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Holloway-Kew KL, Rufus-Membere P, Anderson KB, Tembo MC, Sui SX, Hyde NK, Diez-Perez A, Kotowicz MA, Pasco JA. Associations between parameters of peripheral quantitative computed tomography and bone material strength index. Bone 2022; 155:116268. [PMID: 34856422 DOI: 10.1016/j.bone.2021.116268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bone material strength index (BMSi) is measured in vivo using impact microindentation (IMI). However, the associations between BMSi and other bone measures are not clear. This study investigated whether bone parameters derived by peripheral quantitative computed tomography (pQCT) are associated with BMSi. METHODS Participants were men (n = 373, ages 34-96 yr) from the Geelong Osteoporosis Study. BMSi was measured using an OsteoProbe (Active Life Scientific, USA). Bone measures were obtained at both the radius (n = 348) and tibia (n = 342) using pQCT (XCT 2000 Stratec Medizintechnik, Germany). Images were obtained at 4% and 66% of radial and tibial length. Associations between pQCT parameters and BMSi were tested using Spearman's correlation and multivariable regression used to determine independent associations after adjustment for potential confounders. Models were checked for interaction terms. RESULTS Weak associations were observed between total bone density (radius 4%; r = +0.108, p = 0.046, tibia 4%; r = +0.115, p = 0.035), cortical density (tibia 4%; r = +0.123, p = 0.023) and BMSi. The associations were independent of weight, height, and glucocorticoid use (total bone density: radius 4%; β = 0.020, p = 0.006, tibia 4%; β = 0.020, p = 0.027 and cortical density: radius 4%; β = 4.160, p = 0.006, tibia 4%; β = 0.038, p = 0.010). Associations with bone mass were also observed at the 66% radial and tibial site, independent of age, weight, and glucocorticoid use (β = 4.160, p = 0.053, β = 1.458, p = 0.027 respectively). Total area at the 66% tibial site was also associated with BMSi (β = 0.010, p = 0.012), independent of weight and glucocorticoid use. No interaction terms were identified. CONCLUSION There were weak associations detected between some pQCT-derived bone parameters and BMSi.
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Affiliation(s)
- Kara L Holloway-Kew
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.
| | - Pamela Rufus-Membere
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Kara B Anderson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Monica C Tembo
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Adolfo Diez-Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Spain
| | - Mark A Kotowicz
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; Barwon Health, Geelong, Australia; Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; Barwon Health, Geelong, Australia; Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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Scott D, Johansson J, Ebeling PR, Nordstrom P, Nordstrom A. Adiposity Without Obesity: Associations with Osteoporosis, Sarcopenia, and Falls in the Healthy Ageing Initiative Cohort Study. Obesity (Silver Spring) 2020; 28:2232-2241. [PMID: 33012137 DOI: 10.1002/oby.22984] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Obesity is commonly defined by BMI rather than adiposity, which may have differential effects on musculoskeletal health. Musculoskeletal outcomes were compared in older adults with normal adiposity and normal BMI (NA-NBMI), those with high adiposity but normal BMI (HA-NBMI), and those with high adiposity and high BMI (HA-HBMI). METHODS In 3,411 70-year-olds, obesity was defined as BMI ≥ 30 kg/m2 and adiposity as body fat percentage ≥ 25% (men) or ≥ 35% (women) from dual-energy x-ray absorptiometry. Bone parameters were measured by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Sarcopenia was defined as low handgrip strength with or without low appendicular lean mass. Falls were self-reported 6 and 12 months later. RESULTS Prevalence of NA-NBMI, HA-NBMI, and HA-HBMI was 14.2%, 68.1%, and 17.7%, respectively. Compared with HA-HBMI, HA-NBMI had increased likelihood for sarcopenia (adjusted odds ratio: 3.99; 95% CI: 1.41-11.32) and osteoporosis (2.91; 95% CI: 2.35-3.61) but similar likelihood of falls (P > 0.05). HA-NBMI had lower values for bone geometry parameters, as well as grip strength, than both NA-NBMI and HA-HBMI (all P < 0.05). CONCLUSIONS High adiposity without high BMI is more common than BMI-defined obesity in older Swedish adults but does not provide similar protection from osteoporosis and sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School-Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - Jonas Johansson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Peter Nordstrom
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordstrom
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Lambert C, Beck BR, Harding AT, Watson SL, Weeks BK. Regional changes in indices of bone strength of upper and lower limbs in response to high-intensity impact loading or high-intensity resistance training. Bone 2020; 132:115192. [PMID: 31846824 DOI: 10.1016/j.bone.2019.115192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/22/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Abstract
