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Boonrod A, Piyaprapaphan P, Kittipongphat N, Theerakulpisut D, Boonrod A. Deep learning for osteoporosis screening using an anteroposterior hip radiograph image. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:3045-3051. [PMID: 38896146 DOI: 10.1007/s00590-024-04032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE Osteoporosis is a common bone disorder characterized by decreased bone mineral density (BMD) and increased bone fragility, which can lead to fractures and eventually cause morbidity and mortality. It is of great concern that the one-year mortality rate for osteoporotic hip fractures could be as high as 22%, regardless of the treatment. Currently, BMD measurement is the standard method for osteoporosis diagnosis, but it is costly and requires special equipment. While a plain radiograph can be obtained more simply and inexpensively, it is not used for diagnosis. Deep learning technologies had been applied to various medical contexts, yet few to osteoporosis unless they were trained on the advanced investigative images, such as computed tomography. The purpose of this study was to develop a deep learning model using the anteroposterior hip radiograph images and measure its diagnostic accuracy for osteoporosis. METHODS We retrospectively collected all anteroposterior hip radiograph images of patients from 2013 to 2021 at a tertiary care hospital. The BMD measurements of the included patients were reviewed, and the radiograph images that had a time interval of more than two years from the measurements were excluded. All images were randomized using a computer-generated unequal allocation into two datasets, i.e., 80% of images were used for the training dataset and the remaining 20% for the test dataset. The T score of BMD obtained from the ipsilateral femoral neck of the same patient closest to the date of the performed radiograph was chosen. The T score cutoff value of - 2.5 was used to diagnose osteoporosis. Five deep learning models were trained on the training dataset, and their diagnostic performances were evaluated using the test dataset. Finally, the best model was determined by the area under the curves (AUC). RESULTS A total of 363 anteroposterior hip radiograph images were identified. The average time interval between the performed radiograph and the BMD measurement was 6.6 months. Two-hundred-thirteen images were labeled as non-osteoporosis (T score > - 2.5), and the other 150 images as osteoporosis (T score ≤ - 2.5). The best-selected deep learning model achieved an AUC of 0.91 and accuracy of 0.82. CONCLUSIONS This study demonstrates the potential of deep learning for osteoporosis screening using anteroposterior hip radiographs. The results suggest that the deep learning model might potentially be used as a screening tool to find patients at risk for osteoporosis to perform further BMD measurement.
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Affiliation(s)
- Artit Boonrod
- Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Nut Kittipongphat
- Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daris Theerakulpisut
- Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Rd, Khon Kaen, Thailand
| | - Arunnit Boonrod
- Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Rd, Khon Kaen, Thailand.
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Bae YK, Kang MH, Lee JH, Sim YJ, Jeong HJ, Kim G. Changes in bone mineral density and clinical parameters after stroke in elderly patients with osteopenia. Medicine (Baltimore) 2024; 103:e37028. [PMID: 38277561 PMCID: PMC10817016 DOI: 10.1097/md.0000000000037028] [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: 09/15/2023] [Accepted: 01/02/2024] [Indexed: 01/28/2024] Open
Abstract
We aimed to determine the association between changes in bone mineral density (BMD) of the lumbar spine, bilateral femoral necks and clinical parameters in ambulatory older adult patients with stroke who were diagnosed with osteopenia. This retrospective study included ambulatory patients older than 65 years diagnosed with stroke between January 2019 and June 2021. Osteopenia was diagnosed within 1 month after stroke diagnosis. Subsequently, follow-up BMD was performed within 12 to 14 months. The manual muscle test and modified Barthel index were measured as clinical parameters, and bone turnover markers were measured as biochemical markers. The Wilcoxon signed-rank test was used to compare whether a significant difference in the change in BMD was noted at each site measured at 1-year intervals. The BMD of the paretic and non-paretic femoral necks decreased significantly over time, but no significant change was observed in the BMD of the lumbar spine. Bone turnover markers were significantly changed at follow-up. Patients with modified Barthel index of less than 82 had significant bone loss only on the paretic side of the femoral neck. The BMD of the paretic side of the femoral neck was significantly decreased regardless of the strength of the hip and knee extensors. Although older adult patients with stroke and osteopenia can walk independently, more active osteoporosis treatment is needed to prevent bone loss and fractures, including improvement in daily living function and bilateral lower extremity strength training.
