0.97–0.99) for intra-observer and 0.98 (95% CI, 0.96–0.99) for inter-observer reliability. The coefficient of variation for kinetic BV was 0.20 and the mean difference (bias) for BV (liter) between Bod Pod and Kinect was 0.16 (95% CI, −1.2 to 1.6), while the limits of agreement (LoA) were 7.1 to −7.5 L. The mean bias for FM (kg) between DXA and Kinect was −0.29 (95% CI, −2.7 to 2.1), and the LoA was 12.1 to −12.7 kg. The adjusted R² obtained using an FM regression model was 0.86. The measurements of this 3D camera-based system aligned with the reference measurements, showing the system’s feasibility as a simpler, more economical screening tool than current systems. Full article

Lagomorphs, which include hares, rabbits, and pikas, are herbivorous animals renowned for their exceptional running abilities. The femur, the largest and strongest bone in their bodies, plays a crucial role in supporting their weight and facilitating movement. This study aimed to investigate the structural and functional changes in the femora of hares during their development in a sex-dependent manner, and the influence of aging on femur structure and function. Various mechanical properties, including stiffness and strength, as well as densitometry and morphology, were evaluated. The study was conducted on n = 24 hares collected from a hunting district in the Lublin region of Poland and divided into four groups: young females, adult females, young males and adult males (n = 6 animals each). Dual-energy X-ray absorptiometry (DXA) was used to measure bone mineral content (BMC) and bone mineral density (BMD), and a three-point bending test was performed to assess mechanical properties. The findings revealed age-related differences in bone properties, with adult males exhibiting increased BMC, and BMD compared to young males. Geometrical properties of the femora mid-diaphysis, such as cortical index and cross-sectional area, remained relatively unchanged during maturation. Regarding mechanical properties, the femora of young males exhibited higher elastic work compared to those of young females, while the femora of adult males exhibited higher elastic and breaking work than those of adult females. The stiffness of femora was higher in adult females compared to young females. The results provide insights into the development and aging of hare femora and contribute to our understanding of the relationship between bone mechanical properties, musculoskeletal system, and aging in the wild. This knowledge can inform animal husbandry practices in captivity and enhance our broader understanding of the ecological functions of lagomorphs. Full article

Background: Transitioning to university involves several changes, which might affect dietary habits. The present study aimed to assess the potential relationships involving adherence to the MedDiet, body composition, and metabolic markers within a Portuguese university sample. Methods: A cross-sectional study involved 70 participants, 52 women, and 18 men (23.00 ± 7.00 years old and a BMI of 21.99 ± 2.79 kg/m²). The average MedDiet adherence of participants was 9.23 points, as evaluated by the 14 point validated questionnaire, with classifications of low and high (under or over 9 points, respectively). Body composition was assessed using X-ray dual densitometry (DXA), and metabolic markers were collected from capillary blood. Results: Statistically significant differences in HDL cholesterol and the total/HDL cholesterol ratio were found between groups. Lower levels (p < 0.05) of visceral (VAT) and subcutaneous adipose tissue (SAT), BMI, and waist circumference were found in the higher MedDiet adherence group. Those measures were negatively correlated (p < 0.05) with the adherence scores to the MedDiet. Conclusion: Higher adherence to MedDiet seemed to have a favorable and important impact on lipid profiles, primarily HDL-c. A positive relationship between MedDiet adherence and body composition distribution was also described, mostly due to the influence of higher adherence to MedDiet at lower levels of VAT and SAT in Portuguese university students. Full article

Background and Objectives: The relationship between osteoarthritis (OA) and osteoporosis (OP) has been analysed for over four decades. However, this relationship has remained controversial. Numerous observational and longitudinal studies have shown an inverse association between the two diseases and a protective effect of one against the other. On the other hand, some studies show that patients with OA have impaired bone strength and are more prone to fractures. The study’s main objective was to determine the bone mineral density (BMD) of the spine and hip (femoral neck) of postmenopausal women of different ages, with radiologically determined OA of the hip and knee, as well as to determine the correlation between BMD values and age in the experimental group. Materials and Methods: The retrospective cohort study included 7018 patients with osteoarthritis of peripheral joints and the spine, examined by a rheumatologist in an outpatient rheumatology clinic at the Institute for Treatment and Rehabilitation, Niška Banja from July 2019 to March 2021. A nested anamnestic study was conducted within the cohort study of patients, and it included two groups: an experimental group composed of 60 postmenopausal women, and a control group composed of the same number of women. Out of 120 patients, 24 did not meet the criteria for the continuation of the study (due to technical errors—radiographic and/or densitometry artefacts). Fifty-six postmenopausal women (aged 45–77 years) with hip and knee radiological OA were examined as an experimental group. The participants were divided into two subgroups according to age (45–60 years and over 61 years). The control group included 40 healthy postmenopausal women of the same age range, without radiological OA, with normal BMD of the hip and spine. All patients with OA met the American College of Radiology (ACR) criteria. OA of the hip and knee was determined radiologically according to Kellgren and Lawrence (K&L) classification, and patients were included in the study if a K&L grade of at least ≥ 2 was present. Hip and spine BMD was measured by dual-energy X-ray absorptiometry (DXA). Results: Compared to the control group, we found statistically significantly lower BMD and T-scores of the spine in older postmenopausal women: BMD (g/cm²), p = 0.014; T-score, p = 0.007, as well as of the hip: BMD (g/cm²), p = 0.024; T-score p < 0.001. The values of BMD and T-score of the spine and hip are lower in more severe forms of OA (X-ray stage 3 and 4, according to K&L), p < 0.001. We found negative correlation between BMD and T-score and age only for the hip: BMD (g/cm²), ρ = 0.378, p = 0.005; T-score ρ = −0.349, p = 0.010. Conclusions: Older postmenopausal women with radiographic hip and knee OA had significantly lower BMD of the hip and spine as compared to the control group without OA, pointing to the need for the prevention and treatment of OA, as well as early diagnosis, monitoring, and treatment of low bone mineral density. Full article