It is well known that the bone response to physical activity is highly dependent on the nature of the loads imposed. Despite this, few direct comparisons of the effect of impact-style loading and resistance training on bone have been made. We therefore aimed to compare the effects of 10-month, twice-weekly, high-impact loading and 10-month, twice-weekly, high-intensity resistance training on indices of bone strength of both the upper and lower limbs of young adult women. Physically inactive, otherwise healthy, young adult women (18-30 years) with below average bone mass (T-score ≤ 0) were recruited as part of the OPTIMA-Ex trial. Testing included DXA- and pQCT-derived measures of bone mass and indices of bone strength and QUS-derived measures of bone quality of the dominant (D) and non-dominant (ND) upper (radius) and lower limbs (femoral neck, tibia, calcaneus). The present study examined those participants who completed the impact training (IT; n = 10) and resistance training (RT; n = 12) arms of the trial. Age differed between groups at baseline (IT = 23.2 ± 3.8 years, RT = 20.5 ± 1.8 years; p = 0.042). Compliance with the training programs did not differ (IT = 61.4 ± 15.1%, RT = 66.4 ± 11.2%, p = 0.381). Age and baseline differences in bone outcomes served as covariates for repeated measures and univariate ANCOVA conducted for dependent variables and percent change respectively. IT improved distal pQCT-derived bone mineral density (BMD) of the upper limb (ND radius: total BMD = 8.55 ± 2.26% versus 1.50 ± 2.04%, p = 0.040 and trabecular BMD = 1.86 ± 0.90% versus -1.30 ± 0.81%, p = 0.029) and lower limb (ND tibia trabecular BMD = 1.22 ± 0.55% versus -0.82 ± 0.50%, p = 0.017), more than RT. IT also improved upper limb bone strength index (BSI) (ND radius total BSI = 15.35 ± 2.83% versus 2.67 ± 2.55, p = 0.005) and lower limb BSI (D tibia total BSI = 5.16 ± 1.13% versus 0.37 ± 1.02%, p = 0.008; D tibia trabecular BSI = 3.93 ± 1.76% versus -2.84 ± 1.59, p = 0.014, ND tibia trabecular BSI = 3.57 ± 1.63% versus -3.15 ± 1.48%, p = 0.009) more than RT. Conversely, RT improved DXA-derived cortical volumetric BMD at the femoral neck more than IT (3.68 ± 1.99% versus -4.14 ± 2.20%, p = 0.021). Results suggest that IT and RT provide differing site-specific effects in both the upper and lower limbs, with superior bone responses observed at the distal segment from IT, while RT appeared to have greater effect on the shaft of the bone, on indices of bone-strength in young adult women.
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Affiliation(s)
- Conor Lambert
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; The Bone Clinic, Brisbane, Queensland, Australia
| | - Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
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Scott D, Johansson J, McMillan LB, Ebeling PR, Nordstrom P, Nordstrom A. Associations of Sarcopenia and Its Components with Bone Structure and Incident Falls in Swedish Older Adults. Calcif Tissue Int 2019; 105:26-36. [PMID: 30899995 DOI: 10.1007/s00223-019-00540-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/25/2019] [Indexed: 02/07/2023]
Abstract
The aim of this study was to compare bone structure parameters and likelihood of falls across European Working Group on Sarcopenia in Older People (EWGSOP2) sarcopenia categories. 3334 Swedish 70-year olds had appendicular lean mass (normalized to height; ALMHt), lumbar spine and total hip areal BMD (aBMD) estimated by dual-energy X-ray absorptiometry. Volumetric BMD (vBMD) and structure at the distal and proximal tibia and radius were estimated by peripheral quantitative computed tomography. Hand grip strength and timed up-and-go were assessed, and sarcopenia was defined according to EWGSOP2 criteria. Incident falls were self-reported 6 and 12 months after baseline. Only 0.8% and 1.0% of participants had probable and confirmed sarcopenia, respectively. Almost one-third of participants with confirmed sarcopenia reported incident falls, compared with 20% for probable sarcopenia and 14% without sarcopenia (P = 0.025). Participants with confirmed sarcopenia had poorer bone parameters (all P < 0.05) except endosteal circumference at the proximal radius and tibia, while those with probable sarcopenia had lower cortical area at the proximal radius (B = - 5.9; 95% CI - 11.7, - 0.1 mm2) and periosteal and endosteal circumferences at the proximal tibia (- 3.3; - 6.4, - 0.3 and - 3.8; - 7.5, - 0.1 mm2, respectively), compared with those without sarcopenia. Compared with probable sarcopenia, confirmed sarcopenic participants had significantly lower lumbar spine and total hip aBMD, distal radius and tibia total vBMD, and proximal radius and tibia cortical vBMD, area and thickness (all P < 0.05). Swedish 70-year olds with confirmed sarcopenia demonstrate poorer BMD and bone architecture than those with probable and no sarcopenia, and have increased likelihood of incident falls.