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Affiliation(s)
- Yeong Kyun Bae
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
| | - Myeong Hun Kang
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
| | - Jae Hyun Lee
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
| | - Young Joo Sim
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
| | - Ho Joong Jeong
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
| | - GhiChan Kim
- Department of Physical Medicine and Rehabilitation, Kosin University Gospel Hospital, Busan, South Korea
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Amin H, Syed FA, Khan MA, Sultan Z, Bukhari M. Partial body fat percentage as a predictor of fragility fractures in a large cohort: a cross-sectional study. Rheumatol Adv Pract 2024; 8:rkae010. [PMID: 38390590 PMCID: PMC10882437 DOI: 10.1093/rap/rkae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Objectives BMI is a component of fracture risk calculators; however, it may be too simplistic to predict fracture risk. There is emerging evidence for the role that fat plays as a predictor of fracture. Partial body fat percentage (PBF%) may be a novel way to predict both hip and non-hip fractures. The aim of this study is to evaluate PBF% as a predictor of fragility fractures. Methods A multivariate logistic regression analysis was conducted looking at PBF% as a predicter of both non-hip and hip fractures in an observational cohort. Our results were adjusted for age, biological sex, gender, smoking status, excess alcohol consumption (>3 units/day), current steroid therapy and the T-scores in both femurs. To allow for comparison, the same model was used with BMI, height and weight as the primary predictor of fracture. A subgroup analysis was conducted stratified by fracture site. A sensitivity analysis using a negative binomial regression was conducted. Results A total of 31 447 patients were included in our analysis [mean age 64.9 years (s.d. 12.9)]. PBF% was shown to predict all non-hip fractures after adjustment [odds ratio (OR) 22.14 (95% CI 15.08, 32.50)]. Hip fractures were not predicted by our model [OR 4.19 (95% CI 0.43, 41.46)]. Sensitivity analysis demonstrated a lack of predictive capability for hip fracture but not non-hip fractures. Conclusion PBF% may be a suitable predictor for all non-hip fractures, independent of confounding variables. More research is needed on whether it can predict hip fractures.
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Affiliation(s)
- Hamzah Amin
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Fauzaan Ali Syed
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Muhammed Aqib Khan
- Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Morecambe Bay, UK
| | - Zain Sultan
- Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Morecambe Bay, UK
| | - Marwan Bukhari
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
- Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Morecambe Bay, UK
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Kim S, Na Y, Ko M, Park JY, Yoon H, Song JY, Chung YJ, Shin I, Kim C, Park JH, Kim MR. Comparison of the Right and Left Femur Bone Mineral Densities in Postmenopausal Women. J Menopausal Med 2023; 29:112-118. [PMID: 38230594 PMCID: PMC10796208 DOI: 10.6118/jmm.23021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/02/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVES Bone mineral density (BMD) is measured in the hip and posteroanterior spine; moreover, according to the 2019 International Society for Clinical Densitometry guidelines, unilateral hip can be used. This study aimed to determine whether there is a difference between the BMD of both the femurs in postmenopausal women. METHODS A total of 343 postmenopausal women were enrolled in this study from January 1, 2010, to December 31, 2019 at a single tertiary hospital. By using the Hologic® Horizon W DXA System, the femur and spine BMD was measured; BMD was recorded in g/cm². Following regions were analyzed in both the femurs: the femur neck, the trochanter area, and total femur. RESULTS Mean age at imaging was 62 ± 9.7 years, and significant difference in the total BMD of both the femurs (P = 0.003) was observed. In secondary analysis, patients with osteoporosis showed significant contralateral BMD discrepancies in trochanter and total proximal femur BMD (P = 0.041 and P = 0.011, respectively). However, in women with normal BMD, no significant difference between the right and left femur BMD was observed. Furthermore, measurement of solely the unilateral hip can lead to a 16.9% of underdiagnosis in postmenopausal women. CONCLUSIONS In conclusion, it is necessary to check BMD in both hips, particularly in patients suspected of osteoporosis.