Osteoporosis has been defined as the silent disease of the 21st century, becoming a public health risk due to its severity, chronicity and progression and affecting mainly postmenopausal women and older adults. Osteoporosis is characterized by an imbalance between bone resorption and bone production. It is diagnosed through different methods such as bone densitometry and dual X-rays. The treatment of this pathology focuses on different aspects. On the one hand, pharmacological treatments are characterized by the use of anti-resorptive drugs, as well as emerging regenerative medicine treatments such as cell therapies and the use of bioactive hydrogels. On the other hand, non-pharmacological treatments are associated with lifestyle habits that should be incorporated, such as physical activity, diet and the cessation of harmful habits such as a high consumption of alcohol or smoking. This review seeks to provide an overview of the theoretical basis in relation to bone biology, the existing methods for diagnosis and the treatments of osteoporosis, including the development of new strategies. Full article

The historical 1975 Reference Man is a ‘model’ that had been used as a basis for the calculation of radiation doses, metabolism, pharmacokinetics, sizes for organ transplantation and ergonomic optimizations in the industry, e.g., to plan dimensions of seats and other formats. The 1975 Reference Man was not an average individual of a population; it was based on the multiple characteristics of body compositions that at that time were available, i.e., mainly from autopsy data. Faced with recent technological advances, new mathematical models and socio-demographic changes within populations characterized by an increase in elderly and overweight subjects a timely ‘state-of-the-art’ 2021 Reference Body are needed. To perform this, in vivo human body composition data bases in Kiel, Baton Rouge, San Francisco and Honolulu were analyzed and detailed 2021 Reference Bodies, and they were built for both sexes and two age groups (≤40 yrs and >40 yrs) at BMIs of 20, 25, 30 and 40 kg/m². We have taken an integrative approach to address ‘structure–structure’ and ‘structure–function’ relationships at the whole-body level using in depth body composition analyses as assessed by gold standard methods, i.e., whole body Magnetic Resonance Imaging (MRI) and the 4-compartment (4C-) model (based on deuterium dilution, dual-energy X-ray absorptiometry and body densitometry). In addition, data obtained by a three-dimensional optical scanner were used to assess body shape. The future applications of the 2021 Reference Body relate to mathematical modeling to address complex metabolic processes and pharmacokinetics using a multi-level/multi-scale approach defining health within the contexts of neurohumoral and metabolic control. Full article

Dual Energy X-ray Absorptiometry (DXA) is a tool that allows the assessment of bone density. It was first presented by Cameron and Sorenson in 1963 and was approved by the Food and Drug Administration. Misplacing the femoral neck box, placing a trochanteric line below the midland and improper placement of boundary lines are the most common errors made during a DXA diagnostic test made by auto analysis. Hydroxyapatite is the most important inorganic component of teeth and bone tissue. It is estimated to constitute up to 70% of human bone weight and up to 50% of its volume. Calcium phosphate comes in many forms; however, studies have shown that only tricalcium phosphate and hydroxyapatite have the characteristics that allow their use as bone-substituted materials. The purpose of this study is aimed at analyzing the results of hip densitometry and hydorxyapatite distribution in order to better assess the structure and mineral density of the femoral neck. However, a detailed analysis of the individual density curves shows some qualitative differences that may be important in assessing bone strength in the area under study. To draw more specific conclusions on the therapy applied for individual patients, we need to determine the correct orientation of the bone from the resulting density and document the trends in the density distribution change. The average results presented with the DXA method are insufficient. Full article