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Affiliation(s)
- David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia.
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, VIC, Australia.
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Lachlan B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Peter Nordstrom
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordstrom
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Mesinovic J, McMillan LB, Shore-Lorenti C, Zengin A, De Courten B, Ebeling PR, Scott D. Sex-specific associations between insulin resistance and bone parameters in overweight and obese older adults. Clin Endocrinol (Oxf) 2019; 90:680-689. [PMID: 30724369 DOI: 10.1111/cen.13947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/03/2019] [Accepted: 02/04/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To determine sex-specific associations between insulin resistance and bone parameters measured by peripheral quantitative computed tomography in overweight and obese community-dwelling older adults. STUDY DESIGN Cross-sectional study of 79 community-dwelling overweight and obese adults (mean ± SD age 62.8 ± 7.9 years; body mass index 32.3 ± 6.1 kg/m2 ; 58% women). MAIN OUTCOME MEASURES Peripheral quantitative computed tomography assessed distal radius and tibia trabecular volumetric bone mineral density (vBMD) and proximal radius and tibia cortical vBMD, periosteal circumference, endosteal circumference and stress-strain index. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score was calculated from fasting glucose and insulin values. Lean mass was assessed using dual-energy X-ray absorptiometry. Total minutes of moderate and vigorous physical activity (MVPA) were calculated using the Active Australia Survey. RESULTS Men and women in this cohort had no significant differences in fasting glucose and insulin concentrations, HOMA-IR values and diabetes prevalence (all P > 0.05). In women, HOMA-IR was positively correlated with proximal radius periosteal and endosteal circumference (r = 0.331; P = 0.034 and r = 0.325; P = 0.038, respectively). These associations became nonsignificant in multivariable regression analyses; however, HOMA-IR was negatively associated with proximal radius cortical vBMD (B = -4.79; 95% CI -8.66, -0.92) after adjusting for age, lean mass and MVPA. All associations between HOMA-IR and bone parameters became nonsignificant in a sensitivity analysis excluding individuals with diabetes, or self-reported use of glucose-lowering medications. There were no associations between HOMA-IR and bone parameters in men. CONCLUSIONS Homeostatic Model Assessment of Insulin Resistance was negatively associated with radial cortical vBMD in overweight and obese older women, but not in men. Further studies are needed to clarify sex-specific associations between insulin resistance and bone health in overweight and obese older adults.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Lachlan B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Catherine Shore-Lorenti
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Barbora De Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, Victoria, Australia
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Scott D, Johansson J, McMillan LB, Ebeling PR, Nordstrom A, Nordstrom P. Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative. Bone 2019; 120:446-451. [PMID: 30537557 DOI: 10.1016/j.bone.2018.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/19/2018] [Accepted: 12/07/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lower skeletal muscle density, indicating greater infiltration of adipose tissue into muscles, is associated with higher fracture risk in older adults. We aimed to determine whether mid-calf muscle density is associated with falls risk and bone health in community-dwelling older adults. METHODS 2214 community-dwelling men and women who participated in the Healthy Ageing Initiative (Sweden) study at age 70 were included in this analysis. Mid-calf muscle density (mg/cm3) at the proximal tibia, and volumetric bone mineral density (vBMD) and architecture at the distal and proximal tibia and radius, were assessed by peripheral quantitative computed tomography. Whole-body lean and fat mass, lumbar spine and total hip areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. Participants completed seven-day accelerometer measurements of physical activity intensity, and self-reported falls data were collected 6 and 12 months later. RESULTS 302 (13.5%) participants reported a fall at the 6- or 12-month interview, and 29 (1.3%) reported a fall at both interviews. After adjustment for confounders, each standard deviation decrease in mid-calf muscle density was associated with a trend towards greater likelihood of experiencing a fall (OR 1.13; 95% CI 1.00, 1.29 per SD lower) and significantly greater likelihood of multiple falls (1.61; 1.16, 2.23). Higher muscle density was not associated with total hip aBMD, and was associated with lower lumbar spine aBMD (B = -0.003; 95% CI -0.005, -0.001 per mg/cm3) and higher proximal cortical vBMD (0.74; 0.20, 1.28) at the radius. At the tibia, muscle density was positively associated with distal total and trabecular vBMD, and proximal total and cortical vBMD, cortical thickness, cortical area and stress-strain index (all P < 0.05). Only moderate/vigorous (%) intensity physical activity, not sedentary time or light activity, was associated with higher mid-calf muscle density (0.086; 0.034, 0.138). CONCLUSIONS Lower mid-calf muscle density is independently associated with higher likelihood for multiple incident falls and appears to have localised negative effects on bone structure in older adults.