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Affiliation(s)
- Sejin Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoojin Na
- Department of Obstetrics and Gynecology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Minji Ko
- Grace Women's Hospital, Goyang, Korea
| | - Jung Yoon Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyonjee Yoon
- Department of Obstetrics and Gynecology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Yen Song
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn-Jee Chung
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Inhye Shin
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chaewon Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Hyun Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee-Ran Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Rostami-Moez M, Masoumi SZ, Otogara M, Farahani F, Alimohammadi S, Oshvandi K. Examining the Health-Related Needs of Females during Menopause: A Systematic Review Study. J Menopausal Med 2023; 29:1-20. [PMID: 37160298 PMCID: PMC10183767 DOI: 10.6118/jmm.22033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/19/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required.
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Affiliation(s)
- Masoumeh Rostami-Moez
- Research Center for Health Sciences, Education Development Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Marzieh Otogara
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farhad Farahani
- Department of Ear, Nose and Throat, School of Medicine, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shohreh Alimohammadi
- Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Tsorlakis N, Koidou I, Grigoropoulou M, Grouios G. Limb Preference and Limb Bone Mineral Density: an Overview of Empirical Findings. Clin Rev Bone Miner Metab 2022. [DOI: 10.1007/s12018-022-09284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Circulating platelet concentration is associated with bone mineral density in women. Arch Osteoporos 2022; 17:44. [PMID: 35257290 DOI: 10.1007/s11657-022-01089-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/26/2022] [Indexed: 02/03/2023]
Abstract
In this cross-sectional study, enrollment included 818 female adults undergoing bone mineral density (BMD) assessment during the health examination. Subjects with osteoporosis had the lowest circulating platelet concentrations. The circulating platelet concentration was positively correlated with BMD. A high platelet concentration had independently low odds of osteoporosis. PURPOSE Platelets play an important role in bone metabolism. However, the association between circulating platelet counts and bone mineral density (BMD) has been inconsistently reported. We aimed to investigate the relationship between platelet counts and osteoporosis in Chinese women. METHODS In this cross-sectional study, a total of 818 female adults who underwent BMD assessment during the health examination were enrolled. Blood cell counts and biochemistry data were recorded. RESULTS Subjects with osteoporosis had the lowest platelet counts (238 ± 59 × 109/L) compared with subjects with osteopenia (256 ± 64 × 109/L) and a normal BMD (269 ± 76 × 109/L, P < 0.001). The circulating platelet concentration was positively correlated with the BMD of the lumbar spine (r = 0.195, P < 0.001), left hip (r = 0.145, P < 0.001), and right hip (r = 0.149, P < 0.001). According to the receiver operating characteristic curve, the cutoff platelet concentration for differentiating osteoporosis was 260 × 109/L. A high platelet concentration had significantly low odds of osteoporosis after adjusting for other covariates (odds ratio = 0.574, 95% confidence interval: 0.346‒0.953, P = 0.032). CONCLUSION The circulating platelet concentration was significantly correlated with BMD in Chinese women.
