A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis

Hw, Minne; Leidig, Gudrun; Wüster, Christian

doi:10.1016/0378-5122(88)90041-2

Cited by 74 publications

(108 citation statements)

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“…The SDI, an assessment that integrates both the number and severity of fractures, (17,18) has been proposed as a surrogate tool to assess bone quality and has been suggested to be associated with the vertebral fracture risk over time. (19)(20)(21) A recent study by our group has demonstrated in a large sample of AI patients that SH is associated with SDI regardless of age and BMD.…”

Section: Discussionmentioning

confidence: 99%

“…(14) Unfortunately, bone microarchitecture can be assessed directly only by histomorphometric analysis of invasively obtained bone biopsy or by micro-computed tomography (mCT) systems. (15,16) However, the spinal deformity index (SDI), which integrates both the number and the severity of fractures by summing the vertebral deformity grades along the spine from T 4 to L 4 , (17,18) has been proposed as a surrogate tool for assessing bone quality, and it has been suggested to be associated with the vertebral fracture risk over time. (19)(20)(21) A recent cross-sectional study demonstrated in a large sample of AI patients that SH was associated with an increased prevalence of vertebral fractures and a worsening of the SDI regardless of age and BMD.…”

Section: Introductionmentioning

confidence: 99%

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Risk of new vertebral fractures in patients with adrenal incidentaloma with and without subclinical hypercortisolism: A multicenter longitudinal study

Morelli

Eller-Vainicher

Salcuni

et al. 2011

Journal of Bone and Mineral Research

118

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In patients with adrenal incidentalomas (AIs), cross-sectional studies suggested the presence of an association between subclinical hypercortisolism (SH) and an increased prevalence of vertebral fractures (VFx) and spinal deformity index (SDI), which is a clinical index of bone quality. No longitudinal studies investigated the incidence of VFx and SDI changes over time in SH. The aim of this study was to evaluate VFx risk and SDI changes in SH over time. One-hundred-three consecutive AI patients were studied at baseline and after 12 and 24 months. Patients were divided into SH þ (n ¼ 27) and SH -(n ¼ 76) groups on the basis of the presence of two or more among urinary free cortisol greater than 70 mg/24 hours, serum cortisol after 1-mg dexamethasone suppression test greater than 3.0 mg/dL, and adrenocorticotropic hormone (ACTH) less than 10 pg/mL in 2 or more of the 3 evaluations. At baseline and after 24 months, bone mineral density (BMD) by dual-energy X-ray absorptiometry and the presence of VFx and SDI by summing the grade of deformity for each vertebra were evaluated. At the end of follow-up, the SH þ group showed a higher prevalence of VFx (81.5%) as compared with baseline (55.6%, p ¼ .04) and a worsening of SDI (2.11 AE 1.85 versus 1.11 AE 1.47, p ¼ .032) associated with SH regardless of age, gender, body mass index , BMD, baseline SDI, menopause duration [odds ratio (OR) ¼ 12.3, 95% confidence interval (CI) 4.1-36.5, p ¼ .001]. The incidence of new vertebral fractures was higher in the SH þ group (48%) than in the SH -group (13%; p ¼ .001). It is concluded that subclinical hypercortisolism is associated with an increased risk of VFx and a possible deterioration of bone quality. ß

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of new vertebral fractures in patients with adrenal incidentaloma with and without subclinical hypercortisolism: A multicenter longitudinal study

Morelli

Eller-Vainicher

Salcuni

et al. 2011

Journal of Bone and Mineral Research

118

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“…Potential asymptomatic vertebral compression fractures were investigated in all women by standard spinal radiographs in anterior-posterior and lateral positions of the vertebrae Th4-L4. A prevalent fracture was defined, in accordance with previous studies, as at least 20% difference in anterior-posterior, middle-posterior or posterior-posterior adjacent ratio (30,31). Since most patients had a very severe demineralization of the vertebral bodies, it was impossible to use the digitalized technique for vertebral body measurement.…”

Section: Assessment Of Vertebral Fracturesmentioning

confidence: 99%

Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism

et al. 2007

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Objective: Glucocorticoid-induced osteoporosis is the most frequent cause of secondary osteoporosis. Nevertheless, limited data are available on bone status in patients with endogenous cortisol excess. This study is aimed at investigating the role of sex steroids and severity of hypercortisolism on bone mineral density (BMD) and prevalence of vertebral fractures in female patients. Design: Cross-sectional, case-control study. Patients: Seventy-one consecutive women were enrolled: 36 with overt hypercortisolism (26 with ACTH-secreting pituitary adenoma and 10 with cortisol-secreting adrenal tumor) and 35 with subclinical hypercortisolism due to adrenal incidentalomas. They were compared with 71 matched controls. Methods: At diagnosis, we measured serum cortisol, FSH, LH, estradiol, testosterone, androstenedione and DHEAS, and urinary cortisol excretion. BMD was determined by dual energy X-ray absorptiometry at the lumbar spine and femoral neck. Vertebral fractures were investigated by a semiquantitative scoring method. Results: Between women with overt and subclinical hypercortisolism BMD values and prevalence of any vertebral (69 vs 57%, PZ0.56), clinical (28 vs 11.4%, PZ0.22), and multiple vertebral fractures (36 vs 31%, PZ0.92) did not differ. Among patients with subclinical hypercortisolism, amenorrhoic women had a lower BMD (PZ0.035) and more frequent vertebral fractures (80 vs 40%; PZ0.043) when compared with the eumenorrhoic ones. Among women with overt hypercortisolism, there was no difference in lumbar BMD (PZ0.37) and prevalence of fractures (81 vs 60%; PZ0.26) between those amenorrhoic and eumenorrhoic. By logistic regression analysis, lumbar spine BMD values and cortisol-to-DHEAS ratio were the best predictors of vertebral fractures (P!0.01). Conclusions: Vertebral fractures are very common in women with endogenous cortisol excess, regardless of its severity. The deleterious effects of hypercortisolism on the spine may be partly counterbalanced by DHEAS increase at any degree of cortisol excess, and by preserved menstrual cycles in women with subclinical but not in those with overt hypercortisolism.

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“…A subclinical fracture was defined as a 20% difference in anteroposterior, middle-posterior or posterior-posterior adjacent ratio. 20 Statistical analysis Data are reported as mean7s.d. unless otherwise specified.…”

Section: Gonadal Status Assessmentmentioning

confidence: 99%

Effects of various antireabsorptive treatments on bone mineral density in hypogonadal young women after allogeneic stem cell transplantation

Tauchmanovà

Simone

Musella

et al. 2005

Bone Marrow Transplant

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A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis

Cited by 74 publications

References 0 publications

Risk of new vertebral fractures in patients with adrenal incidentaloma with and without subclinical hypercortisolism: A multicenter longitudinal study

Risk of new vertebral fractures in patients with adrenal incidentaloma with and without subclinical hypercortisolism: A multicenter longitudinal study

Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism

Effects of various antireabsorptive treatments on bone mineral density in hypogonadal young women after allogeneic stem cell transplantation

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