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Affiliation(s)
- David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia.
| | - Jonas Johansson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Lachlan B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Anna Nordstrom
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Peter Nordstrom
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
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Nishiyama KK, Agarwal S, Kepley A, Rosete F, Hu Y, Guo XE, Keating CL, DiMango EA, Shane E. Adults with cystic fibrosis have deficits in bone structure and strength at the distal tibia despite similar size and measuring standard and relative sites. Bone 2018; 107:181-187. [PMID: 29154969 DOI: 10.1016/j.bone.2017.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/25/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022]
Abstract
Individuals with cystic fibrosis (CF) have lower bone mineral density (BMD) by DXA and are at higher risk of fracture than healthy controls. However, the 2-dimensional measurement of areal BMD (aBMD) provided by DXA is influenced by bone size and the true extent of the bone deficit is unclear. Our objective was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) and individual trabecula segmentation (ITS) analysis to compare volumetric BMD (vBMD), microarchitecture and estimated strength at the distal radius and tibia in 26 young adults with CF and 26 controls matched for age, gender, and race. To assess the effect of limb length and minimize the confounding effects of size on HR-pQCT outcomes, we scanned participants at both the standard fixed HR-pQCT measurement sites and at a subject-specific relative site that varied according to limb length. CF participants did not differ significantly in age, height, weight, or BMI from controls. Ulnar and tibial lengths were 9mm shorter in CF patients, though differences were not significant. CF patients had significantly lower BMI-adjusted aBMD by DXA at the lumbar spine (8.9%, p<0.01), total hip (11.5%, p<0.01) and femoral neck (14.5%, p<0.01), but not at the forearm. At the fixed radius site, thickness of trabecular plates and torsional stiffness were significantly lower in CF participants than controls. At the relative radius site, only torsional stiffness was significantly lower in CF participants. At the tibia, total, trabecular and cortical vBMD were significantly lower at both fixed and relative sites in CF participants, with fewer, more widely-spaced trabecular plates, lower trabecular connectivity, and lower axial and torsional stiffness. Our results confirm that aBMD is lower at the spine and hip in young adults with CF, independent of BMI and body size. We also conclude that vBMD and stiffness are lower at the weight-bearing tibia. The pathogenesis of these differences in bone density and strength at the tibia appear to be related to trabecular drop-out and reduced trabecular connectivity and to be independent of differences in limb length, as assessed by scanning participants at both standard and relative sites. We concluded that significant deficits in bone structure and strength persist in young adults with CF, despite advances in care that permit them to attain relatively normal height and weight.
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Affiliation(s)
- Kyle K Nishiyama
- Division of Endocrinology, Department of Medicine, Columbia University, New York, NY, United States
| | - Sanchita Agarwal
- Division of Endocrinology, Department of Medicine, Columbia University, New York, NY, United States.
| | - Anna Kepley
- Division of Endocrinology, Department of Medicine, Columbia University, New York, NY, United States
| | - Fernando Rosete
- Division of Endocrinology, Department of Medicine, Columbia University, New York, NY, United States.
| | - Yizhong Hu
- Department of Biomedical Engineering, Columbia University, New York, NY, United States.
| | - X Edward Guo
- Department of Biomedical Engineering, Columbia University, New York, NY, United States.
| | - Claire L Keating
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY, United States.
| | - Emily A DiMango
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY, United States.
| | - Elizabeth Shane
- Division of Endocrinology, Department of Medicine, Columbia University, New York, NY, United States.