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Chen W, Khan Z, Freund J, Pocock N. Dual Hip DXA. Is it Time to Change Standard Protocol? J Clin Densitom 2022; 25:20-23. [PMID: 34391641 DOI: 10.1016/j.jocd.2021.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/18/2021] [Accepted: 07/06/2021] [Indexed: 11/24/2022]
Abstract
Previous studies have examined the utility of bilateral DXA hip bone mineral density (BMD) scans. While most studies demonstrate an advantage of bilateral hip scanning, the studies have been limited by size, or have not included simultaneous lumbar spine scans. To analyse the utility of dual hip scans in a clinical environment, a large retrospective study was performed of DXA BMD of both hips, and lumbar spine, in 17,169 individuals assessed at one centre over 10 years. There was no clinically significant difference in the population mean femoral neck BMD of the left vs the right leg (0.878 vs 0.881g/cm2) or total proximal femoral BMD of the left vs the right leg (0.920 vs 0.919g/cm2). There were however discrepancies in individuals between hip t-scores. For the total hip 1,977 (11.5 %) and 147 (0.9 %) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. For the femoral neck 3,320 (19.3%) and 337 (2.0%) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. Of the total 17,169 individuals there were 2,776 subjects with osteoporosis (T≤ -2.5) using the lumbar spine and right hip, compared to 2,834 subjects using the lumbar spine and left hip. Using the lumbar spine and both hips identified 3,214 individuals with osteoporosis. Diagnosis based on use of the lumbar spine and right hip BMD, or lumbar spine and left hip BMD, therefore failed to identify 15.8%, or 13.4%, of osteoporotic subjects respectively. Additional scanning time required was assessed in 40 subjects prospectively. Performing lumbar spine and both hips, compared to lumbar spine and one hip, required an average additional scan time of 55 seconds. The recommendation of best practise for DXA BMD measurements should be reviewed to consider lumbar spine and dual hip DXA as standard of care.
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Affiliation(s)
- Weiwen Chen
- St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Zulekha Khan
- St Vincent's Clinic, Darlinghurst, Sydney, New South Wales, Australia
| | - Judith Freund
- St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Nicholas Pocock
- St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia.
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Katzenstein TL, Wessman M, Moseholm E, Sandholdt H, Hansen ABE, Lebech AM, Jørgensen NR, Weis N. Prevalence of low bone mineral density among people living with HIV. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1920667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Terese L. Katzenstein
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria Wessman
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark
| | - Ellen Moseholm
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Haakon Sandholdt
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Ann-Brit E Hansen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark
| | - Niklas R Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Nina Weis
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Monteiro C, Ferreira MT, Curate F, Gonçalves D. Assessing the reliability of dual-energy X-ray absorptiometry analyses in burned bones. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1826579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Cristiana Monteiro
- University of Coimbra, Department of Life Sciences, 3000-456 Coimbra, Portugal
| | - Maria Teresa Ferreira
- University of Coimbra, Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences, 3000-456 Coimbra, Portugal
- University of Coimbra, Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, 3000-456 Coimbra, Portugal
| | - Francisco Curate
- University of Coimbra, Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences, 3000-456 Coimbra, Portugal
- University of Coimbra, Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, 3000-456 Coimbra, Portugal
- Technology School, Polytechnic Institute of Tomar, Tomar/Mação, Portugal
| | - David Gonçalves
- University of Coimbra, Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences, 3000-456 Coimbra, Portugal
- University of Coimbra, Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, 3000-456 Coimbra, Portugal
- Archaeosciences Laboratory, Directorate-General for Cultural Heritage (LARC/CIBIO/InBIO), Lisboa, Portugal
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Tsorlakis N, Grouios G, Tsorbatzoudis H, Hatzitaki V. Footedness related differences in femoral bone mineral density in elderly women with osteoporosis. Int J Neurosci 2019; 130:97-102. [PMID: 31549533 DOI: 10.1080/00207454.2019.1664515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The presumed link between lateralized habitual motor activity and bilateral skeletal asymmetry, as result of bone functional adaptation, is the basis for inferences about bone mineral distribution; consequently, bone loss and osteoporosis. As there is no research connecting directly footedness with osteoporosis, the present study was designed to investigate their relation, in elderly women with osteoporosis.Methods: A sample of 420 white, Caucasian race women, older than 65 years, with previous diagnosis of osteoporosis, was recruited for the study. Finally, 164 women met the inclusion criteria and participated. The femoral neck and total hip bone mineral density (BMD) differences between right and left hips of 105 right-footed and 59 non-right-footed women, and the between footedness groups differences of the above right-left BMD differences, were measured with Dual-energy X-ray Absorptiometry (DXA).Results: In right-footers, total hip right-left BMD differences were statistically significant, favoring left femur [t(104) = -2.79, p < .01, two tailed]. In non-right-footers, femoral neck right-left BMD differences were statistically significant, favoring right femur [t(58) =2.025, p < .05, two tailed]. Femoral neck and total hip right-left BMD differences of right- versus non-right-footed women were statistically insignificant.Conclusion: The dominance of the right lower limb had an asymmetric effect on left total hip BMD, while non-right-footedness favored right femoral neck BMD. The findings highlighted the influence of load bearing effects of the body weight and muscle contractions on femoral BMD. We noted a possible association between footedness and BMD, as a result of bone functional adaptation.