Although frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a diverse range of clinical manifestations with secondary hyperparathyroidism usually being the most frequent. With the decline in renal function, CKD-MBD may induce microstructural changes in bone, vascular system and soft tissues, which results in macrostructural lesions, such as low bone mineral density (BMD) resulting in skeletal fractures, vascular and soft tissue calcifications. Moreover, low BMD, fractures, and vascular calcifications are linked with increased risk of cardiovascular mortality and all-cause mortality. Therefore, a better characterization of CKD-MBD patterns, beyond biochemical markers, is helpful to adapt therapies and monitor strategies as used in the general population. An in-depth characterization of bone health is required, which includes an evaluation of cortical and trabecular bone structure and density and the degree of bone remodeling through bone biomarkers. Standard radiological imaging is generally used for the diagnosis of fracture or pseudo-fractures, vascular calcifications and other features of CKD-MBD. However, bone fractures can also be diagnosed using computed tomography (CT) scan, magnetic resonance (MR) imaging and vertebral fracture assessment (VFA). Fracture risk can be predicted by bone densitometry using dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QTC) and peripheral quantitative computed tomography (pQTC), quantitative ultrasound (QUS) and most recently magnetic resonance micro-imaging. Quantitative methods to assess bone consistency and strength complete the study and adjust the clinical management when integrated with clinical factors. The aim of this review is to provide a brief and comprehensive update of imaging techniques available for the diagnosis, prevention, treatment and monitoring of CKD-MBD. Full article

Whilst the assessment of body composition is routine practice in sport, there remains considerable debate on the best tools available, with the chosen technique often based upon convenience rather than understanding the method and its limitations. The aim of this manuscript was threefold: (1) provide an overview of the common methodologies used within sport to measure body composition, specifically hydro-densitometry, air displacement plethysmography, bioelectrical impedance analysis and spectroscopy, ultra-sound, three-dimensional scanning, dual-energy X-ray absorptiometry (DXA) and skinfold thickness; (2) compare the efficacy of what are widely believed to be the most accurate (DXA) and practical (skinfold thickness) assessment tools and (3) provide a framework to help select the most appropriate assessment in applied sports practice including insights from the authors’ experiences working in elite sport. Traditionally, skinfold thickness has been the most popular method of body composition but the use of DXA has increased in recent years, with a wide held belief that it is the criterion standard. When bone mineral content needs to be assessed, and/or when it is necessary to take limb-specific estimations of fat and fat-free mass, then DXA appears to be the preferred method, although it is crucial to be aware of the logistical constraints required to produce reliable data, including controlling food intake, prior exercise and hydration status. However, given the need for simplicity and after considering the evidence across all assessment methods, skinfolds appear to be the least affected by day-to-day variability, leading to the conclusion ‘come back skinfolds, all is forgiven’. Full article

(1) Purpose: Predisposing factors to osteoporosis (OP) as well as dual-source x-ray densitometry (DXA) steer therapeutic decisions by determining the FRAX index. This study examines the reliability of a standard risk factor questionnaire in OP-screening. (2) Methods: n = 553 eligible questionnaires encompassed 24 OP-predisposing factors. Reliability was assessed using DXA as a gold standard. Multiple logistic regression and Spearman’s correlations, as well as the confounding influence of age and body mass index, were analyzed in SPSS (IBM Corporation, Armonk, NY, USA). (3) Results: Our study revealed low patient self-awareness regarding OP and its risk factors. One out of every four patients reported a positive history for osteoporosis not confirmed by DXA. The extraordinarily high incidence of rheumatoid arthritis and thyroid disorders likely reflect confusion with other diseases or health anxiety. FRAX-determining risk factors such as malnutrition, liver insufficiency, prior fracture without trauma, and glucocorticoid therapy did not correlate with increased OP incidence, altogether demonstrating how inaccurate survey information could influence therapeutic decisions on osteoporosis. (4) Conclusions: Contradictive results and a low level of patient self-awareness suggest a high degree of uncertainty and low reliability of the current OP risk factor survey. Full article

This study aimed to identify the interactional relationships between maturation (biological age (BA)) and lean mass on strength development in young athletes from different sports. Using a cross-sectional study design, a sample of 64 young athletes (rowers, swimmers, jiu-jitsu, volleyball, soccer and tennis players) of both sexes (13.6 ± 1.17 years) were recruited. Body composition was assessed using dual energy bone densitometry with X-ray source (DEXA). Strength of upper limbs (ULS), force hand grip (HG), vertical jump (VJ) and jump against movement (CMJ) were recorded. BA was estimated from anthropometrics. BA relationships were identified with upper limb strength in all athletes, and with the lower limb strength of tennis players, only (p < 0.05). An interaction effect between lean mass and BA was found (η²p = 0.753), as was a local effect within the regression models (ƒ² ≥ 0.33). Athletes with a higher concentration of lean mass had superior upper and lower limb strength (p < 0.05). Lean mass showed a local effect (ƒ²) greater than that associated with BA. Although maturation is related to strength development, the strength of the relationship is mitigated by the accrual of lean mass. Specifically, the local effect of lean mass on muscle strength is broader than that of maturation, especially for lower limb strength. Full article