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Hallkvist OM, Johansson J, Nordström A, Nordström P, Hult A. Dairy product intake and bone properties in 70-year-old men and women. Arch Osteoporos 2018; 13:9. [PMID: 29380156 PMCID: PMC6310713 DOI: 10.1007/s11657-018-0420-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/22/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED In the present population-based study including 70-year-old men and women, total dairy product intake was associated with a weak positive association with tibia trabecular and cortical cross-sectional areas. PURPOSE Milk consumption has recently been suggested to increase fracture risk. Therefore, we aimed to investigate associations between dairy product consumption and peripheral bone properties. Furthermore, we explored whether consumption of milk and fermented dairy products affected bone properties differently. METHODS The Healthy Aging Initiative is a population-based, cross-sectional study investigating the health of 70-year-old men and women. Out of the 2904 individuals who met the inclusion criteria, data on self-reported daily dairy product consumption (dl/day), peripheral quantitative computed tomography (pQCT) examinations at the 4 and 66% scan sites of the tibia and radius, and dual-energy X-ray absorptiometry (DXA) scans were collected from 2040 participants. Associations between dairy product consumption and bone properties were examined using multiple linear regression models adjusted for sex, muscle area, meal size, dietary protein proportion, current smoking status, and objectively measured physical activity. RESULTS Total dairy product intake was associated with larger trabecular (2.296 (95% CI, 0.552-4.039) mm2, per dl/day increase, p = 0.01) and cortical cross-sectional areas (CSAs) in the tibia (1.757 (95% CI, 0.683-2.830 mm2, p = 0.001) as measured by pQCT and higher areal bone mineral density (aBMD) of the radius (3.231 (95% CI, 0.764-5.698) mg/cm2, p = 0.01) as measured by DXA. No other measurement in the tibia, radius, femoral neck, or lower spine was associated significantly with dairy product intake. Bone properties did not differ according to the type of dairy product consumed. CONCLUSION No evidence of a negative association between dairy product consumption and bone health was found. Furthermore, total dairy product consumption was associated with increased CSAs in the tibia, regardless of dairy product type. Collectively, our findings indicate the existence of a weak but significant positive association between dairy product consumption bone properties in older adults.
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Affiliation(s)
- Olle M Hallkvist
- Department of Public Health and Clinical Medicine, Section for Occupational and Environmental Medicine, Umeå University, SE-90187, Umeå, Sweden
| | - Jonas Johansson
- Department of Public Health and Clinical Medicine, Section for Occupational and Environmental Medicine, Umeå University, SE-90187, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section for Occupational and Environmental Medicine, Umeå University, SE-90187, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section for Occupational and Environmental Medicine, Umeå University, SE-90187, Umeå, Sweden.
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Karampatos S, Papaioannou A, Beattie KA, Maly MR, Chan A, Adachi JD, Pritchard JM. The reliability of a segmentation methodology for assessing intramuscular adipose tissue and other soft-tissue compartments of lower leg MRI images. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2015; 29:237-44. [PMID: 26702939 DOI: 10.1007/s10334-015-0510-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/06/2015] [Accepted: 11/06/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Determine the reliability of a magnetic resonance (MR) image segmentation protocol for quantifying intramuscular adipose tissue (IntraMAT), subcutaneous adipose tissue, total muscle and intermuscular adipose tissue (InterMAT) of the lower leg. MATERIALS AND METHODS Ten axial lower leg MRI slices were obtained from 21 postmenopausal women using a 1 Tesla peripheral MRI system. Images were analyzed using sliceOmatic™ software. The average cross-sectional areas of the tissues were computed for the ten slices. Intra-rater and inter-rater reliability were determined and expressed as the standard error of measurement (SEM) (absolute reliability) and intraclass coefficient (ICC) (relative reliability). RESULTS Intra-rater and inter-rater reliability for IntraMAT were 0.991 (95% confidence interval [CI] 0.978-0.996, p < 0.05) and 0.983 (95% CI 0.958-9.993, p < 0.05), respectively. For the other soft tissue compartments, the ICCs were all >0.90 (p < 0.05). The absolute intra-rater and inter-rater reliability (expressed as SEM) for segmenting IntraMAT were 22.19 mm(2) (95% CI 16.97-32.04) and 78.89 mm(2) (95% CI 60.36-113.92), respectively. CONCLUSION This is a reliable segmentation protocol for quantifying IntraMAT and other soft-tissue compartments of the lower leg. A standard operating procedure manual is provided to assist users, and SEM values can be used to estimate sample size and determine confidence in repeated measurements in future research.