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Affiliation(s)
- Nikolaos Tsorlakis
- Laboratory of Motor Behaviour and Adapted Physical Activity, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Grouios
- Laboratory of Motor Behaviour and Adapted Physical Activity, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haralambos Tsorbatzoudis
- Laboratory of Humanistic Studies and Sport Psychology, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilia Hatzitaki
- Laboratory of Motor Behaviour and Adapted Physical Activity, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kaushal N, Vohora D, Jalali RK, Jha S. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population - a cross-sectional retrospective study. Osteoporos Sarcopenia 2018; 4:53-60. [PMID: 30775543 PMCID: PMC6362954 DOI: 10.1016/j.afos.2018.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/08/2018] [Accepted: 04/26/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES An understanding of bone mineral density (BMD) pattern in a population is crucial for prevention and diagnosis of osteoporosis and management of its complications in later life. This study aimed to screen the bone health status and factors associated with osteoporosis in an apparently healthy Indian population. METHODS A retrospective review of medical records was done in a tertiary-care hospital for the subjects who had undergone preventive health-check-ups that included BMD measurements at femur-neck, total-femur, and lumbar-spine. RESULTS We evaluated 524 subjects (age, 50.0 ± 12.4 years) including 41.2% female and 58.8% male subjects. Osteoporosis was present in 6.9% subjects (female, 11.1%; male, 4.2%) and osteopenia in 34% subjects (female, 40.3%; male, 29.9%). Absolute BMD was higher in male subjects (P < 0.001) compared to female subjects at all bone sites. Prevalence of osteoporosis increased with age in female subjects, but not in male subjects. Osteoporosis rates in the age-groups of 30-39, 40-49, 50-59, 60-69, and ≥70 years were 3%, 3.4%, 14.3%, 18.6%, and 36.4%, respectively in female subjects while prevalence in male subjects was 0%, 4%, 6.5%, 4.3%, and 5.6%, respectively, at lumbar spine. Height (r = 0.234-0.358), weight (r = 0.305-0.388), body mass index (r = 0.143-0.285) and physical activity (r = 0.136-0.153) were positively; and alkaline phosphatase (r = -0.133 to -0.203) was negatively correlated with BMD (all P < 0.01) at all sites. These parameters retained significant correlation after controlling for age and sex. No correlation of serum 25-hydroxy-vitamin-D and calcium was noted with BMD (P > 0.05) at any site. CONCLUSIONS Further data on absolute BMD, T scores, and prevalence rates of osteoporosis/osteopenia on multiple bone sites have been presented in this article.
