An Update on the Diagnosis and Assessment of Osteoporosis with Densitometry

Kanis, John А.; Glüer, Claus‐C.

doi:10.1007/s001980050281

Cited by 772 publications

(278 citation statements)

References 57 publications

(71 reference statements)

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“…The data from the third National Health and Nutrition Examination Survey (NHANES III) were used as the reference sample to calculate the T-score [41], as recommended by Kanis and Gluer [42]. According to the criterion set by the World Health Organization (WHO), a subject was classified as having osteopenia or osteoporosis if proximal femur BMD was below 1.0 (T-score <−1.0) or 2.5 standard deviations (T-score <−2.5) below the young reference population, respectively [42].…”

Section: Discussionmentioning

confidence: 99%

Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke

et al. 2005

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Following a stroke, reduced level of physical activity and functional use of the paretic leg may lead to bone loss and muscle atrophy. These factors and the high incidence of falls may contribute to hip fractures in the stroke population. This study was the first to examine total proximal femur bone mineral content (BMC) and bone mineral density (BMD) and their relationship to strokespecific impairments in ambulatory individuals with chronic stroke (onset >1 year). We utilized dual-energy X-ray absorptiometry (DXA) to acquire proximal femur and total body scans on 58 (23 women) community-dwelling individuals with chronic stroke. We report total proximal femur BMC (g) and BMD (g/cm 2 ) derived from the proximal femur scans, and lean mass (g) and fat mass (g) for each leg derived from the total body scans. Each subject was evaluated for ambulatory capacity (Six Minute Walk Test), knee extension strength (hand-held dynamometry), physical fitness [Maximal oxygen uptake (VO 2 max)], and spasticity (Modified Ashworth Scale). Results showed that the paretic leg had significantly lower proximal femur BMD, lean mass, and percent lean mass but higher fat mass than the non-paretic leg for both men and women. Proximal femur BMD of the paretic leg was significantly related to ambulatory capacity (r=0.33, p=0.011), muscle strength (r=0.39, p=0.002), physical fitness (r=0.57, p<0.001) but not related to spasticity (r= −0.23, p=0.080). Multiple regression analysis showed that lean mass in the paretic leg was a major predictor (R 2 =0.371, p<0.001) of the paretic proximal femur BMD. VO 2 max was a significant predictor of both paretic proximal femur BMD (R 2 =0.325, p<0.001) and lean mass in the paretic leg (R 2 =0.700, p<0.001). Further study is required to determine whether increasing physical fitness and lean mass is important to improve hip bone health in chronic stroke.

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Section: Discussionmentioning

confidence: 99%

Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke

et al. 2005

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“…Some proponents argue that the presence of osteoarthritis in the lumbar spine, particularly in the older population, render the hip the more preferable site. 11 Unfortunately, largely owing to its size, cost and maintenance needs, DEXA machinery is not widely available for population screening. Peripheral technologies such as accuDEXA have been developed to address this problem, but have not been clearly demonstrated to be effective screening modalities, particularly in patients who may be at increased risk for osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

A comparison of dual energy X-ray absorptiometry of the hip and accuDEXA of the finger for the diagnosis of osteoporosis in men on androgen deprivation therapy for advanced prostate cancer

Bae

Leocádio

Stein

2006

Prostate Cancer Prostatic Dis

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Dual energy X-ray absorptiometry (DEXA) of the hip or spine has been shown to be an effective screening tool for osteoporosis in men undergoing androgen deprivation therapy (ADT) for advanced carcinoma of the prostate. A less expensive alternative to DEXA is the use of peripheral scanners, such as accuDEXA, which measures bone mineral density (BMD) the finger. In this paper, we reviewed 59 patients on ADT who underwent both accuDEXA scan of the non-dominant hand and DEXA scan of the hip. The mean T-scores calculated by the two techniques were similar; however, the individual T-scores correlated poorly with each other. We conclude that men who require ADT for prostate cancer should undergo standard DEXA of the hip for osteoporosis screening.

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“…24 Osteopenia was defined as a T score between −1 and −2.5 and osteoporosis was defined as a T score less than −2.5; where a T score is the number of standard deviations from which a patient's bone mass differs from the mean peak bone mass of healthy young adult. A Z score was also calculated and reflects the number of standard deviations from which a patient's bone mass differs from the mean bone mass of age-and sex-matched controls.…”

Section: Definitionsmentioning

confidence: 99%

Decreased bone mineral density is common after autologous blood or marrow transplantation

Schimmer

Mah

Bordeleau

et al. 2001

Bone Marrow Transplant

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Summary:Survivors of autologous blood or marrow transplantation (ABMT) are predisposed to decreased bone mineral density (BMD), but data are lacking on the incidence and risk factors for this condition. Therefore, we measured BMD in 64 of 68 consecutive ABMT survivors (35 men and 29 women) attending the University of Toronto ABMT long-term follow-up clinic. Patients were evaluated a median of 4.2 years (range: 4.9 months-11.4 years) after ABMT. Median age at evaluation was 49.6 years (range: 23.5-68.2 years). At the L1-L4 vertebrae, 17 (26%) patients (eight men and nine women) had osteopenia and one male (2%) had osteoporosis. Mean BMD at L1-L4 did not differ from healthy young adults or age and sex matched controls. At the femoral neck, 30 patients (46%) (18 men and 12 women) had osteopenia and five (8%) (two men and three women) had osteoporosis. Mean BMD at the femoral neck was significantly lower than in healthy young adults and age-and sex-matched controls. By regression analysis, patients with decreased BMD were older than those with normal BMD (P = 0.02). Gender, body mass index, time from BMT to evaluation and presence of hypogonadism were not associated with decreased BMD. Treatment of decreased bone density was instituted and follow-up data were obtained 1 year after treatment in 22 of 39 patients with reduced BMD. Nineteen (86%) patients had stabilization or improvement of their bone density at follow-up. We conclude that, after ABMT, over half of the patients have evidence of osteopenia or osteoporosis. Men and women were equally affected. In our study, only older age at evaluation was predictive for loss of BMD. We recommend the measurement of BMD as an integral component to the follow-up of ABMT patients. Bone Marrow Transplantation (2001) As the number of long-term survivors of autologous blood or marrow transplantation (ABMT) increases, greater attention is turning to the late complications of this procedure. One such complication is decreased bone mineral densityosteopenia and osteoporosis. Osteopenia is a systemic condition characterized by reduced bone mass and increased susceptibility to bone fracture. Osteoporosis is a more severe reduction in bone mass and a greater susceptibility to bone fracture.In the short term, osteoporosis seems trivial compared with a diagnosis of cancer, but for those cured of their disease, decreased bone mineral density contributes to chronic morbidity and mortality in the form of bone fractures. For example, 50% of patients who sustain an osteoporosisrelated hip fracture require assistance with activities of daily living 1 and elderly patients who suffer an osteoporosis-related hip fracture have an increased 1-year mortality of 12-37%. 2 ABMT predisposes to decreased BMD through early and late acting mechanisms. ABMT is associated with an acute increase in bone turnover due to the high-dose chemotherapy, marrow reinfusion and G-CSF administration, but effects on long-term bone density are unknown. [3][4][5] The late effects of ABMT on BMD are primarily due to t...

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An Update on the Diagnosis and Assessment of Osteoporosis with Densitometry

Cited by 772 publications

References 57 publications

Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke

Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke

A comparison of dual energy X-ray absorptiometry of the hip and accuDEXA of the finger for the diagnosis of osteoporosis in men on androgen deprivation therapy for advanced prostate cancer

Decreased bone mineral density is common after autologous blood or marrow transplantation

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