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Affiliation(s)
- Sarah Karampatos
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. .,Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada. .,Department of Rehabilitation Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
| | - Alexandra Papaioannou
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.,Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada.,Department of Biostatistics and Epidemiology, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Karen A Beattie
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Monica R Maly
- Department of Rehabilitation Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Adrian Chan
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Janet M Pritchard
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.,Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada
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10
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Johansson J, Nordström A, Nordström P. Objectively measured physical activity is associated with parameters of bone in 70-year-old men and women. Bone 2015; 81:72-79. [PMID: 26151120 DOI: 10.1016/j.bone.2015.07.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/25/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022]
Abstract
As the world's population ages, the occurrence of osteoporosis-related fractures is projected to increase. Low areal bone mineral density (aBMD), a well-known risk factor for fractures, may be influenced by physical activity (PA). In this cross-sectional study, we aimed to investigate potential associations between objective measures of PA and bone properties, in a population-based cohort of 1228 70-year-old men and women. We measured volumetric BMD (vBMD, mg/cm(3)) together with cross-sectional area (CSA, mm(2)) by peripheral quantitative computed tomography at sites located 4% and 66% in the distal-proximal trajectory at the tibia and radius. We also measured aBMD (g/cm(2)) by dual energy X-ray absorptiometry at the femoral neck, lumbar spine (L1-L4) and radius. Participants wore triaxial accelerometers for 7 consecutive days to obtain objective estimates of PA. The intensity of the objective PA was divided into light (100-1951 counts/min [CPM]), moderate (1952-5724 cpm) and vigorous (≥ 5725 cpm). Maximal accelerations for the anterior-posterior (z), medio-lateral (x), and vertical (y) axes were also separately assessed. Associations were investigated using bivariate correlations and multiple linear regression, adjusted for height, weight and sex. Vigorous PA showed the strongest association with femoral neck aBMD (β=0.09, p<0.001), while both moderate and vigorous PAs were associated with cortical area and trabecular vBMD in the weight-bearing tibia (all p<0.05). Peak vertical accelerations were associated significantly with cortical area (β=0.09, p<0.001) and trabecular vBMD (β=0.09, p=0.001) of the tibia, whereas peak anterior-posterior accelerations showed no correlation with these properties. No positive association was found between objectively measured PA and bone parameters of the radius. In conclusion, vertical accelerations and moderate to vigorous PA independently predict bone properties, especially in the weight-bearing tibia, in 70-year-old men and women.
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Affiliation(s)
- Jonas Johansson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
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11
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Weatherholt AM, Avin KG, Hurd AL, Cox JL, Marberry ST, Santoni BG, Warden SJ. Peripheral Quantitative Computed Tomography Predicts Humeral Diaphysis Torsional Mechanical Properties With Good Short-Term Precision. J Clin Densitom 2015; 18:551-9. [PMID: 25454307 PMCID: PMC4425635 DOI: 10.1016/j.jocd.2014.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/05/2014] [Accepted: 10/07/2014] [Indexed: 11/17/2022]
Abstract
Peripheral quantitative computed tomography (pQCT) is a popular tool for noninvasively estimating bone mechanical properties. Previous studies have demonstrated that pQCT provides precise estimates that are good predictors of actual bone mechanical properties at popular distal imaging sites (tibia and radius). The predictive ability and precision of pQCT at more proximal sites remain unknown. The aim of the present study was to explore the predictive ability and short-term precision of pQCT estimates of mechanical properties of the midshaft humerus, a site gaining popularity for exploring the skeletal benefits of exercise. Predictive ability was determined ex vivo by assessing the ability of pQCT-derived estimates of torsional mechanical properties in cadaver humeri (density-weighted polar moment of inertia [I(P)] and polar strength-strain index [SSI(P)]) to predict actual torsional properties. Short-term precision was assessed in vivo by performing 6 repeat pQCT scans at the level of the midshaft humerus in 30 young, healthy individuals (degrees of freedom = 150), with repeat scans performed by the same and different testers and on the same and different days to explore the influences of different testers and time between repeat scans on precision errors. IP and SSI(P) both independently predicted at least 90% of the variance in ex vivo midshaft humerus mechanical properties in cadaveric bones. Overall values for relative precision error (root mean squared coefficients of variation) for in vivo measures of IP and SSI(P) at the midshaft humerus were <1.5% and were not influenced by pQCT assessments being performed by different testers or on different days. These data indicate that pQCT provides very good prediction of midshaft humerus mechanical properties with good short-term precision, with measures being robust against the influences of different testers and time between repeat scans.