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Affiliation(s)
- Neelam Kaushal
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Divya Vohora
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Rajinder K. Jalali
- Medical Affairs & Clinical Research, Sun Pharmaceutical Industries Limited, Gurgaon, India
| | - Sujeet Jha
- Institute of Endocrinology, Diabetes and Metabolism, Max Healthcare Inst. Ltd., New Delhi, India
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Öztürk N, Ozturk-Isik E, Ülgen Y. Screening Post-menopausal Women for Bone Mineral Level by Bioelectrical Impedance Spectroscopy of Dominant Arm. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2018; 9:39-47. [PMID: 33584919 PMCID: PMC7852016 DOI: 10.2478/joeb-2018-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Indexed: 06/01/2023]
Abstract
Dominant arm bioimpedance spectroscopy (BIS) and lumbar and hip dual energy X-ray absorptiometry (DXA) measurements were conducted simultaneously on 48 post-menopausal women, aged between 43 and 86 years, with no hip or arm fracture history at Department of Radiology of Istanbul University Cerrahpasa Hospital. According to lumbar DXA results, 21 women were classified as normal, 22 as osteopenia and 5 as osteoporosis; whereas hip DXA results classified 30 women as normal, 15 as osteopenia and 3 as osteoporosis. Only 26 participants had identical lumbar and hip bone mineral density (BMD) diagnostic results. Dominant arm characteristic frequencies of normal subjects were statistically significantly different from osteoporotic subjects based on both lumbar (p < 0.005) and hip classification groups (p < 0.001). Hip and lumbar spine DXA BMD values were significantly correlated (r = 0.55, p < 0.005). The dominant arm BIS characteristic frequency, considered as the single predictor in earlier diagnosis of osteoporosis, was found negatively correlated with DXA measurements for both hip and lumbar spine regions. The Spearman rank correlation coefficient of BIS values with the hip DXA values (r = -0.53, p < 0.001) was higher than that of lumbar spine (r = -0.37, p < 0.001). In receiver operating characteristic (ROC) curve analysis, the best discrimination of dominant arm characteristic frequency was made between normal and osteoporotic subjects based on the hip subgroups (p < 0.001). Both lumbar bone mineral content (BMC) (r = -0.47, p < 0.001) and hip BMC (r = -0.4340, p < 0.005) were statistically significantly correlated with dominant arm characteristic frequency.
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Affiliation(s)
- Nermin Öztürk
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Yekta Ülgen
- Department of Biomedical Engineering, Bahcesehir University, Istanbul, Turkey
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Faisal TR, Luo Y. Study of the variations of fall induced hip fracture risk between right and left femurs using CT-based FEA. Biomed Eng Online 2017; 16:116. [PMID: 28974207 PMCID: PMC5627442 DOI: 10.1186/s12938-017-0407-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/22/2017] [Indexed: 01/23/2023] Open
Abstract
Background Hip fracture of elderly people—suffering from osteoporosis—is a severe public health concern, which can be reduced by providing a prior assessment of hip fracture risk. Image-based finite element analysis (FEA) has been considered an effective computational tool to assess the hip fracture risk. Considering the femoral neck region is the weakest, fracture risk indicators (FRI) are evaluated for both single-legged stance and sideways fall configurations and are compared between left and right femurs of each subject. Quantitative Computed Tomography (QCT) scan datasets of thirty anonymous patients’ left and right femora have been considered for the FE models, which have been simulated with an equal magnitude of load applied to the aforementioned configurations. The requirement of bilateral hip assessment in predicting the fracture risk has been explored in this study. Results Comparing the sideways fall and single-legged stance, the FRI varies by 64 to 74% at the superior aspects and by 14 to 19% at the inferior surfaces of both the femora. The results of this in vivo analysis clearly substantiate that the fracture is expected to initiate at the superior surface of femoral neck region if a patient falls from his/her standing height. The distributions of FRI between the femurs vary considerably, and the variability is significant at the superior aspects. The p value (= 0.02) obtained from paired sample t-Test yields p value ≤ 0.05, which shows the evidence of variability of the FRI distribution between left and right femurs. Moreover, the comparison of FRIs between the left and right femur of men and women shows that women are more susceptible to hip fracture than men. Conclusions The results and statistical variation clearly signify a need for bilateral hip scanning in predicting hip fracture risk, which is clinically conducted, at present, based on one hip chosen randomly and may lead to inaccurate fracture prediction. This study, although preliminary, may play a crucial role in assessing the hip fractures of the geriatric population and thereby, reducing the cost of treatment by taking predictive measure.
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Affiliation(s)
- Tanvir R Faisal
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.,Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60610, USA
| | - Yunhua Luo
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
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