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Affiliation(s)
- Alyssa M Weatherholt
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
| | - Keith G Avin
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA; Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
| | - Andrea L Hurd
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
| | - Jacob L Cox
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Scott T Marberry
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Brandon G Santoni
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA; Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA.
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12
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Frank-Wilson AW, Johnston JD, Olszynski WP, Kontulainen SA. Measurement of muscle and fat in postmenopausal women: precision of previously reported pQCT imaging methods. Bone 2015; 75:49-54. [PMID: 25659205 DOI: 10.1016/j.bone.2015.01.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 01/14/2015] [Accepted: 01/26/2015] [Indexed: 11/17/2022]
Abstract
Peripheral quantitative computed tomography (pQCT) imaging has been used to quantify muscle area and density as well as intermuscular adipose tissue (IMAT) and subcutaneous adipose tissue (SAT) area in the lower and upper limb. Numerous protocols have been reported to derive these soft-tissue outcomes, but their precision has not been assessed in community-dwelling postmenopausal women. The objective of this study was to compare the precision of previously reported analysis protocols for quantifying muscle area and density, as well as IMAT and SAT area in postmenopausal women. Six image analysis protocols using two available software suites (Stratec XCT, BoneJ) were identified from the pQCT literature. Analysis protocols were applied to a sample of 35 older female adults (mean age 73.7; SD 7.2 years), randomly selected from a population based-cohort and scanned twice within an average of 9.7 (SD 3.6) days. Relative precision was calculated as absolute values and as a percentage of the sample mean (root mean square coefficient of variation; CV%RMS). Soft-tissue outcomes across protocols were compared on their log-transformed coefficients of variation using multilevel linear models and Tukey contrasts. For most protocols, CV%RMS for muscle area, density, and SAT area ranged between 2.1 and 3.7%, 0.7 and 1.9%, and 2.4 and 6.4%, respectively. Precision for IMAT area varied considerably, from 3 to 42%. Consideration of these study results will aid in the selection of appropriate image analysis protocols for pQCT-derived soft-tissue outcomes in postmenopausal women.
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Affiliation(s)
| | - James D Johnston
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - Wojciech P Olszynski
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada; Saskatoon Osteoporosis and CaMos Centre, Saskatoon, SK, Canada
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13
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Wong AKO, Hummel K, Moore C, Beattie KA, Shaker S, Craven BC, Adachi JD, Papaioannou A, Giangregorio L. Improving reliability of pQCT-derived muscle area and density measures using a watershed algorithm for muscle and fat segmentation. J Clin Densitom 2015; 18:93-101. [PMID: 24996252 PMCID: PMC5094887 DOI: 10.1016/j.jocd.2014.04.124] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 04/21/2014] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
Abstract
In peripheral quantitative computed tomography scans of the calf muscles, segmentation of muscles from subcutaneous fat is challenged by muscle fat infiltration. Threshold-based edge detection segmentation by manufacturer software fails when muscle boundaries are not smooth. This study compared the test-retest precision error for muscle-fat segmentation using the threshold-based edge detection method vs manual segmentation guided by the watershed algorithm. Three clinical populations were investigated: younger adults, older adults, and adults with spinal cord injury (SCI). The watershed segmentation method yielded lower precision error (1.18%-2.01%) and higher (p<0.001) muscle density values (70.2±9.2 mg/cm3) compared with threshold-based edge detection segmentation (1.77%-4.06% error, 67.4±10.3 mg/cm3). This was particularly true for adults with SCI (precision error improved by 1.56% and 2.64% for muscle area and density, respectively). However, both methods still provided acceptable precision with error well under 5%. Bland-Altman analyses showed that the major discrepancies between the segmentation methods were found mostly among participants with SCI where more muscle fat infiltration was present. When examining a population where fatty infiltration into muscle is expected, the watershed algorithm is recommended for muscle density and area measurement to enable the detection of smaller change effect sizes.
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Affiliation(s)
- Andy Kin On Wong
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Kayla Hummel
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Cameron Moore
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen A Beattie
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sami Shaker
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - B Catharine Craven
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Lora Giangregorio
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Duckham RL, Frank AW, Johnston JD, Olszynski WP, Kontulainen SA. Monitoring time interval for pQCT-derived bone outcomes in postmenopausal women. Osteoporos Int 2013; 24:1917-22. [PMID: 23344257 DOI: 10.1007/s00198-012-2242-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 11/14/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Evidence of measurement precision, annual changes and monitoring time interval is essential when designing and interpreting longitudinal studies. Despite the precise measures, small annual changes in bone properties led to monitoring time intervals (MTIs) of 2-6 years in peripheral quantitative computed tomography (pQCT)-derived radial and tibial bone area, density, and estimated strength in postmenopausal women. INTRODUCTION The purpose of the study was to determine the precision error, annual change, and MTI in bone density, area, and strength parameters in postmenopausal women. METHODS Postmenopausal women (n = 114) from the Saskatoon cohort of the Canadian Multicentre Osteoporosis Study had annual pQCT scans of the distal and shaft sites of the radius and tibia for 2 years. Median annualized rates of percent change and the MTI were calculated for bone density, area, and strength parameters. Root mean squared coefficients of variation (CV%) were calculated from duplicate scans in a random subgroup of 35 postmenopausal women. RESULTS CV% ranged from 1.4 to 6.1 % at the radius and 0.7 to 2.1 % at the tibia. MTIs for the distal radius were 3 years for total bone density (ToD) and 4 years for total bone cross sectional area (ToA), trabecular area, and bone strength index. At the diaphyseal radius, MTI was 3 years for ToA, 5 years for cortical density, and 6 years for polar stress strain index (SSIp). Similarly, MTI for total and trabecular density was 3 years at the distal tibia. At the diaphyseal tibia, MTI for ToA was 3 years and SSIp 4 years. CONCLUSION MTI for longitudinal studies in older postmenopausal women should be at least 2-6 years at the radius and tibia, with specific monitoring of the total and trabecular area, total density, and bone strength at the radius and total and trabecular density, total area, and bone strength at the tibia.
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Affiliation(s)
- R L Duckham
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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15
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Giangregorio L, Lala D, Hummel K, Gordon C, Craven BC. Measuring apparent trabecular density and bone structure using peripheral quantitative computed tomography at the tibia: precision in participants with and without spinal cord injury. J Clin Densitom 2013; 16:139-46. [PMID: 22981715 DOI: 10.1016/j.jocd.2012.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/08/2012] [Accepted: 02/09/2012] [Indexed: 11/23/2022]
Abstract
The objective of the study was to investigate the precision of standard outcomes obtained using peripheral quantitative computed tomography as well as apparent trabecular structure measures in adults with and without spinal cord injury (SCI). Twelve individuals with SCI, mean (standard deviation [SD]) 20 (13)yrs postinjury and mean (SD) age 44 (9)yrs, and 21 individuals without SCI (mean [SD] age: 27 [5]yrs) participated. Repeat scans of tibia epiphysis (4%) and shaft (66%) were performed using a Stratec XCT-2000 (Stratec Medizintechnik, Pforzheim, Germany). Bone mineral density and geometry variables (e.g., cortical thickness, bone area, polar moment of inertia) were derived with manufacturer's software. The following apparent trabecular structure variables were determined using custom software: average trabecular thickness (TrTh) (mm), trabecular spacing (TrSp) (mm), and trabecular number (TrN) (1/mm); average hole size (HA) and maximum hole size (HM) (mm(2)); connectivity index (CI); cortical thickness (CTh) (mm); bone volume to total volume (BVTV) ratio. Root mean square standard deviation and root mean square coefficient of variation (RMSCV; root mean square coefficient of variation percent [RMSCV%]) were calculated. The RMSCV% for all standard bone mineral density and geometry variables was ≤2% except for total area (4% site), where precision was 3.8%. RMSCV% for bone structure variables were as follows: CTh 5.1, TrTh 1.7, TrN 1.9, TrSp 2.6, HA 9.5, HM 20.1, CI 5.1, and BVTV 1.4. Precision for bone density and geometry was excellent across a range of bone mineral densities. RMSCVs for some apparent trabecular structure variables were comparable to that of standard variables. The RMSCV for others may necessitate larger studies to detect between-group differences.
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Affiliation(s)
- Lora Giangregorio
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
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